Call for new approaches to chronic pain managementDate: 26/07/2018
During National Pain Week (23-29 July 2018), Cabrini pain specialist Dr Kenneth Shum is calling for patients and the medical profession to adopt holistic approaches to managing chronic pain, rather than simply relying on pain medications.
Dr Shum, Manager of Cabrini’s Chronic Pain Service, spoke on ABC Melbourne’s Libbi Gorr program on Sunday 22 July to discuss the issues of chronic pain, and to provide advice to callers on how to manage their conditions.
He says that chronic pain, defined as an episode lasting three months or more, is prevalent in the community, with one in five people suffering at any one time, and about one-third of people over 65 years experiencing the condition. “People move in and out of this serious, debilitating condition, but it’s still a large number of people. It is increasingly recognised as a serious condition needing specialised treatment,” said Dr Shum.
“Chronic pain might include neck and back pain from arthritis, nerve pain from a degenerative spinal condition, diabetic neuropathy, conditions such as shingles, and fibromyalgia which is a widespread pain condition. There are many, many causes of pain and we need to understand the cause and establish a treatment path that provides relief and leads to better quality of life.
“There are many treatments including mindfulness, meditation and distraction therapies, as well as medication, and they are all part of learning to manage severe chronic pain conditions.
“Frequently chronic pain can’t be cured, but patients can learn to manage their conditions well, through a variety of techniques.
“We are continuing to better our understanding of why a particular patient might be more likely to develop chronic pain and what is happening to our bodies and minds when we have chronic pain. How we think, how we feel and how we behave can change how chronic pain affects our lives,” he said.
Over the past year, Cabrini Rehabilitation (Hopetoun Street campus) has set up a new pain program which for the first time includes a dedicated pain nurse who:
- Links patients suffering acute and chronic pain with services to meet their needs
- Provides an essential liaison between treatment areas such as Cabrini’s Alan, Ada and Eva Selwyn Emergency Department
- Holds a five-week program to teach patients how to manage their pain and do better in daily life
“Cabrini’s multidisciplinary chronic pain service aims to provide a holistic assessment and then target the appropriate treatment for patients,” says Dr Shum. “A measure of our success is that patients are better able to manage their pain with a variety of strategies, have a healthy outlook on life despite their pain, and ultimately to enjoy a better quality of life.”
Cabrini Rehabilitation patient Helen Boulton has been using mindfulness in her treatment as an outpatient, as well as medication, occupational therapy and psychology. She is 52, and was diagnosed with Complex Regional Pain Syndrome (CPRS) six years ago, but had already been suffering pain for a decade. She was disbelieved by many doctors for years, and it took time and persistence to find a diagnosis and help. “One of my major aims has been to reduce my medication,” she says. “My CPRS isn’t going to be cured, I know that: what we are looking for is to get it to a manageable level where I can be as functional as possible without it flaring.”
Cabrini physiotherapist Jennifer Trotman works with many chronic pain patients at Cabrini’s Pain Clinic. “Chronic pain is quite an isolating condition,” says Ms Trotman. “A huge part of what we teach patients is accepting and understanding their condition, and why they have it, and what they have to do to self-manage”
Ms Boulton says her life is much improved through her treatment: “I’m not Zen all the time, but I’m much calmer. I feel more anchored, more tethered to the world and I’m more aware of my body – I can notice even subtle changes.”