Airing Pain

This edition has been supported by a grant from The D’Oyly Carte Charitable Trust. Osteoporosis is a largely ignored condition that affects over 3 million people in the UK, with women being more at risk; a condition which, because the symptoms are difficult to notice by patients, is often referred to as the ‘silent disease’. In this edition of Airing Pain, we learn why prevention, assessment and management are key factors to deal with this condition and develop a correct model of care in the health services. First-off, Paul Evans speaks to Dr Emma Clark, Consultant in Rheumatology & Osteoporosis at North Bristol Trust, to find out about the causes and characteristics of osteoporosis. She discusses how osteoporosis can be ignored or misdiagnosed as osteoarthritis, as well as ways in which we can look after our bone health. Dr Clark also talks about how she is currently developing a clinical tool for primary care professionals to help them identify signs of osteoporosis when they meet with their pati

This edition has been supported by a grant from the Plum Trust. In September, the British Pain Society’s special interest group on pain management programmes held their annual conference. A workshop entitled ‘Experts by Experience – working together in Pain Management Programmes’ was run in parallel to this. The symposium brought together patient-volunteers and healthcare professionals from four pain management centres around the UK to share their experience of working together.  Dr Nick Ambler, Consultant Clinical Psychologist of the North Bristol NHS Trust’s Pain Management Programme (PMP), facilitated the workshop; chairing an uplifting, frank and empowering discussion on the psychological benefit to patients and the professional value to healthcare trusts of patient-volunteers working within pain management programmes. This special extended edition of Airing Pain comes to you live from the conference, letting you sit in on the discussion.   Patient-volunteer Primrose Granville opens by giving a

In this edition of Airing Pain, Paul Evans looks at the issues concerning pain amongst adolescents, including the impact on parents. First-off, Paul speaks to Dr Jeremy Gauntlet-Gilbert, principal clinical psychologist at the Bath Centre for Pain Services, to talk about the 'end of the road' residential pain management programme the Centre has for young people from across the UK who have not had success at other institutions. Paul also speaks to Amyra and Taylor, who have first-hand experience of the programme, about their time in Bath. They also discuss how chronic pain has affected their personal lives, including their performance at school and in exams. The parents’ experience is also explored as Paul speaks to Taylor’s mum Sandra McCann and Louise Bailey, the mother of another patient. They describe how the Bath Centre for Pain Management has made a positive impact on the ability of their children to have a more regular life. Paul also discusses with Louise and Dr Gauntlet-Gilbert about the wider impac

This edition was facilitated by the British Pain Society and recorded at their Annual Scientific Meeting 2019.  In this edition of Airing Pain, Paul Evans investigates the potential for patients to play an integral role in research, alongside the professionals. Through discussions with patients John and Mark both of whom are part of research groups, he sheds light on the importance of patients shaping the research and treatment of their own condition. From patients being included in directing their own treatment plan to actually influencing the direction of original scientific research, there are many benefits to their involvement. Louise Trewern, a member of the BPS Patient Liaison Committee, speaks of her journey from coming off opioids to working with Doctors in order to help others in similar situations. She highlights need to break down the ‘language’ barrier between professionals and patients.  Margaret Whitehead and Julie Ashworth explore how the BPS and the University of Keele, respectively,

In this second instalment in a mini-series on neuropathic pain, Paul Evans delves into the latest scientific developments on the condition and the ways in which the gap between research and treatments could be bridged.  Following on from Airing Pain 115, which concentrated on targeted Pain Management Programmes, this edition discusses the ‘bio’ element on dealing with neuropathic pain. Speaking to Professor Srinivasa Raja, Paul discusses what exactly is going on in the brain with neuropathic pain. Professor Raja provides a valuable explanation of the science behind the condition. Patrick M. Dougherty, Professor at the Department of Pain Medicine at The University of Texas MD Anderson Cancer Centre then shares with Paul the latest advances in neuropathic pain research. He examines the link between cancer treatments and the condition as well as the potential for treatments such as immunotherapy to combat neuropathic pain in the future.  Contributors: Patrick M. Dougherty, Professor at the Departme

In this edition of Airing Pain, Paul investigates the ideas behind Pain Management Programmes, and highlights the importance of the patient in shaping their own treatment. Internationally recognised Professor Srinivasa Raja speaks to Paul about the differences between nociceptive and neuropathic pain, as well as the complexities of chronic pain and its management. Consultant Clinical Psychologist, Dr Clare Daniel examines the psychological and social components of chronic pain. She discusses the important role of the cognitive behavioural model in Pain Management Programmes. Paul speaks to lead physiotherapist Diarmuid Denneny about the importance of the patient in determining the appropriate response to their pain, by taking into account their life and personal aspirations. Finally, Cameron Rashide, a patient with neuropathic pain among other conditions, speaks of the pain management technique ‘pacing’ and how she has learnt to manage her pain through pushing herself ever so slightly outside her

This edition of Airing Pain is funded by Foundation Scotland. On 1 April 2019 pregabalin and gabapentin, drugs recommended by the National Institute for Health and Care Excellence (NICE) for the management of neuropathic pain, were re-classified as class-C controlled substances. This change means it is illegal to possess pregabalin and gabapentin without a prescription, and illegal to supply or sell them to others, as well as restricting the ease with which doctors and pharmacists can prescribe and dispense them. Also in this edition of Airing Pain, medicinal cannabis: Is it safe? Does it work for pain? Is it legal? Where do people who use these drugs to manage their chronic pain, now stand within UK law? Contributors: Blair Smith, Consultant in Pain Medicine at NHS Tayside, and National Lead Clinician for Chronic Pain in Scotland. Steve Alexander, Associate Professor in Molecular Pharmacology at Nottingham University Cameron Rashide, who lives with neuropathic pain.

This edition is funded by the Arts and Humanities Research Council. Chronic pain often exists ways that cannot be seen. Due to the intangible and ambiguous nature of many chronic pain conditions that lack clear-cut causes and treatment, patients feel frustrated when communicating with healthcare professionals, personal networks, and the public at large; they feel ‘invisible’. Lancaster University’s English and Creative Writing department has built a research network to collect short-form ‘flash’ illness writing; pieces that aim to better represent people’s experiences of chronic pain.  In this edition of Airing Pain We hear from the project’s Principal Investigator Dr Sara Wasson about the many components that make up the project, its origins, and the goal of conveying the experience that millions of people go through every day.  Contributors: Dr Sara Wasson, English and Creative Writing Lecturer, Translating Chronic Pain Lead Investigator, Lancaster University  Holly Hirst, PhD and Associate L

This edition is funded by the Plum Foundation. In this edition of Airing Pain, returning contributor Mark Johnson, Director of the Centre for Pain Research at Leeds Beckett University, speaks to Paul about the experimental methods used in their lab to measure how pain is experienced. Professor Johnson emphasises the difficulty in communicating one’s pain, as it is entirely context driven and based on the experiences of the patient. Paul then heads to Manchester University to speak to Professor of Neuro-Rheumatology Anthony Jones. Paul learns about the different techniques used to measure the alpha waves produced by the brain when pain occurs, how the anticipation of pain is as important as pain itself, and the difficulties that scientists encounter when trying to emulate these signals. We also hear about the brain’s ‘plasticity’; its ability to rewire connection based on sensory experience. Anthony’s research team are developing a ‘smart neuro-therapies’ platform (which you can get involved in, see

This edition is supported by friends of Pain Concern. Director of CSPC Physiotherapy in Leeds, Alison Rose, specialises in working with high-level athletes, particularly those with complex injury histories. Rose speaks to Paul about her experience with chronic pain as being subjective for both athletes and non-athletes, explaining it as a unique “puzzle” that needs to be put together to find the core mechanisms that cause pain. We also hear about the many unexpected physical relationships within our bodies that cause pain, as well as the importance of social networks.  We then hear from Cardiff University Professor of Medical Education Ann Taylor. Professor Taylor speaks about her work exploring how those with chronic pain perceive non-pain related information, and how this information is processed through “fear circuitry” which can have detrimental effects on self-management. Professor Taylor promotes more focus on the ‘social’ aspect of the biopsychosocial model and the benefit of constructive conver

This edition is funded by the Agnes Hunter Trust.  According to Cancer Research UK, 50% of all people in England and Wales diagnosed with cancer survive their disease for ten years or more. This edition of Airing Pain looks at what pain management entails for the other 50%; those that live with terminal cancer. Kate Grafton, Lecturer and Professional Lead for Physiotherapy at Leeds Beckett University, speaks to Paul about her breast cancer diagnosis, her experiences with different treatments, the psychology of mindfulness, and finding the right support group. Paul then heads to St Gemma’s teaching hospice at the University of Leeds to speak to Professor of Palliative Medicine Mike Bennett who explains what palliative care entails as well as the importance of balancing treatment and quality of life. Back at Leeds Beckett we hear from the Director of the Centre for Pain Research Mark Johnson, who has a particular interest in non-pharmacological treatments like TENS machines, acupuncture, and laser

This edition has been supported by the Women’s Fund for Scotland. Fibromyalgia (FM) affects around 2% of the UK population, with 80-90% of those being women, and being a widely misunderstood condition its exact causes are unknown. Widespread pain is the major symptom; but people with FM may also experience fatigue, difficulty sleeping, memory problems ('fibro-fog'), muscle stiffness, and many others. In 2016, EULAR (European League Against Rheumatism) published its Revised Recommendations for the Management of Fibromyalgia. In this edition Paul Evans speaks to Dr Gareth Jones, reader in epidemiology at the University of Aberdeen who was part of the study group. Paul also speaks to Dr Kathryn Martin and Fiona Rennie about their work with Walk With Ease, a programme that encourages walking as a self-management technique for arthritis and musculoskeletal conditions like FM. He even has a go himself! We also hear from Diane about her experiences being diagnosed with FM and her journey using swimming,

This edition’s been part funded by the Women’s Fund of Scotland. Do women and men experience pain differently, or is it only our attitudes towards pain that differ? In this edition of Airing Pain, Paul speaks to healthcare professionals about their findings with the literature surrounding chronic pain and the changing outlooks when it comes to seeking help. Deputy Director of the Bath Centre for Pain Research, Professor Ed Keogh, speaks about his review of men’s health literature in the context of chronic pain, and found that women are more likely to report pain in more body regions in their lifetime compared to men. He considers whether this is due to biological or social/emotional reasons, but emphasises that the variation within males and females is much greater than the variation between the sexes. Can the gender roles society pushes on us affect how we deal with our pain? Senior clinical psychologist of the National Specialist Pain Service in Bath Dr Gauntlett-Gilbert talks to Paul about how th

This edition has been funded by funded by the Health and Social Care Alliance and Edinburgh and Lothians Health Foundation. In 2015 Pain Concern released its report ‘Breaking barriers to self-management of chronic pain in primary care’, marking the end of the first part of its ‘Breaking Barriers’ project. Its aim was to highlight the commonly occurring barriers that patients faced during one-to-one appointments with healthcare professionals, and to advance the primary care management of chronic pain. Phase two of the project was to produce a ‘navigator tool’ to break down those barriers and prepare patients and GPs in order make the most out of their appointments. Phase two is now complete, and in this edition of Airing Pain, Paul Evans speaks to the researchers, patients, and healthcare professionals that allowed this project to happen. Reneé Blomkvist, Pain Concern’s researcher heading the project’s second phase, explains the established barrier in phase one, as well as the methodology used in pre

This edition has been funded by Pain Concern supporter and cyclist Ade and The Sackler Trust. According to the British Pain Society, doctors and other healthcare professionals (HCPs) receive less training in pain management than veterinarians.* With pain being one of the major presenting factors for a large number of medical problems, this edition of Airing Pain looks into what programmes are being implemented to alleviate this knowledge gap. Dr Helen Lakins, deputy lead for the UK Essential Pain Management Course, describes how the course developed from being taught to HCPs in developing countries to being used in Australia and the UK. The predominant aim of the course is in response to the majority of medical undergraduates believing they are not receiving adequate pain training. Swansea University is currently undertaking a research study into patients’ beliefs and expectations of pain medications. Paul speaks to Dr Sherrill Snelgrove and Sarah Long about how the study has found evidence that our

This edition was funded by the Charles Wolfson Charitable Trust. The British Pain Society’s Annual Scientific Meeting (ASM) allows the multidisciplinary nature of the society to be reflected through seminars, scientific programmes, lectures, and workshops. Participants can attend various exhibitions, social events, and seminars to have well-rounded experiences on the subject of pain. In 2017, the BPS presented their Wellness Zone, coordinated by the Dorset Community Pain Service, to allow ‘wellbeing’ focused topics to have a platform. At the Wellness Zone, Paul speaks to Sarah Sturman, Dorset Community Pain Service physiotherapist, about Laughing Yoga. Sturman proposes that we are increasingly finding that emotional health is just as important as physical health, and that Laughing Yoga allows us to celebrate socialising and the natural human attributes of silliness and fun. Paul also speaks to Pain Concern’s own Renée Blomkvist about how pain can affect the way we project ourselves into the world, a

This edition is funded by the Constance Travis Charitable Trust and the Isabella Memorial Trust. Sleep can be a sanctuary from life; a way for the brain to decompress and begin restorative processes, but for those living with chronic pain, the pain/sleep cycle can become a vicious one. In this edition of Airing Pain, Paul speaks to clinical and health psychologist Dr Nicola Tang about how polysomnography, a method of measuring the biophysiological changes that occur during sleep, can suggest aspects of brain functioning during sleep cycles. Dr Tang explains how the deeper stages of sleep, like Rapid Eye Movement, are linked to pain sensation and emotional processing, and when you are deprived of these particular stages of sleep there is evidence of increased levels of pain sensitivity. Paul also speaks to Dr Sue Peacock, consultant health psychologist and author of Sleeping with Pain (2016), about how she found sleep to be one of the major issues among pain clinic patients and her non-pharmacolog

This edition is funded by the JTH Charitable Trust and the Persula Foundation. With between one third and one half of people living with chronic pain in the UK alone, the number of people experiencing the effects of pain explodes when considering family and friendships.* For some of these people, life can become a cycle of hospital visits, blood tests, and scans. So, what can be done to ease these relationships? In this edition of Airing Pain, Paul Evans and eminent psychotherapist Dr Barry Mason speak about their personal experiences with fibromyalgia and ankylosing spondylitis.  With many chronic pain conditions being 'invisible', explaining your pain may seem impossible, and as the family’s 'uninvited guest', it can cause people to close up to those looking to help. Dr Mason explains that not speaking about this uncomfortable topic can lead to further issues, and how opening up can lead to better family teamwork.  Contributors: Dr Barry Mason, Family Psychotherapist, Member of UK Council f

This edition is funded by a grant from the Stafford Trust. For top-level athletes, chronic pain can very quickly end careers. What preparations can be done to combat pain, and how important is patient engagement in rehabilitation? In this edition of Airing Pain, Paul speaks to chronic pain psychologist Dr Greg Clarke about how acute pain can turn chronic in the context of sport, and how the resilience of young athletes can sometimes be a hindrance. Ten years ago, Ade suffered a debilitating spinal injury. Four operations later, he was told by a surgeon that there was nothing they could do. Paul talks to Ade about his decision to attend a pain management programme to educate himself about his pain, and how cycling helped him take control of his situation. Ade has also set up a fund raising campaign, the 21 Days of Pain, to raise money for Pain Concern. He plans to cycle 100km every day for 21 days (2100km!). You can find his website and read about his story here: http://21daysofpain.org.uk/ Contr

This edition is funded by The Agnes Hunter Trust. An ever-increasing cancer survivor rate means chronic pain associated with the condition and its treatment is growing. In the UK alone, cancer survivor rates have doubled in the last 40 years, from 24% to 50%.* In this edition of Airing Pain, Paul Evans speaks to Dr Paul Farquhar-Smith, consultant in anaesthesia and pain medicine at The Royal Marsden Hospital in London, and co-author of Pain in cancer curvivors; filling in the gaps. Dr Farquhar-Smith explains how post-surgical pain in cancer survivors can be caused by damage to the nervous system, what cancer treatments may be associated with this pain, and what pre-surgery steps can be taken to reduce it. Contributors: Dr Paul Farquhar-Smith, Consultant in Anaesthesia at the Royal Marsden Hospital London, and co-author, with Dr Mathew Brown, of Pain in cancer survivors; filling in the gaps. More information: Pain in cancer survivors; filling in the gaps Macmillan's page on cancer pain