Over 250 delegates signed up to our latest webinar on 21 October on pain science and management – the third in a series of “change” webinars from Connect Health Change to make and embed transformation in healthcare.
Persistent pain can be defined as pain that has lasted for more than 3 months. It is a major problem here in the UK and indeed worldwide. A staggering 28 million people in the UK are estimated to have persistent pain and painful conditions such as back pain and arthritis. These are values that emerged in normal times but we are not in normal times and COVID-19 has had a significant impact on all aspects of our lives, including pain.
Event chair Prof Cormac Ryan, Community Pain Champion, Flippin’ Pain and Professor of Clinical Rehabilitation, University of Teesside remarked
Broadly speaking, public understanding, and indeed many healthcare professionals’ understanding, of persistent pain is significantly out of sync with the best scientific evidence. In fact, many things that scientists have known about pain for decades have yet to filter through to the patients and clinicians at the coalface of pain management. Now more than ever we need to think about how we can best address persistent pain on a national scale.
The great line up of speakers tackled the challenge that is persistent pain and the steps we can take to address the problem – views from a mixture of expert patients, clinicians and scientists each with their own unique viewpoint of the problem.
The webinar featured Prof Lorimer Moseley, one of the world’s leading pain scientists and recently made an Officer of the Order of Australia, for ‘distinguished service to medical research and science communication, to education, to the study of pain and its management, and to physiotherapy’. He explained the impact of misinformation and misunderstanding when it comes to pain and how the best scientific knowledge enables better healthcare and lifestyle choices.
We know outcomes are better if people can flip their understanding. Persistent pain is arguably humanity’s most disabling health problem yet there is overwhelming evidence that clinical guidelines alone have not done much to change practice. Any population level approach to solve humanity’s most disabling health problem must incorporate whole of community education.
Richard Pell, Flippin’ Pain Campaign Director and Head of NHS Service Development, Connect Health went on to explain how Flippin™ Pain came about, what it is and its impact both on patients and the NHS
It’s really about bringing the real science of pain to the people: addressing myths, misconceptions and misinformation. Putting people back in the driving seat and giving them the control to make confident, informed choices about their healthcare utilisation, and more broadly, their lifestyle.
We were honoured to hear from Niki Jones, who is a person living with persistent pain, who told us about her remarkable and inspirational pain journey and the role that a better understanding of pain played in that journey.
I’ve had pain for 18 years. For 16 years I’ve been immersed in biomedical, surgery and opioids and one day woke up and found a pain management course online and discovered Lorimer’s videos on YouTube and am 99% recovered. I watched all of them again, and again, and they made such a massive impact on me. And all of this helped me reconceptualise the pain. I could see it as essentially a brain misfunction.
Finally Dr Deepak Ravindran, Consultant in Pain Medicine, Royal Berkshire NHS Foundation Trust and IPASS (Integrated Pain and Spinal Service) Deepak talked about changing the mindset of trauma informed pain practice
We now realise that nociception, the actual release of chemicals when you have an injury, is only one part of the picture. There may be places where nociception is there, but pain isn’t. But predominantly, pain is an experience, an opinion which you are now realising that it is a protective experience that needs to be there, because it is fulfilling a protective response in the brain, what the brain construes as an aversive threat that it needs to protect the organism from. Pain and nociception are not the same.
Key themes from the debate included:
- Short-termism – How to meet the needs of patients for ongoing support in their self-management journeys within pain management services which currently work to a very short-term model?
- Attitudes of Healthcare Professionals – Physiotherapists are now very good at recognising that pain is multifaceted and needs a wider biopsychosocial framework so we can work with the patient. But how do we get our medical colleagues on board with this evidence-based approach?
- Language – The importance of skilling all the MDT on how to ask about trauma in an appropriate way. How can we bring HC Professionals with us – Flippin Pain is the right way – what else is missing in the health care lexicon. We need to use the same language for our patients as this is what needs to change first.
- Medication – How can we educate our primary care colleagues with ‘managed’ opioid reductions and understanding the whole picture rather than a didactic approach we sometimes see where things are just reduced or stopped abruptly
- Education – Could we get the holistic approach integrated into Pain ladder and nice guidance as this is where the gatekeepers (GP) refer to for advice. Grass roots education
- Resources – Psychology and psychological therapies are woefully under resourced
Feedback included:
- Such an inspirational talk
- I’m really happy this webinar connected so many people from the pain management field!
- Really interesting to hear Nikki’s story of facial & head pain, great inspiring stuff.
- I love that Deepak has drawn from literature outside the medical to inform his practice. General reading into human performance and well-being (positive psychology, behaviour economic, anthropology, etc.) has informed my practice extensively.
- Lorimer’s videos are so accessible and easy to understand
Watch the full recording and individual speaker recordings here:
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