Effective treatment for chronic pain

A more modern approach to treating pain

Most patients with persistent pain will be familiar with the term ‘pain management’. Working together with our patients we prefer to ‘treat’ persistent pain rather than simply ‘manage’ it. This is actually easier than it sounds when you focus on treating the the whole person who is suffering in lots of different ways rather than just the body part that hurts. We follow a modern, biopsychosocial philosophy using a team of specialists in pain physiotherapy, psychology and pain medicine to really understand the route causes of our patients’ problems, and deliver effective, life-changing treatment.

Pain is always real (it’s exactly what the sufferer says it is), it needs to be unpleasant in order to grab your attention and happens when your brain (mostly subconsciously) concludes that, on balance, your body is somehow under threat. Pain perception is certainly influenced by tissue quality but this is only to a limited degree in many cases and especially the longer a pain problem has gone on. It always involves your immune, autonomic and endocrine systems and is shaped by emotions, prior experiences, beliefs and expectations as well as the social context of the sufferer. Developing a more accurate understanding of why we feel bodily symptoms, one that decreases fear and encourages movement without thoughts of causing harm, is a vital part of feeling better again. Improving sleep quality, lifestyle habits as well as all aspects of physical and mental wellbeing can have really profound effects on how we feel and function.

Unfortunately, the mainstream more medically-focused view of pain often fails to appreciate the real underlying reasons for how and why we perceive bodily symptoms. The general assumption underlying this approach is that pain is always a result of damage to tissues and that scans and other tests will identify the problems so that medicine and surgery can put things right again. You cannot scan pain, in the same way that you cannot scan hunger or fatigue; pain is a perception, not a direct sensation caused by something that is structurally wrong with the body.

What patients in pain are telling us

“Nobody is taking me seriously”. Our patients invariably tell us that they have not previously been adequately listened to (with empathy), that they do not feel believed and had their experiences properly validated.

“I didn’t trust the Doctor. It was as if I was somehow to blame”. Communication needs to happen in an open and non-judgemental way where there is trust built through effective communication between clinician and patient.

“Too much jargon.” Communication needs to be in simple and understandable terms that make sense.

“Everyone I have seen seems to tell me something different”. Patients want to feel supported and have someone working with them in a collaborative way. They are sick of being passed onto yet another person and have to explain everything all over again. There is a sense that each ‘specialist’ has their own viewpoint which somehow contradicts what the last person said.

“Doctors seem to be quite negative about my prognosis”. Patients tell us that they want optimistic support which inspires hope and the possibility of change but at the same time being realistic.

“I left the consultation feeling more anxious and desperate.” Too often patients tell us that there has been quite negative messaging from healthcare providers in the past leaving them feeling more anxious than they already were. And in more pain.

“I don’t just want more medication or injections. They are not working for me.” Most patients want to feel reassured and empowered and actually change their lives without having to rely on medication and invasive medical or surgical procedures.

Patients are the real experts

We explain to patients that they are the real experts in the patient/clinician relationship. They know moment to moment how they feel, how this affects them emotionally as well as physically and how it intrudes on their lives often becoming overwhelming and all consuming. But persistent pain can be a very confusing experience and so working as a team, with us looking from the outside in, alongside patients’ own very intuitive sense of what is going on provides the best opportunity to progress forward in a positive manner. In this way the patient is always at the centre of a shared decision-making process with our guidance. Ultimately it is the patients who end up working things out for themselves learning self-management skills whilst getting back to living meaningful valued lives again.