photo: Joyce Fleur and Rhian Lewis with Bedwyr Pritchard and Pat Owen.
The three NHS Trusts in North Wales have contributed to the first National Pain Strategy which aims to improve the lives of patients suffering from Chronic Non-malignant Pain.
The National Pain Strategy for Wales is launched on June 19th and is the first of its kind in the UK.
The document outlines major changes which will mean improved services and equity across Wales; getting the right service delivered by the right people, to the right patient at the right time and in the right place.
To put pain in context, it is estimated that approximately one in five of all consultations with a general practitioner relate to pain in some form. In terms of chronic back pain alone, the estimated cost to the NHS is £481 million a year, with non-NHS costs (such as private consultations and prescriptions) being an additional £197 million.
Rhian Lewis, Consultant Anaesthetist at the North West Wales NHS Trust said: “Chronic non-malignant pain covers a wide range of painful conditions from arthritis through to phantom limb pain, back pain through to nerve damage pain affecting individuals physically, psychologically and socially .These common conditions can result in disability and can affect anyone at any age and from any social background. They also have a significant impact on quality of life and individuals' abilities to undertake the activities of daily living.”
She added: “Managing these conditions calls for the input of a range of professionals as well as the support of the voluntary sector and other public services. Research has shown that if patients are well managed in the initial phase of their pain with the appropriate care then huge reductions in chronic pain can be made and suffering and the financial burden can be reduced significantly."
Pain Services in North Wales
Chronic (long-term) pain affects a high proportion of the population and can have a devastating impact on sufferers’ lives. They sometimes find themselves unable to carry on with work, socialising and leisure activities and even struggle to look after themselves day to day. Pain is invisible and people who suffer pain every day can feel isolated. Some feel that other people don’t understand or even believe they have the problem. Many feel very anxious about making their pain worse, or worry about how they will cope as they get older.
The Pain Services in North Wales, based at the Gwynedd, Glan Clwyd and Wrexham Maelor hospitals, are staffed by teams of consultant doctors, specialist nurses, clinical psychologists and physiotherapists. Patients seen by the service suffer from a variety of chronic pain problems, such as spine and joint pain, nerve damage pain or conditions like fibromyalgia or chronic headache, abdominal or chest pain. The service works together with family doctors and other community services to help people manage their long-term pain as independently as possible.
Joyce Fleur, Clinical Nurse Specialist at the North West Wales NHS Trust said: “Patients in the service are assessed and usually offered a range of methods to try to reduce the pain, such as injections, medications, physiotherapy, TENS or acupuncture, depending on their individual problems and preferences. But managing chronic pain is about working together, and sufferers often need to put a lot of effort into adapting to their pain and adjusting their lifestyle themselves, to cope better with it so that it doesn’t interfere with their lives too much.”
The Pain Services give help and guidance for people to achieve this, either one-to-one or in groups on Pain Management Programmes in Caernarfon and Rhyl. The Programmes run over eight weeks, where patients learn about many aspects of managing pain, such as planning and pacing activity, setting and working towards targets, exercising safely and comfortably, learning relaxation and meditation techniques, and dealing with emotional aspects of pain.
So far, there is no magic wand to take away long-term pain, but it is possible to learn to live a rewarding life despite it.
Patients’ Stories
Bedwyr Pritchard of Deganwy suffered from chronic pain for over two years following a slipped disc. The problem gradually got worse and affected his work as a BT Engineer. His employers however were very understanding in allowing him time off work to attend the Pain programme. Bedwyr says that as well as suffering extreme physical pain, he was also affected mentally by his back problems and became depressed as a result: “It’s something that affects your whole life and makes you think twice before doing anything. I just felt that there was nothing I could do about it and it then began to affect me mentally. The most mundane thing like picking up a frying pan could set it off. Most people seem to think that back pain is caused by trying to lift something that is extremely heavy but that’s not the case with me.”
Attending the Pain Clinic at Ysbyty Gwynedd has had an extremely positive effect on Bedwyr’s condition and the alternative approaches have given him a new outlook and enabled him to manage his condition more effectively: “The programme teaches you to use your mind to control the pain and encourages you to think about it in a different way. I was taught some Tai Chi as part of it which focuses on channeling your energy. I must admit I was very wary about all of it at the beginning but it has had a very positive impact. I have been very surprised at the effect it has had and would recommend it to anyone. I would encourage others who have chronic pain to try it because this service means that people don’t have to suffer in silence any more.”
Pat Owen of Bethesda Bach near Caernarfon has suffered with chronic pain in her neck for nearly 18 years following a horse riding accident. During this time she tried many remedies, including physiotherapy but things gradually got worse and worse until she became very depressed and withdrawn without even realising it. She first heard about the Pain Service on a visit to her GP who suggested she give it a try. “The service has been an absolute God send to me,” she said. “I haven’t looked back and it has given me a new lease of life.” The Pain team taught Pat how to relax and manage her pain more effectively and introduced techniques such as Tai Chi as alternative therapies: “They made me stop and think before doing things. One of the main reasons for the pain was that I got very stressed once it started and this made the situation worse. Now I am able to sit and relax for half an hour and ease the pain away. It has helped me take control of my condition instead of it controlling me and I’m now even able to ride horses again so I’m absolutely delighted with the results.”