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Pain Management

The Chronic Pain Team

Aim

The aim of the programme is to help people with chronic, or persisting pain, and their family and friends, to manage their pain problem. The programme does not aim to "cure" the pain itself.

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What Is Chronic Pain?

Chronic pain has been felt by the sufferer for more than 6 months. It is real pain that is present for most of the time and is distressing. It does not mean there is an injury or disease still in the body after this time. It means the pain system carrying the messages in the nerves is faulty and sends false pain messages. There is no treatment at present that can correct these faults.

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Why Is Chronic Pain Rehabilitation Needed?

In the past 10 years health care practitioners have worked with people to help them understand and cope with their pain and its effect on their lives. This approach helps people to become more confident and get the best out of their life despite their pain.

A lot of time can be spent looking for a cure to get rid of the pain. This is frustrating, upsetting and demoralising. It wears the person down emotionally and physically, especially as the pain itself cannot be seen or measured. It is also distressing for people around the person. It is a tough process to realise and accept that there is no cure for chronic pain.

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What Accepting Chronic Pain Means?

Accepting that there is no cure means that for now and the next few years, there will be no answers or ways to get rid of the pain completely. The future may be different. There is a lot of research in Britain and North America which will help health care practitioners gradually develop new ways to help reduce chronic pain.

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What Is Chronic Pain Rehabilitation?

Information on :-

  • the difference between acute and chronic pain
  • how the pain systems in the body work
  • why physical movements help the body
  • how muscles, joints and other tissues work
  • how drugs work in the body to help reduce pain

Developing skills :-

  • to stretch and strengthen muscles, joints and bones
  • to use relaxation methods to reduce tension in muscle-bound joints and help with stressful thoughts
  • in goal setting to achieve more confidently
  • in problem solving
  • in pacing to become more active
  • in using drugs to best effect
  • to understand moods of depression, worry and anger and to feel less of them in tackling sleep problems
  • to focus attention on what can be achieved and not on the pain itself

It is about getting the most out of life despite the pain and knowing how best to do it.

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What Happens On a Programme?

A group of 6-10 people with chronic pain work together in 9 sessions of three and a half hours over a 6 week period. There is a follow up session at 3 months to feedback on progress and look at ways to manage difficulties.

MK :- pain sufferer on a programme, "From the beginning I realised they were just like me, frustrated and in pain, all from different walks of life. We were not promised a cure but we were going to learn how to manage the pain."

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What Is a Typical Session Like?

A session is made up of 4 parts:-

  • feedback on success and difficulties with new skills, experiments and goals
  • talks and discussions e.g. what ways drugs can help, understanding anger and frustration
  • relaxation skills to unwind the body and mind
  • learning ways to stretch and strengthen the body

It is to share experiences and focus on coping with pain and its effects better, focusing on what and how to improve difficulties rather than listening to distressing experiences over and over which can be distressing.

MK :- "All the information we were given was easy to follow and we were asked if we understood. If not we discussed the problems. Believe me, it was good and so friendly, both the talks and the exercises. It flew by and before we knew it, it was over."

Patients are asked to attend all sessions to build up skills and confidence step by step. Missing a step means losing a skill and being less confident. There are frequent breaks and people can sit, stand or move around as they wish.

Each session includes physical activity to help improve mobility, flexibility and stamina. This is paced and leads to being able to walk further, stand longer and do more activities.

A partner, family member or friend is invited to 2 of the sessions to learn about the programme and how to help the participant be successful with the changes.


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The Team Members

Tracy Sanderson - Senior Physiotherapist

Dr. Frances Cole - GP with specialist training in Cognitive Behavioural Therapy

Dr. Philip Taylor - Consultant Anaesthetist

Mark Pitkethly :- Clinical Psychologist


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How To Get On To The Programme

Step 1

People are referred by their GP or specialist. They are sent questionnaires, which they fill in and return. These take some time to complete but they help the team to understand the pain and its effects on the person and their life.

Step 2

The person is invited to an assessment with two of the team members, a friend or relative may also come. The assessment lasts about 75 minutes with the person and the team working together to make a list of the problems the pain is causing. The effects of the pain on physical activities, moods, relationships, social life and views of the future are looked at.

Step 3

The person identifies the three most important problems from the list.

Step 4

A plan is made on different ways to make changes to these important problems. A decision is made with the person as to who is responsible for the changes. There are usually several options, such as :-

  • working with a team member on a one to one basis
  • a medication change or stopping a medication if it is unhelpful
  • joining the group based pain rehabilitation programme
  • other treatments such as hydrotherapy, a trial of a TENS machine or a course of acupuncture

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And Finally

People who have participated in Pain Rehabilitation Programmes do not have any significant reduction in their pain, but they are able to do more, cope better with flare-ups and often have reduced dependence in their medication. They feel more in control and are more optimistic about their future.

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Useful Links

www.backpain.org/

Back Care for healthy backs

www.nhsdirect.nhs.uk/

NHS Direct Online

www.vh.org/

Virtual Hospital

www.bradfordhospitals.nhs.uk

Bradford Hospitals An NHS Foundation Trust

In partnership with team members from Halifax, Huddersfield and Dewsbury, the Bradford Pain Rehabilitation Team offers workshops for Health Care Professionals on topics such as :-

  • Holistic Assessment of the Chronic Pain Patient
  • Acute versus Chronic Pain Mechanisms
  • Goal Setting
  • Pacing of Activities
  • Using Medication to Best Effect

For information contact:

Deborah Crothers

Pain Management Co-ordinator

Pain Therapy

The Calderdale Royal Hospital

Halifax.

Tel: 01422 357171 - Ext. 4085.

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