What criteria should I use to determine if a patient with chronic pain requires referral to a pain management specialist?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 16 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

Refer people to a pain specialist when there are red flag signs and symptoms that may indicate serious underlying pathology. ()

Non-specialist management is failing, with chronic pain poorly controlled. ()

There is significant distress related to the pain. ()

Where specific specialist intervention or assessment is required, such as suspected complex regional pain syndrome. ()

Consider referral if the person has uncontrolled pain despite optimal management. ()

Referral is also indicated if the pain significantly limits lifestyle, daily activities, or sleep, or if the underlying health condition has deteriorated. (, )

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