Prue Butler, Physiotherapist at the Royal Brisbane and Women's Hospital and member of our Statewide Persistent Pain Management Clinical Network has joined us again to share what research says about persistent pain.
- What sort of advances have been made recently with regards to management of persistent pain?
- Recognition that, for most people with persistent pain, opioid medication is not beneficial and has other negative side effects.
- Persistent pain is often not a true reflection of the state of joint/area the pain feels like it is coming from. We know patients can have very severe pain but no actual injury and vice versa.
- The discovery of numerous areas of the brain that form part of the pain 'neuromatrix'. It was originally thought that we had a 'pain centre' in our brains. There are several parts of the brain which work together to create a pain experience, along with our spinal cord. Our brain and spinal cord 'turn up' or 'turn down' how much pain is produced.
- In the case of spinal (neck or back) pain, changes noted on x-rays, CT scans or MRIs have often been present prior to the onset of pain. For example, at least 60 per cent of people in their 50s not experiencing any pain will find they have disc bulges on their MRI.
- Having a deep understanding of how pain is produced helps to reduce pain.
- Is there a cure for persistent pain?
In short, there is no 'quick fix' for persistent pain. There is no medication, diet, exercise type, surgical procedure or piece of equipment that can completely and permanently stop persistent pain. This is because we know pain has many 'ingredients'. Pain is the product of a brain that weighs up what's going on in our tissues (our bones, nerves, ligaments etc), what's going on with our thoughts and feelings, and what's going on in our lives. The good news is that we know that the brain and spinal cord changes that occur over time to create persistent pain can, with time, be reduced.
- How can people with persistent pain stay up to date with what the latest research is?
If your patient is internet-savvy there are many great websites to follow:
- If a patient has been recommended a special new treatment for persistent pain, should they give it a go?
The causes of persistent pain vary from individual to individual. This means that a treatment that has worked for one person may not work as well for another. A patient's first point of call should be their GP, or at least someone who has an up to date understanding of pain science. They should be confident to ask health professionals, 'what is the evidence for this treatment?'. Whilst a treatment might sound exciting and new, it is important to understand all of the 'pros and cons' of the treatment before deciding to go ahead with it. It is distressing when multiple treatments are tried with little success. This can be avoided by ensuring you feel well informed about suggested treatments.
For more information on persistent pain in Queensland, visit the network's website.
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