Centre anti douleur à Gap : Hôpital de Gap

A centre anti-douleur is a specialized medical facility in France dedicated to managing chronic pain. These centers offer multidisciplinary care combining medical treatments, psychological support, and physical therapy. France has over 250 chronic pain structures (structures spécialisées douleur chronique) throughout the country that provide comprehensive pain management services.

These centers address various conditions including cancer pain, neurological disorders, rheumatic conditions, and post-operative pain. Patients typically need a referral from a doctor to access these specialized services.

To access a centre anti-douleur in France, you need:

• A prescription or referral from your general practitioner (GP) or specialist physician
• To have experienced chronic pain lasting more than 3 months
• To have tried conventional treatments without adequate relief

The centers are open to anyone with persistent pain over a long period whose condition has not been helped by standard treatment from a GP or specialist. Waiting times vary, but some centers reported wait times of 3-5 months before the COVID-19 crisis, which increased slightly afterward.

French pain centers provide multimodal and multidisciplinary treatments including:

• Pharmacological treatments: pain medications, antidepressants, anticonvulsants
• Interventional procedures: nerve blocks, epidurals, capsaicin patch applications
• Physical therapies: physiotherapy, adapted physical activity programs
• Psychological support: cognitive behavioral therapy, counseling
• Complementary approaches: acupuncture, hypnosis, relaxation techniques
• Patient education: self-management strategies and therapeutic education

The multidisciplinary team typically includes pain specialists, nurses, psychologists, physiotherapists, and sometimes social workers who work together to create a personalized treatment plan.

Pain centers in France employ multidisciplinary teams that commonly include:

1. Pain medicine physicians (often anesthesiologists)
2. Specialized nurses (pain resource nurses)
3. Clinical psychologists
4. Physiotherapists
5. Occupational therapists

Additionally, centers may collaborate with rheumatologists, neurologists, psychiatrists, and rehabilitation specialists. According to surveys, most French pain centers have at least 0.5 full-time equivalent physicians and 1.5 full-time equivalent paramedical staff. The team works together to address the biopsychosocial aspects of chronic pain.

The COVID-19 pandemic severely impacted French pain centers:

• 42% of human resources were reallocated to COVID units and other services
• 72% reduction in in-person appointments
• Increased wait times: delays rose from a median of 3 months to 3.5 months

However, centers adapted quickly by implementing telemedicine solutions. Approximately 91% of respondents used telephone consultations or video calls to maintain patient follow-up. Despite the challenges, pain specialists maintained continuity of care for urgent cases including severe pain, cancer patients, and those needing interventional procedures. By the end of the crisis, 62% of centers had fully restored their teams.

The duration of chronic pain management in France varies significantly based on individual needs:

Initial consultation: Patients often need several appointments to complete a comprehensive assessment and develop a treatment plan.

Treatment programs: Adapted physical activity programs typically last 3 months, with sessions 1-3 times per week. Medical and rehabilitation programs may require longer engagement.

Long-term follow-up: Follow-up frequency is higher during the initial phase until symptoms stabilize, then reduced to every 3-6 months if the situation evolves favorably. Some patients may require ongoing care for years, while others achieve relief after just a few visits. The primary care physician coordinates long-term management in collaboration with the pain center team.