'The last injury report by Save the Children stated 50,000 casualties in children from 2020 to 2025, and we think that's an underestimation…'

Can mental and physical trauma in childhood lead to a lifetime of pain?

‘If you’re exposed to things like abuse, neglect and various household challenges, and external challenges like war and displacement, you might be more likely to develop poor health…’

‘One of the things that’s come out, particularly within our Ukraine collaborators, is that their children have high pain scores, regardless of injury severity and regardless of pain management…’
What are the lessons from history that we ignore at our peril?
'We asked, was there anything they wanted to tell us about their experiences? A number of them wrote about the Second World War. Some of them, exactly as you say, said we just got on with it, and they were very stoic, but there were others who...'
And what can be done?
'Some say, well, you can't avoid adversity happening, and that is true. My answer to that is if you can intervene after some adversity, then…'This episode features discussion of trauma and conflict that some listeners may find distressing.

Thanks go to the British Pain Society: all interviews were recorded at their 2026 Annual Scientific Meeting.

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This episode is produced in partnership with the British Pain Society. The interview with Sam Hughes was recorded at their 2025 Annual Scientific Meeting.

Can nature and mindfulness help pain?

This episode of Airing Pain looks at the interplay between nature and mindfulness, and how they can become part of the pain management toolkit.

Nature and neuroscience. Understand the science with Dr Sam Hughes. Learn how nature interacts with pain, and how this interaction works in virtual reality.

Greater connections. We join the Edinburgh and Lothians Greenspace Trust on one of their group wellbeing walks. We look at the benefits of building connections with nature, each other and ourselves.

Focusing on the here and now. We hear from trained and accreditedmindfulness teacher Cath Ashby. Cath explains how the practice of mindfulness can be applied to nature, and what this can do for pain.

Contributors:

Dr Sam Hughes, a Senior Lecturer in Pain Neuroscience at the University of Exeter
Elly Kinross, a Woodlands and Greenspace Officer with the Edinburgh and Lothians Greenspace Trust
Cath Ashby, a trained and accredited mindfulness teacher

Pain Concern’s free, online mindfulness sessions

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This episode is produced in partnership with the British Pain Society. These interviews were recorded at their 2025 Annual Scientific Meeting. The 2026 Annual Scientific Meeting is just weeks away – register here.
Amongst other things, here we tackle the taboo subject of acute period pain, highlight how changes in primary care are improving the pain management landscape, and discuss common misconceptions about opioid use.

Does period pain need rethinking? Understand the research with Katy Vincent, Professor of Gynaecological Pain at the University of Oxford.
Can a health and wellbeing coach change patient lives? One of the latest developments in pain management, as explained by NHS coach Phoebe Williams.
Do opioids get a fair press? Great for pain from an accident, surgery or fall. But for chronic pain? Dr Jane Quinlan, consultant in pain management, gives an overview and some top tips.

Contributors:

Prof Katy Vincent, Professor of Gynaecological Pain at the University of Oxford

Phoebe Williams, Health and Wellbeing Coach at NHS Hammersmith & Fulham

Dr Emma Davies, National Clinical Lead for Persistent Pain at NHS Wales Performance and Improvement

Tim Atkinson, Vice Chair of the British Pain Society’s Expert Patient and Carer Committee

Dr Jane Quinlan, Consultant in Anaesthesia and Pain Management at the Oxford University Hospitals NHS Foundation Trust

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‘if you’re treating people in pain, you’re treating autistic people in pain’
Do neurodivergent people experience pain differently?

The simple answer – and the slightly more complicated one

Why you, or your patients, aren’t recovering
Building relationships across neurotypes
Pain thresholds, pain anxiety, pain communication…

With Dr David Moore, Reader in Pain Psychology at Liverpool John Moores University

Thanks go to the British Pain Society – this interview was recorded at their 2025 Annual Scientific Meeting.

Read Pain Matters 91 now.

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This episode of Airing Pain explores how social factors impact the onset, experience and treatment of pain.
…understanding how things like your thoughts, your fears, your social interactions influence your biology can be really, really powerful…
…you're not just dealing with the pain, you're holding it in for everyone else…
…we normalise, and even celebrate, different types of pain for different genders…
* Can stress cause chronic pain? The research, explained… with Cormac Ryan, Professor of Clinical Rehabilitation at Teesside University. * What can pain do to relationships? What can relationships do to pain? Pain masking, social withdrawal, the power of attunement… with Rebecca Pearson, Professor of Developmental Psychology and Epidemiology at Manchester Metropolitan University. * How do sex and gender affect pain? Sex hormones, gender identity, social modelling… with Katelynn Boerner, Assistant Professor in the Department of Paediatrics at the University of British Columbia.

Thanks go to:

The British Pain Society – the interviews in this episode were recorded at their 2025 Annual Scientific Meeting.

If you have any feedback about Airing Pain, you can leave us a review via our Airing Pain survey

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Pain Education Classes – Learn to live well with pain

“A life-changing experience” – Lindsay McLean, Airing Pain #150
This episode of Airing Pain explores the transformative impacts of pain education classes.
Featuring excerpts from a live education session, here we look at how a brief, free course—delivered by trained volunteers with lived experience—is empowering people to navigate life with chronic pain.
Listen to hear how patients are learning more about their pain and the toolbox of techniques available to manage it.
These sessions are the result of a unique collaboration between Pain Concern and the NHS. They are available both online and in person (in Glasgow, run by NHS Greater Glasgow and Clyde’s pain management team). Find out more in ‘Additional Resources’ below.
“[The sessions] offer hope”
“If you can learn to turn the volume of pain down, you can bring back joy and an ability to participate in life”
“Now I’m in control of the pain instead of the pain being in control of me”
Watch Lorimer Moseley’s ‘Why Things Hurt’, as highlighted by educator Joan Melville, here – https://youtu.be/gwd-wLdIHjs?si=ckR6O4CN7LPM9a9K.

Contributors: Dr David Craig, Joan Melville, Georgina McDonald, Mairi McWilliams, Lindsay McLean, Heather Wallace.

This podcast has been produced in collaboration with NHS Greater Glasgow and Clyde.

Pain Concern thanks the following funders for their unrestricted educational grants: Richer Sound; NHS Lothian Charity, The National Lottery Community Fund; The Hugh Fraser Foundation; The Trades House of Glasgow Commonweal Fund.

Additional Resources:

Explore our free Pain Education Classes and sign up.

If you have any feedback about Airing Pain, you can leave us a review via our Airing Pain survey

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Airing Pain #149: Why pain persists: from childhood trauma to faulty immunity

This edition of Airing Pain looks at the research into why pain persists, how we can identify people at risk and whether we could prevent it happening.
In this episode:

How does acute short-term pain turn into chronic, persistent pain? Kathleen Sluka explains that people who experience psychological trauma at young ages are more likely to have chronic pain later in life. What scientists think is happening is that psychological trauma or other stressful events actually change your immune system.
Shafiq Skikander adds that a lot of patients with fibromyalgia may have had early life stressors. In addition, when they come to clinic presenting with fibromyalgia, they usually have a history of depression.

So how does this happen?

Gareth Hathway explains that slowly but surely, our understanding of the basic mechanisms is advancing. We now understand that babies do feel pain, young people do feel pain. It has a long-term consequence. We need a specialist approach to managing pain at every part of the life course. We need to think about how we measure that pain and how we treat that pain.

The interviews were recorded at the British Pain Society’s Annual Scientific Meeting, 2024.

Contributors:
Shafiq Sikander, a professor of sensory neurophysiology at the William Harvey Research Institute, Queen Mary University, London.

Gareth Hathway, professor of neuroscience at the University of Nottingham’s’ school of life sciences.

Kathleen Sluka, a professor in physical therapy and rehabilitation science at the University of Iowa in the United States.

Thanks
The interviews were recorded at the British Pain Society’s Annual Scientific Meeting, 2024.

This programme describes research using laboratory animals that is consistent with Pain Concern’s Humane Care and Use of Animals in Medical Research Policy.

Additional Resources:

You can join our Airing Pain online community:

Airing Pain online community

If you have any feedback about Airing Pain, you can leave us a review via our Airing Pain survey

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This edition of Airing Pain focuses on advances in understanding and managing chronic pain, from neuroimmune mechanisms to new diagnostic and treatment approaches.
In this trailer, listen to excerpts from the full program on: how does acute, short term pain turn into chronic, persistent pain? * Why do early life experiences affect later life pain? * And why do existing tools for measuring pain fall short?*

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Full Episode available: 5/3/2025

This Airing Pain episode explores how neurodivergent individuals experience pain, potential links to hypermobility, and the need for better education to support conditions like autism and ADHD.

Neurodiversity refers to the different ways a person’s brain processes information.

It is an umbrella term used to describe a number of conditions including Autism or Autism Spectrum Conditions; ADHD; Dyscalculia; Dyslexia; Dyspraxia, or Developmental Coordination Disorder (DCD), and more.

In this episode:

Dr. Clive Kelly discusses research on co-occurring conditions in neurodivergence, highlighting varied symptoms and how pain perception differs among individuals.
Dr Jessica Eccles talks about her research into the relationship between joint hypermobility and neurodevelopmental conditions like ADHD and autism.
We hear from Ren Martin, an autistic learning disability nurse and mother of three neurodivergent children, and Ceri Reid of Parents Voices in Wales, advocating for better neurodiversity and mental health services.
Throughout the episode, we hear from Imogen Warner, whose writings are featured in the Autistic Girls Network, and who highlights the reality of being a young autistic person.

Contributors:

Dr. Clive Kelly, Consultant Physician and Rheumatologist, James Cook University Hospital and University of Newcastle-upon-Tyne.
Dr Jessica Eccles, Reader in Brain-Body Medicine at Brighton and Sussex Medical School.
Ren Martin, neurodevelopmental specialist.
Ceri Reid, neurodivergent mother and founder of Parents Voices in Wales.
Imogen Warner, student with lived experience of autism and chronic pain.
Jane Green MBE, founder of SEDSConnective

We are immensely grateful to The British Humane Association and The Heather Hoy Charitable Trust whose generous grants made this podcast possible.

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Artist Jason Wilsher-Mills has lived with pain and chronic polyneuropathy since he was a child.
In this interview he talks about his recent exhibition at the Wellcome Collection in London called "Jason and the Adventure of the 254"

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"Susan Birth, Chief Executive of Ehlers-Danlos Support UK, explores the challenges faced by individuals with Ehlers-Danlos syndromes and hypermobility spectrum disorders, touching on symptom management, NHS navigation, and promising new research."

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"Simon Harvey, General Manager of Able in South Wales, discusses supporting adults with learning disabilities, autism, and neurodivergent conditions. He reflects on the podcast's relevance for families and individuals, sharing personal insights about pain management and raising autistic children with ADHD."

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Airing Pain 148: Links between hypermobility and neurodivergence
Released on: 5/3/2025
This Airing Pain episode explores how neurodivergent individuals experience pain, potential links to hypermobility, and the need for better education to support conditions like autism and ADHD.

Neurodiversity refers to the different ways a person’s brain processes information.

In this episode:

Dr. Clive Kelly discusses research on co-occurring conditions in neurodivergence, highlighting varied symptoms and how pain perception differs among individuals.
Dr Jessica Eccles talks about her research into the relationship between joint hypermobility and neurodevelopmental conditions like ADHD and autism.
We hear from Ren Martin, an autistic learning disability nurse and mother of three neurodivergent children, and Ceri Reid of Parents Voices in Wales, advocating for better neurodiversity and mental health services.
Throughout the episode, we hear from Imogen Warner, whose writings are featured in the Autistic Girls Network, and who highlights the reality of being a young autistic person.

Contributors:

Dr. Clive Kelly, Consultant Physician and Rheumatologist, James Cook University Hospital and University of Newcastle-upon-Tyne.
Dr Jessica Eccles, Reader in Brain-Body Medicine at Brighton and Sussex Medical School.
Ren Martin, neurodevelopmental specialist.
Ceri Reid, neurodivergent mother and founder of Parents Voices in Wales.
Imogen Warner, student with lived experience of autism and chronic pain.
Jane Green MBE, founder of SEDSConnective

We are immensely grateful to The British Humane Association and The Heather Hoy Charitable Trust whose generous grants made this podcast possible.

Time Stamps:

00:43 Understanding Neurodivergence and Pain

04:46 The Relationship between Hypermobility and Neurodivergence

12:06 Gender Differences in Diagnosis and Pain

13:49 Ren Martin’s Personal Experience

32:27 Diagnosis for Neurodivergent Individuals

35:18 Challenges in Education for Neurodivergent Children

42:40 Training for Educators and Healthcare Workers

Links Referred to in this Episode:
* School toolkit for JHS and EDS - School Toolkit for EDS and JHS * Parents Voices in Wales: Resources & Key Documents – Parents Voices in Wales CIC * Autistic Girls Network: https://autisticgirlsnetwork.org/ * Ehlers-Danloss Society: https://www.ehlers-danlos.com * Hypermobility Syndrome Association. - The HMSA | The Hypermobility Syndromes Association * Healios: https://healios.org.uk/ * SEDSConnective: https://www.sedsconnective.org/

If you have any feedback about Airing Pain, you can leave us a review via our Airing Pain survey

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This episode of Airing Pain focuses on person-centred care. Person-centred care is based on the individual rather than on a generic group of patients.
In this episode: * Vicky Sandy-Davis, Lead Nurse of Independent Health and Social Care, talks about the importance of recognizing the value of person-centred care, specifically for people with intellectual or learning disabilities

Ian Taverner and Sarah Harrisson discuss the importance of involving people living with chronic pain in research studies so that researchers can be guided by those with experience of chronic pain
Professor Nicole Tang and Jenna Gillett share findings from their research on mental defeat. For people living with chronic pain, mental defeat can be a way of characterizing how the pain impacts a person's perceived loss of autonomy which can lead to a loss of identity when experiencing repeated episodes of pain.

The interviews were recorded at the British Pain Society’s Annual Scientific Meeting, 2024.
Contributors:
Vicky Sandy-Davis, Lead Nurse for Independent Health and Social Care, West Midlands

Ian Taverner, Chair of the Public Advisory Group of CRIISP (Consortium to Research Individual, Interpersonal and Social Influences in Pain)

Sarah Harrisson Research Associate in Applied Health Research at Keele University, Specialist Pain Physiotherapist with the IMPACT Community Pain Service (Midlands Partnership NHS Foundation Trust) in Stoke-on-Trent

Professor Nicole Tang, Director of the Warwick Sleep and Pain Laboratory, Academic Co-Lead for the Warwick Health Global Research Priority Mental Health Theme

Jenna Gillett, PhD student at Warwick University and Lecturer in Psychology at the University of Buckingham.

If you have any feedback about Airing Pain, you can leave us a review via our Airing Pain survey

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Airing Pain 146: Irritable Bowel Syndrome & Inflammatory Bowel Disease

This edition of Airing Pain focuses on two conditions affecting the gut: Irritable Bowel Syndrome (IBS) and Inflammatory Bowel Disease (IBD). Both affect the digestive system, and both cause pain. In this episode we learn about what separates these outwardly similar sounding conditions, how they are diagnosed, and what treatments might be available.

Dr David Bulmer discusses the key differences and distinguishing features of IBS and IBD, the latest research into these conditions, and potential medicinal treatments for managing the pain they cause.
Professor Rona Moss-Morris sheds light on remission, pain, and symptom management for IBS and IBD, and the challenges these conditions present. We hear about research into the use of Cognitive Behavioural Therapies designed specifically to help manage IBS and IBD symptoms.
The interviews were recorded at the British Pain Society’s Annual Scientific Meeting, 2024.
Contributors:
Dr David Bulmer, Associate Professor at Cambridge University, specialising in visceral pain and gastrointestinal disease, with a special interest in IBS, IBD, and pain.
Prof. Rona Moss-Morris, Professor of Psychology as Applied to Medicine and Head of the Department of Psychology at the Institute of Psychology, Psychiatry and Neuroscience, King’s College London. Lead for Digital Therapies at the NIHR Maudsley Biomedical Research Centre. She has a special interest in factors that affect symptom experience and adjusting to chronic medical conditions.
Time Stamps:
01:29 Paul Evans introduces Dr David Bulmer, Associate Professor at the Department of Pharmacology at Cambridge University.
01:46 Dr David Bulmer explains the difference between Irritable Bowel Syndrome and Inflammatory Bowel Disease and how they are diagnosed.
02:50 Bulmer discusses research into the potential causes of IBS and IBD, including localised allergic response and potential genetic markers.
06:18 Bulmer describes a study into the use of antidepressants for the treatment of IBS.
07:29 Bulmer discusses new treatments for Inflammatory Bowel Disease, and how far these impact the actual pain experienced.
12:17 Bulmer explains the ‘Low FODMAP’ diet treatment.
14:17 Evans introduces Professor Rona Moss-Morris, Professor of Psychology as Applied to Medicine and Head of the Department of Psychology at King’s College London.
14:22 Moss-Morris explains the term ‘remission’ and how it is applied to IBS and IBD.
16:33 Moss-Morris discusses clinical trials using Cognitive Behavioural Therapy (CBT) for those with IBS and IBD symptoms.
18:53 Moss-Morris explains what CBT is and how it is used.
23:16 Moss-Morris discusses the use of apps and digital approaches to treatment.
27:55 Moss-Morris gives a final message on pain.

If you have any feedback about Airing Pain, you can leave us a review via our Airing Pain survey

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Coming 9th October: This edition of Airing Pain focuses on Irritable Bowel Syndrome (IBS) and Inflammatory Bowel Disease (IBD) – two outwardly similar sounding conditions, but the devil is in the details.
Our contributors are experts on visceral pain, gastrointestinal disease, and psychological factors affecting chronic conditions; find out what they have to say in the latest edition of Airing Pain, coming soon.
The interviews were recorded at the British Pain Society’s Annual Scientific Meeting, 2024.
Contributors:
Dr David Bulmer, Associate Professor at Cambridge University, specialising in visceral pain and gastrointestinal disease, with a special interest in IBS, IBD, and pain.
Prof. Rona Moss-Morris, Professor of Psychology as Applied to Medicine and Head of the Department of Psychology at the Institute of Psychology, Psychiatry and Neuroscience, King’s College London. Lead for Digital Therapies at the NIHR Maudsley Biomedical Research Centre. She has a special in interest factors that affect symptom experience and adjusting to chronic medical conditions.

If you have any feedback about Airing Pain, you can leave us a review via our Airing Pain survey

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Airing Pain 145 Rethinking Pain: Pain Management in the Community

This edition of Airing Pain centres on rethinking the traditional clinician-patient relationship in pain management and exploring alternative approaches to bringing pain management back into the community.
Dr Barbara Phipps, GP and Lifestyle Medicine expert, discusses the development and benefits of group consultations for pain management.
Dr Jackie Walumbe sheds light on the pervasive inequalities in chronic pain services, highlighting the value of communities and member-led collaboratives in building and shaping self-management.
Prof. Mark Johnson, Dr Kate Thompson, and Kerry Page talk through the benefits of de-medicalising pain management, shifting the focus to a community setting.
We hear about the fantastic work of Rethinking Pain, a community-based pain support service in Bradford and Craven, and the inspiration this can serve for future chronic pain services and self-management initiatives.
The interviews were recorded at the British Pain Society’s Annual Scientific Meeting, 2024.
Contributors:
Dr Barbara Phipps, Practising NHS GP and Teaching Fellow at the University of Edinburgh, currently running a community based Chronic Pain management service within the NHS. Barbara has a special interest in Lifestyle Medicine, and is a trustee of the British Society of Lifestyle Medicine.
Dr Jackie Walumbe, Clinical Academic Advance Practice Physiotherapist in the Complex Pain Team at University College London Hospitals NHS Foundation Trust and Honorary Research Fellow at University of Oxford.
Professor Mark Johnson, Professor of Pain and Analgesia and Director of the Leeds Beckett Pain Team (Centre for Pain Research) at Leeds Beckett University.
Dr Kate Thompson, Senior Lecturer and Researcher at Leeds Beckett University, with a background in physiotherapy and special interest in pain research.
Kerry Page, Programme Lead for Rethinking Pain, the chronic pain community service based in Bradford District and Craven.

Time Stamps:
01:58 Paul introduces Dr Barbara Phipps, Practising NHS GP and Teaching Fellow at the University of Edinburgh, currently running a community based Chronic Pain management service within the NHS. Barbara has a special interest in Lifestyle Medicine, is and is a trustee of the British Society of Lifestyle Medicine.
02:27 Dr Barbara Phipps discusses the development of group consultations for people with long-term primary pain.
07:28 Paul and Barbara discuss the importance of people being believed about their pain, perception of pain experiences, and detection on functional MRI scans.
10:41 Paul draws upon issues the funding in pain management services and who decides whether a treatment programme is value for money or not.
10:53 Paul introduces Dr Jackie Walumbe, Clinical Academic Advance Practice Physiotherapist in the Complex Pain Team at University College London Hospitals NHS Foundation Trust and Honorary Research Fellow at University of Oxford.
11:04 Dr Jackie Walumbe discusses her research on understanding how the term and practice of Self-Management is understood and acted on by people living with chronic pain, particularly those who don’t have ongoing contact or access with specialist pain services, and the relationship between this and policy makers’ decisions.
14:42 Paul and Jackie discuss key findings regarding issues of inequality, and a report by Versus Arthritis (Unseen, Unequal and Unfair: Chronic Pain in England), reflecting issues of policy and politics and the importance of other communities in filling the gaps.
18:09 Paul introduces Rethinking Pain, a community-based service for adults living with long-term pain, in Bradford District and Craven.
18:28 Paul introduces Dr Mark Johnson, Professor of Pain and Analgesia and Director of the Leeds Beckett Pain Team (Centre for Pain Research) at Leeds Beckett University.
18:37 Paul introduces Dr Kate Thompson, Senior Lecturer and Researcher at Leeds Beckett University, with a background in physiotherapy and special interest in pain research.
18:40 Paul introduces Kerry Page, Programme Lead for Rethinking Pain, the chronic pain community service based in Bradford District and Craven.
18:47 Kerry Page discusses the Rethinking Pain service, its background, services, and success.
19:57 Dr Kate Thompson explains how Rethinking Pain’s approach differs from other community pain management programmes
20:58 Dr Mark Johnson talks about how pain is a context driven experience, and the importance of understanding how the narrative matters when it comes to managing pain.
25:49 Kerry Page recalls the importance of giving time to listen to the pain community and those living with chronic pain, and the way that Rethinking Pain’s initiative provides this through Health Coaches.
35:53 Kerry page discusses how pain management services can help to reach more people and connect people and organisations from across the pain community.

Additional Resources:
Rethinking Pain

Inequalities in Chronic Pain Report - Versus Arthritis

If you have any feedback about Airing Pain, you can leave us a review via our Airing Pain survey

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Coming 14th August: This edition of Airing Pain centres on rethinking the traditional clinician-patient relationship in pain management and exploring alternative approaches to bringing pain management back into the community.
Is the 1-to-1 doctor-patient consultation the best we can do? How can we help people to feel more empowered in managing their own pain? Our contributors are experts in pain management, research, and community engagement; find out what they have to say in the latest edition of Airing Pain, coming soon.
The interviews were recorded at the British Pain Society’s Annual Scientific Meeting, 2024.

Contributors:
Dr Barbara Phipps, Practising NHS GP and Teaching Fellow at the University of Edinburgh, currently running a community based Chronic Pain management service within the NHS. Barbara has a special interest in Lifestyle Medicine, and is a trustee of the British Society of Lifestyle Medicine.
Dr Jackie Walumbe, Clinical Academic Advance Practice Physiotherapist in the Complex Pain Team at University College London Hospitals NHS Foundation Trust and Honorary Research Fellow at University of Oxford.
Professor Mark Johnson, Professor of Pain and Analgesia and Director of the Leeds Beckett Pain Team (Centre for Pain Research) at Leeds Beckett University.
Dr Kate Thompson, Senior Lecturer and Researcher at Leeds Beckett University, with a background in physiotherapy and special interest in pain research.
Kerry Page, Programme Lead for Rethinking Pain, the chronic pain community service based in Bradford District and Craven.

If you have any feedback about Airing Pain, you can leave us a review via our Airing Pain survey

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Airing Pain 144: Dilemmas in Pain Research

This episode of Airing Pain focuses on the challenges that researchers must overcome when researching pain and developing new treatment approaches. Many questions remain unanswered in the field of pain research. For example, we might know that a treatment works for some people living with pain, but we might not know how it works or why some people benefit and some do not.
So, there is a lot of research being done to try to better understand pain. This leads to another problem: how to cope with the amount of new information emerging from research and trials? It is important that new research data is made more accessible for clinicians, healthcare workers, patients, and researchers. Data is no use unless it can be assessed and summarized so that doctors can understand how to use it to benefit their patients.
Our contributors for this edition are leaders in this field and they discuss some of the issues they have encountered whilst conducting their research into pain and how to treat it.
The interviews were recorded at the British Pain Society’s Annual Scientific Meeting, 2023.

Contributors:
Professor Robert Brownstone, Brain Research UK Chair of Neurosurgery, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology.
Dr Neil O'Connell, Reader in Physiotherapy, Brunel University, Chair of the International Association for the Study of Pain (IASP) Methods, Evidence Synthesis and Implementation Special Interest Group. He is an advisor to Pain Concern.
Dr Kirsty Bannister, Neuroscientist and Associate Professor at King’s College London.
Time Stamps:
1:22 Paul introduces Professor Robert Brownstone, Brain Research UK Chair of Neurosurgery at University College London.
1:32 Prof. Brownstone explains what a spinal cord stimulator is, the lack of progress made with this form of treatment, the varied results the treatment gets, and why some people experience long-term pain following back surgery.
7:40 Paul talks about Cochrane, a global independent network of health practitioners, researchers, and patient advocates who review research findings to provide a more precise estimate of the effects of a treatment.
7:54 Paul introduces Dr Neil O’Connell, a Reader at Brunel University who was the Co-ordinating editor of the Cochrane Pain, Palliative and Supportive Care (PaPaS) group.
8:35 Dr O’Connell discusses how Cochrane reviews research and clinical trials, and the complexities involved in gathering and interpreting evidence when developing interventions.
17:04 Paul introduces Dr Kirsty Bannister, a neuroscientist and Associate Professor at King’s College London who specialises in neuropharmacology and runs a research group that uses animals to examine the mechanisms of pain processing.
17:22 Dr Bannister talks about why animal models are useful for researching the responses people may have to different pain processes and researching chronic pain by measuring neuronal responses to pain.
21:44 Paul and Dr Bannister discuss the limitations of using animals to research chronic pain.
23:48 Paul and Dr Bannister explore why looking at a patient's experience of pain first can better inform lab research on animal models for understanding and researching pain.
30:03 Prof. Brownstone gives some advice for those considering a spinal cord stimulator as an intervention they want to try.

Additional Resources:
Cochrane

Pain Matters 73: Neuropathic pain issue

Pain Matters 79: Navigating pathways to live well with pain

Pain Matters 80: What treatment really works

Neuropathic Pain

If you have any feedback about Airing Pain, you can leave us a review via our Airing Pain survey

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Coming 12 June: This edition of Airing Pain focuses on the dilemmas and roadblocks that researchers encounter when researching pain and developing interventions, how they may overcome them, and why systematic reviews of research are so important.

Our contributors for this edition are leaders in this field and they discuss some of the issues they have encountered whilst conducting their research into pain and how to treat it.

Interviews in this edition were recorded at the British Pain Society Annual Scientific Meeting.

Contributors:

Professor Robert Brownstone is a Professor and Head of Neurosurgery at University College London.

Dr Neil O’Connell is a Reader in the Physiotherapy Division of the Department of Health Sciences at Brunel University London. He is also a member of Cochrane's central editorial board.

Dr Kirsty Bannister is an Associate Professor of Neuroscience/Neuropharmacology at King’s College London.

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This edition of Airing Pain focuses on the treatment of pain, the importance of catering treatment to a person’s individual genetic makeup, and why addressing the psychological dimensions of pain is crucial in treating it effectively.

The process of finding a medication or treatment that works for a person often involves a lot of trial and error, which can be a frustrating process for someone to go through. This process can be side-stepped through the use of personalised medicine, where information about a person’s genetic makeup is used to tailor and optimise their treatment so it is as effective as possible.

Although medication is oftentimes a vital part of treating pain, incorporating psychological treatment alongside medication can be hugely beneficial when it comes to making pain management better for those living with acute or chronic pain. Changing how someone thinks about pain can enhance their response to the physical components of the treatment they receive.

Our contributors for this edition discuss the ways in which the treatment of pain can be made more effective for people by incorporating personalised medicine or psychological treatments into a person’s care plan. Please leave us a review on this platform or give feedback via our Airing Pain survey.

Contributors:
Professor Tony Dickenson, Professor of Neuropharmacology at University College London.

Dr. Beth Darnall, PhD, Professor of Anesthesiology, Perioperative and Pain Medicine at Stanford University School of Medicine. Director, Stanford Pain Relief Innovations Lab.

Professor Irene Tracey, Vice Chancellor of the University of Oxford and a Professor of Anaesthetic Neuroscience in the Nuffield Department of Clinical Neurosciences.

Read transcript

Thanks:
This edition of was made possible thanks to funding from the Guy Fawkes Charitable Trust and support from the British Pain Society.

Time Stamps:
1:11 Paul introduces Professor Tony Dickenson,who he spoke to at the British Pain Society Annual Scientific Meeting 2022.

3:21 Professor Tony Dickenson discusses ‘precision medicine’, ‘personalised medicine’, and how looking at peoples' genetic makeup can help medical professionals treat pain more effectively.

14:21 Paul introduces Dr Beth Darnall, who he spoke to at the British Pain Society Annual Scientific Meeting 2023.

14:54 Dr Beth Darnall explains the psychological components of how people experience pain.

20:24 Paul introduces Professor Irene Tracy, who he spoke to at the British Pain Society Annual Scientific Meeting 2023.

20:57 Dr Irene Tracy discusses the work she's done on neuroimaging and how the human brain constructs the experience of pain.

23:22 Paul and Dr Tracy talk about what neuroimaging tells us about the multidimensional way the human brain reacts to pain.

26:06 Beginning of discussion about Empowered Relief, a psychology-based intervention that provides people with skills and tools to help manage their acute or chronic pain.

26:31 Dr Beth Darnall discusses the psychological side of treating pain and how empowered relief is used to help people manage their pain.

29:10 Dr Beth Darnall talks about the psychological tools people learn through Empowered Relief and how they help with pain management.

Additional Resources:
Airing Pain 100: Glasgow Pain Education Sessions
Empowered Relief
Pain Matters 80: What treatment really works

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Coming 10 April: This edition of Airing Pain focuses on the treatment of pain, the importance of catering treatment to a person’s individual genetic makeup, and why addressing the psychological dimensions of pain is crucial in treating it effectively.

This edition will be funded by the Guy Fawkes Charitable Trust and was created with support from the British Pain Society.

Contributors:

Professor Tony Dickenson, Professor of Neuropharmacology at University College London
Dr. Beth Darnall, PhD, Professor of Anesthesiology, Perioperative and Pain Medicine at Stanford University School of Medicine. Director, Stanford Pain Relief Innovations Lab.
Professor Irene Tracey, Vice Chancellor of the University of Oxford and a Professor of Anaesthetic Neuroscience in the Nuffield Department of Clinical Neurosciences.

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Pain Concern would like to remind listeners that the topic of chronic pain can be uncomfortable for those with lived experience of chronic pain. Please read the description for information about this edition's content.

In a 2020 US study, it was found that ‘Implicit bias remains a contributor to healthcare disparities.’ This can be based on gender, ethnicity, disability or locality, and has the potential to affect somebody no matter their background.

In Airing Pain 142, we begin with specific references to disparities in Musculoskeletal (MSK) treatment, and how we can learn from other healthcare fields to increase patient satisfaction; we then focus on how both internal and external stigma can lead to discrimination in treatment; before ending with a discussion about why ethnic minorities are being inadvertently discriminated against in the pain management setting.

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Contributors:
Professor Jonathan Hill is the Director of Research for the School of Allied Health Professionals, and a Professor of Physiotherapy, in the Keele School of Medicine.

Dr Ama Kissi is a post-doctoral fellow at the University of Ghent and a Clinical Psychologist.

Dr Whitney Scott is a clinical psychologist who lectures at Kings College London and is the research lead at the INPUT Pain Management Unit at Guy’s & St Thomas’ Hospital.

Time Stamps:
1:30: Professor Jonathan Hill speaks about the disparities in musculoskeletal pain treatment in primary care.

6:04: Sharing their experiences and research, Paul and Jonathan discuss the differences between Pain Management and Diabetes care.

9:59: Jonathan Hill highlights the importance of differentiating between people accessing pain management care frequently and infrequently.

15:26: Jonathan Hill alludes to the ‘Restore’ trial in Australia, and the success of integrating physiotherapists into the pain management care system.

18:44: Dr Whitney Scott talks about the stigma and discrimination of people living with pain.

24:44: Whitney Scott discusses the way that health care professionals can work with people in pain who feel stigmatised.

26:01: Paul and Dr Ama Kissi discuss the disparities in pain management for different ethnicities and hypothesise why this might be the case.

31:17: Ama Kissi shares her own experiences as a black woman in the healthcare environment - this segment discussed childbirth.

Thanks:
This edition of Airing Pain was possible thanks to support from the British Pain Society

If you’re looking for more information and support on managing pain visit painconcern.org.uk.

Additional Resources:
Pain Matters 84 - This magazine issue focuses on inequalities in public health.
Stigma and Pain Management - US Department of Health and Human Services.
‘Stigma and Chronic Pain’ - A research article published in ‘Pain and Therapy’.
Further information on the Restore Trial

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This edition of Airing Pain sheds light on the unique challenges of living with cancer as a child or young adult, and the later impacts of the cancer treatment they underwent during the critical formative years. Airing Pain speaks to experts on the longitudinal impacts of cancer for these age groups; across medical, physical, and psychosocial.

Pain and fatigue are commonly reported as the most significant negative impact on quality of life when living with cancer. Until quite recently there has been little research in the area of living with cancer and experiencing medical treatments for cancer as a child or young adult during the critical formative years, and even less so on the long-term impacts these treatments can have throughout later adulthood.

Our contributors discuss a variety of determinants that impact long-term effects such as type of treatment, type of cancer, their personal resilience, and their family and social support networks. We also hear of the opportunities in improving cancer care for these age groups, particularly with the difficult transition from child to adult care units.

Contributors:

Emeritus Professor Sam Ahmedzai, NIHR National Specialty Lead for Cancer
Professor Diana Greenfield, Senior Consultant Nurse at Sheffield Teaching Hospitals Trust
Ceinwen Giles, Co-CEO, Shine Cancer Support

Time Stamps:

0:50 Paul introducing Emeritus Professor Sam Ahmedzai, an internationally recognised pioneer in setting up palliative medicine. 2022 British Pain Society interview.

2:53 Discussion around later hormonal effects of some successful treatments used to eradicate and manage cancer in children and teenagers.

5:54 Professor Diana Greenfield, Senior Consultant Nurse at Sheffield Teaching Hospitals Trust, NHS, on the transition between paediatric to adult cancer care.

13:18 The importance of family-centred care. Defined as a house or unit of care that can be traditional or non-traditional but represents a holistic support network.

18:00 Ceinwen Giles, Co-CEO, Shine Cancer Support, working to provide support for people in their 20s 30s and 40s who have lived with cancer and chronic cancer.

19:00 Ceinwin Giles talking on her personal experience of receiving treatment for non-Hodgkin lymphoma and challenges in finding peers her own age who share her experiences.

21:54 Managing early-life considerations alongside cancer. Career uncertainty, mental health in jobs, as well as fertility, relationships, and dating.

23:00 The difficult transition from child to adult care, in terms of having fewer people and services supporting as an adult. There are opportunities to improve the easing of this transition, especially following the pandemic where services are stretched.

25:20 Invitation to respond to the Airing Pain survey.

26:02 Summary of the key take home messages for children and young adults, and those caring for them.

Additional Resources:

Airing Pain 140: Childhood Pain - Adverse Experiences and Parental Relationships
Shine Cancer Support
Families and Children Resource Page
Airing Pain 118: Pain Management in Young People

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This edition of Airing Pain is on the topic of early childhood experiences.
(Content warning: includes abuse, neglect, and household dysfunction)
The World Health Organisation states that ‘adverse childhood experiences (ACE) can have lifelong consequences on a person’s health, and well-being, and can lead to a person developing persistent pain in later life’. A lot of this research is conducted in adults, and of course with changes in attitudes and beliefs surrounding raising children over the years, would they consider events in their childhood to be adverse?
Listen to learn more about this complex discussion. Find out how this kind of trauma in formative years impacts neurobiologically on the stress response, and causes changes on a structural and functional level in the brain that can predispose young people not only to pain but depression, cardiovascular disease, behaviours with increased health risks, and can have impact on mortality.
Contributors: * Dr Katie Birnie, Clinical Psychologist at the University of Calgary, on the importance of validating pain in young people. * Professor Lesley Colvin, Project Lead at Consortium Against Pain InEquality (CAPE) and Professor of Pain Medicine at the University of Dundee, and consultant in pain services. * Jen Ford, DRAP Pain Physio & Therapy Lead at Bath Centre for Pain Services & Bristol Paediatric Pain * Professor Lesley Colvin, Project Lead at Consortium Against Pain InEquality (CAPE) * and Professor of Pain Medicine at the University of Dundee, and consultant in pain services. * Professor Tim Hales, Project Lead at CAPE and a non-clinical Professor of anaethesia at the University of Dundee. * Dr Lauren Heathcote, Senior Lecturer in health psychology at Kings College London

Timestamps
2:06 Prof Tim Hales discusses the impact on ACE on chronic pain and how people respond to treatment.
7:02 Prof Lesley Colvin Professor on how ACE causes persistent pain.
16:05 Dr Lauren Heathcote discusses the psychology of pain and symptom perception in young people.
23:26 Jen Ford on the different approach required when working with children.
26:05 Dr. Katie Bernie explore the importance of children and family partnerships.

Related links
CAPE Consortium Against Pain InEquality

Health Scotland – Adverse Childhood Experiences

TED talk: Carol Dwerk – The Power of Believing you can improve

Bath Centre for Pain Services

Airing Pain survey

Pain Concern Children and Families resources

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This edition of Airing Pain was recorded at the Living Well with Persistent Pain in Wales conference during Pain Awareness Month in September 2023. The topic of the conference was the launch of the revised Persistent Pain guidance first published in 2019.

The COVID-19 pandemic has changed how we live and access services. How are healthcare professionals who treat patients with persistent pain capitalising on this improved digital literacy by using a digital-first approach to improve the patient experience at their clinics? With the aim of this year's conference being to see the person and not the symptoms, how can the patient's voice be heard and kept central to ensure this is done? And finally, how can the Third Sector and the NHS work more cohesively to work towards this goal? Listen or read the transcript to find out more.

Contributors
Bethany Davies Health care support worker, Aneurin Bevan University Health Board
Gethin Harries, Physiotherapist, Powys Health Board (Powys Living Well Service).
Eluned Morgan MS, Health Minister
Owen Hughes National Clinical Lead for Persistent Pain in Wales
Stephen Allan, Regional Director New Citizen’s Voice Body for Wales
Dr Sue Jeffs, National Clinical Lead for Persistent Pain Patient organisation representatives
Mary Cowern Head of Nation for Cymru Versus Arthritis
Heather Wallace, Pain Concern

Representatives of other organisations present at the event, including Health Education for Improvement Wales, Real City Strategy North Wales, Cardiff and Vales University Health Board and Case UK Ltd.

Read Transcript Feedback survey

Timestamps
0:35 Eluned Morgan MS welcomes delegates to the launch of the revised Living With Persistent Pain in Wales guidelines.
3:04 Owen Hughes explains the updates to the guidelines.
6:04 Eluned Morgan MS on the feedback received regarding the guidence and how it can continue to evolve.
6:35 Representatives from Real City Strategy North Wales and Powys Living Well Service discuss how those living with pain can be supported.
12:48 Eluned Morgan MSanda representative from Cardiff and Vales University Health Board talk about self-management and peer support groups.
23:59 Mary Cowern, Neil Fowler and Bethany Davies on how the guidelines will impact their organisations.
37:39 Eluned Morgan MS on the need to reduce ineffective treatments.
38:35 Information on upskilling for healthcare professionals from Catrin from Health Education and Improvement Wales.
40:38 The Patient Voice – Stephen Allan, Eluned Morgan MS and Dr Sue Jeffs on the importance of patients informing on the services available.
48:11 Heather Wallace reflects on the event and a final request about person-centred care from Eluned Morgan MS.

Additional Resources * Living with Persistent Pain in Wale Guidance * eppcymru.org * All Wales Analgesic Stewardship Guidance * CaseUK * Versus Arthritis * Airing Pain 109 Fibromyalgia * Airing Pain 121: Living with Persistent Pain in Wales * Well-being of Future Generations (Wales) Act 2015

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Is self-compassion a trait or a state of being? This edition is inspired by findings that suggest stronger self-compassion is associated with reduced impact of chronic pain.

Self-compassion, in this sense, is the ability to respond to pain and difficulties with kindness and openness rather than criticism. this episode we ask our artistic contributors, and ourselves, how to step towards achieving self-compassion and the importance of movement in looking after our bodies.

This edition of Airing Pain was made possible by the invaluable contributions of our participating artists who showcased their works at the Edinburgh Fringe Festival, and those in the academic field. We learn the motives behind using dance as a way of supporting those in pain, but also expressing and communicating pain to audiences.

Contributors:

Dr Sarah Hopfinger, Artist and Researcher (Edinburgh Fringe: “Pain and I”)

Victoria Abbott-Fleming MBE, Founder of the Burning Nights CRPS

Dr Emma Meehan, Associate Professor, Centre for Dance Research

Tali Foxworthy Bowers, Choreographer and Movement Director (Edinburgh Fringe: “Monoslogue”)

Jenna Gillett, PhD Student, Department of Psychology University of Warwick

The music used at the beginning of this edition was an original composition for Pain & I by Alicia Jane Turner.

Imagery provided by Sarah Hopfinger.

Time Stamps:

1:35 – Miriam Introduces Sarah Hopfinger’s “Pain and I” performance during Edinburgh’s Festival Fringe, and asks what techniques from the world of dance offer those living with pain?

3:41 – Pacing as a technique. Also see 13:25 for Sarah Hopfinger on pacing.

6:34 – Emma Meehan, at the British Pain Society, on how dancers living with pain approach pain.

8:34 – Introducing Tali Foxworthy-Bowers

15:54 – A huge thank you, and invitation, for filling in our survey

16:20 – Emma Meehan and research into what somatic practices in movement can offer those living with pain.

18:20 – The importance of sharing and telling stories about pain experiences as an act of self-compassion for performers, and mutual connection. See also 25:53 for a continuation of this sentiment from Tali Foxworthy Bowers.

21:25 – Pain catastrophising, how we frame pain, and techniques for being kinder to ourselves with self-love and compassion.

27:54 – Suggestions of how to support those close to you who are living with pain.

31:34 – Emma Meehan discussing agency with pain, as showcased at the British Pain Society ASM 2023.

35:10 – The role of charities in patient support, and what else can charities be doing?

37:27 – Chronic pain is chronic strength: acceptance of pain as part of the bodies we love and care for.

Additional Resources:

Burning nights

NHS Resources

Somatic Practice

Dr Meehan's Book: Performing Process

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This edition of Airing Pain was prompted by the 2022 NICE Guidelines which followed a Public Health England report (2019) looking at medicines associated with dependence and withdrawal.Read transcript

This new legislation follows increased concerns in high levels of prescribing.

This edition discusses the challenges and opportunities of de-prescribing; and poses a shift in focus towards supported self-management and de-medicalising the management of pain for some patients. By this we mean the exploration of alternative therapies and supported self-care customised to individual needs, which come hand-in-hand with any de-prescribing of medicines.

We discuss the incredibly important role of the advanced pharmacist practitioner in adjusting the prescriptions of medicine, and the long-term regular use of pharmacists for these purposes.

Contributors:Dr Emma Davies, Advanced Pharmacist Practitioner specialising in Pain Managemen

Dr Keith Mitchell, Consultant in Pain Medicine at the Royal Cornwall Hospital

Dr Jim Huddy, GP and Clinical Lead for Chronic Pain

This edition of Airing Pain was possible thanks to support from the British Pain Society.

Time Stamps:0:49 – Paul introducing the topic NICE Guidelines 2022, following from a Public Health England report 2019 looking at medicines associated with dependence and withdrawal.

1:38 – Introducing Dr Emma Davies; advanced pharmacist practitioner in pain management, Co-Founder to Living Well With Pain, prescribing for chronic pain, and involved in setting NICE guidelines.

2:46 - Discussing risk-benefit of prescribing an increasing dose of pain management medicines.

6:23 – The problem: knowing the medicines may be harmful but a lack of correct support in place for other ways of living with pain. Reducing this type of medicine must come hand-in-hand with proper support to living well with pain.

7:24 – What does support look like? Alternative therapies and support based on their personalised circumstances.

9:15 – Talk from the Patient Group at the British Pain Society on intersectional problems and barriers to accessing care particularly for socially minoritized individuals and groups.

9:58 – The importance of personalised pain management and how to address this from the perspective of a Pharmacist Practitioner

12:00 – Discussion of possible criticisms of NICE Guidelines

13:28 – Introducing the educational resources Pain Consultants Dr Keith Mitchell and Dr Jim Huddy, at Royal Cornwall Hospital, have put together for prescribers.

14:12 – Introducing Dr Frances Cole’s 10 footstep model to pain management as another possible alternative to prescribing.

15:10 – Personalised care for each patient and supported self-management.

16:26 – Social prescribers and upskilling non-clinicians to provide the support needed towards de-medicalising the management of pain for some cases.

17:27 – Discussion on how to pose non-medical supported self-management to patients, in place of medicalised support.

17:49 – Explaining the Pain Café in Cornwall; the benefit of belonging to a peer group outside of typically medicalised spaces, and the power of sharing challenges and experiences in a common location or setting.

20:00 – Invitation to fill in our survey

20:45 – Advanced pharmacist practitioner, Dr Emma Davis, on the diverse and essential roles pharmacists play in pain management.

21:40 – Introducing the ‘medication review’.

24:18 – Exploring the concept of reaching the limit of helpfulness with multiple cross-over medicines. Thinking about making small reductions in prescribing.

25:52 – Dependence forming medicines as part of the structured medical review, in England.

28:48 – The ‘healing power of a good book’: escapism techniques.

More Information:

Referenced Edition 123: Dr Jim Huddy Royal Cornwall Hospital, in ‘Opioids and Chronic Pain’

The Pain Café in Cornwall

Imagine If – Social Prescribing Team

NICE Guidelines (2022) ‘Medicines associated with dependence or withdrawal symptoms’

Living Well with Pain – Ten Footsteps Programme

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What’s around the corner? This edition of Airing Pain platforms four internationally recognised clinicians from the British Pain Society Annual Scientific Meeting
Recently healthcare technology and innovation has seen a rapid acceleration, particularly following disruption caused by the Covid 19 pandemic. In this edition we look around the corner and examine the most current technological advances for pain therapy, especially those that can be used with or even in replacement of conventional medical treatments.

The Airing Pain team attended the British Pain Society ASM in 2022, to listen and interview top thought-leaders on pain technology advancements and the projects they are working on. Hear them introduce their specialist areas of: new scientific evidence for fibromyalgia; neuropathic pain in the form of phantom limb and post-surgery back pain; and cutting-edge developments in neuromodulation techniques, specifically non-invasive Virtual Reality and Gaming for treating neurological distortions.

Contributors: * Dr Stephen Ward, Chair of Scientific Committee, St Thomas Hospital London * Dr Simon Thomson, Consultant, Pain Medicine and Neuromodulation, Mid and South Essex University Hospitals NHS Trust * Dr Owen Williamson, Pain Medicine Specialist, School of Interactive Arts and Technology at Simon Fraser University Vancouver British Columbia * Dr Timothy Deer, Interventional Pain Doctor West Virginia and President of The Spine and Nerve Centers

Time Stamps:
0:20 – Introductory quotes of internationally recognised Clinicians from the British Pain Society Annual Scientific Meeting (ASM).
1:24 - Introduction by Paul Evans to British Pain Society ASM attendance.
1:58 - Dr Stephen Ward, Chair of Scientific Committee, St Thomas Hospital London, on emerging scientific evidence for the study of Fibromyalgia.
5:16 - Dr Simon Thomson, Consultant, Pain Medicine and Neuromodulation, Mid and South Essex University Hospitals NHS Trust introducing the basics of neuromodulation and neuropathic pain, using secondary back pain as an example.
11:10 – Dr Simon Thomson on the process of Spinal Cord stimulation and equipment.
18:33 - Dr Owen Williamson, Pain Medicine Specialist, School of Interactive Arts and Technology at Simon Fraser University Vancouver British Columbia, on virtual reality (VR) for chronic pain treatment, particularly the uses of VR for painful distortions.
25:05 – Dr Owen Williamson on his talk titled ‘Modifying the Matrix: Virtual Reality’ at the British Pain Society ASM.
30:22 – Dr Owen Williamson on potential drawbacks to using VR Therapy. Followed by a discussion of mitigation techniques; artificial intelligence and body sensors for patient-monitoring in virtual environments.
32:56 - Invitation to fill out our Online Survey
32:42 – Introducing Dr Timothy Deer, Interventional Pain Doctor West Virginia and President of The Spine and Nerve Centers of the Virginias on the future of personalised management and remote home programming to benefit those living with chronic pain.
39:08 - Dr Owen Williamson discussing the optimistic yet cautionary future of virtual reality and wider emerging technologies for pain therapy; the importance of preserving empathy as typically found in the doctor-patient relationship.

Special Thanks:
This edition of Airing Pain was possible thanks to support from the British Pain Society.

More Information:
Airing Pain 61: Deciding Together
Pain Matters 73: Neuropathic Pain Issue
Manage Your Pain leaflet
Chronic Pain and Health Inequalities

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This edition of Airing Pain examines how Covid-19 has impacted on the relationship between patient and healthcare professional.

In the two or so years of living with Covid-19, the face-to-face relationship between doctors and patients was one of the first casualties. With restrictions relaxed, have we returned to the status quo, or has what was developed at breakneck speed led to new working practices?

In 2019, just months before Covid-19 became part of our lives, a workshop, ‘Experts by Experience – Working Together in Pain Management Programmes’ explored an innovative approach to pain management in which patients became integral members within the clinical pain team. Has this relationship survived social isolation and lockdowns?

Contributors include Consultant in Pain Medicine with the University Hospital Southampton NHS Foundation Trust, Dr Cathy Price and Consultant Clinical Psychologist Dr Nick Ambler of the North Bristol NHS Trust, and people living with chronic pain.

Issues covered in this programme include:
COVID, self-management of long-term conditions, peer support, communicating pain, community healthcare, patient volunteer, support group, training course, volunteering and workshops.

Time Stamps:

1:15 –Dr Cathy Price on delivery rapidly changing from face-to-face to online, having to prioritise vital healthcare, and what didn’t work remotely.
6:00 – Dr Cathy Price on the barriers the technology can create.
7:05 – Paul Evans recaps Airing Pain 119 Experts By Experience: Working Together In Pain Management Programmes
10:10 –Dr Nick Ambler talks on the Experts by Experience: Working Together In Pain Management Programmes Workshop.
14:12 –Nick on the service user involvement in delivering Pain Management Programmes and what it means for health professionals.
17:00 –Paul ask Nick how a GP could approach a repeat consultation about pain to create a productive outcome.
19:55 –How the Covid pandemic impacted the work of pain clinics.
22:25 – Paul questions whether post-pandemic approaches to healthcare will revert.
27:00 – Cathy Price on the positive outcomes of working during a pandemic.
28:00 – Nick Ambler on the impact of patients being part of the team.
30:00 – Primrose Granville on her pain management programme experience.

Contributors: * Dr Cathy Price, Consultant in Pain Medicine with the University Hospital Southampton NHS Foundation Trust * Dr Nick Ambler of the North Bristol NHS Trust * Patient-volunteer Primrose Granville, and other people living with chronic pain.

Special Thanks:
This edition of Airing Pain was supported by the British Pain Society and funded by grants from the James Weir Foundation, the Hospital Saturday Fund and the Erskine Cunningham Hill Trust.
More Information:
Pain Matters* 78: managing pain during the coronavirus pandemic * Airing Pain #119 Experts by experience Working Together In Pain Management Programmes * Airing Pain 133: How Group Consultations Can Help Long COVID And Other Conditions

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What is mental defeat and does it have an impact on the experiences of those living with pain?

In this edition of Airing Pain, Paul Evans interviews the team at the Warwick Study of Mental Defeat in Chronic Pain (WITHIN Project) and research participants, as well as taking part in the study as a participant himself.

The study, which runs until May 2023, is investigating how mental defeat can influence pain sensation, sleep patterns, social activity, physical activity and the general health of individuals who have chronic pain.

Mental defeat is defined as the perceived loss of autonomy in the face of uncontrollable, traumatic events. In the context of chronic pain this can be explained as a loss of identity and self in relation to repeated episodes of pain.

Paul talks to the team about their experimental, lab-based study and the sleep-tracking survey, then undergoes the lab experiment himself. Afterwards, he discusses how he found it and the possible outcomes of the research. He also interviews other participants on their experience.

It is hoped that the WITHIN Project will generate important information to help further understand the influence that mental defeat has on distress and disability in chronic pain patients. This is essential listening for anyone wanting to know more about the research process, or wanting to participate.

Issues covered in this programme include: Mental defeat, pain research, insomnia, psychological effects of pain, chronic pain, patient perspective, acceptance and commitment therapy, research participation, pain thresholds.

Time Stamps:
0:25 Dr Nicole Tang, the Principal Investigator, discusses the definition of mental defeat.
1:22 Explanation of the WITHIN Study of Mental Defeat in Chronic Pain.
5:55 Jenna Gillett, PHD student and study researcher, on the relationship between pain and mental defeat.
7:17 Jenna Gillett and Dr Nicole Tang explain the sleep tracker study.
12:19 The impact of the COVID pandemic on the study – adaptations and the unexpected outcomes.
14:00 Participant Lauren Pulsford describes her experience of taking part in the study.
16:00 ProducerPaul Evans meets Research Fellow Kristy Themelis to participate in the lab-based experiment.
20:00 Dr Nicole Tang on the association between chronic pain and Post Traumatic Stress Disorder.
21:00 Exploring what happens to those with chronic pain have a strong sense of mental defeat.
22:00 Explanation of the longitudinal study – looking at sense of defeat, pain and activity over time.
23:00 Jenna Gillett talks about Acceptance and Commitment Therapy and its possible links with mental defeat.
24:00 Back in the lab with Paul Evans and Kristy Themelis, measuring his pain pressure threshold.
27:00 Paige Karadag, research assistant, explains the challenges of recruiting research participants online.
31:30 Paul Evans and Kristy Themelis discuss the experiments that he participated in and how he found it.
35:30 Paige Karadag and Jenna Gillett outline the criteria for research participants for the study, which will be running until May 2023.
39:00 Participant Caroline Perry offers her take on why people should take part.

Contributors: * Dr Nicole Tang, Principal Investigator, WITHIN project, University of Warwick. * Jenna Gillett, PHD student, WITHIN project, University of Warwick. * Lauren Pulsford, research participant with lived experience of chronic pain. * Paul Evans, research participant with lived experience of chronic pain. * Dr Kristy Themelis, Research Fellow, WITHIN project, University of Warwick. * Paige Karadag, Research Assistant, WITHIN project, University of Warwick. * Caroline Perry, research participant with lived experience of chronic pain.

Special Thanks to the WITHIN team at University of Warwick
This edition of Airing Pain has been funded by grants from the Medical Research Council.

More Information: * Warwick Study of Mental Defeat in Chronic Pain * Pain Concern Getting a good night’s sleep leaflet * Pain Matters Magazine * Airing Pain 119: Experts by Experience: Working together in pain management programmes

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How the symptoms of long COVID are being managed using group consultations and the many things long COVID has in common with other long-term conditions.

Now that COVID has become a part of our day-to-day lives, so too has long COVID. So, with so much money now being directed towards researching treatments for long COVID, how might this impact the way we treat all manner of chronic conditions?

In this episode of Airing Pain, Paul Evans interviews the team at the Berkshire Pain Clinic, who run a specific long COVID service, on treating people with the condition. Notably, there are many similarities between the symptoms of long COVID and the symptoms of other long-term conditions, such as fibromyalgia or chronic fatigue syndrome. Issues like managing pain, fatigue, sleep and pacing are not only common in those with long COVID, but those with chronic illness in general. This raises the possibility that the money being spent now on long COVID may have a far wider reaching benefit in the long term.

The team at the Berkshire Pain Clinic have already found success in using group consultations to manage long COVID. Listen, or read the transcript, to find out how these consultations are run and why they are proving so beneficial.

Issues covered in this programme include:

group consultations, long COVID, self-management of long-term conditions, fibromyalgia, fatigue, brain fog, shortness of breath, pacing, sleep problems, building support networks, managing mood problems and goal setting.

Time Stamps:

02:02 – Dr Deepak Ravindran explains how existing knowledge can help us to manage long COVID.

08:22 – Dr Rupa Joshi explains how group consultations can provide support to those with long-term conditions.

11:09 – how did group consultations start at the Berkshire Pain Clinic?

13:50 – Dr Rupa Joshi discusses how both patients and healthcare professionals can learn from group consultations.

14:17 – how do group consultations for long COVID differ from those for other health conditions?

15:33 – Dr Deepak Ravindran on how our understanding of COVID and long COVID have changed.

18:52 – Caroline Mole shares her experience of long COVID, pain and fatigue and how it has impacted her life.

20:25 – Dr Deepak Ravindran shares how his experience of COVID gave him perspective on the experiences of his chronic pain patients.

21:54 – how funding for long COVID can help those living with other long-term conditions.

24:25 – Airing Pain producer Paul Evans shares his experience of fibromyalgia and how it has a lot in common with long COVID.

26:04 – could the treatments we discover for long COVID be used for people with other conditions?

27:13 – Caroline Mole explains what it was like to have a long COVID flare up and her struggles with fatigue.

29:08 – Greg Scott on talking therapies and managing the mental health aspects of long COVID and other conditions.

32:06 – Health and Wellbeing Coach Fatema Hafizji on empowering people with long-term conditions to achieve their goals.

35:54 – Personal Trainer Kerry Doe explains how she supports people to return to exercise following COVID.

40:38 – Saira Mirza on the role of the physiotherapist in managing long COVID and other conditions and the importance of breathing techniques.

Contributors:

Dr Deepak Ravindran, Clinical Lead for Pain Medicine and Clinical Lead for the Berkshire LongCOVID Integrated Service at Royal Berkshire Hospital
Dr Rupa Joshi, Managing Partner at Woodley Centre Surgery
Caroline Mole, who lives with long COVID and is a participant in the long COVID group consultation programme.
Greg Scott, Cognitive Behavioural Therapist for ‘Talking Therapies‘ a psychological service of the Berkshire Healthcare NHS Foundation Trust.
Fetama Hafizji, Health and Wellbeing Coach for the Wokingham North Primary Care Network
Kerry Doe, a personal trainer who works with long COVID patients.
Saira Mirza, Advanced Physiotherapy Practitioner for long COVID and pain management

Special Thanks:

This edition of Airing Pain has been funded by grants from the James Weir Foundation, the Hospital Saturday Fund and the Erskine Cunningham Hill Trust.

More Information:

Pain Matters 78: managing pain during the coronavirus pandemic
Airing Pain 122: the many faces of research and fibromyalgia
Long term effects of coronavirus (long COVID)
Deepak Ravindran Long COVID playlist – Youtube

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How do you identify illness in young children and coping as a family.

This Airing Pain was recorded at the Scottish Network for Arthritis in Children SNAC’s 2022 Family Weekend at Crieff Hydro, which brings together families recently affected by juvenile idiopathic arthritis and some of the country’s leading paediatric rheumatology experts.

Issues covered in this programme include:

juvenile idiopathic arthritis, autoimmune disease, coping as a family, rheumatology, paediatrics, support networks, identifying illness in young children, movement and exercise

Time Stamps:

minutes: seconds

00:00 - introduction to SNAC's family weekend by Sharon Douglas

04:03 - introduction to juvenile idiopathic arthritis by Julie Duncan

07:13 - how does juvenile idiopathic arthritis present?

09:00 - what is SNAC and personal stories from a parent.

12:56 - parent of a child with juvenile idiopathic arthritis shares how they first spotted it.

14:42 - Vanessa Raimondo discusses medication options for juvenile idiopathic arthritis.

18:44 - parents & children share their stories.

21:33 - Vanessa Raimondo discusses medication side effects.

23:57 - Alison Ross discusses coping mechanisms for juvenile idiopathic arthritis & more on medications and treatments.

30:23 - parent of a child with juvenile idiopathic arthritis on her daughter's journey with JIA, medications and diagnosis.

31:15 - coping as a parent of a child with juvenile idiopathic arthritis.

31: 54 - coping with juvenile idiopathic arthritis as a family

34: 29 - parents of a child with juvenile idiopathic arthritis share their family's story.

39:10 - how does juvenile idiopathic arthritis make the children who suffer from it feel?

41: 18 - family from Shetland share their story of having a child with JIA in a remote area.

43:27 - Jo Walsh tells us about SPARN (Scottish Paediatric & Adolescent Rheumatology Network) and how they support families with JIA.

47:00 - how to handle the transition from children's health services to young adult services.

48:06 - Vanessa Raimondo tells us about what we can do (aside from medications) to manage JIA.

49:27 - young person shares their experience of juvenile idiopathic arthritis and still enjoying sports, exercise and success growing older with JIA.

54:20 - Sharon Douglas, chairperson and co-founder of SNAC, conclusion and raising awareness about JIA.

Special Thanks:

This programme exists due to funding from Trefoil House Organisational Grants, the New Park Educational Trust and WCH Trust for Children.

Contributors:

Parents (and their children) of 23 children between the ages of 5 and 14 who have juvenile idiopathic arthritis.
Sharon Douglas - SNAC (Scottish Network for Arthritis in Children) chairperson & co-founder.
Julie Duncan – General Paediatrician NHS Lothian District General Rheumatology Clinic.
Vanessa Raimondo - Rheumatology Nurse based in Edinburgh.
Alison Ross – Children’s Arthritis Nurse working in Aberdeen.
Jo Walsh – Paediactric Rheumatologist based in Glasgow, working as part of SPARN (Scottish Paediatric and Adolescent Rheumatology Network).

More Information:

SNAC - Supporting Children & Families with JIA
Versus Arthritis
SPARN - Scottish Paediatric & Adolescent Rheumatology Network
Airing Pain 106 - Pain Education for Doctors, Patients and Parents
Airing Pain 99 - Transition Services for Adolescents with Chronic Pain
Airing Pain 78 - Putting Children's Pain in the Picture
Airing Pain 59 - Pain in the Family: Young Adults 1 of 2
Airing Pain 60 - Pain in the Family: Young Adults 2 of 2

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What causes different types of face pain and what treatment is available?In this episode of Airing Pain we cover facial pain in its many forms, what treatments are available and how to cope better with your pain.

Funded by The Hospital Saturday Fund.

In collaboration with UCLH Royal National ENT & Eastman Dental Hospitals. The way our face feels and how we move it is a massive part of our identity. Feeling pain in the face, or not being able to use your face the way you want to, is not only a physical burden on the person suffering, but a heavy psychological load to cope with as well.

Issues covered in this programme include:facial pain, unnecessary dental treatments, tooth ache, face and identity, management techniques, trigeminal neuralgia, neuropathic pain, carbamazepine, neurosurgery, pain management programmes, psychology and pain, temporomandibular disorder, burning mouth syndrome, persistent idiopathic facial pain, central sensitisation syndrome, physiotherapy, acceptance & commitment therapy

Time Stamps:

01: 54 - Trigeminal neuralgia (TN): what is it and what does it feel like? Dr Joanna Zakrzewska explains.

06:27 - Dr Zakrzewska discusses what treatments are available for TN, including carbamazepine.

10:37 - How can neurosurgery help treat TN?

18:11 - Psychology Pain Management Programmes (PMPs) for sufferers of TN.

19:11 - Susie Holder on the psychological impact of face pain.

21:36 - Dr Roddy McMillan discusses temporomandibular disorder (TMD) as a source of face pain.

22:29 - Burning mouth syndrome and other types of face pain.

25:50 - Treatments available for other types of face pain.

28:30 - TMD and how it is different from other types of face pain (usually neuropathic in origin).

30:00 - What is central sensitisation syndrome?

32:21 - Pain management for chronic pain sufferers.

36:05 - Susie Holder explains what acceptance and commitment therapy (ACT) is.

44:07 - Obstacles to living well with pain, including the coronavirus pandemic.

Contributors:

Dr Joanna Zakrzewska, consultant in oral medicine specialising in trigeminal neuralgia at the Department or Oral Medicine and Facial Pain at the UCLH NHS Foundation Trust.
Susie Holder, clinical psychologist on the facial pain team at the Royal ENT and Eastman Dental Hospitals, UCLH NHS Foundation Trust.
Dr Roddy McMillan, consultant in oral medicine and facial pain at the Royal ENT and Eastman Dental Hospitals, UCLH NHS Foundation Trust.

More Information:

Pain Matters magazine issue 77: face the pain
Airing Pain 12: Trigeminal Neuralgia, Pelvic Pain & Cannabis
Airing Pain 115: Neuropathic pain 1 of 2, targeted Pain Management Programmes
Airing Pain 116: Neuropathic pain 2 of 2, latest research
My live well with pain
Trigeminal Neuralgia Association UK

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Scotland’s Pain Management Programmes (PMPs) and what support is available after graduating.

This edition of Airing Pain has been funded by a grant from the Health and Social Care Alliance Scotland Self Management Fund administered on behalf of the Scottish Government.What do you know about Pain Management Programmes (PMPs)? Do you know how they function? About the positive outcomes they have? Do you know if there are any PMPs near you?

In this episode of Airing Pain we learn about PMPs and the communities and support networks that are being formed as a result.

In collaboration with Health Unlocked and Alliance Health and Social Care Scotland, Pain Concern have created a small number of online forums designed for people who have graduated a PMP to stay connected and continue to support one another once the programme has ended. These forums are open only to PMP graduates. Not only can graduates communicate with one another on our Health Unlocked forums, they can also communicate with the healthcare professionals who delivered their PMP.

For Pain Concern this is a preliminary experiment to determine whether forums like these are beneficial, and if we should create more!

Paul Evans speaks to Health Unlocked moderator and PMP graduate Louise Cromie about all things Pain Management Programmes, how support networks can be pivotal in someone’s pain journey and, of course, about our Health Unlocked forums.

Issues covered in this programme include:pain management programmes, self-management, supporting one another in pain, pain community, pain education, the spoon theory, managing pain in a crisis, fatigue, burnout

Time Stamps:

00:21 – Louise Cromie & Paul Evans discuss the origins of the Health Unlocked forums.

01:13 – Louise Cromie shares her own journey with chronic pain.

03:37 – When doctors tell you ‘there’s nothing we can do’ & the vital role specialist pain teams can play.

06:05 – Being believed & having your pain experience validated.

08:36 – A biopsychosocial approach to pain & how to break the cycle of doing too much on good days, then paying for it after.

11:02 – How to manage your pain in unforeseen circumstances.

12:44 – How do Pain Management Programmes (PMPs) help people in pain.

14:53 – The mask we wear when we’re in pain & learning how to lower it.

20:43 – Helping those around you learn about pain & how to be supportive.

22:50 – How to continue coping once a Pain Management Programme ends.

25:14 – How did Pain Concern get involved in supporting PMP graduates?

27:08 – Louise Cromie on becoming a Health Unlocked forum moderator.

Contributors:

Louise Cromie, current Moderator for the Health Unlocked Forum & graduate of a Pain Management Programme (PMP).

More information:

Scottish National Residential Pain Management Programme
Greater Glasgow & Clyde Pain Management Programme
‘The Spoon Theory’ & other self-help resources from Great Western Hospitals NHS Foundation Trust
Pain Concern Health Unlocked
Pain Management Programmes NHS

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Determining what Shingles really is and why vaccine uptake is so low?

This edition of Airing Pain has been funded by a grant from The RS Macdonald Charitable Trust and The Stafford Trust

What exactly is Shingles? We often hear it thrown into conversation alongside a virus many of us have already had: Chickenpox. So how are the two linked? Why is one more associated with young people and the other with older people? The answer is they are both infections caused by the varicella-zoster virus. The vast majority of us had the Chickenpox virus when we were children, with many parents even intentionally exposing their children to the virus. Shingles, on the other hand, occurs after someone has already had Chickenpox when the virus (which remains in the body) is reactivated.

One of the main worries people have about having Shingles is the potential to develop Post Herpetic Neuralgia (PHN). This is defined as persistent pain 3 months after the initial rash developed. Unfortunately PHN is a chronic condition which causes burning neuropathic pain. This condition is caused by the damage the virus inflicted during its reactivation.

Paul Evans speaks to health professionals and somebody with lived experience of Shingles & PHN in order to illuminate the intricacies of the varicella-zoster virus, how it works and how it affects us throughout our lives.

Time Stamps

1:55 - Dr Michael Serpell speaks: What is Shingles and how does it affect us?

6:15 - Dr Robert Johnson speaks: What is Post Herpetic Neuralgia (PHN)?

11:35 - Jan Fisher, who has lived with PHN for 8 years, speaks about her experience.

14:55 - Marian Nicholson from the Shingles Support Society speaks: Shingles awareness, treatment & what to do if you think you have Shingles?

16:55 - Dr Robert Johnson speaks about treatment for Shingles & PHN.

20:05 - Jan Fisher elaborates on her own experience of medication for PHN.

21:25 - Dr Michael Serpell on what you can expect from PHN treatment & pain management techniques.

26:10 - Dr Robert Johnson discusses the Shingles vaccination.

26: 45- Marian Nicholson speaks about the rollout of the Shingles vaccination and who is eligible.

27:45 - Dr Robert speaks about the low uptake of the vaccine and why it's important to get it.

33:11 - Dr Robert Johnson on amitriptyline and studies on preventing PHN.

35:15 - Final words from Jan Fisher on why you should get the Shingles vaccine.

Issues covered in this programme include:Shingles, Chickenpox, varicella-zoster virus, neuropathic pain, Post Herpetic Neuralgia, pain management, virus reactivation, insomnia, vaccination, vaccine uptake, side effects, amitriptyline, Gabapentinoids, depression.

Contributors:

Dr Michael Serpell, Consultant in Anaesthesia & Pain Medicine at Stobhill Hospital Glasgow.
Marian Nicholson, Director of the Herpes Viruses Association & Shingles Support Society.
Dr Robert Johnson, Honorary Senior Research Fellow, Bristol Medical School, University of Bristol.
Jan Fisher, had the Shingles virus & lives with Post Herpetic Neuralgia.

More information:

Shingles Support Society
Airing Pain 46: Post-Herpetic Neuralgia and Migraine
Airing Pain 115: Neuropathic Pain 1
Airing Pain 116: Neuropathic Pain 2
Pain Concern’s leaflet on Neuropathic Pain
Herpes Viruses Association
NHS Guidance for Shingles
British Pain Society
IASP Global Year Against Neuropathic Pain 2014-15

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Looking into one of the most globally prevalent types of pain, back pain, and exploring different cultural attitudes towards pain.

This edition of Airing Pain was created in association with the International Association for the Study of Pain (IASP) and has been funded by the Plum Trust.Back pain is one of the most common types of pain that people report. It can arise due to any number of causative factors and can occur in any part of the back. Lower back pain and Sciatica are particularly common and affect approximately 577 million people globally.

In this episode of Airing Pain we have collaborated with the International Association for the Study of Pain (IASP) who are dedicating their global year 2021 to back pain. 2021 Global Year About Back Pain - IASP (iasp-pain.org)

We also dedicate a portion of the episode to useful pain management advice that will benefit anybody living with pain, including those with back pain.

Time Stamps

2:00 – Pain Patient Advocate Mary Wing from GAPPA speaks: what is GAPPA?
5:25 – IASP Global Year about Back Pain.
6:20 – Physiotherapist Otieno Martin Ong'wen speaks: global attitudes towards pain and therapeutic exercise.
14:00 - Clinical Research Project Assistant Vina Mohabir speaks: Living with long-term pain and attending pain clinics and the ‘3 P Method’.
19:31 – Otieno Martin Ong’wen speaks: on fostering patient empowerment.
22:05 – Vina Mohabir speaks: on communicating your pain and masking pain.
23: 55 – Mary Wing speaks: on her experience with pain, pain psychology and pain management courses.
26:46 - Otieno Martin Ong’wen speaks: on how different cultural approaches impact psychological therapies for the treatment of pain and therapeutic exercise.
39:56 – Final words from Vina Mohabir.

Issues covered in this programme include: pain from a global perspective, pain in developing countries, Global Alliance of Partners for Pain Advocacy (GAPPA), chronic condition management, back pain, IASP Global Year about Back Pain, self-management approaches, physiotherapy, therapeutic exercise, pain in rural areas, physical strategies, pharmaceutical strategies, psychological strategies, the ‘3 P Method’, masking pain, pain psychology.

Contributors:

Mary Wing, Pain Patient Advocate, Global Alliance of Partners for Pain Advocacy (GAPPA), Australia.
Otieno Martin Ong’wen, Orthopedic Manual Therapist, Movement Dysfunction Specialist, Physiotherapist, Afyafrica Orthopedic Services, Nairobi.
Vina Mohabir, Clinical Research Project Assistant, The Hospital for Sick Children, Toronto.

More information:

IASP Global Year About Back Pain 2021

With thanks to:

IASP, International Association for the Study of Pain – https://www.iasp-pain.org/

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This edition of Airing Pain has been funded by educational grants from The R. S. Macdonald Charitable Trust and The Stafford Trust.Do you, someone you care for or perhaps your patients, suffer from persistent burning or gnawing pain? Many don’t know that often, neuropathic pain presents as a burning sensation. Persistent pain can impact all areas of our lives. It can stop us from sleeping, working and pursuing the hobbies we enjoy. Unfortunately, sometimes the healthcare professionals we see about our pain are unaware of the multitude of pain management techniques we can adopt to try and minimise the impact pain has on our lives. Different types of pain are widely misunderstood and many of us don't know much about the conditions that can cause them.

What do you think of when you think of Parkinson's Disease? Many would say a tremor or shaking limbs, but persistent pain can be one of the most debilitating symptoms of Parkinson's Disease. The fastest growing neurological condition in the world is poorly understood and pain is a major unmet need in those who live with it.

Ground-breaking studies funded by the charity Parkinson's UK are shedding new light on the relationship between Parkinson's pain and neuropathic pain. Persistent pain that affects people who have Parkinson's Disease is widely misunderstood and something that many of us are entirely in the dark about. If you suffer with Parkinson's, the chances are you will be all too familiar with the burning, gnawing pain associated with the disease.

In this programme Paul Evans speaks to Kirsty Bannister, a doctor of neuroscience at Kings College London, who discusses the role that 'pain-blocking nerve pathways' and psychological status play for those who experience chronic pain. We also hear from former primary school teacher Janet Kerr, who shares with us her own experience of dealing with Parkinson's Pain and how she manages it with things like yoga and distraction techniques such as massage.

Contributors:

Carol Vennard, Clinical Nurse Specialist in Parkinson's Disease Nurse Specialist, NHS Greater Glasgow and Clyde
Janet Kerr, ex-primary school teacher who lives with Parkinson’s Disease
Kirsty Bannister, Senior Lecturer and Principal Investigator at the Institute of Psychiatry, Psychology & Neuroscience, Kings College London.

More information:

Parkinson’s UK
Airing Pain 115: Neuropathic Pain 1
Airing Pain 116: Neuropathic Pain 2
Pain Concern’s leaflet on Neuropathic Pain
Institute of Neurological Sciences, Neurology in NHS Greater Glasgow and Clyde
Senior Lecturer and Principal Investigator Kirsty Bannister’s key publications
Finding a Parkinson’s Nurse - https://www.parkinsons.org.uk/information-and-support/parkinsons-nurses
IASP Global Year Against Neuropathic Pain 2014-15
Stress Management Society, Stress Awareness Month April 2021.

With thanks to:

IASP, International Association for the Study of Pain – https://www.iasp-pain.org/
The British Pain Society, An alliance of professionals advancing the understanding and management of pain for the benefit of patients – https://www.britishpainsociety.org/.

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This edition has been funded by the Women’s Fund for Scotland.

The Coronavirus pandemic has been long and isolating for everyone, but particularly for those who experience abuse. The pandemic and subsequent lockdowns have seen an increase in the level and severity of domestic abuse.

In this episode of Airing Pain, our host Paul Evans discusses the isolating effects of Covid-19, trauma and how this can contribute to the development of debilitating chronic illnesses such as Fibromyalgia and Chronic Fatigue Syndrome.

An article by author and domestic abuse survivor Kath Twigg will accompany this extended episode of Airing Pain. You can read all the related articles from related to this programme in this issue of Pain Press, our free online supplement.

Contributors:

Kath Twigg, Senior Lecturer in social work, trainer, mentor, writer, and domestic abuse survivor
Dr Lene Forrester, Clinical Psychologist at Albyn Hospital, Aberdeen
Dr Joht Singh Chandan, Academic Clinical Lecturer at the Murray Learning Centre, University of Birmingham
Dr Kate Gillan, Clinical Psychologist for NHS Greater Glasgow and Clyde
Professor. Caroline Bradbury-Jones, head of Gender-Based Violence and Health at the University of Birmingham.

More Information:

Zero Tolerance - www.zerotolerance.org.uk
NHS Greater Glasgow & Clyde, How can the Pain Management Service help you? (PDF) - https://www.nhsggc.org.uk/media/259486/leaflet-how-can-the-glasgow-pain-service-help-you.pdf
Scottish Government, Important advice for people with chronic pain (PDF) -https://www.gov.scot/binaries/content/documents/govscot/publications/advice-and-guidance/2020/03/coronavirus-covid-19-tailored-advice-for-those-who-live-with-specific-medical-conditions/documents/chronic-pain/chronic-pain/govscot%3Adocument/Patient%2BInformation%2BLeaflet%2B-%2Bfor%2Bpeople%2Bwith%2Bchronic%2Bpain%2B-non-shielding%2B061120.pdf
NHS Greater Glasgow & Clyde, Pain Services - https://www.nhsggc.org.uk/your-health/health-services/chronic-pain/information-and-resources-for-patients/
Heads Up - http://www.headsup.scot/
Mind - https://www.mind.org.uk/
Mind, Post-traumatic stress disorder (PDF) - https://www.mind.org.uk/media-a/2950/ptsd-2018.pdf
Mind, Post-traumatic stress disorder - https://www.mind.org.uk/information-support/types-of-mental-health-problems/post-traumatic-stress-disorder-ptsd/complex-ptsd/
Scottish Women’s Aid - https://womensaid.scot/
Refuge - https://www.refuge.org.uk/
Refuge, Support for men - https://www.refuge.org.uk/get-help-now/help-for-men/
Scottish Women’s Rights Centre - https://www.scottishwomensrightscentre.org.uk/.

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This edition has been supported with a grant from Kyowa Kirin donated for this purpose.

While opioids are seen as an effective treatment method for acute pain, there is an increasing debate on the efficacy of opioids when treating chronic pain conditions. One of the most common side effects of long-term opioid usage is constipation. Conditions like irritable bowel syndrome are more common in people who are living with chronic pain conditions, so better understanding of the connection between opioids and constipation is key for medical professionals currently working with chronic pain patients.

Following on from Airing Pain 123, this edition sees Paul Evans speaks to Dr Maria Eugenicos, who is a gastroenterologist at the University of Edinburgh. Dr Eugenicos starts by outlining the different conditions that are treated at her gastro-intestinal clinic and how these conditions can present. Dr Eugenicos then discusses the prevalence of opioid-induced constipation in clinical patients and how shifting treatment methods and properly educating patients on their conditions can help to improve their standard of living.

Contributors:

Dr Maria Eugenicos, Senior Lecturer/Gastroenterologist at the Western General Hospital Gastroenterology Department, University of Edinburgh
Dr Cathy Stannard, Consultant in Pain Medicine and Pain Transformation Programme Clinical Lead for NHS Gloucestershire Clinical Commissioning Group.

More information:

Airing Pain 123 – painconcern.org.uk/airing-pain-123-opioids-and-chronic-pain/
The IBS network – theibsnetwork.org
British Pain Society – britishpainsociety.org
IASP Global Year for the Prevention of Pain 2020 – iasp-pain.org/GlobalYear.

With thanks to:

Maggie’s Centre, a resource network designed to help cancer patients and their families – maggies.org.

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This edition has been supported by a grant from The Champ Trust and Foundation Scotland.

According to the most recent Scottish Diabetes Survey in 2018, there are an estimated 304,000 people living with a diagnosis of diabetes in Scotland, around 5% of the population. A long-term effect of diabetes can be the development of diabetic neuropathy. This edition of Airing Pain focuses on neuropathic pain in people with diabetes, and how the X-PERT diabetes courses helps people to deal with the complications that arise when living with diabetes.

First up, Paul Evans speaks to David Bennett, Professor of Neurology at the University of Oxford, who outlines the differences between type 1 and type 2 diabetes and how the initial treatment plan differs between the types. Professor Bennett then goes on to describe how neuropathy develops in people living with diabetes and how neuropathic pain manifests.

Paul then talks with Steve Sims, who lives with diabetic neuropathy as a result of type 2 diabetes. Paul and Steve discuss how they have adjusted their diets to deal with type 2 diabetes and how the X-PERT diabetes course has helped them to adjust to living with diabetes.

Contributors:

Professor Dave Bennett, Professor of Neurology, Nuffield Department of Clinical Neurosciences, University of Oxford
Steve Sims, Secretary, Cardiff Diabetes Group.

More information:

The X-PERT diabetes courses – diabetes.co.uk/education/x-pert.html
British Pain Society – britishpainsociety.org
Pain Concern leaflet on Neuropathic Pain – painconcern.org.uk/neuropathic-pain
Pain Concern leaflet on Diet and Pain – painconcern.org.uk/diet-and-pain/
IASP Global Year for the Prevention of Pain 2020 – iasp-pain.org/GlobalYear.

With thanks to:

The British Pain Society (BPS), who facilitated the interviews at their Annual Scientific Meeting in 2019 - britishpainsociety.org
The International Association for the Study of Pain (IASP) iasp-pain.org
Diabetes UK, a leading UK charity that involves sharing knowledge on diabetes - www.diabetes.org.uk/.

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This edition has been supported by a grant from Kyowa Kirin.

The opioid crisis reached its peak in the United States in 2017, where addiction and overprescription have led to 218,000 deaths from prescription overdoses between the years of 1999 and 2017. The side effects of opioids can affect the day-to-day activities of people managing long-term or chronic pain, yet society as a whole has yet to fully evaluate the relationship between opioids and addiction.

In this edition of Airing Pain, producer Paul Evans talks to two leading pain specialists. First off, Paul Evans meets with Dr Srinivasa Raja, who discusses opioids effects on the body’s opioid receptors and how the human body processes pain. Dr Cathy Stannard then talks about the increase of opioid prescriptions in the UK and how the opioid crisis in the United Kingdom developed.

In the second half of the programme, Paul speaks with Louise Trewern, a chronic pain patient and patient advocate, about opioids’ detrimental effect on her quality of life and how she was able to transition towards more effective methods of chronic pain management.

Finally, Paul sits down with Dr Jim Huddy, a GP in Cornwall, who explains how the medical community is re-evaluating the relationship between opioids and chronic pain.

Contributors:

Dr Srinivasa Raja, Professor of Anaesthesiology and Critical Care Medicine and Neurology at the Johns Hopkins University School of Medicine, Maryland, USA
Dr Cathy Stannard, Consultant in Pain Medicine and Pain Transformation Programme Clinical Lead for NHS Gloucestershire Clinical Commissioning Group
Louise Trewern, Vice Chair of the Patient Voice Committee at the British Pain Society
Dr Jim Huddy, Cornwall GP and Clinical Lead for Chronic Pain at NHS Kernow Clinical Commissioning Group.

More information:

British Pain Society – britishpainsociety.org
Opioid prescribing for chronic pain guidance – england.nhs.uk/south/info-professional/safe-use-of-controlled-drugs/opioids
Faculty of Pain Medicine’s opioids resources – fpm.ac.uk/opioids-aware.

With thanks to:

The British Pain Society (BPS), who facilitated the interviews at their Annual Scientific Meeting in 2019 - britishpainsociety.org
The International Association for the Study of Pain (IASP) iasp-pain.org.

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This editionhas been supported with a grant from The Mirianog Trust donated for this purpose. It was recorded at the end of April 2020, the second month of the UK’s Covid-19 lockdown. All interviews were recorded prior to the crisis.As research for a Covid-19 vaccine is a priority for the scientific community, this edition of Airing Pain focuses on the roles of researchers, and in particular the many disciplines that come together to increase the understanding, and therefore the management of chronic pain.

First up, Paul Evans speaks to neurologist Claudia Sommer, whose research into fibromyalgia opens debate as to whether the condition should be treated as neuropathic pain.

Physiotherapist David Easton then talks about the research-led ESCAPE PAIN rehabilitation exercise programme for people with osteoarthritis in their hips or knees.

And finally, Paul visits the University of Bristol, where neuroscientist Bridget Lumb talks of the need for further research into the link between familiar contact and social interaction with chronic pain – particularly relevant at a time of social distancing – and social anthropologist Rachael Gooberman-Hill explains the role of the anthropologist in health and pain research.

Contributors:

Dr Claudia Sommer, Professor of Neurology at the University of Würzburg in Germany and President-Elect of the International Association for the Study of Pain
David Easton, Physiotherapist at the Hywel Dda University Health Board in West Wales
Dr Bridget Lumb, Professor of Neuroscience at the University of Bristol
Dr Rachael Gooberman-Hill, Professor of Health and Anthropology and Director of the Elizabeth Blackwell Institute for Health Research at the University of Bristol.

More information:

Fibromyalgia Action UK - fmauk.org

With thanks to:

The British Pain Society (BPS), who facilitated the interviews at their Annual Scientific Meeting in 2019 - britishpainsociety.org
The International Association for the Study of Pain (IASP) iasp-pain.org.

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This edition has been partially funded by an educational grant from Grünenthal Limited, donated for this purpose.In April 2019, the Minister for Health and Social Services in Wales launched the guidance document Living with Persistent Pain in Wales. Later, in December, the Chronic Pain Policy Coalition brought together some of Wales’s leading pain experts at the home of the Welsh parliament (or Senedd Cymru) in Cardiff, at an event chaired by Neil Betteridge, co-chair of the Chronic Pain Policy Coalition, a group which brings together a wide range of chronic pain stakeholders including professional bodies, patient organisations, parliamentarians and industry representatives from across the UK.

This edition of Airing Pain was recorded live at the event, where clinicians, academics, policy-makers and people living with pain came together to discuss both the new document and the future of chronic pain services across the region.

With thanks to the Chronic Pain Policy Coalition, the Welsh Government and the conference organisers for facilitating the recording of this event.

Contributors:

Neil Betteridge, Co-Chair, Chronic Pain Policy Coalition
Dr Paul Cameron, Specialty Advisor to the Chief Medical Officer for Scotland
Professor Ernest Choy, Head of Rheumatology, Cardiff University
Mary Cowern, Wales Director, Versus Arthritis
David Easton, Physiotherapist, Hywel Da NHS Trust
Dr Lucy Morris, GP partner, Bellevue Practice, Newport
Professor Ann Taylor, Professor in Medical Education, Cardiff University.

More information:

The Chronic Pain Policy Coalition – chronicpainpolicycoalition.com
Versus Arthritis – versusarthritis.org
Welsh Pain Society – welshpainsociety.org.uk
Living with Persistent Pain in WalesPDF guidelines.

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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 patients.

Paul also speaks to Sarah Leyland, Nurse Consultant at the Royal Osteoporosis Society, about the new focus on prevention, mainly in terms of lifestyle changes and developing a model of care designed to identify people who are at higher risk of osteoporotic fractures. She also describes the range of physical exercises she has developed to reduce the risk of fractures and help with pain after fractures.

Contributors:

Dr Emma Clark, Rheumatology & Osteoporosis Consultant at North Bristol NHS Trust
Sarah Leyland, Osteoporosis Nurse Consultant at the Royal Osteoporosis Society.

More information:

Royal Osteoporosis Society - ros.org.uk

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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 funny, relatable and inspiring testimony of how volunteering with her PMP has transformed and empowered her life and experience of pain.

Dr Debbie Joy, Clinical Psychologist and Clinical Lead of Pain Services for NHS Solent Trust, addresses some of the initial anxieties she had around the introduction of patient-volunteers to a clinical setting, but ultimately asserts that they are ‘definitely stronger with experts by experience by their side’.

Pain coaches for NHS Dorset – Penny and Debbie – offer constructive advice for professionals and volunteers on how you pain coach and engage with people living with pain effectively and sympathetically.

The founder of Glasgow Community Pain Education Sessions – John Bremner, talks about how this model of expert by experience in action works, and how they run it ethically and effectively. Lindsay talks about how rewarding an experience it has been, volunteering as a pain trainer for this initiative, encouraging others to get involved.

The symposium ends with the group sharing their experiences and insights in an open floor discussion.

Contact your GP or relevant pain management programme if you are interested in volunteering.

Contributors:

Dr Nick Ambler, Consultant Clinical Psychologist for the North Bristol NHS Trust’s Pain Management Programme
Primrose Granville, person living with pain and patient volunteer with the North Bristol NHS Trust Pain Management Programme
Dr Deborah Joy, Clinical Psychologist and Clinical Lead of Pain Services for the NHS Solent Trust
Penny and Debbie, pain coaches for the Dorset NHS Trust
John Bremner, person living with pain, pain trainer and founder of Glasgow Community Pain Education Sessions
Lindsay, person living with pain and pain trainer for Glasgow Community Pain Education Sessions
Dr Martin Dunbar, Clinical Lead and Consultant Psychologist for NHS Great Glasgow and Clyde.

More information:

Airing Pain 32:Pain Management Programmes
Glasgow Community Pain Education Sessions
Volunteer from home with Pain Concern: painconcern.org.uk/get-involved/volunteer/.

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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 impact on siblings and the rest of the family.

Dr Gauntlet-Gilbert also talks about the Centre’s commitment to transitional support for individuals between adolescence and adulthood as well as beyond. This edition concludes with the parents and young people delivering their verdict on the Bath Centre for Pain Services’ programme. One that indicates it is a very hard but rewarding process, with the young people clearly finding enjoyment in their time there.

Contributors:

Dr Jeremy Gauntlet-Gilbert, Principal Clinical Psychologist at the Bath Centre for Pain Services
Louise Bailey, parent
Sandra McCann, parent
Amyra, young person
Taylor, young person.

More information:

Bath Centre for Pain Services: www.bathcentreforpainservices.nhs.uk/.

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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, are encouraging patient involvement. Specifically, Julie talks about the University of Keele’s efforts to improve primary care with their programme PROMPPT.

Finally, Paul discusses the future work required to challenge the “doctor knows better” attitude excluding patients from influencing the treatment of their condition for future generations.

Contributors:

John Norton, patient
Mark Farmer, patient
Louise Trewern, member of the BPS Patient Liaison Committee
Margaret Whitehead, past co-chair of the BPS Patient Liaison Committee
Julie Ashworth, Senior Lecturer University of Keele and Honorary Consultant at the Community Pain Service with Midlands Partnership Foundation Trust.

More information:

INVOLVE, National Institute for Health Research, https://www.invo.org.uk/
National Voices, https://www.nationalvoices.org.uk/
Citizen Science Association, https://www.citizenscience.org/
BPS Patient Liaison Committee https://www.britishpainsociety.org/about/bps-committees/
Proactive clinical Review of patients taking Opioid Medicines long-term for persistent Pain led by clinical Pharmacists in primary care Teams (PROMPPT) https://www.promppt.co.uk/.

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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 fromAiring 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 Department of Pain Medicine, Division of Anaesthesiology and Critical Care, The University of Texas MD Anderson Cancer Centre, Houston
Professor Srinivasa Raja (John Hopkins School of Medicine, USA).

More information:

Neuropathic pain fact sheets and support, IASP https://www.iasp-pain.org/GlobalYear/NeuropathicPain
News, information and support at RELIEF, IASP Pain Research Forum https://relief.news/
The University of Texas MD Anderson Cancer Centre https://www.mdanderson.org/?_ga=2.205594646.486343381.1563359882-181156349.1563359882
Neuropathic Pain information, National Institute for Health and Care Excellence (NICE), https://www.nice.org.uk/search?q=Neuropathic+pain.

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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 comfort zone.

Contributors:

Dr Clare Daniel, Consultant Clinical Psychologist, Buckinghamshire Healthcare NHS Trust
Diarmuid Denneny,Physiotherapy Lead at the National Hospital for Neurology and Neurosurgery Pain Management Centre in London
Professor Srinivasa Raja, Johns Hopkins School of Medicine, USA
Cameron Rashide, person living with pain.

More Information:

Neuropathic Pain - Explanations and support at The National Hospital for Neurology and Neurosurgery Pain Management Centre in London - https://www.uclh.nhs.uk/OurServices/ServiceA-Z/Neuro/PMC/Pages/Home.aspx.

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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.

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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 Lecturer in English, Manchester Metropolitan University
Zoe Lambert, Lecturer, English and Creative Writing, Lancaster University.

More information:

Translating Chronic Pain website: http://wp.lancs.ac.uk/translatingpain/.

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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 ‘More Information’ below), a way for patients to measure their brain’s alpha waves, which are important in controlling sensory experiences. The research could have significant implications in pain management. The team are employing a unique collaborative theatre piece, Pain, the Brain and a Little Bit of Magic to help patients, healthcare professionals, and the public to understand these complex systems.

Contributors:

Professor Mark Johnson, Professor of Pain and Analgesia and Director of the Centre for Pain Research, Leeds Beckett University
Professor Anthony Jones, Professor of Neuro-rheumatology at Manchester University, Human Pain Research Group Lead, creator of Pain, the Brain, and a Little Bit of Magic.

More information:

University of Manchester neurofeedback study volunteering - http://research.bmh.manchester.ac.uk/pain/ and click the 'Want to Volunteer?' tab at the top of the page
Pain, the Brain, and a Little Bit of Magic - https://www.manchester.ac.uk/discover/news/pain-the-brain-and-a-little-bit-of-magic-as-research-goes-from-lab-to-stage/.

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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 conversations between patients and their healthcare professionals, something which Pain Concern’s Navigator Tool aims to do.

We hear again from Professor Mark Johnson of Leeds Beckett University, contributor to Airing Pain 110, about the importance of delivering healthcare with a social emphasis.

Contributors:

Alison Rose MCSP HCPC, Director of CSPC Physiotherapy, Leeds
Professor Ann Taylor, Programme Director for the MSc in Pain Management at Cardiff University
Professor Mark Johnson, Professor of Pain and Analgesia and Director of the Centre for Pain Research, Leeds Beckett University.

More information:

NHS England site on Social Prescribing: https://www.england.nhs.uk/personalisedcare/social-prescribing/
Men's Sheds: https://menssheds.org.uk/
Talking to Your Doctor, Pain Concern's Navigator Tool: http://painconcern.org.uk/talking-to-your-doctor-3/.

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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 therapy. Professor Johnson talks Paul about the mechanisms of these treatments and their various limitations and strengths.

Contributors:

Professor Mike Bennett, St. Gemma's Professor of Palliative Medicine, University of Leeds
Professor Kate Grafton, Principal Lecturer and Professional Lead for Physiotherapy, Leeds Beckett University
Professor Mark Johnson, Professor of Pain and Analgesia and Director of the Centre for Pain Research, Leeds Beckett University.

More information:

Cancer Research UK: https://www.cancerresearchuk.org/
Macmillan Cancer Support: https://www.macmillan.org.uk/
Shine Cancer Support: http://www.shinecancersupport.org/.

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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, yoga, and mindfulness as self-management techniques.

Contributors:

Diane, person living with fibromyalgia
Dr Gareth Jones, Reader of Epidemiology, Epidemiology Group, University of Aberdeen
Dr Kathryn R. Martin, Lecturer in Epidemiology, Epidemiology Group, University of Aberdeen, 'Walk With Ease' Programme
Fiona Rennie, 'Walk With Ease' leader.

More information:

Fibromyalgia Action UK - www.fmauk.org
'Walk With Ease' programme on Arthritis Research UK website - https://www.arthritisresearchuk.org/news/arthritis-today/2018/march/can-community-walking-programmes-help-people-with-arthritis-to-walk-with-ease.aspx
NHS Fibromyalgia - https://www.nhs.uk/conditions/Fibromyalgia/.

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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 the societal expectations of how we handle pain can feed into depression and guilt.

Specialist physiotherapist at UCL Hospitals’ Pain Management Centre Katrine Petersen discusses the lack of literature on men’s pain, especially pelvic pain, as well as her experiences in using physiotherapeutic strategies in the context of chronic pain syndromes.

Contributors:

Dr Ed Keogh, Deputy Director of Bath Centre for Pain Research, Bath University
Katrine Petersen, Specialist Physiotherapist at University College London Hospitals’ Pain Management Centre
Dr Jeremy Gauntlett-Gilbert, Senior Clinical Psychologist of the National Specialist Pain Service in Bath.

More information:

Pelvic Pain Support Network: https://www.pelvicpain.org.uk/.

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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 preparing the navigator tool.

Paul speaks to GP study participant Dr John Hardman, who has a particular interest in chronic pain, about his experience piloting the tool and how it allows both patients and GPs to focus their appointments. We then visit the University of Dundee to hear from the Scottish Government’s Lead Clinician on Chronic Pain and member of the research steering group, Professor Blair Smith, about his views on the role the navigator tool could play in helping people conceptualise and discuss their pain.

At St. Triduana’s Medical Practice in Edinburgh, Lucy and her GP Dr Louise Bailey talk about their experiences in using the tool, and how the practice is trying to use supported self-management to further help its patients.

Contributors:

Dr John Hardman, GP, Navigator Tool study participant
Professor Blair Smith, Scottish Government Lead Clinician for Chronic Pain, Professor of Population Heath Science, University of Dundee
Dr Louise Bailey, GP, Navigator Tool study participant
Renée Blomkvist, Pain Concern researcher for the Navigator Tool
Lucy Murphy, Patient, Navigator Tool study participant.

More information:

The Navigator Tool is free to download from Pain Concern's website along with the study, the report, FAQs, and a wealth of resources from experts into managing long term pain. Just visit our website here
Airing Pain 72: Breaking the Barriers to Managing Pain.

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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 beliefs about medication and illness can feed into how we manage pain.

Finally, Paul speaks to psychologist Dr Jo McParland of Glasgow Caledonian University about her involvement in a study focusing on parent appraisals of injustice when their child has chronic pain. Dr McParland emphasises the importance of highlighting the child’s experience, as well as validation from both HCPs and parents themselves.

Contributors:

Dr Joanna McParland,Senior Lecturer in Psychology, Glasgow Caledonian University
Dr Helen Makins, Clinical Lead of The Essential Pain Management Course, Consultant in Pain Medicine & Anaesthesia, Gloucestershire Hospitals and Dilke Memorial Hospital
Dr Sherrill Snelgrove, Associate Professor, Public Health, Policy and Social Sciences, Swansea University
Sarah Long, Pharmaceutical Advisor, NHS Wales.

More information:

Ade’s “21 Days of Pain” Campaign: http://www.21daysofpain.org.uk/
More information on Swansea University long term pain research study: http://painconcern.org.uk/wp-content/uploads/2018/08/Poster-with-link-2.pdf.

*Andrew Baranowski, BPS President

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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, and how self-management can help find an identity.

Going even further back to the BPS ASM 2016, Paul talks to psychologist Dr Brock Bastion on the nature of happiness and pain. Dr Bastion’s speaks about his work looking into the nuances of pain and negativity, and how society's view that you 'should' be happy creates more pressure and stress.

Contributors:

Sarah Sturman, Specialist Pain Physiotherapist, Dorset Community Pain Service
Dr Brock Bastian, Pain, happiness, and morality Psychologist, University of Melbourne
Renée Blomkvist, Medical Anthropologist & Pain Concern Researcher.

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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-pharmacological approaches. Dr Peacock discusses how focusing on restructuring sleep patterns resulted in nearly all patients having improved quality of sleep.

Contributors:

Dr Nicole Tang, Clinical and Health Psychologist, University of Warwick, Chartered Psychologist with the British Psychological Society
Dr Sue Peacock, Consultant Health Psychologist, Associate Fellow of The British Psychological Society and author of Sleeping with Pain: Strategies for a restful night from a pain management expert.

More information:

Pain Concern's leaflet, Getting a Good Night's Sleep.

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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 for Psychotherapy.

*http://bmjopen.bmj.comcontent/6/6/e010364.

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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/

Contributors:

Dr Gregg Clarke: Clinical Psychologist specialising in Chronic Pain, Neurorehabilitation and Sport Psychology
Ade: Cyclist and Pain Concern supporter, living with chronic pain.

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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

*http://www.cancerresearchuk.org/health-professional/cancer-statistics/survival

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In 2010, Airing Pain was conceived as a way for those with chronic pain, unable to leave their homes and attend support meetings, to easily access vital resources.

Heather knew that this undertaking would require a skilled and experienced producer, so she reached out to Paul Evans. In this edition, Paul reminisces about the first phone call they had together, his eye-opening experience of realising just how large the pool of knowledge on pain was, and how the pain education sessions came to be.

Paul then heads to Eastwood in the south of Glasgow to sit in on one of our sessions. He speaks to both pain education trainers and participants about their experiences how their relationship with pain has changed as a result.

Contributors:

Heather Wallace, Founder of Pain Concern
Angela O’Neil, Pain Education Session Trainer Volunteer for NHS and Pain Concern
Georgina McDonald, Pain Education Session Trainer Volunteer
Britney, Pain Education Session Attendee
Claire Mitchell, Clinical Health Psychology Student at Strathclyde University and Pain Education Session Trainer Volunteer
Esther McFarlane, Pain Education Session Attendee and Ex Pain Management Nurse
Lyn Watson, Clinical Nurse Specialist in Pain Management Programme for NHS Greater Glasgow and Clyde.

More information:

Pain Concern’s Glasgow based Pain Education Sessions: painconcern.org.uk/how-we-help/pain-education-sessions-glasgow/.

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This edition was funded by a grant by the Agnes Hunter Trust

With 8% of young people in the 13-18 age range affected by chronic pain (15,000 living with arthritis alone), the transition to adulthood, and the medical support that accompanies it, is an important process.

Pain management consultant Dr Mary Rose and nurse Mandy Sim of the Royal Hospital for Sick Children in Edinburgh speak to Paul Evans about the methods they use to make the transition into adulthood as supportive as possible, as well as the importance of educating patients, parents and schools on the biopsychosocial aspects of pain and its management.

Dr Alison Bliss, paediatric anaesthesia and chronic pain consultant at Leeds Children’s Hospital, emphasises the importance of finding a balance between cultivating independence in young-adults with pain and helping them find the support in their transitional period.

Paul also speaks to Dr. Line Caes, psychology lecturer at Stirling University, touches on the nuances in dealing with how young people see themselves in comparison to their peers and making the classroom a more accepting space.

Contributors:

Dr Mary Rose, consultant at the pain management clinic at Edinburgh’s Sick Children’s Hospital
Mandy Sim, pain nurse specialist at Edinburgh’s Sick Children’s Hospital pain management clinic
Dr Alison Bliss, consultant in paediatric anaesthesia and chronic pain at Leeds Children’s Hospital
Dr Line Caes, psychology lecturer at University of Stirling’s School of Natural Science, researcher in paediatric psychology and psychological aspects of children’s pain.

More information:

Royal Hospital for Sick Children Edinburgh Charity: https://echcharity.org/
Scottish Transitions Forum’s “Principles of Good Transition”: https://scottishtransitions.org.uk/summary-download/
National Institute for Health and Care Excellence (NICE) guidance on transition services: https://www.nice.org.uk/guidance/ng43

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This edition is funded by Pain Concern’s donors and friends, assisted by an educational grant from Grünenthal.

The International Association for the Study of Pain (IASP), formed in 1973, is the leading forum of scientists, clinicians, healthcare providers and policy makers supporting and promoting the study of pain and using that knowledge to improve pain relief worldwide.

Each year IASP focuses on a different aspect of pain that has global relevance. In 2017, IASP focused on pain after surgery, and joint pain was the focus of 2016. In this programme, Paul Evans speaks to Dr Paul Wilkinson, task force lead for the 2018 Global Year for Excellence in Pain Education.

IASP hopes to advance the understanding of pain in the areas of government, professional and research education and ultimately create strategy to communicate the gaps in pain education globally.

Paul also speaks to clinical psychologist Dr Nicholas Ambler, patient trainer Lisa Parry and assistant psychologist Sareeta Vyas at the Bristol Pain Management Programme to find out if there is a correlation between investment in pain management research and development and patient benefit.

Contributors:

Dr Paul Wilkinson, Director of pain management services in Newcastle and lead of IASP 2018 international task force
Dr Nicholas Ambler, Clinical Psychologist and lead of NHS North Bristol Pain Management Programme
Lisa Parry, patient and patient trainer at NHS North Bristol PMP
Sareeta Vyas, Assistant Psychologist and leader of sleep management programme at NHS North Bristol PMP.

More information:

For more information on IASP, please visit * International Association for the Study of Pain website https://www.iasp-pain.org/index.aspx * IASP’s 2018 Global Year of Excellence in Pain Education https://www.iasp-pain.org/Membership/SIGDetail.aspx?ItemNumber=742.

For more information on NHS North Bristol Pain Management Programme, visit: * https://www.nbt.nhs.uk/clinicians/services-referral/pain-clinic-services-clinicians/pain-management-programmes-pmp.

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This programme is supported by an educational grant from the Tillyloss Trust.

Along with food, shelter and clothing, sexual expression is one of the basic human needs. It allows us to express love and fulfils our need for human connection, but for the 14.3% of people in the UK living with moderately or severely disabling chronic pain, sex can be met with trepidation and anxiety.[1] This is understandable, as it is estimated that 75% of those that live with chronic pain experience sexual dysfunction.[2] There can also be a certain amount of embarrassment in discussing chronic pain and its effect on sexual activity with healthcare professionals, especially if they don’t have the skills to address these issues. This is why Pain Concern has updated its sex and chronic pain leaflet with authors Katrine Petersen, senior physiotherapist, and Dr Sarah Edwards, clinical psychologist, who specialise in abdominal pelvic pain at the Pain Management Centre, University College London Hospitals NHS Foundation Trust. You can find the leaflet on our website here: http://painconcern.org.uk/sex-chronic-pain-leaflet/

In this edition of Airing Pain, Paul speaks to Dr Edwards and Petersen about the major difficulties patients experience when it comes to living with chronic pain and managing sexual intimacy and techniques that can be used to combat them (you can find these techniques in our leaflet). Denise Knowles, family counsellor and psychosexual therapist working with relationship support charity Relate, speaks about her experiences of how relationships can be affected not only by physical pain, but by mental pain as well. She also stresses the importance of the distinction between ‘sex’ and ‘intimacy’.

Contributors:

Denise Knowles, Counsellor, Family Counsellor and Psychosexual Therapist with charity Relate
Dr Sara Edwards, Psychologist, Specialist in Abdominal Pelvic Pain at Pain Management Centre, UCL Hospitals NHS Foundation Trust
Katrine Petersen, Specialist Physiotherapist in Pain Management, Chronic Abdomino-Pelvic Pain at Pain Management Centre, UCL Hospitals NHS Foundation Trust
Meda Minard, Gynecologist from Denmark.

More information:

Pain Management Centre at NHNN, NHS University College London Hospitals: https://www.uclh.nhs.uk/OurServices/ServiceA-Z/Neuro/PMC/Pages/Home.aspx
Relate, relationship support charity: https://www.relate.org.uk/about-us
Brook, charity for sexual health and wellbeing for under 25s: https://www.brook.org.uk/
FPA, sexual health charity: https://www.fpa.org.uk/what-we-do
Vulval Pain Society: http://www.vulvalpainsociety.org/vps/
Pain Concern website, leaflet on sex and chronic pain: http://painconcern.org.uk/sex-chronic-pain-leaflet/.

Footnotes:

The British Pain Society -https://www.britishpainsociety.org/mediacentre/news/the-silent-epidemic-chronic-pain-in-the-uk/
Robert Rothrock http://painconcern.org.uk/sex-and-chronic-pain/.

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This programme was funded by an educational grant from Napp Pharmaceuticals Ltd.

In 2017, the British Pain Society celebrated its fiftieth year as one of the foremost organisations for furthering the understanding of pain, and is now the oldest and largest multidisciplinary pain-focused organisation in the UK.

Founded as The Pain Group in 1967, its membership was limited purely to anaesthetists working in pain clinics. In 1979, the organisation registered as a charity, changing its name to the Intractable Pain Society of Great Britain and Ireland.

Over the years, the organisation became increasingly multidisciplinary and, in 1988, changed its name to The Pain Society to reflect this shift. The society’s membership and activities continued to grow, and in 2004 the Pain Society transferred all its assets to an organisation with charitable status and became The British Pain Society.

As the largest professional organisation in the field of pain, the BPS continues to strive to provide an evidence-based, multidisciplinary approach to raising awareness for those living with pain, and to elevate pain education and management.

To celebrate this storied fifty years, Pain Concern invited Dr Andrew Baranowski, current president of the BPS, Professor Sir Michael Bond, one of the world’s leading authorities on the psychological effects of pain and one of the people involved in the society’s origins, to speak with Pain Concern’s chair Heather Wallace. This discussion explores the past, present and future of The British Pain Society.

Contributors:

Dr Andrew Baranowski, British Pain Society President
Professor Sir Michael Bond, founding member and former president of the BPS
Heather Wallace, Pain Concern Chair and BPS honorary member.

More information:

For more information about The British Pain Society, please visit their website: https://www.britishpainsociety.org/
International Association for the Study of Pain: https://www.iasp-pain.org/ Pain Concern: http://painconcern.org.uk/.

AiringPain #ableradio #painconcern #chronicpain #painmanagement #thebritishpainsociety #iasp #healthcareprofessionals #nappharmaceuticals #bps

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This programme was funded by grants from RS Macdonald Charitable Trust and the Hospital Saturday Fund.

Complex regional pain syndrome affects 1 in 3,800 new people every year in the UK*. It is a poorly understood condition and it can be frustrating for patients who are suffering to find peace of mind. The Royal National Hospital for Rheumatic Disease in Bath began its rehabilitation service for individuals with CRPS in 1999 and is one of the very few in the UK with outpatient and inpatient care dedicated to CRPS.

The centre, led by Professor Candy McCabe, strives to improve patients’ lives through up-to-date multidisciplinary techniques ranging from occupational therapy to mirror visual feedback (MVF). Michael and Julie, patients currently enrolled in the rehabilitation programme, speak to Paul about the injuries that caused them to develop the syndrome, how it affects their lives, and how the programme is helping them cope.

Paul also sits in on a session with Senior Physiotherapist Emma Houlihan and patient Chris, whose entire left side of his body has been affected by CRPS, to explore the therapies used at the centre to try to help him regain normal sensation.

Clinical Specialist Physiotherapist Jane Hall describes the process that new patients will go through, and how the centre helps patients even after they have left the programme.

Contributors:

Professor Candy McCabe, clinical lead for the complex regional pain syndrome service.
Emma Houlihan, Senior Physiotherapist
Charlie Ewer-Smith, Clinical Specialist Occupational Therapist
Dr Jane Hall, Clinical Specialist Physiotherapist
Keri Johnson, Clinical Specialist Physiotherapist
Chris, patient in the rehabilitation programme
Michael, patient in the rehabilitation programme
Julie, patient in the rehabilitation programme.

More information:

National centre for the management of CRPS website: https://www.crpsandcancerlateeffects-bath.org.uk/
The CRPS network, website run by the team in Bath: http://www.crpsnetworkuk.org
NHS Choices on CRPS: http://www.nhs.uk/Conditions/Complex-Regional-Pain-Syndrome/Pages/Introduction.aspx
CRPS UK, patient led organisation for people with CRPS: https://crps-uk.org/
Burning Nights, increasing awareness of CRPS in the UK and worldwide: http://www.burningnightscrps.org/.

*NHS: http://www.nhs.uk/Conditions/Complex-Regional-Pain-Syndrome/Pages/Introduction.aspx.

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This programme was funded by grants from the RS MacDonald Charitable Trust and The Hospital Saturday Fund.

The first of two programmes on complex regional pain syndrome, or CRPS, which can be described as continuous and sometimes debilitating pain that can be confined to one limb, but has been known to spread to other parts of the body. CRPS is poorly understood, and no direct cause has been identified.*

In this edition of Airing Pain, Paul Evans speaks to Sunny Boshoff, author of CRPS Awareness: Moving Against Pain, who has had her own experiences with the syndrome, describing the agonising sensations she felt while living with CRPS.

Professor Frank Birklein, head of the Peripheral Nerve Disorders and Pain Research and Treatment at the Department of Neurology, University Medical Centre Mainz in Germany is one of the world’s leading authorities on CRPS. He explains the meaning behind the syndrome’s name, what can cause it, and how understanding of the disease has progressed.

Clinical lead for the complex regional pain syndrome service at the Royal United Hospitals in Bath, Professor Candy McCabe, speaks about her experiences of treating people suffering from the disease, how it effects their emotional wellbeing, and the psychological therapies used to help people manage their pain.

Contributors:

Sunny Boshoff, author of CRPS Awareness: Moving Against Pain
Dr. Frank Birklein, head of Peripheral Nerve Disorders and Pain Research and Treatment at the Department of Neurology, University Medical Centre Mainz
Professor Candy McCabe, clinical lead for the CRPS service at the Royal Hospitals in Bath and the Florence Nightingale Foundation Chair in Clinical Nursing Practise Research at the University of West England Bristol.

More information:

For more information on CRPS, visit:

NHS Choices CRPS http://www.nhs.uk/Conditions/Complex-Regional-Pain-Syndrome/Pages/Introduction.aspx
CRPS UK, a patient led organisation for people with CRPS https://crps-uk.org/
Burning Nights, increasing awareness of CRPS in the UK and worldwide: http://www.burningnightscrps.org/
From CRPS UK https://crps-uk.org/what-is-crps/.

AiringPain #AiringPainSeries9 #ChronicPainAsAConditionInItsOwnRight #CRPS #ExplainingPain #PainConcern #PainManagement #PainManagementProgrammes #PsychologicalApproachesToPainManagement

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This programme was funded by a grant from The D’Oyly Carte Charitable Trust.

Getting some gentle exercise tops the NHS’ list of ten self-help tips for managing pain, with distraction and communication also playing important roles. In this episode of Airing Pain we see how gardening can help with all three, and the benefit for our minds as well as our bodies.

We talk to Craig Lister and Chris Speirs from The Conservation Volunteers about their community garden project Green Gym, which brings together volunteers in shared green spaces in cities across the UK. One such space is Waterlow Park in London, where Paul chats to volunteers Maddy and Rosie about how the weekly sessions have helped them overcome difficulties including depression, anxiety and chronic pain.

A few miles away from Waterlow Park is the Rheumatology department at Whipps Cross Hospital, where clinical nurse specialist Margaretta Rooney created a garden designed specifically with the needs of patients with arthritis in mind. Raised beds allow people to sit down as they weed, reducing stress on the joints, and a patio means there’s no need for mowing or other heavy equipment.

For fifteen years, volunteers Brian and Josephine have been meeting up each week to help tend to the garden. Brian explains how, thanks to Margaretta, even with arthritis in his hands he still has green fingers and enjoys the social aspect of being out in the fresh air with his friend. Josephine describes the vital role the garden played in managing her chronic pain and depression, and the feeling of giving back to the department and hospital community.

Contributors:

Chris Speirs, Health Development Manager The Conservation Volunteers
Craig Lister, Managing Director of the TCV Green Gym
Maria Schlatter, Project Officer at TCV Green Gym
Josephine, Whipps Cross Hospital garden volunteer
Brian, Whipps Cross Hospital garden volunteer
Margaretta Rooney, clinical nurse specialist in rheumatology at Whipps Cross University Hospital NHS Trust
Rosie, Green Gym volunteer
Maddy, Green Gym volunteer.

More information:

For advice on gardening with disability and specially adapted equipment, see Thrive: http://thrive.org.uk/thrives-carry-on-gardening-website.aspx
The gardening and arthritis booklet leaflet mentioned by Margaretta can be ordered or downloaded from the Arthritis Research UK website: http://www.arthritisresearchuk.org
To get involved with a TCV green gym near you, visit The Conservation Volunteers: https://www.tcv.org.uk/greengym
To contact Margaretta about helping with the Whipps Cross garden, email production@painconcern.org.uk and we’ll put you in touch!

#airingpain #painconcern #gardening #greengym #TCV #chronicpain

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This programme was funded by a grant from The Schuh Trust.

There are around 4.5 million people living with diabetes in the UK, and every day more than 20 leg, foot or toe amputations are carried out as a result of diabetic neuropathy. This is particularly shocking, as four out of five of these amputations could have been avoided with proper care*.

People with diabetes are often bombarded with advice on diet and exercise, however as with any long term condition it can affect all aspects of life. In this episode of Airing Pain we talk to Linda McGlynn from Diabetes Scotland and clinical specialist physiotherapist Ben Davies.

Linda explains how diabetes affects the nervous system and why it’s so important to look after our feet. Ben describes some the results of his research into pain management for those with diabetic neuropathy, and why diabetes specialists left feeling “clinically impotent” should look towards the pain community for better treatment models.

Contributors:

Ben Davies, clinical specialist physiotherapist in pain management at Sirona CIC
Linda McGlynn, Patient and NHS Engagement Manager Diabetes Scotland.

More information:

For more support and information on living with diabetes, as well as advice on how to look after your feet, visit * NHS Choices www.nhs.uk/Livewell/foothealth/Pages/Diabetesandfeet.aspx * Diabetes UK ‘Putting Feet First’ www.diabetes.org.uk/putting-feet-first#camp.

*Figures from Diabetes UK: https://www.diabetes.org.uk/putting-feet-first, https://www.diabetes.org.uk/Professionals/Position-statements-reports/Statistics/Diabetes-prevalence-2016/

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This programme was funded by a grant from The Schuh Trust.

Gout is the most common form of inflammatory arthritis and affects 1 in 40 people in the UK. So why do we still see it as something that exists only in the pages of Victorian novels? In this episode of Airing Pain we go inside the Houses of Parliament and speak with MPs, clinicians, patients and UK Gout Society members to find out why.

What is gout? Gout is a type of arthritis caused by a build-up of uric acid crystals in the joints, most frequently the feet. As with many conditions, flare-ups can be brought on by a number of factors including lifestyle, stress and diet. Some people, however, have a genetic predisposition. Paul Webber and Alan Hughes both suffer with gout, describing the pain as being repeatedly being kicked in the shin and worse than a red-hot poker.

What’s the treatment? Treatments for reducing pain during attacks include icing the joint and taking medications, however there are also long term treatments. There are lifestyle changes we can make, such as consuming less yeast-rich food and drink, staying active and drinking plenty of water. Despite being relatively inexpensive to treat, gout comes at a great cost to the economy and society, as the Chief Executive of ARMA, Sue Brown, highlights.

Consultant Rheumatologist Dr Jonathon Rees identifies a lack of awareness in primary care, with cases often going undiagnosed. Paul also talks to Michael Snaith about his early gout and gender research at the UK’s first gender reassignment, and Lord Ramsbotham sums up perfectly why gout really is no laughing matter.

Contributors:

Jim Shannon MP for Strangford
Dr George Nuki, professor of rheumatology at the University of Edinburgh
Paul Webber, gout sufferer
Alun Hughes, gout sufferer
Dr Tim Tait, Consultant Rheumatologist, Royal Hallamshire Hospital
Stuart Reed, gout sufferer and patient trustee of the UK Gout Society
Dr Jonathan Rees, Consultant Rheumatologist and Sports Medicine, Cambridge University Hospitals NHS Foundation Trust
Dr Adrian Dunbar, GP with a special interest in musculoskeletal medicine and chronic pain
Sue Brown, Chief Executive of Arthritis & Musculoskeletal Alliance
Dr Michael Snaith, retired Consultant Rheumatologist and trustee of the UK Gout Society
Lord Ramsbotham, cross bench member of the House of Lords and gout sufferer
Lynsey Conway, UK Gout Society Secretariat.

More information:

For more support and information on living with gout, visit * NHS Choices Gout www.nhs.uk/Conditions/gout/Pages/Introduction.aspx * The UK Gout Societywww.ukgoutsociety.org.

AiringPain, #PainConcern, #AbleRadio, #gout, #UkGoutSociety, #ShoutAboutGout

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This programme was funded by a grant from The Schuh Trust.

Back pain causes more disability than any other condition in the UK[1]. It is the second most common cause of absence from work, resulting in the loss of four million working days per year[2]. This comes at a heavy price not only for the NHS, the Department for Work and Pensions, and the UK economy – reported to be costing each £480 million, £5 billion and £9.6 billion a year respectively – but for the increasing number of us who will experience back pain at some point in our lives.

Over 40% of over 50s go on to develop back pain[3], and with an ageing population it’s more important than ever that we know what we can do to prevent, reduce and manage this common but debilitating ailment.

Dr David Rogers is an Orthopaedic Physiotherapy Practitioner at the Royal Orthopaedic Hospital in Birmingham. In 2016 he co-authored the book ‘Back to Life: How to unlock your pathway to recovery (when back pain persists)’ with Dr Grahame Brown, in which readers can find clear, practical strategies for managing and relieving low back pain. David explains the ideas behind the book, the biopsychosocial model and why it’s so important, while Paul tries some 7:11 breathing and relaxation techniques.

Contributors:

Dr David Rogers, Orthopaedic Physiotherapy Practitioner at Royal Orthopaedic Hospital, Birmingham and co-author of ‘Back to Life: How to unlock your pathway to recovery (when back pain persists)’.

More information:

For more support and information on living with persistent back pain, visit * Back Care: www.backcare.org.uk/ * NHS Choices: www.nhs.uk/Conditions/Back-pain/Pages/Introduction.aspx * To order a copy of David’s book, Back to Life, via Amazon click here: https://www.amazon.co.uk/Back-Life-pathway-recovery-persists-ebook/dp/B01CHNXBI0/ref=sr13?ie=UTF8&qid=1494245099&sr=8-3&keywords=back+to+life

Footnotes: 1. Figures from NHS Healthy Evidence Forum: http://www.nhs.uk/news/2014/03March/Pages/Back-pain-leading-cause-of-disability-study-finds.aspx 2. Statistics from Back Care: http://www.backcare.org.uk/wp-content/uploads/2015/02/Back-Facts-for-Employers-Factsheet.pdf 3. Statistics from Back Care: http://www.backcare.org.uk/wp-content/uploads/2016/11/Builders-back-pain.pdf

Activity #AiringPain #Anxiety #back #Backpain #BacktoLife #Biopsychosocial #Breathing #ChronicPain #Exercise #FightFlightFreeze #FlareUps #Goals #GrahameBrown #DavidRogers #Catastrophising #Lowbackpain #Mindfulness #NICEguidelines #NonMedicationtreatment #Pacing #PainConcern #PainManagement #PersistentBackPain #Relaxation #SelfManagement #Social #SMARTtargets #Stretches #Stress #Visualisation #Work #7:11

Back to Life: How to unlock your pathway to recovery (when back pain persists)

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This programme was funded by grant from W G Edwards and the Cruden Charitable Foundation.

According to a survey carried out by the Alzheimers Society, Dementia is the most feared health condition in the UK. Last year alone, 225,000 people developed dementia.

Paul talks to Professor Peter Passmore about the challenges of treating chronic conditions in people who develop dementia, including different medications and why we instinctively link age with pain.

In 2012 Lloyd Hughes authored a report, Managing Chronic Pain in Patients with Dementia. Now a GP trainee, Lloyd discusses how he incorporates his findings into every day patient care and what we can do as individuals to prepare for a future that may well include dementia.

Andy Lowndes, Deputy Chair of Glasgow based charity Playlist for Life, describes the power of music in helping those living with dementia - whether as a patient, carer or loved one - connect with each other and reconnect with themselves.

Contributors:

Professor Peter Passmore, Professor of ageing and geriatric medicine at Queen’s University Belfast
Dr Lloyd Hughes, GP trainee specialising in geriatric and stroke medicine at the Royal Infirmary Edinburgh
Andy Lowndes, Deputy Chair of Playlist for Life.

More information:

For more support and information on living and caring for people with dementia, visit * www.nhs.uk/Conditions/dementia-guide/Pages/about-dementia.aspx * www.playlistforlife.org.uk/ * www.alzheimers.org.uk/ * www.dementiauk.org/ * www.dementiacarer.net/.

To read Lloyd Hughes’ report 'Managing Chronic Pain in Patients with Dementia', click here: https://www.gmjournal.co.uk/uploadedfiles/redbox/.../gmaug2012p18.pdf

To upload your own playlist to Playlist For Life click here: http://www.playlistforlife.org.uk/your-space/submit-a-playlist/#3106.

dementia #airingpain #painconcern #ableradio #audioboom #playlistforlife #music #chronicpain

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This edition has been funded by a grant from the Women’s Fund For Scotland.

Interstitial cystitis, aka painful bladder syndrome, is a poorly understood bladder condition that causes long-term pelvic pain and problems with urination. The charity Bladder Health UK estimates that 400,000 people in UK live with the condition. Of them, 360,000 are women.

Anne Cameron, retired nurse and now coordinator for Bladder Health UK in Scotland, explains the varied symptoms and treatments available, and how certain factors can make the path to diagnosis far from smooth for some women.

Jen stresses the importance of support groups in alleviating feelings of stress and isolation, and Pat describes how she overcame her initial reservations to try different self-management techniques, including yoga and mindfulness.

Dr Shona Brown is a clinical psychologist and part of the multi-disciplinary team at the EXPPECT pelvic pain clinic in Edinburgh’s Royal Infirmary. She describes the impact of pelvic pain on patients’ emotional wellbeing and why it’s important to include a psychological approach in pain management programmes.

Contributors:

Anne Cameron, retired nurse and Scotland Coordinator for Bladder Health UK
Jennifer Hayes, pelvic pain support group member
Pat Brown, patient at EXPPECT clinic at Edinburgh Royal Infirmary
Dr Shona Brown, clinical psychologist at the EXPPECT clinic at Edinburgh Royal Infirmary.

For more support and information on living with pelvic pain, visit:

bladderhealthuk.org/
www.pelvicpain.org.uk/
www.exppectedinburgh.co.uk/
www.vulvalpainsociety.org/
www.painconcern.org.uk/

airingpain #ableradio #painconcern #audioboom #chronicpain #bladder #bladderpain #cystitis #interstitialcystitis #pelvicpain #mindfulness #relaxation #yoga #yogaforpain #painmanagement #selfmanagement #psychology #bladderhealthuk #womenspain #womensfundforscotland

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This edition has been funded by a grant from the Women’s Fund For Scotland.

Vulvodynia is a nerve-based pain, often described as a burning or stinging sensation, which affects the vulva. 1 in 7 seven women are estimated to experience Vulvodynia at some stage during their life and the condition can be very distressing to live with, impacting on everything from clothing choices to relationships.

Dr Winston de Mello explains why many women with Vulvodynia experience difficulties on the path to diagnosis and why GPs under pressure create a “postcode lottery” for those in pain without any visible symptoms.

Dr Rebekah Shallcross describes what she found in her research into women’s experiences of Vulvodynia, including sexist treatment by some healthcare professionals, a lack of awareness of the condition within the medical community and the stigma associated with genital pain. The role played by penetrative sex in social constructions of female identity can create feelings of guilt and shame in patients with Vulvodynia where physical intimacy is problematised by pain, feelings which Dr Shallcross links with historical gender inequality and patriarchal attitudes towards sex.

Gynaecology consultant Dr David Nunns discusses the importance of the “four Ps” in patient treatment and improving the lives of those with Vulvodynia: patient education, pain modification, physiotherapy and psychological support. Plus the importance of discourse in raising awareness and reducing pain and associated stress.

Contributors:

Dr Winston de Mello, Consultant in Anaesthesia and Pain Medicine, University Hospital of South Manchester
Dr Rebekah Shallcross, trainee clinical psychologist and a research associate at the University of Manchester
Dr David Nunns, gynaecology consultant at Nottingham City Hospital and a trustee of the Vulval Pain Society.

More information:

For more information and support on Vulvodynia visit the Vulval Pain Society. http://www.vulvalpainsociety.org/vps/.

airingpain #ableradio #painconcern #audioboom #chronicpain #vulvodynia #vulvalpain #vulvalpainsociety #pelvicpain #GPs #healthcareprofessionals #gender #patriarchalmedicine #painmanagement #selfmanagement #psychology #womenspain #womensfundforscotland

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An estimated 15,000 people in the UK are living with Sickle Cell disease and at least 250,000 are carriers. Dr Elizabeth Rhodes explains the causes and symptoms of the genetic blood disorder, the areas where it is most prevalent and who is affected.

One such patient is Khadijat Jose, who describes her experiences growing up in Nigeria and why being a carrier of the disease is an advantage in countries with Malaria. For those with the condition however, each day can bring severe pain often requiring admission to hospital. Dr Oliver Seyfried highlights the life-limiting effects of this pain, especially on young people, and the challenges it poses in all spheres of life.

Self-management is therefore hugely important for those with Sickle cell disease, whether the pain experienced is mild or severe. Paul discusses the different approaches taken by the Red Cell Pain Management team at St George’s Hospital with clinical psychologist Dr Jenna Love and specialist physiotherapist Rebecca McLoughlin. Both emphasize the importance of being able to tackle sickle cell pain from an emotional and psychological perspective as well as a physical one.

Thanks to progress in medical training and increased awareness, the quality of life for Sickle Cell patients continues to improve. Dr Oliver Seyried and Dr Jenna Love mention the national sickle cell screening programme and parent education, on which more information can be found here: https://phescreening.blog.gov.uk/category/sct/

Contributors:

Dr. Elizabeth Rhodes, consultant haematologist at St. George’s Hospital in London
Khadijat Jose, PhD student at Cardiff University
Dr. Oliver Seyfried, consultant in pain medicine and anaesthesia at St. George’s Hospital in London
Dr Jenna Love, clinical psychologist at St George’s Hospital in London
Rebecca McLoughlin, specialist physiotherapist at St George’s Hospital in London.

More information:

For more information about Sickle Cell disease visit the Sickle Cell Society website: http://sicklecellsociety.org.

airingpain #painconcern #audioboom #ableradio

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This edition is funded by Grünenthal.

Around 20 per cent of Europe’s adult population live with chronic pain and the consequences for individuals and society are devastating. In this edition of Airing Pain we head to the Societal Impact of Pain meeting in Brussels to hear from the patients, healthcare professionals and policy makers coming together to improve the lives of people in pain across the continent.

Dr Chris Wells explains why pain management is a matter of life and death and how to put pain higher up the political agenda. MEP Theresa Griffin takes up the baton with a call to make the workplace accessible to those living with pain.

Jane Moejlink describes the challenges of getting a diagnosis for interstitial cystitis and Sjögren’s syndrome in the face of sceptical doctors and the language barrier, while Professor Ilora Finlay makes the case for a different view of palliative care. Plus: an update from Ireland and bursting balloons to raise awareness.

Contributors:

Dr Chris Wells, President of the European Pain Federation (EFIC®)
Jane Meijlink, Chairman of the International Painful Bladder Foundation
Dr Martin Johnson, Chronic Pain Lead at the Royal College of General Practitioners and Co-Chair of the Chronic Pain Policy Coalition
Ilora Finlay, Professor of Palliative Medicine, Cardiff University
John Lindsay, Chairperson, Chronic Pain Ireland
Joop van Griensven, President, Pain Alliance Europe
Theresa Griffin, MEP for the North West of England.

AiringPain, #Pain Concern, #Able Radio

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This edition is funded by the Agnes Hunter Trust.

More people than ever before survive cancer, but the disease and treatment can have long-lasting effects on health, including chronic pain. In this edition of Airing Pain we visit Maggie’s Centre, Edinburgh, which pioneers a compassionate, personalised approach to supporting those with cancer and survivors of the disease.

Cancer Nurse Andy Anderson explains how the tranquil, homely environment at Maggie’s gives service users a chance to regain control. Claire Tatterstall speaks about her long struggle with bone cancer, the stigma surrounding the ‘C word’ and the pain resulting from her life-saving treatment.

While Claire takes her pain as a reminder that she’s ‘still here’, the immense gratitude many survivors feel can lead to their pain going unreported, says cancer pain specialist Dr Lesley Colvin. She explains why cancer can lead to chronic pain and how we can improve pain management in palliative care and for survivors.

Contributors:

Andy Anderson, Cancer Nurse, Maggie’s Western General Hospital, Edinburgh
Claire Tattersall
Dr Lesley Colvin, Consultant/Reader in Pain Medicine in the University department of Anaesthesia, Critical Care and Pain Medicine, Western General Hospital, Edinburgh.

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This edition is funded by the Agnes Hunter Trust.

Over ten million people in the UK live with arthritis and it is the most common cause of pain. Professor David Walsh of Arthritis Research UK explains what causes the different types of arthritis, why the nervous system is the main culprit in arthritis pain and he updates us on the most promising lines of current research into drug treatments.

But there is much more to living well with arthritis than taking medication as producer Paul Evans finds out at an Arthritis Care Wellbeing Day in Renton, Scotland. He joins a specially adapted tai chi lesson and finds out from Sharon MacPherson about what to eat and drink and what to avoid when managing the condition: ‘Sassy Water’ is in, alcohol is out.

The workplace can be a challenge for anyone managing pain with 50 per cent of those with rheumatoid arthritis leaving work within a year. Hazel Muir emphasises the importance of knowing your rights and being able to explain about your pain to employers and colleagues.

Contributors:

David Walsh, Professor of Rheumatology, University of Nottingham and Director, Arthritis Research UK Pain Centre
Sharon MacPherson, Project Officer – Joint Activity, Arthritis Care
Hazel Muir, Employability Officer, Arthritis Care.

arthritis #diet #exercise #work

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This edition is supported by Forces in Mind Trust and the MacRobert Trust.

In the third instalment of our Airing Pain miniseries on military veterans living with pain we focus on the relationship between pain and psychological wellbeing. Anxiety, fear and anger are common responses to pain, but guilt and post-traumatic stress disorder (PTSD) can also be heavy burdens for ex-service personnel, explains clinical psychologist Dr Alan Barrett.

Gabriel Gadikor was caught in a rocket attack while serving in Iraq and has since suffered chronic pain and psychological trauma. He describes the coping strategies he has learnt while a patient at Dr Barrett’s clinic, including using a favourite perfume to ‘ground’ himself when troubled by pain and difficult thoughts or emotions. Although attitudes in the military have begun to change, it can still be difficult for servicemen and women to admit to psychological distress and many may not be coming forward to get the support they need. Gabriel urges his former colleagues facing the same issues to seek help: ‘the longer you keep your problem, the more difficult it is to treat’.

Contributors:

Dr Alan Barrett, Clinical Lead, the Pennine Care Military Veteran Service for Greater Manchester and Lancashire
Gabriel Gadikor, army veteran.

More information:

Anyone who has served in the British armed forces can be referred or self-refer to any of the Military Veteran Services across the UK. Visit the Pennine Care Military Veteran Service website to find out more: www.penninecare.nhs.uk/your-services/military-veterans-service.

Psychologicalapproachestopainmanagement #Psychologicaleffectsofpain

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This edition has been funded by the MacRobert Trust and the Forces in Mind Trust.

Hundreds of veterans of the conflicts in Iraq and Afghanistan sustained injuries leading to the loss of one or more limbs. In the second of this Airing Pain miniseries on pain management for ex-service men and women we look at the support available to help amputees rebuild their lives.

At the Specialist Mobility Rehabilitation Centre (SMRC) in Preston Gregg Stevenson tells Producer Paul Evans about his two-year journey towards regaining mobility and adjusting to civilian life after losing his lower legs in an explosion. Thanks to prosthetic legs, a dedicated team of healthcare professionals and his own determination, Gregg is now a personal trainer helping others in similar situations.

Dr Fergus Jepson, who oversees the medical care at SMRC, explains why getting a prosthetic limb is just the first step on the road to recovery. Candy Bamford, the Centre’s Counselling Psychotherapist, describes how she helps veterans to control their pain and confront traumatic memories by using psychological techniques better suited to the military background of her patients than the more typical ‘talking therapies’.

Contributors:

Dr Fergus Jepson, Consultant in Amputee Rehabilitation Medicine, Specialist Mobility Rehabilitation Centre (SMRC), Preston
Candy Bamford, Counselling Psychologist, SMRC, Preston
Gregg Stevenson, Personal Trainer, SMRC, Preston.

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This edition has been funded by the MacRobert Trust and the Forces in Mind Trust.

‘Pain is inevitable, but suffering is optional.’

A motto tattooed onto the arm of a wounded veteran which, although easier said than done, is good advice for anyone living with pain. But how can ex-service personnel get the support they need to manage the pain and psychological trauma resulting from what are often horrific injuries?

Producer Paul Evans finds out in this the first edition of Airing Pain’s miniseries on former members of the armed forces who live with pain. Infantry veteran Michael Clough, whose injuries left him with complex regional pain syndrome (CRPS) and requiring the amputation of his leg, shares his story of the difficult transition from military hospitals to NHS care. Claire Stephens, CEO of the charity Wound Care for Heroes, and herself medically-retired after injury, outlines how care can be improved. We also hear from pain management specialists with military backgrounds about the challenges faced by this patient group. Vincent De Mello explains why ex-servicemen in pain often feel abandoned and says that the effects reach beyond the individual to the whole family, while Dominic Aldington discusses the problem of veterans feeling their pain is disbelieved by civilian clinicians.

Contributors:

Dr Winston De Mello, Consultant in Anaesthesia and Pain Medicine, Wythenshawe Hospital, Manchester
Michael Clough, army veteran
Lt Col Dr Dominic Aldington, Consultant in Pain Management and Clinical Lead, Hampshire Hospitals NHS Foundation Trust
Claire Stephens, CEO, Wound Care for Heroes.

More information:

Lt Col Dr Dominic Aldington is able to take NHS referrals of ex-servicemen at his pain clinics in Basingstoke and Winchester. Visit thepainteam.com to find out more.

Complexregionalpainsyndrome #Educatinghealthcareprofessionals #Funding andavailabilityofpainservices #Primary care

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Tens of thousands of soldiers in the First World War survived with limb amputations, but doctors and wider society were unprepared for and often unsympathetic to the long term pain they experienced.

Professor Andrew Rice brings us up to date with developments since then in treating pain caused by nerve damage and explains what makes neuropathic pain different from everyday pain. Although the drugs used to treat neuropathic pain may have improved, side effects are still a major problem for many.

Researcher Sheena Derry discusses how we can balance out the risks and benefits. Understanding the harm caused by a drug can be challenging because even research study participants given sugar pills rather than real drugs may experience adverse effects.

Psychologist Lena Vase explains that the latest research on the placebo effect shows that it’s always worth a doctor’s time to listen sympathetically to a patient.

Contributors:

Andrew Rice, Professor of Pain Research, University College London
Sheena Derry, Senior Scientific Officer, Pain Research Unit, University of Oxford
Lena Vase, Professor of Psychology, Aarhus University
Michael Clough, army veteran.

Amputationanphantomlimbs #Neuropathicpain #Medication #Painkillersandsideeffects

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‘In hospital. Don’t know what’s going to happen to me.’

These words, written by a child asked to describe her pain after surgery, speak of the anxiety caused by a failure to reassure and explain.

This edition of Airing Pain focuses on the communication challenges faced by children and those caring for them. Producer Paul Evans hears from Alyson Twycross and Bernie Carter – both are nurses and academics specialising in children’s pain – about how these barriers can be overcome using art produced by the children to represent their pain and its effect on them.

Twycross explains why it’s important for children to be informed and involved in decisions about their care. She also gives tips for parents on helping children recover from surgery and minimise the risk of developing post-surgical pain.

Contributors:

Alyson Twycross, Head of Department for Children’s Nursing, London Southbank University
Bernie Carter, Professor of Children’s Nursing, University of Central Lancashire
Zara
Aimee.

Artsandcrafts #Childrenandyoungpeopleinpain #Communicationskills #Explainingpaintochildren #Postsurgicalpain

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How can healthcare systems adapt to meet the needs of people in pain? Airing Pain returns to Northern Ireland to find out how the findings of the Painful Truth report into chronic pain will be put into practice.

The Painful Truth had a big impact on decision makers – chronic pain is now recognised as a condition in its own right, healthcare professionals receive pain education and people in pain have a bigger voice in developing their services – but with resources tight and pressure on services, putting the report’s recommendations into practice won’t be easy.

We hear some of the stories behind the statistics. Zara and Aimee, teenagers living with pain, talk about how they cope with the ‘invisible’ illness of pain and rising above the challenges they face in their social lives and school work. Margaret Peacock and Carrie describe their difficulties in getting help from the medical profession.

Contributors:

Pamela Bell, Chair of the Pain Alliance of Northern Ireland
Prof Maureen Edmondson, Chair of the Patient and Client Council in Northern Ireland
Louise Skelly, Head of Operations at the Patient and Client Council in Northern Ireland
Carrie
Meave McLaughlin, Member of the Legislative Assembly of the Northern Ireland Assembly Health Committee
Margaret Peacock, Chair of Fibromyalgia Support Northern Ireland
Dr Anne Kilgallenm, Deputy Chief Medical Officer, DHSSPS, Northern Ireland
Tricia Bowers, Training Manager, Arthritis Care Northern Ireland
Zara
Aimee
Jillian
Christine McMaster, Pain Forum Northern Ireland.

Carers #Epidemiologyofpain #Healthcarepolicy #Socialandeconomicimpactofpain #Unemployment #Work

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In the second programme in our Good Work double bill we hear how people in pain and their families are affected by barriers to employment and support.

Kieran McGee and his wife Anne-Marie tell how his neuropathic pain and a lack of ongoing support put an end to both his career and hers as she became his full-time carer. Angela O’Neill recalls having to leave the nursing job she loved and her ‘distressing’ experience of a poorly managed back to work scheme.

Staff at the Health and Social Care Alliance set out how the Access to Work programme can help people managing long term conditions to overcome obstacles to getting to and thriving in the workplace. And Jason Leitch of NHS Scotland discusses the Glasgow effect – Scotland’s largest city’s inequalities of health and life expectancy – and how to reduce them.

Find out more about the programmes and organisations featured in this episode: Health and Social Care Alliance Scotland Healthyworkinglives.com (NHS support for people with long term conditions and their employers) Access to Work

Contributors:

Professor Jason Leitch, Clinical Director of the Healthcare Quality Unit, NHS Scotland
Kieran McGee
Anne-Marie McGee
Angela O’Neill
Andrew Strong, Policy and Information Manager, the Health and Social Care Alliance Scotland
Louise Coupland, Health and Employability Manager, the Health and Social Care Alliance.

Carers #Epidemiologyofpain #Healthcarepolicy #Socialandeconomicimpactofpain #Unemployment #Work

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This edition is funded by a grant from the Moffatt Trust.

As many as a quarter of people with chronic pain go on to lose their jobs, so what can be done to make staying in work more achievable? We look for answers in this first of two episodes focusing on employment.

‘With the right support, many people on sick leave, could be in work or helped back to work faster’, says Dame Carol Black, independent expert advisor to the government. She explains why ‘good work’ – work where people are listened to, respected and have some control – is not only important for our mental wellbeing, but can even predict back pain.

The result of Dame Black’s report into this issue was the government’s Fit to Work scheme. Occupational therapist Gerry McFeely describes how the programme aims to help those on sick leave to develop a Return to Work Plan.

Contributors:

Dame Carol Black, Expert Advisor on Health and Work to Public Health England in the Department of Health
Gerry McFeely, Macmillan Consultant Occupational Therapist for Cancer and Long Term Health Conditions Specialising in Vocational Rehabilitation, Astley Ainslie Hospital, Edinburgh.

Occupationaltherapy #Socialandeconomicimpactofpain #Work

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Could music be a key resource for managing pain? The results of a survey on music and chronic pain are promising, according to psychologist and musician Prof Raymond MacDonald. Meanwhile, most of us are already using music to influence our own psychological wellbeing.

We don’t need to wait until the research is in, says Dr Don Knox – people in pain can already ‘build music into their everyday pain management strategies’. He explains why whether it’s Tchaikovsky or the Ramones, our own tunes make the biggest impact on pain.

Finally, Producer Paul Evans gets a singing lesson from composer Gareth Williams, who explains why most of us are not breathing well and how vocal exercises can help.

Contributors:

Raymond MacDonald, Professor of Music Psychology and Improvisation, Edinburgh University
Dr Don Knox, Senior Audio Lecturer, Glasgow Caledonian University
Gareth Williams, Composer, Edinburgh University.

Music #Psychologicalapproachestopainmanagement

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This edition is funded by a grant from the Schuh Trust.About 10% of the adult population experience disabling levels of foot pain. Producer Paul Evans hears from the experts about professional help, self-management and why we need toes. Gordon Hendry explains what podiatrists do – and it doesn’t involve using a hammer and chisel to lop off a bunion – and why we should appreciate the complex and clever structures that are our feet (and toes). More women than men are affected by foot pain. Jody Riskowski weighs up whether tight-fitting shoes are to blame.

As a former elite athlete retired because of injury, Riskowski shares her experiences of rehabilitation and gives tips for finding the middle ground between overdoing it and over-resting, while Kathryn Martin tackles the issues of getting active despite foot pain.

Contributors:

Gordon Hendry, Lecturer in Musculoskeletal Rehabilitation, Glasgow Caledonian University (GCU)
Dr Jody Riskowski, Lecturer, Institute for Allied Health Research, GCU
Dr Kathryn Martin, Lecturer in Epidemiology, University of Aberdeen.

Footpain #Activityrestcycle #Exercise #Pacing

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This edition is part of a project funded by the Health and Social Care Alliance.

We know that supported self-management reduces the impact of chronic pain on daily life, but many people in pain feel they are not getting that support from their GPs. Pain Concern’s research shows how simple things like short appointment times and long waiting lists for pain management services combine with more complex problems of communication and culture to hamper self-management.

And it’s not only people in pain who are frustrated with the system – GP Dr Graham Kramer outlines the problems with a medical approach that tries to fix problems that can’t be fixed. That means a difficult journey towards acceptance for people with pain and a transformation in the way doctors interact with patients from being ‘parent’ to ‘coach’.

Contributors:

Katy Gordon, Researcher, Pain Concern
Martin Dunbar, Clinical Lead, Glasgow Pain Management Programme
Graham Kramer, Scottish Government Clinical Lead for Self-management and Health Literacy.

Educatinghealthcareprofessionals #Generalpractitioners #Healthcarepolicy #Primarycare #Psychological #Pychologicalapproachestopainmanagement

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Over 100,000 women in the UK have been affected by female genital mutilation (FGM) with devastating long-term consequences including persistent pain. Janet Graves hears from FGM survivors and the healthcare professionals treating them about this culturally-embedded practice and how to uproot it.

Hanna Gilbremedhen and Valentine Nkoyo speak about the impact being cut as children has had on their psychological and physical health as well as their relationships. Nkoyo also explains how her Mojato Foundation is working to mobilise opposition to FGM from within the communities affected. Gilbremedhen’s experience of undiagnosed chronic pain after FGM highlights the lack of knowledge among healthcare professionals. Clinics with experience in seeing women with FGM are vital, says Specialist Midwife Juliet Albert, if they are to get the care they need.

Midwife, ‘fighter’ against FGM and founder of the Hope Clinic Asia Eden shares her story and stresses the importance of education in ensuring the safety of the next generation. For a comprehensive list of FGM clinics and resources visit forwarduk.org.uk For more information on the Mojato Foundation visit valentinenkoyo.com The Hope Clinic: fgmhopeclinic.co.uk

Contributors:

Juliet Albert, Specialist FGM Midwife, Queen Charlotte Hospital, Imperial College Healthcare NHS Trust and Project Lead at the Acton African Well Woman Clinic
Valentine Nkoyo, Mojatu Foundation, Nottingham
Hana Gibremedhen, Mojatu Foundation, Nottingham
Aisa Eden, Specialist Midwife.

Pelvicpain #Cultureandpain #Educatinghealthcareprofessionals #Familyandrelationships #Genderandpain #Psychologicaleffectsofpain

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Make sure you stand up and do a few stretches after listening to this episode of Airing Pain!

‘Movement is medicine’ for people in pain, says consultant physiotherapist Eve Jenner. But it’s about more than just exercise – physiotherapists can help people understand pain, know the difference between ‘hurt and harm’ and get a better night’s sleep. Understanding pain matters for doctors and public health officials too, argues pioneer of pain management services Professor Michael Bond. It’s not just political correctness to look at pain as a problem in itself; it’s a question of biology. Changes in the spinal cord make pain persist. Getting the message across could be a matter of life and death. Research suggests that delays in the diagnosis and treatment of persistent pain can reduce life expectancy, Dr Manohar Sharma says. He explains why working as a team of different specialists, including the person in pain, is crucial for making the complex spinal interventions he specialises in succeed.

Contributors:

Michael Bond, retired professor of psychological medicine
Manohar Sharma, Clinical Director of Pain Medicine at The Walton Centre, Liverpool
Eve Jenner, independent consultant physiotherapist.

Backpain #Chronicpainasaconditioninitsownright #Educatinghealthcareprofessionals #Insomnia #Physiotherapy #Psychologicalapproachestopainmanagement

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Can a doctor ever be too sympathetic? Health psychologist Professor Tamar Pincus explains why this might be the case – patients with long term conditions can feel like they are being ‘looked after’ rather than taking responsibility for their own health. Pincus also clears up some myths about the role of psychology in chronic pain and makes the case for acceptance and commitment therapy (ACT) as a key part of the pain management toolkit. Acceptance can be difficult when people in pain are under pressure from those around them to be ‘the person they were before the pain’.

GP Frances Cole’s rehabilitation service puts the people – not ‘patients’ – she sees in control of guiding their own treatment with the aim of being the best they can be with the pain. She asks them to focus on what matters most to them and helps them connect to ‘a new world’ where they can learn skills and knowledge from other people who’ve faced the same challenges.

Contributors:

Tamar Pincus, Professor in Health Psychology, Department of psychology, Royal Holloway, University of London (RHUL)
Frances Cole, GP and Pain Rehabilitation Specialist.

Cognitivebehaviouraltherapy #Educatinghealthcareprofessionals #Generalpractitioners #Psychologicalapproachestopainmanagement

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If someone steps on your toe, your toe hurts – simple as that, right?

Wrong! Professor Rolf-Detlef Treede explains how the brain and nervous system make pain and why we can feel pain in a part of the body that hasn’t been harmed. It’s not just a question of good science, Treede argues – better understanding will decrease discrimination against people in pain.

Genes also have a role to play in the story of pain, says Professor Ana Valdes. Her research is helping to explain why some people develop conditions such as fibromyalgia, migraine or rheumatoid arthritis and others do not based on differences in our makeup at the molecular level. Even our psychological responses to pain are affected by differences in the nervous system. Valdes believes these more sophisticated approaches to pain offer hope of effective treatment in the future.

Contributors:

Ana Valdes, Associate Professor and Reader, Faculty of Medicine & Health Sciences, University of Nottingham
Rolf-Detlef Treede, Professor of Neurophysiology, Heidelberg University, Germany.

Arthritis #Depression #Fibromyalgia #Migraine #Educatinghealthcareprofessionals #Epidemiologyofpain #Explainingpain #Psychologicaleffectsofpain #Research

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This edition is funded by a donation from the residents at Falcon House, Edinburgh.

It’s well established that pain needs to be understood and treated as a biopsychosocial problem, but what about the spiritual side of life? Professor of nursing and Anglican chaplain Michelle Briggs speak to Paul Evans about how some people in pain can find relief and meaning in the prayer and community engagement offered by their faith.

We’ve looked at the issue of pain education before – Emma Briggs gives an update on the struggle to increase pain training for doctors and improve its quality. Her interdisciplinary pain management course brings healthcare professionals together with a focus on empathy, working as a team and understanding the importance of drug and non-drug treatments.

Physiotherapy and mental health care might seem at opposite ends of the pain management spectrum, but physiotherapist Nathan Goss sets out why we have to see pain as a mind-body problem and argues that mental health difficulties are ‘something we all experience’.

Contributors:

Michelle Briggs, Professor of Nursing, Leeds Metropolitan University and Anglican chaplain
Emma Briggs, Lecturer, King’s College London and Chair of the British Pain Society Pain Education Special Interest Group
Nathan Goss, Senior Physiotherapist, Pain Management Programme at the Walton Centre, Liverpool.

Cultureandpain #Educatinghealthcareprofessionals #Explainingpain #Physiotherapy #Psychologicalapproachestopainmanagement #Psychologicaleffectsofpain

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Friends don’t always understand, they don’t get out much and they’re faced with daunting responsibilities, but they wouldn’t change a thing about their families. So say the young people Paul Evans meets at a support day for carers in south east Wales.

There are 178,000 young carers in England and Wales doing unpaid work for parents too ill to perform essential household tasks or even look after themselves. Kerris Olsen-Jones, who works to support these children and young people – some as young as five years old – says that they sometimes ‘miss the opportunity to be children’. She and her colleagues help the young people to socialise and make the most of the opportunities available to them.

However, many young carers do not see themselves as carers, so may not get access to support. Ethan Mason, who cares for his mother who has fibromyalgia, describes how as an adolescent he had to deal with a house fire alone, while fire safety officer Julie Goodfield gives fire prevention tips for people with disabilities and their carers. More information on support for young carers can be found at childreninwales.org.uk Visit our webpage for young adult carers to listen to more Airing Pain programmes on this topic and find out more about the help available across the UK: painconcern.org.uk/how-we-help/young-adults.

Contributors:

Adrian, Amy, Courtney, Emma, Ethan, Leon, Sophie, Tom, young carers
Kerris OIsen-Jones, Young Adult Carer Development Worker
DJ, Young Adult Carer Support Worker
Julie Goodfield, Fire Safety Officer.

Carers #Familyandrelationships #Youngpeopleandchildren

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This edition is funded by a grant from the Dorothy Howard Charitable Trust.

In this edition of Airing Pain we hear how healthcare professionals can use hypnotic techniques to help people in pain. This is not the hypnosis of stage performances, but rather simple skills that can be mastered by most people. When patients enter the ‘meditative-type’ state of hypnosis they are able to use the imagination to change the perception of their pain and even reduce its intensity, says retired GP Dr Ann Williamson. More than just relaxation, hypnosis, she argues, gives us access to ‘mind-body links’ that are ideally suited for addressing both the physical and emotional dimensions of pain. Dr Jane Boissiere, also a doctor practising hypnosis, calls the lack of availability of hypnosis on the NHS ‘a tragedy’. She believes it is the most effective way of addressing medically unexplained symptoms by targeting emotional trauma in a way that puts the patient in control.

Contributors:

Dr Ann Williamson, British Society of Clinical and Academic Hypnosis
Dr Jane Boissiere, British Society of Clinical and Academic Hypnosis.

Fibromyalgia #Generalpractitioners #Hypnosis #Psychologicalapproachestopainmanagement #Psychologicaleffectsofpain

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This edition is funded by Grünenthal.

Almost 100 million EU citizens have chronic pain, but there is still much progress to be made in improving diagnosis and treatment. Pain Concern’s Rowena Jacobs attended the fifth Societal Impact of Pain symposium to find out how patient groups, healthcare professionals and policy makers are coming together to push pain up the agenda. We hear about a successful initiative to change the culture around opioid prescriptions in Italy and the problems facing patients across the continent due an excessive fear of drug dependence, while Northern Irish representatives explain how the Painful Truth campaign has brought the patient experience of pain home to healthcare professionals and policy makers, leading to greater recognition of pain. Pain specialists at the forefront of the campaign for better care explain why education and awareness raising is still such an important issue and Lars Møller, representing a Danish patient group, recalls his struggle to be get treatment for pain in the face of ignorant healthcare professionals. Finally, people in pain are urged to get involved in the fight for better pain management services by putting pressure on politicians.

Contributors:

Lars Møller, Vice President, Danish Association of Chronic Pain Patients
Prof Hans Kress, Head of Department of Special Anaesthesia and Pain Therapy, Medical University of Vienna
Dr Giustino Marassi, Pain Specialist, Italy
Dr Willem Scholten, International Doctors for Healthier Drug Policies (IDHDP)
Neil Betteridge, Vice Chair of the Chronic Pain Policy Coalition in the UK
Louise Skelly, Head of Operations, Patient and Client Council, Northern Ireland
Dr Pamela Bell, Chair of the Pain Alliance of Northern Ireland
Dr Chris Wells, President, European Pain Federation.

Chronicpainasaconditioninitsownright #Educatinghealthcareprofessionals #Epidemiologyofpain #Fundingandavailabilityofpainservices #Generalpractitioners #Healthcarepolicy #Opioids #Socialandeconomicimpactofpain #Psychologicaleffectsofpain

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This edition has been funded by Pfizer.

Physiotherapy, exercise, medications and clinical psychology all play an important role in pain management, but what happens if these treatments don’t give people the relief they need to get their lives back on track? For some patients, more invasive treatments can make a big difference, but there are often difficult decisions to be faced, as Paul Evans discovers from sitting in on one of specialist in interventional pain management Dr Ron Cooper’s clinics in Causeway Hospital, Coleraine.

We hear from patients who have often waited years before being referred to the clinic where they will be considered for interventional treatments such as spinal cord stimulation, nerve-blocking injections and radio frequency treatment. Dr Cooper explains why interventional treatments are more appropriate for some patients than for others, how they are thought to work and why it’s important to see them as part of a broader pain management strategy.

Contributors:

Dr Ron Cooper, Consultant in Anaesthesia & Pain Relief, Causeway Hospital, Coleraine.

Backpain #Complexregionalpainsyndrome #Lowbackpain #Neuropathicpain #Postsurgicalpain #Trigeminalneuralgia #Exercise #Painmanagementprogrammes #Spinalcordstimulation #Surgery

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This edition has been funded by a grant from the Moffat Charitable Trust.

How can people left disabled and housebound by chronic pain be supported to live independently? Producer Paul Evans visits two Edinburgh-based organisations with different approaches to transforming the lives of people in pain.

The Lothian Centre for Inclusive Living (LCIL) is run by disabled people for disabled people with the aim, as its name suggests, of helping people to live full lives despite their condition. A key part of their service is supporting people as they apply for the benefits to which they are entitled in an often confusing and frustrating system. Jacqueline Todd recalls her struggle to be recognised as eligible for the Personal Independence Payment (PIP) and the freedom she has gained from adaptations to her home.

At the Thistle Foundation Paul speaks to members and staff about how their exercise and lifestyle classes bring people ‘out of the darkness’ of social isolation and pain. John Cunningham found the ‘supremely fit’ people at his local gym intimidating, but the welcoming and supportive environment has ‘changed [his] life dramatically’. Course leader Linda Douglas talks about the importance of finding a ‘safe space’ where people can focus on their strengths and find out what works for them.

Contributors:

Kirsty Henderson, Information and Communications Officer, LCIL
Jacqueline Todd, service user and volunteer, LCIL
Linda Douglas, lifestyle management course leader, Thistle Foundation
John Cunningham, member, Thistle Foundation
Margaret Hendry, volunteer and member, Thistle Foundation.

More information:

You can find out more about the organisations featured in this programme at: www.lothiancil.org.uk.

Fibromyalgia #Benefits #Exercise #Occupationaltherapy #Pacing #Peersupport

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This edition has been funded by Pain Concern’s friends and supporters.

In this edition of Airing Pain we hear about how people in pain can take an active role in their care through shared decision making and technological tools.

‘Being collaborative is fundamental’ for managing pain, says Dave Tomson, a GP working on the MAGIC Programme (Making good decisions in collaboration). He speaks to Producer Paul Evans at the British Pain Society’s (BPS) Annual Scientific Meeting in Manchester about the advantages and challenges in developing an approach to medicine where decisions are made by doctors and patients together.

Technology can play a transformative role in empowering people in pain, but there are also pitfalls to be avoided. Jason Davies discusses the pros and cons of ‘telemedicine’ as a pain specialist working in the remote Argyll region of north western Scotland. Other members of the BPS Special Interest Group on Information and Communication Technology discuss the things patients and doctors should be looking out for when using online resources and the cultural change needed to make technology work – people in pain empowered to take responsibility for their pain.

Contributors:

Dr Dave Tomson, GP
Meherzin Das, Clinical Lead, Dorset Pain Management Unit and Chair of the British Pain Society’s Information and Communication Technology Special Interest Group
John Worth, Founder and CEO of Know Your Own Health
David Barrett, Member of the British Pain Society’s Information and Communication Technology Special Interest Group
Dr Jason Davies, Consultant Anaesthetist, Lorn & Islands Hospital, Oban and Clinical Lead, Argyle Pain Service.

Communicationskills #Educatinghealthcareprofessionals #Fundingandavailabilityofpainservices #Healthcarepolicy #Painmanagementinremoteareas #Talkingtoyourdoctor

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This edition has been funded by the City of Edinburgh Council and NHS Lothian’s Self-directed Support Innovation Fund.

In the second of our two programmes focusing on young carers for people in pain, we hear about the effect of pain on relationships between parents and children.

Family therapist Liz Forbat explains how pain can disrupt transitions from childhood to independent adulthood, especially during those difficult teenage years. She discusses with presenter Paul Evan’s his ‘martyrdom’ approach to managing chronic pain – he recalls keeping his children at a distance from it – and the dangers of building barriers between family members in a bid to protect them from the effects of the pain.

We hear the young person’s perspective from Kim Radtke, who grew up with a father often made irritable and emotionally unavailable by his ankylosing spondylitis. The situation was exacerbated, Kim says, because she and her brother did not fully understand the condition and were therefore unable to empathise and communicate with their father about it. Only as an adult has she been able to make the step – so important, according to Liz Forbat – of separating the pain from the person.

Contributors:

Kim Radtke
Liz Forbat, Family therapist and Reader in Cancer and Palliative Care, University of Stirling.

More information:

To find a qualified family therapist or for more information visit the UK Council for Psychotherapy website: www.psychotherapy.org.uk.

Ankylosingspondylitis #Carers #Communicationskills #Explainingyourconditiontochildren #Familyandrelationships #Psychologicaleffectsofpain #Youngpeopleandchildren

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This edition has been funded by the City of Edinburgh Council and NHS Lothian’s Self-directed Support Innovation Fund.

Lost childhood, financial burden, emotional turmoil and guilt – these are some of the challenges facing young people who care for people in pain on top of the caring itself. They’re often left feeling invisible, going unrecognised and unsupported for years.

In the first of two programmes putting young carers centre stage, Paul Evans talks to a family about how pain has affected their lives. Erin McGuigan was hospitalised after developing debilitating pain in her limbs and now uses wheelchair and crutches. She explains how her condition has affected her brother and sisters. Her sister, Donna, talks movingly of her feelings of powerlessness, how she has encouraged Erin, and the need to keep listening and understanding.

Terri Smith a Member of the Scottish Youth Parliament (MSYP), explains why and how she is campaigning to improve the situation for young carers. Hours of freely-given care saves the Scottish Government £1.4 billion a year, but often leaves young people struggling to stay in education and financially insecure.

Contributors:

Erin McGuigan
Donna McGuigan, young carer
Lorna McGuigan, Erin’s mother
Terri Smith, MSYP for Edinburgh and Northern Leith.

Carers #Childrenandyoungpeopleinpain #Communicationskills #Familyandrelationships #Painmanagementprogrammesandyoungpeople #Residentialpainmanagementprogrammes #Socialandeconomicimpactofpain #Youngpeopleandchildren

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This edition has been funded by a grant from the Scottish Government.

'You have to learn to live with it.’ Pete Moore’s GP told him after running out of treatment options for chronic pain. From his own experiences of learning how to live with pain, Pete Moore developed the Pain Toolkit (first a leaflet and now a multimedia web resource) to help kick-start other people’s efforts in self-management.

Producer Paul Evans caught up with Pete at the British Pain Society’s Manchester meeting for an in-depth introduction to the Pain Toolkit. Rather than relying on an exclusively medical model of endless prescriptions, the Toolkit represents an educational approach giving people strategies for self-management. It’s an approach that goes beyond just treating the pain and looks at mood, sleep, exercise and relationships.

Pete describes how the Pain Toolkit uses images and humour to make self-management messages – gathering a supportive team of healthcare professionals, pacing and relaxation – hit home and the ways in which technology can help get the message out there.

Contributors:

Pete Moore, Creator of the Pain Toolkit.

Communicationskills #Educatinghealthcareprofessionals #Exercise #Generalpractitioners #Pacing #Patientperspective #Psychologicalapproachestopainmanagement

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This edition has been funded by a grant from the Scottish Government.

‘Pain medicine isn’t good at dealing with the effect of pain on the person’, says Jonathan Bannister, head of the multidisciplinary pain team at Ninewells Hospital, Dundee. Paul Evans visits the clinic where Mr Bannister and some of his colleagues talk about how they care for people in pain.

We hear about the difficulties of getting a referral and how pain specialists can help GPs add pain management to their armamentarium, or doctors’ toolkit. Physiotherapist Lynn Sheridan describes how she has to win the trust of patients scared of visits to the “physio-terrorist” after encounters with the vigorous methods of traditional physiotherapy. Her more gentle approach focuses on regaining function and helping people do more without flare-ups.

Helping people distinguish between their thoughts and the truth is one of the key aims of Clinical Psychologist, Dr Jonathan Todman. He explains why mental health is very often affected by chronic pain and how pain affects people with mental health problems.

Contributors:

Jonathan Bannister, Consultant in Anaesthesia and Pain Management, Ninewells Hospital, Dundee
Lynn Sheridan, Physiotherapist, Ninewells Hospital, Dundee
Jonathan Todman, Clinical Psychologist, Ninewells Hospital, Dundee.

Activityrestcycle #Educatinghealthcareprofessionals #Flareup #Generalpractitioners #Healthcarepolicy #Pacing #Painmanagementprogrammes #Primarycare #Psychologicalapproachestopainmanagement #Psychologicaleffectsofpain #ReferraltopainmanagementprogrammesbyGP

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This edition has been funded by a grant from the Scottish Government.

If only pain were visible... Deborah Padfield talks to Presenter Paul Evans about her project collaborating with people with pain to produce works of art that represent their experiences. Her photographs are co-creations, using objects and ideas brought to the studio by the orofacial pain patients from University College Hospitals, London.

The art produced not only provides a voice for individuals who may have felt their experiences marginalised by the medical establishment and wider society, but is also part of a study aimed at finding better ways for people to communicate their pain. Images created by Padfield – from a clenched fist to flying sparks – are now being trialled by patients not part of the project as visual prompts in ordinary medical consultations.

‘Pain is a memory’, says Dr Rajesh Munglani, explaining how the way we feel pain is affected by past experiences and our emotions. From the phantom limb pain of a soldier wounded in action to an injured motorist caught up in a bitter legal struggle for compensation, the context of chronic pain can be crucial in helping or hindering people from moving on. The different ways people perceive their pain also means, Dr Munglani argues, that perhaps pacing is not right for everyone, all of the time – a big night out might mean a few days in bed for a teenager with pain, but provide an important boost to their confidence.

Contributors:

Dr Deborah Padfield, Artist and Researcher, Slade School of Art, University College London
Dr Rajesh Munglani, Consultant in Pain Medicine, West Suffolk Hospital, Bury St Edmunds.

Artsandcrafts #Benefits #Communicationskills #Cultureandpain #Explainingpain #Explainingyourconditiontoothers #Pacing #Patientperspective #Psychologicaleffectsofpain #Talkingtoyourdoctor #Amputationandphantomlimbs #Fibromyalgia #Orofacialpain #Trigeminalneuralgia

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This edition has been funded by a grant from the Scottish Government.

We hear about two very different ways of giving people in pain the knowledge and power to help themselves.

Will we soon be able to get a prescription of yoga on the NHS? Christine Johnson speaks to yoga teacher Anna Semlyen about a study that shows yoga can be an effective and cost-effective treatment for chronic low back pain. Semlyen, who helped design the programme used by the research trial, recalls how she has seen people get back into gardening or extreme sports after taking up yoga. The research study found a similar effect among the group of patients using yoga: reduced levels of disability and fewer days off work compared to the control group. Not only is this a low-tech and cheap treatment, but it’s also empowering, argues Semlyen, as it lets people ‘be their own healers’.

‘How are you?’ Three little words often dreaded by people in pain. Gareth Parsons explains to Paul Evans why these simple social rituals can be so difficult for people in pain and how social interactions can instead be made empowering. Parsons’ work on participatory action research gets people in pain together to recognise the negative attitudes or oppression experienced in daily life and find ways to help themselves. The real experts on pain are not the clinicians of researchers, but the people who live with it every day, he argues.

Contributors:

Anna Semlyen, yoga teacher, British Wheel of Yoga
Gareth Parsons, Lecturer, University of South Wales.

Further resources:

You can find out more about using yoga to help with lower back pain and buy the yoga programme book and accompanying CD from the project’s website: Yogaforbacks.co.uk.

Arthritis #Backpain #Lowbackpain #AlternativetherapyontheNHS #Communicationskills #Exercise #Explainingyourconditiontoothers #Peersupport

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Delving into the issues surrounding opioids and healthcare within prisons and investigating the relationship between memory and pain.

This edition has been supported by a grant from the Scottish Government.

Paul Evans talks to Dr Cathy Stannard, a Consultant in Pain Medicine at Frenchay Hospital in Bristol, who outlines the use and misuse of opioids in chronic pain management. She points out that whilst opioids are a useful analgesic for some people, they can have a detrimental effect on others due to their strong side effects. She emphasises the need for healthcare professionals to be aware of how to use opioids effectively as a pain management resource.

Paul also meets Dr Rajesh Munglani, a Consultant in Pain Medicine in Cambridge, who has carried out research into the relationship between pain and memory. He describes chronic pain as a circuit that can be triggered by seemingly small events or memories and highlights the importance of context and memories on pain. He explains that medical or psychological intervention is needed to disrupt the circuit of pain.

Then Paul speaks to Dr Cathy Stannard and Dr Ian Brew, a prison GP, about healthcare within prisons. Stannard reveals some problems in this area, saying that some medicines are a tradable commodity in prisons and that often prisoners’ account of pain are treated with mistrust. She reports that the situation is improving, as the healthcare needs assessment that prisoners receive when they arrive in prison now includes a section on pain, alongside the original sections on substance misuse and psychiatric disorders. Dr Ian Brew emphasises that prisoners deserve to receive equal healthcare to those outside of prison and says evidence suggests that good healthcare, alongside other rehabilitation initiatives in prisons, can reduce the rate of re-offending.

Contributors:

Dr Cathy Stannard, Consultant in Pain Medicine at Frenchay Hospital in Bristol and chair of consensus group and editor of British Pain Society’s Guidelines on Opioids for Persistent Pain: Good Practise
Dr Rajesh Munglani, Consultant in Pain Medicine in Cambridge and was a lecturer in the University of Cambridge researching mechanisms of chronic pain
Dr Iain Brew, GP working in prisons.

Amputation #phantomlimbs #Neuropathicpain #Generalpractitioners(GPs) #Healthcarepolicy #Medication #Opioids #Research

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This edition has been supported by a grant from the Scottish Government.

Paul Evans meets Dr Paul Davies, a Consultant Neurologist from Northampton General Hospital, who explains that whilst most headaches are benign and can be self-medicated, some headaches – those that are frequent and very painful – require medical attention. He outlines the different types of headaches, including migraines, tension headaches and cluster headaches, and says that each kind requires a specific treatment. Dr Davies admits that GPs have a long way to go in diagnosing and treating chronic headaches effectively.

Dr Mick Serpell, a Consultant in Anaesthesia and Pain Medicine in Glasgow, gives us an introduction to topical medicine – medication applied to the surface of the body rather than introduced into it. The medication is applied to the painful area and the drug has a painkilling effect at a local level. Topical medicines can take the form of a cream, a gel or a plaster impregnated with a drug. We hear about two types which are usually used to treat neuropathic conditions – lidocaine and a chilli pepper plaster. One benefit of topical treatments is that they have very few side-effects and can usually be used alongside other analgesics.

Finally, Paul meets Michael Lee, a Research Associate at Oxford Centre for the Functional Magnetic Resonance Imaging of the Brain, who carries out extensive research into placebos ¬– treatments given purely for psychological effect. In defiance of those sceptical of the placebo effect, Lee’s brain imaging research shows that placebo medications can have a visible effect on the way that pain is transmitted to the brain. Lee also highlights the importance of psychological context in treatment, saying that what a patient believes about their doctor, their medication and the therapeutic process as a whole affects their response to medication.

Contributors:

Dr Paul Davies – Consultant Neurologist at Northampton General Hospital and runs headache clinic at John Radcliffe Hospital in Oxford
Dr Mick Serpell – Consultant in Anaesthesia and Pain Medicine in Glasgow
Michael Lee – Research Associate at Oxford Centre for the Functional Magnetic Resonance Imaging of the Brain.

Clusterheadaches #Headache #Migraine #Neuropathicpain #Brainimaging #Medication #Painkillersandsideeffects #Psychologicalapproachestopainmanagement

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This edition has been funded by a grant from the Scottish Government.

At the launch of a new guideline on treatment of chronic pain in Scotland, Paul Evans speaks to patients and healthcare professionals about how to raise awareness and improve care.

Marion Beatson and Susan Scott describe the struggles they both endured in trying to get appropriate care after developing chronic pain. They both hope that the new guideline will help people in pain get the support they need in future by setting out clearly the treatment they can expect to receive. Marion’s daughter Chloe talks movingly about how her own life and her relationship with her mum have been affected by Marion’s chronic pain.

Norma Turvill believes the guidelines could raise awareness of the under-recognised issue of chronic pain which is still not understood by some healthcare professionals and Steve Gilbert explains how they could help transform treatment in primary care. Paul Cameron discusses the guideline’s advice on exercise and the different ways in which patients can access exercise therapies.

In this programme:

Dr Steve Gilbert, National Lead Clinician for Chronic Pain, Healthcare Improvement Scotland
Norma Turvill, Physiotherapist and Chronic Pain Services Facilitator
Marion Beatson, Patient representative
Lesley Colvin, Chair of SIGN Guideline Group
Susan Scott, Patient representative
Paul Cameron, Pain Specialist Physiotherapist.

Backpain #Chronicpainasaconditioninitsownright #Neuropathicpain #Carers #Educatinghealthcareprofessionals #Exercise #Explainingpaintochildren #Familyandrelationships #Generalpractitioners(GPs) #Healthcarepolicy #Painmanagementprogrammes #Painkillersandside-effects #Patientperspective #Primarycare #Work

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This edition has been funded by the Big Lottery Fund’s Awards for All Programme in Wales.

In the previous edition of Airing Pain we explored the pros and cons of taking pain management into the community. This time Paul Evans travels to Powys – the most sparsely populated county in Wales – to see how community pain management works in practice at the programme run by Ystradgynlais Community Hospital.

Course leader Gethin Kemp explains that the community approach makes pain management techniques available to people who are unable to undertake a residential programme. For people whose lives may have been completely taken over by pain the course offers strategies for coping with the emotional fallout, increasing their activity levels through pacing and getting a good night’s sleep.

Participants on the programme Toni and Nia explain what they hope to get from it. We hear from them again at the end of the 8-week course when they reflect on the progress they have made – from learning to communicate more effectively to rediscovering a love of painting.

Contributors:

Gethin Kemp, Physiotherapist and PMP programme leader
Toni Williams, participant
Nia, participant.

Depression #Activityrestcycle #Communicationskills #Familyandrelationships #Insomnia #Medication #Pacing #Painmanagementinremoteareas #Painmanagementprogrammes #Patientperspective #Psychologicalapproachestopainmanagement #Psychologicaleffectsofpain #Socialandeconomicimpactofpain

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This edition has been funded by the Big Lottery Fund’s Awards for All Programme in Wales.

‘Good pain services, based in the community will make a huge difference to the lives of individuals and the NHS’, says Sue Beckman, speaking on behalf of the NHS’s Delivery and Support Unit at the Welsh Pain Society Annual Scientific Meeting. But what does moving pain services into the community mean?

Beckman, together with pain specialists Mark Ritchie, Mark Turtle and Rob Davies debate the key issue of where pain management should take place.

General Practitioners (GPs) are often those closest to ‘the community’ – they often see patients over the course of years, but limited training in chronic pain and lack of time in appointments pose problems. The panellists also discuss the challenges of bringing services closer to the isolated communities of rural Wales while ensuring that as many people as possible can access pain services by public transport. Finally, could moving services away from the pain clinic ‘demedicalise’ chronic pain by causing healthcare professionals and their patients ‘to think outside the box’?

Contributors:

Mark Ritchie, GP specialising in pain management
Mark Turtle, Consultant Anaesthetist, West Wales General Hospital
Rob Davies, Consultant Anaesthetist, Pontypridd & Rhondda NHS Trust
Sue Beckman, Welsh Government Delivery and Support Unit.

Educatinghealthcareprofessionals #Epidemiologyofpain #Fundingandavailabilityofpainservices #Generalpractitioners(GPs) #Painmanagementinremoteareas #Primarycare #Socialandeconomicimpactofpain

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This edition has been funded by a grant from the Scottish Government.

Christine Johnston heads to Brussels to investigate the impact that pain has on society as a whole at the Societal Impact of Pain lobby group’s fourth annual event.

Christine talks to Neil Betteridge of Neil Betteridge Associates which promotes a holistic approach to pain management. Betteridge explains that early intervention is beneficial not only for the patient but also for employers, as it leads to faster, more effective treatment and less time spent outside of the workplace. Jamie O’Hara, who works with Adelphi Real World and the Haemophilia Society, discusses the results of a survey carried out about the effect pain has on society, which found that those living with chronic pain and their carers experience disproportionately high levels of unemployment.

Christine also speaks to Jacqui Lyttle, an Independent Commissioning Consultant, who criticises the current care given to those with chronic pain conditions, citing wrong diagnoses and the subsequent delays in accessing effective treatment as the main issues. She explains that pain management costs more when it’s not managed effectively than when it is, both in terms of money and in working days lost through illness.

Paul Evans meets Jillie Abbott, the Projects Officer of Trigeminal Neuralgia Association, who describes the organisation’s attempts to raise awareness of the little-understood condition within the healthcare profession, citing the high frequency of misdiagnoses and ineffective treatment as the motivation for this educational focus. She also shares some coping mechanisms that can help those living with Trigeminal Neuralgia and emphasises the need for better communication between people living with the condition and healthcare professionals.

Contributors:

Christine Johnston – Pain Concern
Neil Betteridge – Owner of Neil Betteridge Associates and Vice-Chair of Chronic Pain Policy Coalition
Jamie O’Hara - Adelphi Real World and elected trustee of Haemophilia Society
Jacqui Lyttle - Independent Commissioning Consultant
Jillie Abbott – Projects Officer of Trigeminal Neuralgia Association.

Orofacialpain #Trigeminalneuralgia #Carers #Educatinghealthcar professionals #Socialandeconomicimpactofpain #Talkingtoyourdoctor #Unemployment #Work

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This edition has been funded by the Big Lottery Fund’s Awards for All Programme in Wales.

'Imagine how it feels like if you’re in pain and people won’t help you.'

Like other healthcare professionals, nurses can sometimes struggle to understand the perspective of people living with pain. At a training day for student nurses devoted to chronic pain, Gareth Parsons impresses on his audience the importance of believing the patient and delivers some uncomfortable truths based on his research about the frustrations people with pain often have of healthcare professionals: ‘you are the problem!’

Equipped with the training they receive, hopefully this group of nurses will instead be part of the solution. The first step is understanding that chronic pain is a condition in its own right – this way the nurses will be aware of the problems of treating chronic pain as if it were acute (for example, excessive use of opioids) and be able to help tackle anxiety and fear.

With a better sense of the nature of chronic pain, nurses will be less likely to ‘throw drugs’ at the problem, Owena Simpson says. She guides the student nurses in a session of relaxation therapy, while Maria Parry teaches the students basic massage techniques and recalls her own experiences of how a patient of hers was able to overcome insomnia thanks to massage therapy. Gareth Parsons finishes the session with an acupuncture lesson and explains why this treatment may be more effective for some patients than for others.

Contributors:

Gareth Parsons, Senior Lecturer in Adult Nursing, University of Glamorgan
Maria Parry, Senior Lecturer in Palliative Care, University of Glamorgan
Owena Simpson, Senior Lecturer in Adult Nursing, University of Glamorgan.

Chronicpainasaconditioninitsownright #Complexregionalpainsyndrome #Neuropathicpain #Acupuncture #AlternativetherapyontheNHS #Educatinghealthcareprofessionals #Explainingpain #Medication #Opioids #Painkillersandsideeffects #Patientperspective #Primarycare #Specialistnurse

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This edition has been funded by a grant from the Scottish Government.

In this edition of Airing Pain Paul Evans explores the possibility of controlling pain through techniques that focus on the brain and the mind.

Paul meets Aleksandra Vuckovic, a rehabilitation engineer at the Southern General Hospital in Glasgow, who is conducting research into the use of neuro-engineering techniques to control chronic pain in those with injuries to the central nervous system. She explains that neuro-engineering works through patients training themselves to identify the part of their brain that controls their pain and then reducing it using brain waves. One of her patients, Andy Nisbet, shares his own experience of the technique and discusses the potential for future advancements in this method.

Paul also speaks to Vidyamala Burch, founder and director of Manchester-based organisation Breathworks, which offers training for healthcare professionals and individuals in mindfulness-based approaches to chronic pain. She introduces us to the mindfulness technique, which fuses modern medicine with age-old eastern practices, and talks about the advantages of becoming aware of emotional and physical states as they occur. Burch explains that mindfulness allows people to identify the behaviour patterns related to their suffering and to make a conscious choice about that behaviour. This technique impacts on all areas of a person’s life: allowing them to reduce stress, maintain good relationships with those around them and increase their self-esteem.

Contributors:

Aleksandra Vuckovic – rehabilitation engineer, Southern General Hospital, Glasgow
Andy Nisbet – patient undergoing neuro-engineering
Vidyamala Burch – founder and director of mindfulness organisation Breathworks.

Neuropathicpain #Brainimaging #Educatinghealthcareprofessionals #Familyandrelationships #Mindfulness #Painmanagementprogrammes #Patientperspective #Psychologicalapproachestopainmanagement #Psychologicaleffectsofpain #Research #Socialandeconomicimpactofpain

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This programme was funded by the Scottish Government.

Migraine is not ‘just a headache’ – it’s a disabling condition that can cause major disruption to work and personal life. So says David Watson, a GP who specialises in treating patients with chronic headaches.

Dr Watson explains that the ‘migraine brain’ is extra sensitive to changes in the environment, how small changes to lifestyle can help people to minimise episodes and how to avoid the pitfall of medication overuse. He also gives helpful advice on how patients with migraine can best prepare for a visit to their GP.

Post-herpetic neuralgia is another frequently misunderstood condition with myths about its contagiousness and relationship to chickenpox and shingles causing confusion. Marian Nicholson of the Shingles Support Society clears up these misunderstandings and emphasises the importance of preventative treatments. We also hear about a new vaccine which should help to protect older people who are most at risk of developing post-herpetic neuralgia after shingles.

Contributors:

David Watson, General Practitioner, Aberdeen and Chair of the SIGN Guideline on Headache
Marian Nicholson, Director of the Shingles Support Society.

Activityrestcycle #Genderandpain #Headache #Medication #Migraine #Migraineclinic #Painkillersandsideeffects #Postherpeticneuralgia #Primarycare #Shingles #Talkingtoyourdoctor #Work

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This programme was funded by the Big Lottery Fund’s Awards For All programme in Northern Ireland.

Healthcare professionals and people with pain need to work together to manage chronic pain conditions, but how is this achieved in practice? Paul Evans speaks to a GP, physiotherapist and clinical psychologist to find out more.

We begin by hearing from GP and pain specialist Neville McMullan about his work with Ulster Hospital to improve access to pain management programmes by bringing them out of the hospital into the community and giving people the skills to manage their own pain.

Dr McMullan stresses the importance of getting patients out of a cycle of inactivity and physical deterioration. This is where physiotherapy comes in as we hear from Ashley Montgomery, a physiotherapist at Ulster Hospital. Montgomery describes how understanding the reality of chronic pain, being believed and getting the balance between rest and activity right can give people confidence to take the first steps towards self-managing their condition.

Consultant Clinical Psychologist Jenny Maguire explains how acceptance and commitment therapy (ACT) builds upon CBT (cognitive behavioural therapy) to help people adjust to living with pain as a long term condition.

Contributors:

Dr Neville McMullan, GP, Belfast
Ashley Montgomery, Physiotherapist, Ulster Hospital
Jenny Maguire, Consultant Clinical Psychologist.

Activityrestcycle #Cognitivebehaviouraltherapy #Explainingpain #Generalpractitioners(GPs) #Pacing #Painmanagementprogrammes #Physiotherapy #Primarycare #Psychologicalapproachestopainmanagement #ReferraltopainmanagementprogrammesbyGP

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This edition has been funded by the Big Lottery Fund’s Awards for All Programme in Northern Ireland.

In this edition of Airing Pain, Paul Evans speaks to experts from Belfast and London about the similarities, differences and challenges in treating pain in infants and the elderly.

Maria Fitzgerald, Professor of Developmental Neurobiology at University College London, mentions the outdated theory that babies do not experience pain and how this misconception has been disproved. She raises the issue of communication, perhaps the biggest problem with babies and the elderly (particularly those with dementia) - if they cannot communicate about their pain effectively, their pain often cannot be adequately addressed. She also discusses the scientific research she and her team are carrying out as well as the importance of treating pain at an early age.

Paul speaks to Dr Pamela Bell, Chair of the Pain Alliance of Northern Ireland and former Lead Clinician for Pain Services at the Belfast Trust. She discusses how pain treatments work for infants and the consequences of not managing pain during the early stages of their development.

Peter Passmore, Professor of Aging and Geriatric Medicine at Queen’s University Belfast, talks to us about the large number of dementia patients who are thought to live with pain and the need for medical staff and carers to be able to recognise changes in the patients’ behaviour and therefore become more able to address their pain.

Contributors:

Maria Fitzgerald, Professor of Developmental Neurobiology at University College London
Dr Pamela Bell, Chair of the Pain Alliance of Northern Ireland and former Lead Clinician for Pain Services at the Belfast Trust
Peter Passmore, Professor of Aging and Geriatric Medicine at Queen’s University Belfast.

Dementia #Postsurgicalpain #Brainimaging #Carers #Childrenandyoungpeopleinpain #Communicationskills #Explainingyourconditiontoothers #Facialexpressionsasameasureofpain #Medication #Olderpeople #Opioids #Patientperspective #Psychologicalapproachestopainmanagement #Research #Sleep #Talkingtoyourdoctor #Youngpeopleandchildren

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This programme was funded by the Big Lottery Fund’s Awards For All programme in Northern Ireland.

In this edition of Airing Pain, Paul Evans travels to Northern Ireland to visit a patients’ organisation, the Patient and Client Council. The Council provides patients with an independent voice in the health and social care system by involving those who live with chronic pain in the decision-making process and supporting patients who wish to make a complaint, with the overall aim of improving patient services in Northern Ireland.

Louise Skelly, Head of Operations at the Council, describes her organisation’s work promoting information and advice across the healthcare system and using patients’ experience, suggestions and stories to raise awareness of chronic pain. She highlights some of the advances and improvements that the Council has brought about in recent years.

Paul also speaks to pain patient and member of the Patient and Client Council’s pain strategy group, Jay Flood Coleman, who shares his own personal experiences of chronic pain which has been complicated further by a series of health issues.

Board member of the Patient and Client Council, Rena Shepherd, who herself lives with chronic pain, contributes with her first-hand expertise and explains that with little adjustment on the part of employers, employees suffering from long-term pain conditions can still work full-time and be productive, with self-management pain courses proving very beneficial.

Contributors:

Louise Skelly, Head of Operations at The Patient and Client Council
Jay Flood Coleman, patient and Council strategy group member
Rena Shepherd, board member of the Patient and Client Council

benefits #childrenandyoungpeopleinpain #chronicpainasaconditioninitsownright #educatinghealthcareprofessionals #generalpractitioners(GPs) #integratedhealthandsocialcarehealthcarepolicy #occupationaltherapy #painmanagementprogrammes #patientperspective #work

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This programme was funded by the Big Lottery Fund's Awards For All programme in Northern Ireland.

Paul Evans visits an endometriosis support group in Belfast, and interviews founder Anna Jaminson and guest speaker gynaecologist Dr David Hunter.

Dr Hunter discusses the research about how endometriosis develops and people living with the condition describe their experience in depth, including the impact upon personal relationships with family and friends. Members of the support group talk of their immense relief at finding people with similar stories to share.

We hear about the difficulties in diagnosing endometriosis – often mistaken for other conditions such as Irritable Bowel Syndrome – but also about some recent improvements to its management and the crucial role of sympathetic healthcare professionals.

We also learn more about surgical treatments and their likely prognoses, including hysterectomy, and we hear about the physical, psychological and emotional impact of such surgery.

Contributors:

Dr David Hunter, gynaecologist
Anna Jaminson, founder of Belfast endometriosis support group
Linda Harris, group member
Nuala Campbell, group member
Robin Atchison, group member
Louise, group member

Endometriosis #Surgery #Familyandrelationships #Patientperspective #Educatinghealthcareprofessionals #Explainingyourconditiontoothers #Peersupport #Pelvicpain #Visceralpain

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Presenter Paul Evans travels to Northern Ireland to meet a multidisciplinary pain team at Craigavon Area Hopsital, including doctors, psychologists and physiotherapists, led by Dr Paul McConaghy. We find out how cases of chronic pain are discussed by experts of different disciplines and how management strategies are then put into place. The importance of educating GPs about chronic pain is discussed, as well as the need for empathic and respectful professionals.

Paul Evans sees how the team works by sitting in on a meeting about an example patient: Dr Sam Dawson presents the case of a 38 year old woman with chronic lower back pain. Referred by her GP, treatment so far has not led to improvement and she is now experiencing depression.

The team discuss the strategies they would use in working together with such a patient. Psychologist Dr Nicola Sherlock stresses the importance of treating depression as it not only hinders the management of a person’s pain but worsens the symptoms and she and physiotherapist Michele McGeown explain the importance of dealing with pysychological issues, particularly fear of movement, in helping patients improve their physical fitness. The team also talk about how they could use TENS (transcutaneous electrical nerve stimulation) machines to help some patients and how medical doctors and psychologists can work together to understand how a patient is likely to respond to injections. Finally, Dr Jim McMullan explains how GPs can learn from and complement the multidisciplinary approach by listening carefully to the patient and taking into account psychological and social as well as physical aspects of their condition.

Glossary:

Red flag: Red flags are clinical indicators of possible serious underlying conditions requiring further medical intervention. Red flags were designed for use in acute low back pain, but the same principle can be applied more broadly in the search for serious underlying health problems in assessing a patient with any kind of acute pain.
Yellow flag: Yellow flags are psychosocial indicators suggesting increased risk of progression to long-term distress, disability and pain. Like Red Flags, yellow flags were designed for use in acute low back pain but can also be applied more broadly to assess the likelihood of the development of persistent problems in patients with any kind of acute pain.

In this programme:

Dr Nicola Sherlock, Clinical Psycholologist with an interest in Pain Management
Dr Sam Dawson, Registrar
Dr Paul McConaghy, Consultant in Anaesthesia & Pain Management
Mrs Michele McGeown, Specialist Pain Physiotherapist
Dr Jacek Sobocinski, Consultant in Pain. Management & Anaesthesia
Dr Jim McMullan, GP and lecturer at Queens University.

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This programme focuses on pain in children and young people, including the different needs they have and the unique challenges that their care presents compared to adult patients.

Paul Evans and Christine Johnston talk to experts at children’s hospitals in Edinburgh and Glasgow about the strategies they use for helping young people to cope with pain. Although there are obvious differences between treating an infant and a teenager, the aim is always to enable young people in pain to live the fullest lives they can, while minimising the effects on their education and socialisation.

We also consider the wider impact of a young person in pain upon the family unit and we hear from Sam Mason about how chronic pain has impacted his life at home and at school.

In this programme:

Jean Eadie, Paediatric Physiotherapist, Royal Hospital for Sick Children, Yorkhill, Glasgow
Pamela Cupples, Consultant Anaesthetist, Royal Hospital for Sick Children, Yorkhill, Glasgow
Mary Rose, Consultant Anaesthetist, Pain Clinic, Royal Hospital for Sick Children, Edinburgh
Sam and Lynn Mason, Patient and family member
Mandy Sim, Pain Management Nurse, Pain Clinic, Royal Hospital for Sick Children, Edinburgh.

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t the launch of the National Pain Audit at the Science Museum in London, Paul Evans talks to people who took a leading role in its development about the need for an audit and what their findings suggest needs to be done in the future.

For the first time, the Audit will make available to patients and healthcare professionals detailed information on local pain management services. Richard Langford and Cathy Price of the British Pain Society discuss the reports findings, including the need for more pain clinics to adopt the minimum international standard for interdisciplinary services. This would enable them to take a biopsychosocial approach to pain management, which, as Richard Langford explains, can make a crucial difference to patients. Cathy Price also discusses how pain clinics could do more to help patients remain in or get back into employment.

We also hear from Christine Hughes and Jean Gaffin, who have both been involved in the campaign for better pain services, about the problem of inconsistent service provision and the need to work towards a national standard.

For more information on the National Pain Audit and to find out about your local pain services visit: www.nationalpainaudit.org

In this programme:

Prof Richard Langford
Cathy Price
Christine Hughes, Secretary of Pain UK
Jean Gaffin, Honorary Member of the British Pain Society
Charles Dobson.

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Paul Evans speaks to Professor David Taylor from the University College London School of Pharmacy about the perceptions and reality of the pharmacist’s role and their skills. Pharmacist Emma Hinks talks about how pharmacists can help you with services like the Medicines Use Review (MUR), which looks at how you are getting on with your medicines. We also hear about the increasing emphasis on pharmacists communicating with their service users, working together with other services and recommending non-pharmaceutical forms of treatment.

In this programme:

Professor David Taylor, Professor of Pharmaceutical and Public Health Policy at the University College London School of Pharmacy
Emma Hinks, Community Pharmacy Facilitator for Cwm Taf Health Board in South Wales, Pharmacist at Prince Charles Hospital in Merthyr.

AbleRadio #AiringPain #PainConcern

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In this programme Professor Lorimer Moseley, Professor of Clinical Neurosciences and Chair in Physiotherapy at the University of South Australia, explains the relationship between chronic pain and the brain, incorporating personal stories which illuminate this relationship. The importance of providing good explanations of pain to those living with it is also looked at. According to Moseley, the evidence shows that learning about your chronic pain can lead to a reduction in the pain you experience.

In this programme:

Professor Lorimer Moseley, Professor of Clinical Neurosciences and Chair in Physiotherapy at the University of South Australia.

AbleRadio #AiringPain #PainConcern

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In this programme we explore issues affecting the management of chronic pain across the diverse societies of Europe.

In May 2012 over 400 delegates representing 35 European countries met in Copenhagen at the third Societal Impact of Pain conference organised by EFIC (the European Federation of the International Association for the Study of Pain Chapters). Airing Pain was there to listen in and speak to patient groups and leading experts on pain and public health policy from across the continent. We hear how chronic pain accounts for 500 million lost working days in the European Union every year, costing the EU economy over 34 billion Euros.

Interviewees talk about the strengths and weaknesses of pain management in their part of the continent, including Italian successes in raising political interest in pain treatment and a shining example of good practice in Kirklees, Yorkshire.

In this programme:

Professor Hans Kress, president of EFIC
Dr Beverly Collett chair of the chronic pain policy coalition in the UK
John Lindsay, vice president of Pain Alliance Europe
Justino Marasi manages a public company providing health care services for a population of about 350 thousand people in central Italy
Anne Lloyd, trustee of the Patients’ Association in the UK
Dr Judith Hooper is the Director of Public Health for NHS Kirklees and Kirklees council
Dr Chris Wells is president elect of EFIC
Liisa Mikkonen of the Finish Pain Association
Prof Stephen Bevan, director of work force effectiveness at the Work Foundation
Pia Frederiksen of the Danish Association of Chronic Pain Patients.

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A special edition of Airing Pain, covering the 2012 Northern Ireland Pain Summit, organised by the Pain Alliance for Northern Ireland. There we interviewed representatives from government and the voluntary sector, health professionals, and of course patients.

We hear about the needs of patients and provision of pain services in Northern Ireland from, among others, Chief Medical Officer, Dr Michael McBride, and Dr William Campbell, Consultant in Anaesthesia and Pain Medicine at Ulster Hospital, Dundonald, Belfast. Patients attending the summit give us their stories and say what brought them there and Tanya Kennedy, director of Business in the Community, sets out her thoughts on how the world of business can better take account of chronic pain.

Dr Pamela Bell, Chair of the Pain Alliance for Northern Ireland, and Kate Fleck, national Director for Arthritis Care in Northern Ireland, conclude with their thoughts on the ‘road map’ for action following on from the pain summit.

In this programme:

Dr Michael McBride, Chief Medical Officer for Northern Ireland
Dr Pamela Bell, Chair of the Pain Alliance for Northern Ireland
Kate Fleck, national director for Arthritis Care in Northern Ireland
Dr William Campbell, Consultant in Anaesthesia and Pain Medicine at Ulster Hospital, Dundonald, Belfast
Tanya Kennedy, director of Business in the Community

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In this programme we look at ankylosing spondylitis (AS), a form of arthritis affecting the spine. Paul Evans speaks to Iain MacDonald and Tom Downie of the Edinburgh branch of the National Ankylosing Spondylitis Society, about their role in supporting people with the condition. Paul also talks to Janice Johnson of PSALV (Psoriasis Scotland Arthritis Link Volunteers) about psoriasis.

We also interview speakers from the Annual Scientific Meeting of the British Pain Society. Pain Concern’s Sue Clayton gives a patient perspective to healthcare professionals, while Emma Briggs of the British Pain Society’s Pain Education Special Interest Group explains the importance of improving the pain education of healthcare professionals.

In this programme:

Iain MacDonald and Tom Downie, Edinburgh branch of the National Ankylosing Spondylitis Society
Janice Johnson, PSALV (Psoriasis Scotland Arthritis Link Volunteers)
Sue Clayton, Pain Concern
Emma Briggs, Lecturer at the Florence Nightingale School of Nursing and Midwifery, Kings College London and Chair of the British Pain Society’s Pain Education Special Interest Group

AbleRadio #AiringPain #PainConcern

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We hear about orofacial pain (pain of the face and mouth) from Dr Barry Sessle, a professor in the Faculty of Dentistry at the University of Toronto in Canada. Dr Sessle also explains why some types of chronic pain are more common in women than men. Continuing with this topic, clinical psychologist Dr Amanda Williams talks about pelvic pain and the difficulties men in particular have in coming forward to seek treatment.

The International Association for the Study of Pain designated 2012 as the Global Year Against Headache. We speak with a husband and wife on how they manage as a couple to live with husband Phil’s debilitating cluster headaches.

In this programme:

Dr Barry Sessle, Professor in the Faculty of Dentistry at the University of Toronto
Dr Amanda Williams, clinical psychologist, University College London
Phil and Sue O’Brien, living with cluster headaches

AbleRadio #AiringPain #PainConcern

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Airing Pain sheds some light on pain management programmes: what they are, and how they can help. Paul Evans pays a visit to the Glasgow Pain Management Programme where he talks to health professionals and patients.

The programme’s clinical leader, consultant clinical psychologist Martin Dunbar, explains how his team help patients rebuild their lives despite continuing to experience pain. We hear patients on the programme speak about how they have benefited from sharing their experiences and better understanding their pain and Lyn Watson, the programme’s specialist nurse, talks about how she helps patients to manage their medications and get the most out of medical appointments.

In this programme:

Martin Dunbar, Consultant Clinical Psychologist, Glasgow
Lyn Watson, Nurse Specialist, Glasgow Pain Management Programme

AbleRadio #AiringPain #PainConcern

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In this programme we feature two areas of research which are helping in the understanding of pain.

Professor Karen Davis, a neuroscientist at the University of Toronto, Canada, explains how brain-imaging technology has revealed the overlap between experiences of pain and other sensations such as fear.

Dr Yves De Koninck, Director of the Quebec Pain Research Network, discusses how the latest research on chronic pain supports the position that pain is a condition in its own right caused by abnormalities in the nervous system.

In this programme:

Professor Karen Davis, neuroscientist, University of Toronto
Dr Yves De Koninck, Director of the Quebec Pain Research Network

AbleRadio #AiringPain #PainConcern

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How can patients with chronic pain get involved with research into managing their condition? Paul Evans talks to SUCCESS (Service Users with Chronic Conditions Encouraging Sensible Solutions) a group of patients, carers and former patients with experience of chronic conditions who work with researchers at Swansea University. The service users get involved with advising research teams working on healthcare policy, ensuring that patients’ priorities are reflected in social research and policy and that researchers get the benefits of the service users’ expertise.

In this programme:

Angela Evans, Research Officer, Swansea University
David Rae, College of Human and Health Science, Swansea University
Members of SUCCESS, including Mostyn Toghill, John Flynn, Angela Evans & Jill Edge

AbleRadio #AiringPain #PainConcern

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Fibromyalgia affects an estimated 2.7 million people in the UK, yet it is a condition which is poorly understood leaving the people with it often facing ignorance and prejudice. Presenter Paul Evans, who has fibromyalgia himself, talks with Lexy Barber about her experiences of coping with it. We also hear from Professor Ernest Choy and Professor Dwight Moulin about advances in medical knowledge of the condition and possible ways of managing symptoms.

In this programme:

Prof Ernest Choy, Professor of Rheumatology, Cardiff University
Prof Dwight Moulin, Professor in the Departments of Clinical Neurological Sciences and Oncology, University of Western Ontario

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In the previous edition of Airing Pain we featured the work of the charity, Arthritis Care, and, following up from that programme, Paul Evans looks into their self-management programme, the Challenging Pain Workshop, which is available to people with any kind of chronic pain, not just arthritis. We listen in to the course’s volunteer tutors and participants as they discuss learning to pace activities and improving communication skills. We also hear from Rachel Gondwe about how volunteers gain from sharing their experiences of pain and about a trial run by Arthritis Care in partnership with a health authority to measure the effectiveness of self-management programmes.

In this programme:

Jill Davies and Herbie Roley, Challenging Pain Workshop leaders
Rachel Gondwe, Training Services coordinator with Arthritis Care
Kirstine MacDowall, volunteer tutor at Arthritis Care
Toyin Onasanya, Arthritis Care’s South England training administrator

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In this programme we tackle the issue, raised by Judy on our forum, of how people with arthritis – which often has no obvious physical symptoms – can get help in explaining their condition to those around them. Professor David Walsh explains about the different kinds of arthritis. Jo Cumming, Kate Llewelyn and Minal Smith of Arthritis Care talk about their own experiences of the challenges of living with pain and how the information the charity provides can help people like them.

Although arthritis is commonly thought to be a condition which only affects the elderly it can affect people of all ages – even babies. Kate Llewelyn, who developed arthritis at a young age, tells us about Arthritis Care’s booklet for parents, which provides strategies on how to adapt family life when a child is diagnosed with a form of the disease.

In this programme:

Prof David Walsh, Associate Professor in Rheumatology, University of Nottingham and Director, Arthritis Research UK Pain Centre
Jo Cumming, Kate Llewelyn and Minal Smith, Arthritis Care

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The relationship between doctor and patient is crucial in managing pain. In this programme we look at how the British Pain Society’s newly launched Pain Patient Pathways Project should improve the way health professionals manage chronic pain conditions. We’ll hear from a patient about her varied experiences with health professionals and from doctors involved with treating pain about the importance of patients getting involved in the treatment of their own condition.

In this programme:

Douglas Smallwood, British Pain Society
Dr Mark Ritchie, GP, Swansea
Kevin Geddes, Director of Self Management with the Long Term Conditions Alliance in Scotland
Dr Martin Johnson – Royal College of General Practioners’ UK Champion in chronic pain; on the executive committee for the Pain Patient Pathways
Jean Smith, patient

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Nine out of ten people report a lifetime history of head pain and 2012 has been designated the Global Year Against Headache by the International Association of the Study of Pain. Paul Evans finds out more about migraines from Dr Giles Elrington of the National Migraine Centre in London. We also hear from people who live with chronic migraine about their experiences, what triggers their episodes and the treatments they’ve tried, and Heather Sim tells us the steps to take to get referred to a migraine clinic.

In this programme:

Dr Giles Elrington, Medical Director, National Migraine Centre, London
Heather Sim, Chief Executive of The National Migraine Centre
Patients including: Keri Bucholz, Emma Williams and Chris Whitehouse.

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Paul Evans takes the plunge with Daphne Wood of Pain and Able to find out more about how swimming combined with the Alexander Technique can help people with persistent pain conditions. Physiotherapist and Pain Concern expert advisor Paul Cameron answers listeners’ questions on issues from dehydrated spinal discs to losing weight to reduce pain.

In this programme:

Daphne Wood, Pain and Able
Paul Cameron, Pain Specialist Physiotherapist, NHS Fife

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Paul Evans talks to Sunny Boshoff about her experience of complex regional pain syndrome and learns more about the causes of the condition from Dr Bill Macrae. We also hear from him and Dr Joan Hester about their work counselling and treating patients requiring limb amputations, including the use of the Visual Feedback Mirror to help those who have phantom sensations in their amputated limb.

In this programme:

Sunny Boshoff, patient
Dr Bill Macrae, retired (formerly Ninewells Hospital, Dundee)
Dr Joan Hester, Consultant in Pain Medicine, King’s College Hospital, London

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People with mental illness and chronic pain often find it difficult to access the treatment they need. Specialist nurse Valerie Conway talks about her work in providing carers with the skills to better look after people with Alzheimer’s and dementia who have pain.

Measuring pain through facial expressions is one way in which health professionals can become more aware of the needs of those who are unable to verbalise their experience. Professor Jeffrey Mogil tells Airing Pain about his work measuring pain responses in the facial expressions of mice and how this could help in understanding human pain and in finding new drug treatments for pain.

We also hear from Sue Clayton about how sharing her experiences and getting pain management advice at a pioneering chronic pain support group in the eighties helped her put her life back together after post-surgical pain.

In this programme:

Valerie Conway, Clinical Lead, NHS Community Services Chronic Pain, Kent
Prof Jeffrey Mogil, Professor of Pain Studies, McGill University
Sue Clayton, past member of BPS patient liaison

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In this programme we hear about the challenges facing people with chronic pain in isolated parts of the country and how a pain management programme in the Highlands is helping such patients. Dr Cathy Stannard clears up some of the misunderstandings surrounding opioids and explains when they can and can’t help with chronic pain and the possible side-effects of taking them.

In thsi programme:

Jackie Milburn. Clinical Nurse Manager, Chronic Pain Service, NHS Highland
Dr John Macleod, Consultant Anaesthetist, NHS Highland
Dr Cathy Stannard, Consultant in Pain Medicine, Frenchay Hospital, North Bristol NHS Trust

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Pain has a huge impact not just on individuals but also on society, healthcare systems and the economy. Airing Pain takes a look at how the International Association for the Study of Pain’s Declaration of Montréal and EFIC (the European Federation of International Association for the Study of Pain Chapters) are working to drive pain up the political agenda. We interview experts in healthcare policy and chronic pain treatment as well as patient groups at EFIC’s European Societal Impact of Pain symposium for their views on how the way society and the medical profession respond to pain could be improved.

In this programme:

Dr Beverly Collett, Consultant Pain Medicine, University Hospitals of Leicester NHS Trust
Dr Brian McGuire, Senior Lecturer in Clinical Psychology, National University of Ireland, Galway
Gina Plunkett, Chairperson, Chronic Pain Ireland
Prof Dr. Michael Zenz, President. DGSS. Dept of Anaesthesiology, Intensive Care and Pain Therapy. Ruhr-University Bochum

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Pain can sometimes seem like an ‘uninvited guest’ or ‘intruder’ into family life. In this programme we look at the strain pain places on all personal relationships and how family therapy can help. Clinical psychologist Dr Elaine McWilliams talks about the impact of pain on the sexual and intimate side of a relationship, and she and family therapist Jan Parker also explain the effects of pain on the parent-child relationship. Psychiatrist Dr John Rolland explains how a ‘resilience approach’ can help families to move forward together.

In this programme:

Dr John Rolland, Clinical Professor of Psychiatry, University of Chicago and Co-Director, Chicago Centre for Family Health
Jan Parker, Association for Family Therapy
Dr Elaine McWilliams, Consultant Clinical Psychologist

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Pain has often been seen as an inevitable part of getting older. Airing Pain listened in to a panel of experts at a ‘Growing Old with Pain: Innovation, Creativity and Development’ conference in Edinburgh to hear how pain treatments can dramatically improve the quality of life of older patients. The importance of family and carers taking an active role in the management of elderly patient’s pain is highlighted, along with the importance of raising awareness of the best treatments for pain in older people among health professionals. We also hear the inspirational story of Michael and Rosemary Morrison who together have rebuilt their lives around their chronic back pain and the benefits of using computers and computer games to access information and exercise.

In this programme:

Michael and Rosemary Morrison, Pain Association Scotland
Ron Marsh, Patient
Dorothy-Grace Elder, ex MSP, campaigner
Dr Beverly Collett
Prof. Dennis Martin, Director of Centre for Rehabilitation Sciences, Teesside University
Professor Peter Passmore, Queens University Belfast
Dr Pat Schofield, Director of Study for Advanced Nursing, Centre of Academic Primary Care
Dr Kevin Voles, Consultant Clinical Psychologist

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Airing Pain was at the launch of the British Pain Society’s Primary and Community Care Special Interest Group where we heard from healthcare professionals who are working to improve the management of pain conditions in the UK. The crucial role of GPs in recognising and treating pain was especially emphasised.

Plus, is pain all in the mind? Paul Evans learns about the science behind pain in the brain and the exciting studies being done by Prof Irene Tracy and her team at the Oxford University Brain Imaging Unit.

In this programme:

Prof Richard Langford – BPS president
Dr Martin Johnson – RCGP clinical champion for pain management
Dr Mark Porter – Celebrity GP and journalist
Prof Irene Tracy – Director of the Oxford university brain imaging unit
Ms Ann Taylor – Pain community centre, Speaker at event

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Pain management programmes teach people with pain the strategies they need to live as full a life as possible. Paul Evans talks to patients and professionals at Astley Ainslie Hospital in Edinburgh to hear their uplifting approaches to pain management. The programme focuses on the way that mind and body work together, with psychologists playing as important a role as physiotherapists. It looks at how tackling negative thoughts and patterns of behaviour are as crucial as dealing with the physical aspects of pain.

We also get an insight into the amazing benefits of hydrotherapy for those in pain, helping people to take the first step towards getting back into exercise.

In this programme:

John McLennan – initial assessment of patient
Leanne Nicholas – clinical psychologist’s approach, thought strategies
David Gillanders – Acceptance and Commitment Therapy (ACT)
Nuno Fereira – ACT and its effects
Margaret Kerr – hydrotherapy and how it works
Lorraine and patients – hydrotherapy in practice

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Communication is fundamental to the relationship between patient and healthcare professional. In this programme Airing Pain looks at this issue from both the patient and doctor’s point of view. Psychologist David Craig of Glasgow comments on his communication skills training DVD for chronic pain professionals. GP Mark Ritchie explains how depression and chronic pain can be linked, and gives advice on how patients can prepare for medical consultations, using the memory aid: Ideas, Concerns, and Expectations. And finally, we hear from a number of patients about how they effectively broke down any communications barriers with health professionals in order to gain the most that they could from their consultations.

In this programme:

Dr David Craig - Chronic Pain Communication Skills
Dr Mark Ritchie – Depression and chronic pain
Marion Beatson – Speaking to a psychologist
Ron Marsh – Relationship with health professionals
Michael Morrison – Relationship with health professionals

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Paul Evans meets Edith Mowatt who has nerve root pain and hears how she has learned to manage her condition and about her experience of spinal cord stimulation. We hear a doctor’s view on these machines from Dr Steve Gilbert, and how they can also be used to treat complex regional pain syndrome. Dr Candy McCabe tells us more about this condition, as well as the use of mirrors in therapy for phantom limb pains.

Finally, Professor Mark Blagrove and Dr Nicole Tang explain how pain affects sleep, and how a good night’s rest with the help of cognitive behavioural therapy can ease pain symptoms.

In this programme:

Edith Mowatt – Nerve root pain
Dr Steve Gilbert, Queen Margaret Hospital, Fife
Prof Candy McCabe – Complex Regional Pain Syndrome, phantom limbs and Mirror Therapy
Prof Mark Blagrove – Sleep and pain
Dr Nicole Tang – CBT and sleep

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How do culture and religion affect the way we experience and manage our pain? Dr Shilpa Patel, Dr Sue Peacock and Sir Michael Bond talk about the relationship between cultural background and pain.

Also in the programme: Dr Steve Gilbert answers questions from people experiencing back pain; Phil Sizer of Pain Association Scotland provides advice on pain management programmes; and we learn about the epidemiology of pain and hear from Generation Scotland about how their study of pain in the Scottish population can help with the identification of risk factors.

In this programme:

Prof Blair Smith- Generation Scotland
Prof Sir Michael Bond – Pain management in developing countries
Dr Steve Gilbert – Q+As on back pain
Phil Sizer – Pain Association Scotland
Dr Shilpa Patel – Cultures and pain
Dr Sue Peacock – Cultures, gender and pain

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Paul Evans looks at the often uncomfortable subject of pelvic pain and how both women and men can get help. Dr William Notcutt, expert on medicinal cannabis use, talks about the potential for pain relief, side-effects and future possibilities of the controversial drug.

Nicky Jones tells her story of living with trigeminal neuralgia, with Jillie Abbot and Prof Joanna Zakrzewska providing more information.

In this programme:

Dr Steve Gilbert – Q+As on back pain, Pelvic Pain in Men
Dr Natasha Curran- Pelvic Pain
Dr William Notcutt- Cannabis and Pain
Prof Joanna Zakrzewska- Facial Pain/Trigeminal Neuralgia
Jillie Abbott- Trigeminal Neuralgia
Nicky Jones- Living with Trigeminal Neuralgia

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Paul Evans gets a knitting lesson when he visits the Stitchlinks group in Bath, where people use craft activities to manage their pain. Betsan Corkhill and Dr Mike Osborn talk about the medical science behind it, while the knitting group talk about their own experiences. We also meet Dr Laura Mitchell who subjects volunteers to pain tolerance testing to see how music can help relieve feelings of pain.

In this programme:

Betsan Corkhill- Stitchlinks
Dr Mike Osborn- The Science of Stitchlinks
Stitchlinks Members- Their Experiences
Dr Laura Mitchell- Music and Pain

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Paul Evans visits the Centre for Pain Services at the Royal National Hospital for Rheumatic Diseases at Bath to find out about the pain management programme there. Clinical Director Dr Lance McCracken explains how the programme helps people get on with their lives and we meet the patient group to learn about their experiences in living with pain, what brought them to Bath and the things they’ve learned during their time on the programme. We also hear about how the team at Bath provide specific services to younger people and how pain affects their families and sleeping habits.

In this programme:

Bath Patient Group- Their Experiences
Dr Lance McCracken- Pain Management Programme
Dr Hannah Connel- Young People and Pain
Sam Barton-Growing up in Pain
Jan Barton- Personal Story

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We take a look at the role of the pain specialist nurse in the community, eavesdropping on two consultations given by Kathryn Nur at her nurse-led clinic at Tenby Cottage Hospital, Pembrokeshire. We hear how Kath helps her patients, learning about what TENS machines are, how to use them and how they can help those in pain, how acupuncture can also help, and the importance of listening to what the patient has to say.

On the contentious issue of how little training medical students receive on pain matters – fewer hours than vets – Ann Taylor from the faculty of pain medicine at Cardiff University talks about a web service that may go some way towards redressing the imbalance.

In this programme:

Kathryn Nur, pain specialist nurse for Hywel Dda Health Board in West Wales
Ann Taylor: Faculty of Pain Medicine, Cardiff University.

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In the wake of the government’s introduction of the Employment and Support Allowance (ESA) which will see all people already on incapacity benefits reassessed for their ability to work by 2014, Airing Pain discusses benefit reforms as well as how work affects those living in pain and how they can stay in, or get back into, work.

Chris Main, Professor of Clinical Psychology at Keele University, and Elaine Heaver of the Bath Centre for Pain Research take us through the evidence showing the health benefits from being in work and explain how GPs now give ‘fit notes’ as well as sick notes. Paul Watson gives some advice on how to stay in work and talk to your employer and Dr Shilpa Patel talks about the barriers faced by unemployed people with chronic pain.

In this programme:

Elaine Heaver- Getting Back to Work Research
Prof Chris Main- Cognitive Behavioural Therapy
Dr Shilpa Patel- Barriers to Work
Prof Paul Watson- Q+A

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Airing Pain visits the Frenchay Hospital Pain Clinic in Bristol where we hear from staff and patients. Paul Evan sits in on a consultation with physiotherapist Pete Gladwell and hears the advice given to one patient about how to increase her mobility and exercise without causing flare up. We learn about how to talk to your health professional and the different ways of assessing pain. Also covered is how well funded Pain Care is by the health services, and the patients at Frenchay tell us their stories of living with and managing pain.

In this programme:

Dr Cathy Stannard – Pain Specialist
Pete Gladwell – Physiotherapist
Sister Rose Marriot – Pain Nurse
Ron Watt – Patient
Mrs Margaret Howdle – Patient

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Pacing is the thing that makes the most difference to his patients’ lives, says David Laird, Consultant in Anaesthesia and Pain Management in County Durham. We hear about how pacing allows people to build up slowly to doing more, and Pete Moore describes getting his life back on track and becoming a patient expert on pain management.

Also in the programme: Dr David Walsh provides information about the different forms of arthritis and the treatments available and Dr Paul Johnson and Nia Taylor set out some of the opportunities and challenges facing pain services over the next few years. In our Q&A session, specialist nurse Ruth Day answers your questions on painkillers.

In this programme:

Dr Martin Johnson
Ruth Day, Pain Nurse, Torbay: (Q&A)
Nia Taylor
Val Conway
Dr David Laird, Consultant in Anaesthesia and Pain Management
Dr David Walsh
Pete Moore, Creator of the Pain Toolkit

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Pain management programmes can ‘remove the barriers’ that prevent people with pain from living a normal life, says Dr Owen Hughes of the Pain and Fatigue Management Centre in Bronllys, Wales.

Presenter Lionel Kelleway returns to the Bronllys Residential Pain Management Programme where he himself was a patient to talk with staff and patients about what happens on the programmes and also shares his own experience. Mary Rhys Williams describes her work as an occupational therapist helping patients to adjust their lifestyles and consultant Mark Turtle explains what makes a patient suitable for a pain management programme. We also hear from Sheila Day, whose partner has chronic pain, about the challenges faced by the loved ones of people with pain.

In this programme:

Berni Bustin- Pyschologist
Rhian Evans-Living with Pain
Mary Rhys Williams- Advanced Occupational Therapist
Sheila Day- Living with a person in pain
Tracy Thomas- Living in Pain
Dr Owen Hughes- Bronllys
Dr Mark Turtle-Bronllys
Lionel Kelleway- Personal Journey

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In this programme Airing Pain looks at a range of lifestyle changes and psychological approaches we can use to help with managing pain. Dr Rae Bell tells us how a good diet can help in managing pain, telling us about foods which are natural painkillers and why we should perhaps give cola a miss. Ron Parsons describes the exercise routine which has helped him to manage his lower back pain.

Prof Chris Main discusses Cognitive Behavioural Therapy and Vidyamala Burch explains how mindfulness can help people to live in the moment and accept pain while overcoming fear, anxiety and depression. Pain specialist Dr Mark Turtle answers your questions on weight loss, getting referred to a pain management programme by your GP and coping with visits to the dentist in our Q+A session.

In this programme:

Dr Rae Frances Bell (diet)- Head of Multidisciplinary Clinic, Haukland University Hospital, Bergen, Norway
Vidyamala Burch- Mindfulness
Ron Parsons- Patient Interview
Prof Chris Main- Cognitive Behavioural Therapy
Dr Mark Turtle-(Q&A) Consultant Anaesthetist and Pain Specialist

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Chronic pain is as widespread in children and young people as in the population as a whole, but is probably even less well understood. Jan Barton and her son Sam, who grew up in constant pain, discuss their struggle to get a proper diagnosis and to find effective treatment, while, Dr Christina Liossi explains how hypnosis can be particularly valuable as an approach to managing pain for children. Dr Amanda Williams describes the psychologist’s role in helping patients manage their pain and Dr Tonya Palermo explains how a psychologist can explain pain to young people.

We also pay tribute to the late Claire Rayner, indefatigable campaigner for patients’ rights and patron of Pain Concern, who died October 12th aged 79.

In this programme:

Heather Wallace- Claire Rayner Tribute
Dr Martin Johnson- Claire Rayner
Claire Rayner- Patron’s Voice
Sam Barton- Growing up in Pain
Jan Barton- Growing up with Pain
Dr Tonya Palermo- Children in Pain
Dr Christina Liossi- Children in Pain and Hypnosis

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Elizabeth Carrigan of the Australian Pain Management Association talks about how pain management techniques helped her come to terms with chronic neuropathic pain after spinal injury. We speak to experts on neuropathic pain about how nerve damage can lead to prolonged pain and the drug treatments available, including amitriptyline, anti-epileptic drugs and the more controversial opioids. We also take a look at the issue of chronic pain after nerves are damaged in surgery or chemotherapy.

Also in the programme: Dr Mark Turtle is in the chair for our Q&A session providing answers to your questions about living with and managing pain.

In this programme:

Dr Steve Allen -Neuropathic Pain
Elizabeth Carrigan- Living with Pain
Professor Blair Smith- Neuropathic Pain
Lionel Kelleway- Living with Pain
Jan Barton- Growing up in Pain
Dr Mick Serpell – Neuropathic Pain
Dr Paul Farquar-Smith -Post-operative Pain
Dr Julie Bruce – Post-operative Pain

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In this first Airing Pain programme we introduce the subject of pain and its management with contributors with a variety of expertise and experience. Professors Blair Smith and Richard Langford take us through the causes of chronic pain and conditions associated with it, while Sherrill Snelgrove and Kiera Jones talk about the challenges faced by patients in being understood by the health professions. Dr Beverly Collett and explains the importance of the patients’ own understanding in managing their condition and keeping active.

We also feature short interviews with some of the experts we’ll hear more from in later programmes: Professor David Walsh discusses the importance of multidisciplinary approaches in helping patients to manage their pain, Professor Nick Alcott and Claire Rayner encourage older people to get help with their pain and Nicole Tang talks about how people with pain can improve their sleep, and finally, Pete Moore give some words of encouragement based on his own experience of learning to live well with pain.

In this programme:

Dr Beverly Collett –Introduction to Pain
Dr Sherrill Snelgrove – Chronic Lower Back Pain
Kiera Jones- Personal Story
Dr David Laird- Pacing
Dr Steve Allen- Pain Clinics
Claire Rayner, Patron of Pain Concern- Nursing and Pain/Patron’s Voice
Professor Blair Smith- “What is Pain?”
Professor Richard Langford- The British Pain Society
Professor David Walsh-Arthritis Related Pain
Ian Semmons (Chair, Action on Pain)- Action on Pain
Professor Nick Allcock- Pain in Older People
Dr Nicole Tang- Sleep and Pain
Pete Moore- Living with Pain

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AbleRadio #AiringPain #PainConcern

AbleRadio #AiringPain #PainConcern

AbleRadio #AiringPain #PainConcern

AbleRadio #AiringPain #PainConcern

AbleRadio #AiringPain #PainConcern

AbleRadio #AiringPain #PainConcern

AbleRadio #AiringPain #PainConcern

AbleRadio #AiringPain #PainConcern

AbleRadio #AiringPain #PainConcern

AbleRadio #AiringPain #PainConcern

AbleRadio #AiringPain #PainConcern

AbleRadio #AiringPain #PainConcern

AbleRadio #AiringPain #PainConcern

AbleRadio #AiringPain #PainConcern

AbleRadio #AiringPain #PainConcern

AbleRadio #AiringPain #PainConcern

AbleRadio #AiringPain #PainConcern

AbleRadio #AiringPain #PainConcern

AbleRadio #AiringPain #PainConcern

AbleRadio #AiringPain #PainConcern

AbleRadio #AiringPain #PainConcern

AbleRadio #AiringPain #PainConcern