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Living with persistent pain

About 11% of the British population experience persistent pain and it has many different causes. Persistent pain has a major physical impact on people’s lives, but it also has many negative emotional, social, and psychological effects. It affects people in personal and domestic tasks, in work, leisure and can affect relationships. People with persistent pain often feel depressed, frustrated, worried, anxious, sad or helpless because of the pain they are experiencing. Family and friends may experience many of these feelings too.

What is the pain management programme?

This is a psychologically based rehabilitation programme for patients with persistent pain and complex pain-related disability. It aims to provide patients with persistent disabling pain the ability to manage their symptoms with psychological, physical and behavioural support. The purpose of the programme is to promote self-management and provide techniques to empower change, improve quality of life and reduce suffering.

Assessment

Assessments are carried out by experienced clinical psychologists, physiotherapists and nurses specialising in persistent pain. A full medical history is taken to ensure that the patient is medically appropriate for pain rehabilitation intervention. The clinicians carefully assess and thoroughly ensure individuals are offered the most appropriate therapeutic intervention to provide the best outcome.

Treatment model

The treatment programmes use various psychological approaches such Cognitive Behavioural Therapy (CBT), Acceptance and Commitment Therapy (ACT) and Compassion Focussed Therapy (CFT). These approaches have strong evidence in the treatment of persistent pain and have been shown to provide good outcomes for patients. These models are used alongside education and a tailored exercise programme for a healthy lifestyle focus.

All interventions are designed to reduce the impact of pain on a person’s life and aim to reduce pain-associated disability.

Group members

This programme is suitable for adults over the age of 18 with long-standing pain and associated disability that have not responded to conventional treatment interventions. The following symptoms and behaviours may be present:

• Multiple, widespread, or mixed chronic pain (MSK and/or non-MSK) > 6 months
• Significant disability from persistent pain
• Significant impairment of function with insufficient response to optimal pathway of interventions
• Present with co-morbidities (experience other health problems at the same time)
• Take high doses of prescribed drugs e.g., opioids >120 mg morphine equivalents and/or additional drugs
• Exhibit disabling levels of distress, depression, or anxiety
• Use alcohol or prescribed drugs inappropriately to relieve symptoms of pain and distress
• Use recreational drugs to relieve pain
• Overuse of healthcare resources e.g., frequent A&E attendance or hospital admissions for pain management
• Have a desire to return to activity/ work 

Format of the programme

Organisation, guidance and teaching are from an experienced team of staff including clinical psychologists, physiotherapists, nurses and a medical consultant in pain management.

The programme runs for 8 weeks to include up to 36 hours of education, exercise and self-directed learning. The group will be delivered either weekly on a face to face basis held at Whittington Community Hall in Worcester (Tuesdays), or virtually via Microsoft Teams (Wednesdays).  Each session will last for an average of 3 hours.

Topics included:

• Understanding pain
• Goal setting
• Pacing techniques
• Handling unhelpful thoughts and fears
• Managing flare ups and set backs
• Relaxation techniques
• Mindfulness
• Stress management
• Cognitive behavioural therapy courses for improving sleep
• Medication
• Nutrition
• Benefits of exercise

There will be weekly exercise sessions comprising of gentle stretches and exercises tailored to individuals’ capabilities. The exercises will help improve your strength, stamina, flexibility and mobility.

The programme will enable patients to connect with others who understand what it is like to live with persistent pain.

Open the Pain Management Programme Patient Information Leaflet here.