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

Refer people to a pain specialist when there are red flag signs and symptoms that may indicate serious underlying pathology. (¹)

Non-specialist management is failing, with chronic pain poorly controlled. (¹)

There is significant distress related to the pain. (¹)

Where specific specialist intervention or assessment is required, such as suspected complex regional pain syndrome. (¹)

Consider referral if the person has uncontrolled pain despite optimal management. (²)

Referral is also indicated if the pain significantly limits lifestyle, daily activities, or sleep, or if the underlying health condition has deteriorated. (¹, ²)