Think You Might Have An Injury Causing Chronic Pain?
Suffering from long-term chronic pain is debilitating and can affect every aspect of a patient's life. With the condition thought to affect around half of the adult population in the UK more time and resource is being spent on researching chronic pain, but there is still a massive lack of awareness and understanding about the condition, its causes, its symptoms, and how these symptoms can be treated and managed.
Treating chronic pain outright can be difficult, as the medical cause of pain can be hard to pinpoint; especially as certain conditions, such as fibromyalgia, stem from a problem with the nervous system itself.
A Multi-Disciplinary Approach
Due to this difficulty in treatment, many sufferers instead attempt to manage their pain and take steps to live their life alongside their pain, tackling the issue day by day to improve their overall and long-term outlook. This is of course a constant struggle, but is the unfortunate reality for many chronic pain sufferers.
It is important to recognise that long term pain is unlikely to be managed by a single health care professional with a single pain management programme; it is far more common for pain management to involve an entire health team comprised of GPs, hospital consultants, nurses, pharmacists, physiotherapists, counsellors, and occupational therapists – all of whom will use a number of different techniques to manage pain.
This multi-discipline approach to pain management often requires, or benefits from, referrals to private practices – this is especially true if a long-term prognosis can be improved through early medical intervention – in these instances, claiming compensation against the party that caused your chronic pain, if one exists, can ensure that you are not left facing the bill for your care.
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Medication For Long-Term Pain
Due to the complexities of chronic pain, medication can often take weeks to work and may not immediately reduce pain. Medication should never be used as a standalone treatment and should always be incorporated in to a multi-disciplinary approach that encompasses, among other treatments, physical exercises and counselling.
Many chronic pain sufferers can feel uncertain and unsure about using medication to treat their condition and some painkillers do have worrying side effects, however your GP should discuss all of your options and you should take notes of the effects of any medication you are prescribed in a pain diary, so that you can discuss any concerns with your GP at a follow up appointment.
Medicating chronic pain usually follows a three step process:
- Step one: You will be prescribed simple painkillers, such as paracetamol, and non-steroidal anti-inflammatory drugs, such as ibuprofen, with the intention of managing your pain on the lowest strength medication possible.
- Step two: If these simple painkillers do not abate your symptoms, you could be prescribed with weak opioids, such as codeine, dihydrocodeine and tramadol. Again the hope is that your pain will reduce without having to resort to strong opioids.
- Step three: If your pain still continues strong opioids, such as morphine, oxycodone, fentanyl and buprenorphine, will be prescribed. If you find yourself progressing to this step make sure you have a conversation with your GP about possible side effects, as these stronger medicines will likely have some negative connotations.
Regardless of the strength of the painkillers you are prescribed, your medication should be reviewed on a regular basis to make sure that the balance is right. Balancing pain management with medication should result in respite from your pain while taking the lowest dose of medication possible, so the effect of any potential side effects is minimised.
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Neuropathic Pain Medication
Neuropathic pain, which is usually a consequence of nerve damage, often responds poorly to traditional analgesics like aspirin, codeine and morphine, as such pain specialists often prescribe medication that is usually used for treating other conditions, such as epilepsy and depression, but that have painkilling properties.
Medication of this nature is known as ‘adjuvant drugs’, which is medicine that was originally used for something other than pain.
The most commonly used adjuvant drugs to manage chronic pain were originally prescribed as antidepressants, most commonly amitriptyline and duloxetine. Similarly anticonvulsant or anti-epilepsy drugs, such as gabapentin and pregabalin, are commonly prescribed to chronic pain sufferers.
If your doctor prescribes these drugs it is not because they think you have any of the conditions the medication was designed to combat, but rather because drugs used to manage these conditions can also be effective at combatting certain kinds of pain.
Most of the medication prescribed to you will need to take orally but some are available as patches, ointments, or under the tongue tablets.
Drugs for pain management need to be taken on a long-term basis and will rarely cure the condition; they are more likely to offer a temporary relief from pain.
Pills are rarely the only treatment and management option offered to chronic pain sufferers, most pain specialists will promote a holistic approach that includes several other forms of treatment.
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Cognitive Behavioural Therapy (CBT) For Chronic Pain
Cognitive Behavioural Therapy (CBT) incorporates a range of psychological coaching, designed to manage both physical and mental health problems. The aim is to change your behaviour so that your ability to function in a negative situation is improved. CBT is based on the idea that your thoughts, feelings, behaviour, and the situations you face are all connected and interact with each other regularly.
If you do partake in CBT, either as a standalone treatment or as part of a wider multi-disciplinary approach, the first step will be to assess and understand how these interactions between your characteristics could be creating problems. Once this has been established the next phase of treatment is to work on altering these interactions in a way that helps reduce your pain.
Some of the practical coping skills you may be taught as part of a course of CBT include:
- Relaxation techniques
- Methods for working through negative thoughts and beliefs
- Activity management methods, such as setting goals and pacing methods
- Methods for working with painful or discouraging thoughts and feelings
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Mindful Meditation For Chronic Pain
Another approach that is becoming more popular among chronic pain sufferers is mindfulness, also known as mindfulness meditation.
This is a method for controlling your focus so that it is more connected with the present moment; the aim is to promote actions that are less ‘spur of the moment’ or driven by distress or pressure.
It is thought that being more considered and connected with the present moment could help reduce and manage your pain.
Mindfulness can also help to reduce stress and anxieties, which can make pain feel more severe and are both a part of the cycle of pain. Reducing stress and anxiety can improve your mood and outlook and even these slight differences can make you feel more capable of managing your pain and facing the challenges of the day.
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Long-term pain affects the way in which you move your body, which in turn can affect your ability to carry out certain every day activities. You may find that certain movements are so painful that you avoid them all together but it is important to keep as active as possible.
Failure to keep mobile can lead to loss of joint mobility, muscle strength, co-ordination, balance and function, all of which could result in a deterioration of your condition and thus an increase in pain.
Physical rehabilitation and exercise, while amongst the most difficult treatment options to start, are some of the most important aspects of a pain management plan. Much like other treatment options physical rehabilitation should be part of a wider plan but there have been studies that have shown that physical exercises can be more effective than long-term medication for tackling chronic pain.
Some of the physical therapies that may be recommended by your health team include:
- Occupational therapy
- Joint Protection
- Pain relief exercise
Any physical therapy is usually delivered by an osteopath, chiropractor, physiotherapist or occupational therapist. You may be given exercise to do at home that can be incorporated into your daily routine.
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Pain Management Programmes
A pain management programme usually involves a series of sessions, all aimed at teaching you how to live with your pain.
You will normally attend programmes as part of a group alongside other people who are also suffering from chronic pain. Rather than treating pain directly these management programmes aim to teach you techniques to help you cope with the pain.
Research shows that pain management programmes can result in a better quality of life, better sleep, and improved mobility. Some programmes are held at pain clinics but can also be held at a GP surgery where necessary. Again, you will normally be referred onto a pain management programme by your GP.
As the name suggests, pain clinics are healthcare facilities that have the sole purpose of diagnosing, managing, treating, and supporting sufferers of long-term pain.
Certain clinics may specialise in a particular condition or type of pain but broadly speaking these facilities should offer the specialist help and advice required to manage a unique condition like chronic pain.
There are about 300 pain clinics in the UK, with most being hosted in hospitals. Each clinic will have teams of specialists on hand to support you.
It is at a pain clinic that you may first experience the holistic, multi-disciplinary approach to pain management as clinics often boast varied teams made up of:
- Occupational therapists
Due to their holistic nature you will likely be offered a variety of treatments aimed at reliving your long-term pain, with the specialists in the clinic working together to offer you the best management programme available.
It is important to note that not all hospitals have a specific pain clinic and sometimes it will be a consultant with a special interest in pain that will try to prescribe drugs or co-ordinate treatment with other specialist colleagues in order to control your pain.
However your pain is diagnosed and managed, you will need to be referred to a pain clinic or specialist consultant by your GP.
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Compensation Claim For Best Treatment
If your chronic pain was caused by a particular trigger event, especially an accident that was not your fault, you may be able to claim compensation for your pain, suffering, and direct losses as a result of your ongoing pain.
As well as achieving a sense of justice against the negligent party that caused your long-term pain, claiming compensation can be crucial in ensuring you receive the best possible treatment for your chronic pain.
Early intervention is crucial in many cases of chronic pain and most conditions benefit from an early pain management plan; in many cases the quickest way to access the best possible treatment is to seek a private healthcare provider, which of course can have high associated costs.
In many of the chronic pain conditions our team of chronic pain specialists have successfully acquired early interim payments, which secure a lump sum early in your claims process that can help fund private care and can ease the financial burdens associated with chronic pain.
Further to accessing funds to help you compensate your pain, suffering, and losses bringing a claim can help you manage pain by putting you in touch with supportive experts that have experience of helping other sufferers. Simpson Millar's team of chronic pain specialists can connect you with an expert Case Manager, who will act as a single point of contact for all of your medical appointments, treatments, and pain management programmes.
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