When you or someone you care about experiences pain you do everything possible to alleviate it. But imagine if that pain proved resistant to your efforts, persisting way beyond what could be considered normal, or if its source proved difficult to pinpoint.
Living with chronic pain can be devastating. Unlike acute pain, which lasts for only a short time, chronic pain is easily diagnosed and can generally be treated. Treatment options include medication, therapy or surgery.
Chronic pain persists beyond what is expected for healing, often exists without an apparent cause or condition and it be very difficult to treat.
According to Pain Australia, about 65 percent of people with chronic pain report disruption to daily activities including sleep, sex, work, exercise and routine self-care.This will obviously impact on personal relationships, social interactions and lifestyle.
Understanding the powerful influence our brain has on how we experience pain has grown considerably over the last few years. This knowledge is directly impacting treatments for chronic pain.
“Our experience of pain is entirely subjective,” says Catherine Carracher, Pain and Oncology Services Manager at Epworth. “We know our response to pain is, different for every individual. That’s why some people can walk on hot coals or a bed of nails.”
“When pain becomes chronic, thought patterns become so entrenched that the pain response is almost signaled by the brain, instead of the other way around. Like a patient’s brain knows a particular movement - for example bending over for someone with back pain - is going to hurt before they even do it, and so it does.”
Pain Management Programs work with patients to change these types of behaviours and thought patterns, dealing with the physical challenges and tackling the associated emotional issues such as stress, depression and grief.
“People often seek out ways to manage pain, after developing mental health issues as a consequence of what was originally a physical injury,” says Catherine. “Pain programs aren’t designed to cure the pain, but to provide people with tools to improve their quality of life.”
What’s involved with Pain Management Programs?
A team of allied health clinicians including psychologists, dieticians, physiotherapist and occupational therapist work with patients to identify priorities, set real goals and work towards achieving them. This might be an interstate holiday, sitting courtside at their kids’ basketball game, or just driving to and from work, it’s entirely individual.
Pain management can help patients
· Understand why pain persists and how we ‘feel’ pain
· Use pacing. Starting small and working towards a big goal
· Understand emotions and their impact on pain
· Use their skills and knowledge to find other meaningful activities
David was in his 30s and working as a butcher when he injured his neck. He tried to keep working but the pain, which radiated down one arm, made it impossible. He was devastated by the loss of his job and rapidly became socially isolated.
When he presented at Epworth David had already completed a pain management program but was still experiencing significant issues. His pain had spread to his lower back and other arm. He was overprotective of his injured side and his posture was stooped. Unable to travel independently he relied on a taxi provided by his insurer to get to his appointments and this caused him significant stress.
Typical of many in his position, David was stuck in a cycle of continually trying to push through the pain to achieve what he wanted, in this case returning to life pre-injury. Often referred to as a ‘boom bust’ presentation, it’s a cycle that ends up having the opposite affect.
One of David’s main goals in the program was around socialisation. With no possibility of returning to his original workplace he focused on reconnecting with friends and seeking out other meaningful activities. A psychologist helped him with his communication skills and assertiveness and as a result he met up with some old workmates, including his first employer, who offered him a volunteer position serving customers in his shop.
When the team last saw David he arrived on his motorbike, something that was absolutely beyond him when he began the program. While he still had pain his range of movement had improved dramatically. Being able to demonstrate a work capacity in another area had helped him with his confidence and he was hopeful the role might eventually become paid. If not, he was optimistic that the experience would enable him to apply for other jobs in retail.
* Not his real name