In Touch: winter 2023 - understanding pain

 

 

Chronic pain affects the daily lives of millions of people and, for many, can lead to years of disability and poor quality of life. Pain coaching involves creating a safe environment for the person experiencing chronic pain to tell their story in a way they can feel their pain is validated and they can be helped to have a better understanding of their pain. By helping the patient to
understand and overcome chronic pain, a pain coach can help that person to see the truths of their situation and then move on to shape a positive future

Read Richmond's article here 

 

In everyday life, we often feel pain without suffering. Temporary, non-threatening pains like scratches, stings and bruises are not typically suffered. Conversely, we often suffer profoundly without any pain. Addiction, fear, anxiety, and doubt are all examples of suffering, but typically don’t involve any pain. This article explores the distinction between pain and suffering and how respecting this difference might contribute to better outcomes for those with chronic pain.

 

As with most individuals who work in the healthcare profession, I have a natural curiosity for and interest in helping people. I knew I wanted to be a physiotherapist from a young age and fortunately this passion has continued. I have worked in musculoskeletal (MSK) physiotherapy for more than 12 years and followed many of the common paths: pitch-side sport, postgraduate training in Mulligans, manipulations, acupuncture, taping, massage; you name it, I have probably done it. Some of this knowledge I have kept up and some I have gradually distanced myself from as my passions and knowledge have evolved. I currently work as an Advanced Practice Physiotherapist in chronic MSK pain in a London NHS hospital. This article shares why I chose to work in this area and how it has influenced me professionally and personally.

 

Traditionally, we have studied nociception and pain-via-nociception, but only recently have we started to study pain in the complex / wider sense. Nociception alone cannot however fully explain pain, nonetheless, neuroscience has contributed significantly to our understanding. This article aims at explaining sensitisation and descending modulation and the three mechanistic descriptors of pain in the context of the lived experience of pain.

Louise Trewern 

Ruth Barber

Nerita Lewis

Hannah Vickers

The International Association for the Study of Pain (IASP) defines pain as an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage. Whilst this might be a scientific description, it very often does not do justice to the real lived experience of the individual who faces chronic pain every day.

The accounts in this section are from individuals who know what it is like to live with chronic and persistent pain, and each one has generously shared their thoughts, feelings and methods for managing and, where possible, overcoming their pain. Overwhelmingly, each author reveals their own resilience to dealing with their pain journey, and helps us to continue to recognise that, rather than being an abstract condition to be researched, chronic pain is the lived experience of millions of people who all need to find their own methods for managing it to improve their quality of life.

 

In February 2014, Louis Gifford very sadly passed away and Physio First was proud to honour his memory, thanks to the generosity of his wife Philippa Tindle, with two editions of In Touch that comprehensively covered the theme of pain, a subject that was one of Louis’ passions as a physiotherapist. In our winter 2015 edition, we republished an article that had previously been submitted to us by Louis, based on his Shopping Basket Approach to pain rehabilitation. As this latest edition of In Touch once again addresses the subject of understanding pain, we felt that in recognition of Louis’ continuing influence on how physiotherapists treat pain patients, it was fitting that we revisit his article; an edition on pain is not the same without a contribution from Louis Gifford. For established physios who are aware of Louis’ legacy, this will hopefully be an enjoyable reminder of his work, and for those who are new to the profession, you will be introduced to someone who was perhaps one of the best and most respected physiotherapists and authors within his field.

 

This research aims to understand how self-employment affects the work of private physiotherapists. Initial findings and analysis reveal a variety of factors that have led physiotherapists to engage in self-employed work. The nature of self-employment and working within private healthcare has led physiotherapists to develop skills, competencies and behaviours to navigate work and provide a high level of patient care. Themes include dedication to patients, treating for free, becoming friends and humour. Some findings may be confronting or thoughtprovoking; however, there is an opportunity to use this research to support the physiotherapy profession to navigate their careers successfully, whilst achieving the best outcomes for patients.