Persistent Pain – How to understand and address same?

I realised recently that I have been studying or practicing Physiotherapy for over 20 years now. During this time I have has a plethora of wonderful experiences, having worked in community paediatrics, aged care, sport physiotherapy and sports medicine, musculo-skeletal private practice, strength-training regimes, occupational rehabilitation and corporate health programs, practice valuation and acquisition teams, and business management of various teams of allied health and administrators across South-East Queensland, Regional QLD and Sydney.

By far the most engaging part of my career has been developing my knowledge, understanding and practice around persistent pain – more commonly referred to as chronic pain. I suspect the reason for this lies both with my fascination with how profoundly this disorder impacts the suffering individual; and the striking circus which accompanies them through their surrounding healthcare and societal influences.

Persistent pain is often referred to as the “invisible” disorder. It is poorly understood at both the medical and community level, and even more poorly managed. Persistent pain has a biopsychosocial impact – which means patients are impacted physically, emotionally and socially.

Patients’ suffering from persistent pain naturally think that “cure-searching” and “relief” are of the utmost priority for their care. More often than not, this leads to their various medical and allied health professionals (either knowingly or inadvertently) trying to facilitate same “solutions”, and unfortunately dis-empowering and disabling their patients further as a consequence. An example of this is rife in America currently, where an Opioid addiction crisis is gaining formiddable traction – fueled initially by poor pain management at the primary care level.

What patients, healthcare providers, insurance companies, and society in general must understand is that persistent pain disorders may not be “cured” by treatment, medications, procedures or surgeries; that “answers” lie not in “finding relief”, but rather in receiving effective pain education and development of tangible coping and pain management schemas; that these strategies must integrate physical, psychological and life-style factors; and that the patient’s understanding and involvement is central to durable and meaningful outcomes.

Quite simply, patients with persistent pain need to be managed as people, and not diagnoses.

If you know of anyone whom might be currently losing the battle with persistent pain, and they are currently undertaking some of the aforementioned biomedical approaches in hope of change, please make them aware that current evidence suggests these interventions will more likely than not, lead to poor outcomes.

Please feel free to send them my details to reach out, or direct them to Not for Profit Organisations such as Australian Pain Management Association or Pain Australia, as there is an ability to overcome the severe impact this disease state can have on them through development of effective pain management strategies.