CHAnGEPAin's layered care approach

1 in 5 people in BC (and North America!) have chronic pain, yet there are very few trained physicians specializing in pain management.

At CHANGEpain, we use a layered care approach.  Our aim is to start pain patients with effective, low risk techniques first.  

Why? Science and our own clinic results show that most people get significant benefit in the first layers of care.  This applies to patients that have tried these approaches in the past without success.



"We recommend patients try the Education & Lifestyle (Layer 1) and Myofascial Release (Layer 2) services as early as possible, while waiting for their pain specialist consultation, to get a jump start on their pain management plan."                                                                                                                              CHANGEpain Physicians


Layers 1 and 2

Pain patients may quickly access our CHANGEpain Together Self-Management Programs and Extended Health Services without a referral.  We recommend patients try these services as early as possible, while waiting for their pain specialist consultation, to get a jump start on their pain management plan.  

For MSP covered services, patients need to get a physician referral.  Unfortunately, we have a large number referrals to our MSP services and this has resulted in wait lists.  We are trying to hire more pain physicians to reduce wait times.

Your first visit covered by MSP will be at Starting to CHANGEpain, a Group Medical Visit where you will learn about why persistent pain happens, and the first steps you can take to treat it.  

You MUST take Starting to CHANGEpain before participating in any other MSP-covered service at CHANGEpain.  The evidence is clear - patients get better treatment results if they understand how pain works in their bodies.

After your first visit, you will be encouraged to participate in programs suited for you in Layers 1 and 2:

Layer 3

Many people get significant benefit from layers 1 and 2, and may not need Layer 3 Services.  That said, advanced care for pain patients is in high demand! Unfortunately this means there can be a further wait for a one-on-one consultation with a pain specialist.   

Your First Consultation

When we are ready to see you for your pain consultation, we will send you an email with a health history questionnaire. Please complete this questionnaire as soon as possible. Once you have completed the questionnaire, you must call us to book your consultation! 

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These questionnaires are very important, as they help your pain specialist make the best recommendations and pain treatment for you.

During the consultation, your pain specialist will hear your story, conduct an examination, and create a pain treatment plan for you.

Pain Treatments

Your pain specialist will recommend pain treatments that they think you would benefit from. We always try the simplest, lowest risk treatments first. If you do not get benefit from these treatments, then we may refer you to more complex treatments. This Layered Care Model helps make sure that riskier and more expensive treatments are only given to those that really need them.  Learn about our pain treatments here.

If you have questions about your pain plan, or wish to speak with your pain specialist, you may join one of our Navigating your Pain Plan Group Medical Visits.  We see the majority of our patients in a group visit for their follow up appointments, as there is very limited availability for individual follow up appointments.


CHANGEpain is a shared care clinic. This means that your care will have a whole team involved! You may see many different doctors at CHANGEpain, but they will all have access to your medical records, and your care plan.

We work closely with the community to make trusted referrals to services that are known to help with chronic pain. These may include IMS, Physiotherapy, Occupational Therapy, Kinesiology, Psychology and many others.

Our ultimate goal is to have our patients graduate and be self-managing their pain in 6 months. Our model also aims to help reduce reliance on medications.

Please be aware that we may make medication recommendations but we do not prescribe directly.