Viewing 36 posts - 1 through 36 (of 36 total)
  • If you had a chronic pain issue what health professional would you want to see?
  • glupton1976
    Free Member

    Say – you have a long standing pain issue that isnt going to go way in a hurry and you needed to learn to cope with it, which health or medical profession would you want to see?

    I’m mainly wondering if you’d prefer to see a physio or a psychologist, but other answers could be just as valuable.

    Pieface
    Full Member

    What sort of pain?

    yunki
    Free Member

    I’m going to say… barman or drug dealer

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    glupton1976
    Free Member

    Say – osteoarthritic pain in a knee or something similar.

    Pieface
    Full Member

    Physio on recomendation. I know a good one in Sheffield

    thejesmonddingo
    Full Member

    Most areas have a team that deal with chronic pain,usually led by a doctor who specializes in pain control,but with psychology ,physio and OT support too.I’d want referring to them.

    jota180
    Free Member

    Pain management nurse?

    thejesmonddingo
    Full Member

    These people should cover your area,ask your GP to refer you.
    http://www.knowledge.scot.nhs.uk/pain/nhs-boards/nhs-lothian.aspx

    allthegear
    Free Member

    If you have chronic pain (ie lasting for > 3 months) you should expect to be referred to is psychologist at some point. It’s a good thing, honest.

    Rachel

    thejesmonddingo
    Full Member

    +1 for Rachel,the whole team can give input and support.

    glupton1976
    Free Member

    I dont have any pain. Apart from dissertation induced pain….

    The reason I posted the thread was to see who folk thought would be best to deal with their pain. Physios appear to be casting their net far and wide with respect to the scope of their job and following a discussion with my supervisor today, I’m not sure that physios are necessarily the best folk to deal with a lot of chronic pain issues. The intervention that we were discussing was CBT. At pre-reg level we get taught to do a basic level of CBT, but neither of us are all that sure that this is a good thing for us to take on and think that better qualified professionals would do a much better job of it. Yes to using the training to identify those who would benefit from CBT, but no to trying to use CBT with someone.

    IanMunro
    Free Member

    Not too sure.
    I guess I’d start with google and go with whatever type of treatment best fit it with my philosophies at the time.

    chudsy
    Free Member

    Initially I went to GP, then referred to physio, managed for 2 years with ibuprofen and stretching, and then referred to a pain management specialist for steriod injections which have alleviated my symptoms but still get painful moments and nagging aches in the affected area.

    bruk
    Full Member

    A lot of chronic pain management clinics are headed up by the anaesthesia department. So I would want to see an anaesthetist.

    Pyschology and physio and even acupuncture could also have a role to play based on the diagnosis.

    sunnrider
    Free Member

    nvm

    allthegear
    Free Member

    glupton1976 – I didn’t realise you were a healthcare professional at the time of my reply. You might find something useful on http://www.paincommunitycentre.org, a website I helped create a few years ago with Cardiff University.

    Actually, I’ve just been asked to do a fair few updates to it.

    Rachel

    julianwilson
    Free Member

    I would like to start with being referred/re-referred to a physio but given a reasonable explanation, I hope I would be open minded enough to see a Cognitive Behhavioural Therapist or psychologist.

    But then I am in the trade, so to speak. I am not a therapist but within my broadly systemic outloook, I also borrow bits of CBT very often, and have over the years passed on plenty of my cases for assessment for suitability for CBT by someone more suitably qualified.

    The wording of Glupton’s last post suggests he is on to this already, but I stress the word suitability here: whilst research suggests that the rapport with the therapist is as important or more important that the choice of (rigorously evidence-based, not crystals, tapping or hot stones…) therapy, there are definitely folk/personality types who you can tell will “take to” CBT and some who are less likely to.

    martinhutch
    Full Member

    I wouldn’t want to be offered just one approach – I hope I’d be lucky enough to get access to a multidisciplinary team like this one:

    http://www.bathcentreforpainservices.nhs.uk/Team.aspx

    Unfortunately, pain management isn’t universally well supported across the NHS.

    ratherbeintobago
    Full Member

    So I would want to see an anaesthetist.

    No – you want to see a pain management specialist. While most of them are anaesthetists, chronic pain management is a defined subspecialty with its own postgraduate exams & training requirements.

    Andy

    MrWoppit
    Free Member

    GP. Start at the beginning.

    crikey
    Free Member

    I’d not want to see any single professional.

    The way healthcare is arranged, you would need a single person to oversee your treatment from a pain point of view, but he/she should really act as a facilitator to get you the treatment that you need for each aspect of your chronic pain.

    The GP should be ideally placed to do that, and should then use a multi-diciplinary approach to make sure you get help from pharmacy, from chronic pain anaesthetists, from physio, from social services and so on.

    The idea of physios doing CBT seems a bit strange, and as you have suggested, hints at an attempt to expand a role into an area which is best dealt with by someone else.

    By the time you reach a diagnosis of chronic pain, you should have been through the system of GP, referral, physio, and so on.

    marp
    Free Member

    Hi Glupton,

    Interesting question… I think it depends on the clinicians clinical training and understanding of pain (especially chronic pain), their communication skills to describe the underlying mechanisms behind chronic pain and their ability to listen, empathise with their patient and understand the greater context of their pain. The approach they use should then be centred around the patient and should try to provide insight into their problem and provide solutions to that, which may or may not be analgesic based.

    I think that CBT very much has a place, however it is tricky to say to your patient i’m referring you for behavioural therapy for your back pain. FRP programmes in physio (and physios in general) tend t use quite a lot of CBT in their interventions. they also benefit from having slightly longer assessment times / slots than medics do.

    I’m not sure if you know Mick Thacker’s work looking at immunology and pain or Lorimer Mosely’s stuff looking at perception and pain amongst other things. Really interesting and very thought provoking. I was lucky enough to train under Mick and feel my approach to pain is very different to the average clinician, as i would hope anyone who has seen him or Lorimer talk would be.

    so in conclusion, i’d want to be seen by someone who had the time to listen to me, the personal skills to listen to me and understand my problem and some idea about how to promote healthy activity to promote resoration of function. Personally i would lke an MDT approach including medic, physio and CBT with all singing from the same hymn sheet.

    Marp

    Rusty-Shackleford
    Free Member

    barman or drug dealer

    Same thing.

    timraven
    Full Member

    I’m going to say… barman or drug dealer

    My go to guys 😆

    glupton1976
    Free Member

    Thanks for the input you’ve all given so far, it’s a great help.

    Anyone know anything about Solution Focussed Brief Therapy (SFBT) with respect to chronic pain or OA knees?

    stanley
    Full Member

    Not familiar with SFBT; I’ll go and have a read up.

    If I had a choice of only one type of health professional, then I would hope to end up in front of a good OT. They should be able to call on many intervention models to help with pain management.

    CBT would also be my first thoughts. (An OT will do this under the CB frame of reference).

    beckykirk43
    Free Member

    It would depend on the sort of pain – for the sort of pain you suggested I’d guess a physiotherapist, probably via a GP would be the way to go if it was me.

    I am aware of pain clinics ran by specialist anaesthetists, I was referred to one but didn’t find it useful – but that was a combination of finding the particular doctor unhelpful, probably not giving it enough of a chance and being a bit of an awkward case to begin with. But if other things had failed then I guess that’d be where I’d want referring to…

    I’m not familiar with SFBT. I can see CBT being useful in chronic pain cases, although again…I suspect it depends very much on the individual and the type of pain they are experiencing.

    bwaarp
    Free Member

    Physios appear to be casting their net far and wide with respect to the scope of their job and following a discussion with my supervisor today

    That’s could be because all the Physio’s I’ve met have been jumped up quacks that flog treatments with no evidence to back their use up…

    crikey
    Free Member

    Is that not needlessly inflammatory bwaarp?

    You’ve done a biomedical degree and some statistics, not exactly the experienced professional are we?

    How many physios have you worked with?

    Karinofnine
    Full Member

    I have a chronic pain issue. The discs in my back have degenerated and are continuing to do so. I had stenosis (operated on) and my discs are bulging slightly. I had a discectomy to remove part of a disc which was badly herniated and pressing into my sciatic nerve. I had five blissful months of pain free following the operation but am now in a bit of pain again – last week was horrendous but I can ascribe that to a series of events and I haven’t needed any painkillers today.

    Which professionals would I like to see? A GP who will prescribe Tramadol for me so I can deal with the pain, Ian Goodall the physio from The Physio Room in Hertford who is brilliant, and ultimately another surgeon because I would like replacement discs please in my lumbar spine. (When I have saved up enough money to see me through the recovery period. The company I work for only pay 8 days’ sick in any rolling year.)

    As for psychologists and psychiatrists, I have very little time for or faith in them. Nutters one and all in my experience. I have read a book on CBT and found it extremely useful and illuminating, in fact I keep it by my bedside and refer to it often.

    crikey
    Free Member

    I think in addition that the chronic pain associated with OA of the knees is subtley different from other chronic pain.

    OA of the knees has a well recognised surgical end point. I understand that some people will not get the surgery, and will live with the pain, but I suspect it differs from chronic pain in other circumstances which are not as clearly defined, much like Karinofnine as above.

    Most of the people I see who are ‘chronic pain’ patients have no hope of a surgical ‘cure’ or any surgical intervention, and I suspect that in turn creates a different situation when their pyschological condition is considered in the light of their chronic pain.

    Karinofnine
    Full Member

    What are “pain clinics”? I’ve seen signs for them in hospitals. Does that mean there is pain so bad that can’t be dealt with by painkillers or an operation? My friend had mouth cancer and she had little bottles of morphine to keep her out of pain (there was an end point to that situation, sadly).

    No-one believed how bad my back was because apparently I don’t present like someone who is in a great deal of pain. I keep fit, keep cycling, go to work etc and I make jokes and laugh when things are bad. One day the pain was so bad I just sat down on my door step and actually cried. That was at home though where no-one could see me.

    ratherbeintobago
    Full Member

    Does that mean there is pain so bad that can’t be dealt with by painkillers or an operation?

    Yes, though it does rather depend on what you consider to be an operation.

    beckykirk43
    Free Member

    What are “pain clinics”? I’ve seen signs for them in hospitals. Does that mean there is pain so bad that can’t be dealt with by painkillers or an operation?

    Pretty much. Seems to be where you’re referred if you haven’t improved with “conventional” pain management techniques.

    They can offer different drugs which deal with a different type of pain (things like progabalin), as well as things like injections of anaesthetic, acupuncture and counseling or so the leaflet they gave me said!

    Karinofnine
    Full Member

    Some kind of surgical intervention to cut off/away the bit that hurts or is making you hurt. A bit simplistic I admit, but I’m thinking about what is wrong with me. I had supposed-to-be-painkilling injections in my back, had absolutely no effect. I am a big fan of operations – again, based on my own (obviously very limited) experiences.

    bwaarp
    Free Member

    Is that not needlessly inflammatory bwaarp?

    You’ve done a biomedical degree and some statistics, not exactly the experienced professional are we?

    How many physios have you worked with?

    An incredulous medic friend at the Olympics plus the amount of athletes using Kinesio taping told me all I needed to know.

    Google “Kinesio Tape Physiotherpay.”

    This ones the funniest

    http://www.londonbridgephysiotherapy.co.uk/london-bridge-physiotherapy-kinesio-taping/

    Kinesio Taping is a technique based on the body’s own natural healing process. This Kinesio Taping exhibits its efficacy through the activation of neurological and circulatory systems. This method basically stems from the science of Kinesiology

    ROFLMAO, why aren’t these people being struck off?

    Oh yes….. I know why….it’s because the CSP are encouraging quackery.

    http://www.csp.org.uk/events/kt1-kt2-certified-kinesio-taping-course-kt1-kt2-3-4-nov-2012-cork-ire

    So much for the Physiotherapy profession pushing for evidence based practice, it seems they have reverted to type again.

Viewing 36 posts - 1 through 36 (of 36 total)

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