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  

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. In 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, Coventry University
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.
Images provided by Sarah Hopfinger.

Read transcript

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

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

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

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

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

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

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

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

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.

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.

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.

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 Management
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.

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.

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.

16:26 – Social prescribers and upskilling non-clinicians to provide support.

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

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’.

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

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

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

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.

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

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

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

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 

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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 

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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 

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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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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

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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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.

Read transcript

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 

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 

#AbleRadio #AiringPain #PainConcern

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

#AbleRadio #AiringPain #PainConcern

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

#AbleRadio #AiringPain #PainConcern

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

#AbleRadio #AiringPain #PainConcern

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 

#AbleRadio #AiringPain #PainConcern

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

#AbleRadio #AiringPain #PainConcern

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

#AbleRadio #AiringPain #PainConcern

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

#AbleRadio #AiringPain #PainConcern

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.

#AbleRadio #AiringPain #PainConcern

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. He discusses how he found it, the possible outcomes of the research and also interviews other participants.

The WITHIN Project will generate 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 Producer Paul 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

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

#AbleRadio #AiringPain #PainConcern

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

#AbleRadio #AiringPain #PainConcern