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A New Evidence-Based Model for Preventing Chronic Post-Surgical Pain

The Transitional Pain Service (TPS) at the Toronto General Hospital is the first-of-its-kind clinic providing specialized evidence-based multidisciplinary care for patients who are at an increased risk for developing chronic post-surgical pain.

Welcome to the TPS

Welcome to the TPS

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The TPS Offers Patients Integrated Pre- and Post-Surgical Care

The TPS follows patients from pre-admission, before surgery, and throughout their hospital stay to provide care plans and strategies to help facilitate the transition from hospital to home.

 

Patients are then seen in the outpatient setting by medical and nursing staff, psychologists, and a physiotherapist to help increase functioning, optimize pain control, reduce opioid consumption, and receive emotional and psychological support.
 

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Identify Risk Factors for Chronic Post-Surgical Pain

 

Pain that develops after surgery and persists for at least 3 months is referred to as chronic-post surgical pain.

The primary predictor of chronic post-surgical pain is a pre-existing chronic pain condition. See our infographic below for an overview of common risk factors.

Infographic with a list of 
Risk Factors for Chronic Post-Surgical Pain
 

Benefits of Referring your Patient 

Patients gain access to a multidisciplinary team that delivers coordinated pain treatment.

Our team is composed of health professionals whose practice is informed by the Triad of Chronic Pain Treatment model, including:

  • anesthesiologists, nurse practitioners, psychologists, a physiotherapist, and other allied health providers

Treatment can take place in-clinic at the Toronto General Hospital or by Telemedicine, and includes:

  • pharmacotherapy, interventional pain procedures, psychotherapy, physiotherapy, acupuncture, and patient education

The TPS incorporates medical, psychological, and physical care in chronic pain treatment

Triad of Chronic Pain Treatment

Referring guidelines for pre- and post-surgical patients

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  • Pending surgery or surgery within past 6 months and struggling with pain management

  • History of chronic pain

  • Taking opioid medication before surgery and/or difficulty weaning off opioids after surgery

  • History of depression, anxiety, and/or PTSD or current emotional distress

  • Catastrophic thinking about pain

  • History of substance misuse or dependency

Referrals to the Transitional Pain Service can be made through the central referral hub at the Toronto Academic Pain Medicine Institute (TAPMI).

 

The Transitional Pain Service (TPS) at the Toronto General Hospital is an evidence-based treatment model based on the latest research in transitional and chronic pain care. Please visit our Research page to learn more about studies conducted at the TPS.

We have created a resource page for interested professionals with information and a TPS How-To Guide to support them in establishing a TPS in their healthcare setting.