Pain control far more than dispensing tablets

Jannet McGowan (left) and the rest of the chronic pain team at the DGH.
Jannet McGowan (left) and the rest of the chronic pain team at the DGH.

ACCORDING to Janet McGowan there are currently around eight million people in the UK who suffer from what the experts call chronic pain – pain which is not going to go away.

And she should know. The DGH consultant is helping spearhead a clinic-based approach to long-term pain relief in which shies away from simply handing out more and more medication and tries to help patients in more practical ways.

As she explained to the Herald during its weekly visit to the hospital, “We try to use a multi-disciplinary approach to the problem.

“In our team we have an occupational therapist, physiotherapist and two psychologists who all play their part in what we try and do.

“Of the eight million suffering across the country only a small number will ever get to a clinic like ours. That is sad because we can achieve quite a lot.”

Nestled in an outbuilding set apart from the main DGH, Dr McGowan and her team receive referrals from local GPs for people who are struggling to cope with their pain levels.

They are assessed by Dr McGowan and her colleague Dr Margaret Lonsdale, before a decision is taken on which ways the team can help.

For some this can be a case of changing medication, giving injections or sometimes using pain relief equipment to target the worst areas in a bid to provide short-term relief to sufferers.

“Even GPs sometimes do not have adequate knowledge about how to tackle these problems,” said Dr McGowan.

“It is not just about taking lots of pain killers which can have serious side effects.

“We look at the whole problem to see what we can do to help.”

Many who come through the doors are put on a one-day foundation course in pain management. This teaches basic ways to cope with the constant intrusions into their life which the pain creates.

Breathing exercises can provide a welcome relief to some as can learning what the body is and isn’t capable of.

As Dr McGowan continued, “A key part of our job is managing expectations.

“We cannot take the pain away 100 per cent but we can speak to the patient and find out what is important to them and work towards helping them achieve their goals.”

Selective sufferers are then put forward for a five-week pain management course which allows them to meet with other people in a similar position while trying out exercises and methods which help alleviate their symptoms.

Dr Monika Tuite, who together with Dr Fay Mills concentrate on the psychological side of things, was quick to point out that the course is no easy option.

“The approach we offer,” she said, “requires the patient to be active and take a real role in it.

“Pain management is really hard work but having the multi disciplinary approach means patients benefit from the input of members of the team who all have skills in different areas.

The proof of the pudding, as they say though, is in the eating. And, if either of the two patients the Herald met are anything to go by, the chronic pain team is working wonders.

Kim McKechnie went through the course last year and says the change it brought about in her was nothing short of miraculous.

“Pain can be so isolating,” she said. “In the winter months I can be in the house for 24 hours a day seven days a week.

“Coming to the clinic and meeting other people going through the same thing was priceless.

“Knowing you won’t be judged by anyone was important and it helped me take control of the pain rather than living being controlled by it.

“It has given me a positive outlook. Now I think ‘I can’t do that but what can I do?’”

Fellow sufferer Linda Rayner could not have agreed more.

She explained, “I had hidden behind the pain for so long but not any more.

“There are still difficult patches but I feel better placed to cope with them.

“It [the things she learnt on the pain management course] has become a vital instrument in my life.”

Sadly though, there are simply not the resources to help everyone who needs it. Last year the team received around 220 referrals but could offer only 40 places on its course.

That means, according to Dr Mills, the team has to think of other ways to offer support.

“There are people who have been through it who are looking at starting a long-term support group.

“We have to be quite inventive because of the limited resources at our disposal.”

And Dr McGowan added, “We are all part time here but there is a huge demand for our services.

“It is a shame we have such limited resources because although our approach will not help everyone, those it does help see a big change to their lives.” Anyone suffering from chronic pain should contact their GP.