Essential Pain Management

Unrelieved pain is a major global healthcare problem and its importance is often unrecognised. Pain has many causes including trauma, childbirth, surgery, arthritis and cancer and sometimes the cause cannot be identified. Adequate acute pain management results in fewer medical complications, earlier hospital discharge and improved quality of life. Good chronic pain management optimises quality of life and reduces disability as well as reducing health care costs.

Essential Pain Management (EPM) is a cost-effective, multi-disciplinary programme. Run in over 55 countries it brings together local health workers to improve pain knowledge, implement a simple framework for managing pain and address pain management barriers. The EPM programme is designed for any health worker who comes in contact with patients who have pain.

PainSA has been integral in rolling out the EPM courses in South African Health Science Faculties and for other healthcare workers. We have a list of accredited trainers around the country who can offer training to interested groups. We also host open-access EPM courses where interested health care practitioners can join.


There is a need for Essential Pain Management because:

  • Pain is often poorly treated.
  • Improving knowledge and attitudes can lead to improved pain management.
  • Simple and inexpensive treatments can make a big difference.
How EPM Works

Essential Pain Management is an international program that began in Papua New Guinea and the Pacific and has spread across Asia, Africa and the Americas. We have run – and continue to run – workshops in over 40 countries.

Rat Illustration kindly donated by Mr Timothy Pack © Timothy Pack //timothypack.com/

The Essential Pain Management “RAT” is an important part of the course. RAT stands for Recognize, Assess, Treat and provides the framework for managing a variety of real-life pain scenarios.

Teaching Methods

The Essential Pain Management program has two parts – the EPM 1-day workshop and the EPM instructor workshop. Typically we run a “one-half-one” series of courses. On day one, we run a one-day interactive EPM workshop. The EPM workshop is a program of interactive lectures and group discussions. The workshop teaches a system for recognising, assessing and treating pain (RAT) and addresses pain management barriers.

On day two, participants from the first day attend a half-day instructor workshop. The EPM instructor workshop is designed to provide participants with the knowledge and skills to become EPM instructors. Early handover of teaching to local instructors is important because it encourages co-operation between local health workers, and because local instructors are more likely to understand local problems.

On day three, the newly trained instructors run one or two courses with the help of the visiting team. Essential Pain Management uses a “snowball” model for training. Potential instructors are identified early and, through the instructor workshop, are provided with the skills to run more workshops. They are immediately provided with an opportunity to run their own workshop with the support of more experienced instructors.


Essential pain management application (EPM app)

The EPM app for both iPhone/iPad and Android is available for downloading. Search for <essential pain management> in the App Store or Google play..


Application Description

This app is based on the training program developed by the Faculty of Pain Medicine of the Australian and New Zealand College of Anaesthetists (FPM). Although the app is intended as a mobile companion for those who have attended the course, it may benefit any healthcare worker who cares for patients in pain and should be easy and intuitive to use.

The “RAT” is an important part of the essential pain management course. RAT stands for recognise, assess, treat and provides the framework for managing most pain scenarios. The app takes the user through the RAT formula while assessing a patient, arrives at a pain diagnosis and then suggests non-drug and drug treatments based on the course and manual.

The app’s logbook feature allows the user to record serial patient assessment details including treatments on their handheld device and to export and share this information with colleagues. The users are cautioned here against storing patient identifiers and should seek local guidelines for this. The app can also be used without storing any details. The EPM app includes a basic formulary and a pdf version of the EPM manual.
It will be updated periodically and users will be informed of this. The EPM subcommittee may periodically receive information about the use of the app for quality purposes but will not collect any patient sensitive data. The app is free to download but the EPM Committee ask that feedback is provided via the contact us section to help make it more useful.

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