Lab
Mental health and persistent pain
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Tamar Wildwing posted an update 3 years, 7 months ago
Hi, I am undertaking a PhD in GPs’ role in chronic pain management and am keen to link with others with similar interests. I have a background in learning disabilities and mental health nursing and health commissioning.
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Adrian McGregor posted an update 5 years, 6 months ago
Like most people who have chronic pain or the more modern term of persistent pain, it’s been a rollercoaster ride of trying to ‘fix’ it or reduce the suffering that goes with it. I have been down so many rabbit holes, looking for help and the magic ‘pill’. There are so many inconsistencies when dealing with chronic pain. Lots of so called ex…Read more
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Hi Adrian, welcome to the group, thanks for sharing your experiences so far and linking to your podcast. Look forward to hearing more,
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Hi Adrian,
I think it is a shame when one professional group lays the blame of passivity at one specific group. In General Practice we use whatever resources we can to support our patients. What is available varies greatly from area to area and patient to patient. The whole system carries responsibility including secondary care, social, mental…Read more-
Unfortunately as a patient my experience with my local GP was not helpful in relation to my journey with persistent pain. I remember lots of offers of medications but there was never any psychological help, CBT, pain management course or even a brief understanding of ‘pain’. Even when I got referred to pain clinic I came away with morphine pat…Read more
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lets hope you can educate them 🙂
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Hi Adrian, just listened to your podcast, it was very interesting to hear the journey you have been on. Lots of insights in there that I’m sure will be useful throughout the project. Thanks for sharing it.
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Thanks, appreciate the feedback🤝
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Will Bostock posted an update 3 years, 11 months ago
I am a GP with an interest in the interaction between physical and mental health. I think the distinction is not always a helpful way of understanding humans, and this is especially true with chronic pain. Our health beliefs play an important role in our overall wellbeing, both mental and physical, and as health care professionals there is a…Read more
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Hi William,
I agree that the examination of professionals’ health beliefs would be a potentially very fruitful avenue to explore.
Somewhat related to this is the lack of confidence physical health care workers may have in treating co-morbid mental health conditions, and vice versa for mental health workers. For instance research has indicated…Read more-
Indeed. I have experienced this first hand whilst working in in-patient psychiatry whilst cross covering the main hospital. “Expert generalists” may be able to help in taking an holistic view. Barriers to alternative or holistic therapies such as exercise are interesting. Of course, there is a dynamic between the HCP and the patients health…Read more
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Matthew Mezey posted an update 4 years, 11 months ago
Just thought I’d mention this, in case it’s relevant to the Lab.
Big Life group are doing work to implement a multi-modal practitioner training programme for people who work with clients with multiple needs – so someone doesn’t have to go to multiple places for support e.g. they can deliver housing support, low level mental health interventions,…Read more
The Big Life Way - The Big Life groupMenu-
Hi Matthew,
sounds positive. I’d need to check but I’m pretty sure the Pioneer programme supported a couple of similar projects a few years ago possibly in Lambeth and Dorset. I can’t remember the exact sites. I’ll have a look and let you know.-
If you turn anything up, that would be good to know.
Such cross-boundary innovations often hit real barriers, of course.
In a somewhat similar vein, there was a (multi-modal?) ‘Well’ programme at Bromley By Bow Health GP practices. But the efficiency and effectiveness of what these change agents were able to offer led to their work being rather…Read more
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Hi mathew, I would be interested to explore this further and to see if they already have a footprint here. I think you are right in how much we can go ahead with this because often a long period of networking and trust is needed before such disruptions are entertained but always starting a chat. my email address is drrdeepak@gmail.com
deepak-
Hi Deepak – I think it would be best to explore any issues around this here in the group, so we can draw on its 60+ members.
I’m afraid I personally know very little about multi-modal practitioners etc, so it might be a fairly short chat 😉
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Stewart Loughlin posted an update 5 years, 1 month ago
Hi new to the group,
I have a special interest in neuropathic pain and spinal pain, this focuses around the relationsbip between mental wellnesstrauma and the impact this has on symptoms.I have some experience of this and find the subject fresh and interesting, there is a dynamic between activity – mental wellness and pain behaviour. This is…Read more
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Yes, I agree, and from a psychological perspective, a focus on and engagement in activity can help enhance confidence in managing pain.
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I agree, and I think there could be more than that at work. Grief and stress related to loss can make pain present more acutely – I would be interested in any studies of this. Engagement in life will help with pain management but I have found that when one is presented with extreme circumstances of loss this can cause further episodes of extreme…Read more
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Yes, I think with regard to pain management it is crucial to optimise mental health and reduce negative stressors. It would be interesting how this might be modeled and explored via Bayesian Nets and similar methodologies.
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HI stewart, I see a large number of FM patients and I can definitely agree that stress and traumatic chronic stress is abig part of their pain flares and frequent presentations to their GP or secondary care or ED. The issue is that because we, as HCPs, are not joined up and we give conflicting diagnoses and keep medicalising it in the fear that…Read more
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Anne Thurston posted an update 5 years, 2 months ago
I wanted to thank everyone involved in yesterday’s brilliant workshop. I learnt so much from working with you all and talked to so many interesting people. I’m looking forward to the next phase of the project but I’m also really interested in any opportunities for collaborative working with others. I’ll be emailing a few of you next week but if…Read more
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Owen Hughes posted an update 5 years, 4 months ago
Hi, I am a psychologist leading a pain and fatigue service in rural mid Wales. My career as a pain management professional started over 20 year ago and, somewhat ironically, I have since developed a persistent pain problem of my own. I have worked with individuals in a variety of ways from one to one, community based pain management programmes to…Read more
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Hi Owen,great read. Yes agree on the advancement of the BPS model in relation to persistent pain. After being injured and developing persistent pain I went to many ‘experts’ who willingly treated be in an MSK/biological modality. I only lighter discovered that my symptoms were more likely to be helped by looking into the ‘psychological ‘ and ‘so…Read more
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Hi both,
Thanks for sharing Adrian, language and terminology really came through, and the need to be able to have those conversations. As you highlight, many people have to learn to develop their own understanding and resilience to navigate their symptoms and conditions.It definitely came through from both people living with it and also from…Read more
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This is the really exciting bit of it for me as self-efficacy/self-care/resilience/self-management are skills that can be transferred to so many other areas of a person’s life that may also be having an impact on health and wellbeing. The idea that someone is not defined by a diagnosis or an experience and can continuously build knowledge &…Read more
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Cheryl Berry posted an update 5 years, 5 months ago
Hi I have read the workshop notes with interest as someone who lives with persistent pain for many years and worked within self-care/management lay-led field. Many points appear that are great to see, but more pain medication is only one part of the solution. Developing appropriate ‘for me’ resilience tools from self-care/management, ensures that…Read more
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Hi Cheryl, my experience with a user-led charity for people with MSK conditions recognised the benefits of ‘being in control’ of our health condition using self-care/management. Being empowered in this way and sharing peer experiences offer greater informed choice in seeking to deal with mental/physical health issues.
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Hi Cheryl,
Couldn’t agree more. Resilience is a skill that can be learnt and it does look different for every individual.
Owen
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Will Bostock posted an update 2 years, 11 months ago
Hi,
I’m Will Bostock GP and director of Cambridge Progressive Medicine. I have recently started on the NHS clinical entrepreneurs’ scheme and am developing a project which aims to create a structured primary care programme that explores health beliefs as a direct therapeutic target. It is designed to address mental and physical health in a sin…Read more
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Hello Will, I am very much interested in taking part in your programme. As a mental health practitioner for over 15 years and someone who suffers with long term pain management I look forward to contributing in anyway possible.
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Hi Louise,
That is great. The three most recent episodes of the podcast are all about long term pain. I would be very interested in your insights to the content as a HCP with lived experience.
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Hi Will, I’d be interested to know more about this. Reducing opiate prescribing in chronic pain is high up the agenda but I am concerned about ensuring we can offer people an alternative to support with their self-management.
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Hi Sonal,
Thank you for your interest. Yes it is certainly a challenge. The new NICE guidance recommends very little for primary pain, but we may feel pressure to prescribe when it feels like there is no good alternative. There is, however, a mounting body of evidence for successful interventions focused on health education and alternative…Read more
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Jo Scott posted an update 3 years ago
Hi everyone – I’m sure most of you would have seen that today NICE published updated guidelines on the assessment and management of chronic pain, which has been in development for some time. As the guideline advocates for shared decision making and a person-centred, collaborative approach, I thought it would be a good opportunity to remind you of…Read more
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Hi Jo,
This is a great development. I thoroughly enjoyed reading Paul Chrisp’s article. I have worked with him on another programme and can vouch for his intellect, expertise and integrity.
I am so glad that the NICE updated guidelines on the assessment and management of chronic pain embrace the key role of shared decision-making and within this…Read more -
Versus Arthritis has added a page to its website here;
https://www.versusarthritis.org/news/2021/april/our-view-on-the-nice-chronic-pain-guideline/
We also developed a set of Decision Support Tools for MSK and chronic pain in primary care
https://www.versusarthritis.org/about-arthritis/healthcare-professionals/musculoskeletal-decision-support-tools/
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Chris Thomas posted an update 4 years, 7 months ago
I’m pleased to hear how well the workshop went today. I was sorry to miss it due to it coinciding with the whole day ‘big population health conversation virtual conference’. I am looking forward to attending the Q Lab Workshop in Manchester on 27th.
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Thomas John Rose posted an update 4 years, 7 months ago
A good workshop today. My thanks to organizers and participant.
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Thank you for coming @thomasjohnrose Glad you enjoyed the day!
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Dominic Burton posted an update 4 years, 11 months ago
Hi all,
In my post last week, I mentioned that we have been developing a guide of tools and methods that can be helpful when you’re developing and testing ideas to improve care. The ‘Q Lab Design Canvas’ is now ready to share and the latest version can be downloaded using the link below.
We hope the design canvas provides a resource to learn…Read more
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Looks good Dominic. Will take some time to fully digest though. It has come just at the right time for me as I’m giving ‘design’ some consideration just at the minute. Tom
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I’m particularly interested in task/job design within the service design activity. Although I do like your design canvas this very important aspect is not covered. Two tools I can recommend are Quality Function Deployment (QFD) and blueprinting. For QDQ I can recommend the book ‘The FDQ Handbook’ by ReVelle, Morgan and Cox, and for blueprinting…Read more
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Thomas John Rose posted an update 5 years, 1 month ago
There has been some interesting discussion about anti depression medication on Radio 4 this week.
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Any more information….what day was it on?
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Every day I think. I’ll look up the programme and let you know.
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Hi Adrian and Tom – yes it was Inside Health on 5 March https://www.bbc.co.uk/programmes/m0002z4r
They were talking about the Opioid working group https://www.gov.uk/government/news/opioid-expert-working-group-meets-at-mhraI’m aware that it is a huge issue for pain management. The Live Well With Pain website have also done a lot to raise…Read more
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Hi Tamar.
I am a GP with a special interest in chronic pain and central sensitivity syndromes, such as fibromyalgia. I have been producing a series of podcasts exploring ideas around chronic pain and mind:body connection. My interest is in developing a primary care led structured program to explore this work with patients.
I would love to meet to…Read more
where can we hear the podcasts? Sound fascinating
Its available on all the normal podcast platforms or on my website. I would value any feedback or opportunities to collaborate from the community.
Will.
https://podcasts.apple.com/us/podcast/cambridge-progressive-medicine/id1465674992
Hi Will,
Would be great to speak more about the work you are doing. I’ve just started a QI Fellowship and planning to do a project looking at providing more integrated and personalised medicine to fibromyalgia patients in primary care. Would be great to hear more what youi’re doing – my email is selena.stellman@nhs.net
Hi Tamar,
I’m happy to link up. Would you be interested in the perspective of a patient and a chronic pain sufferer? I’m a great believer in posttraumatic growth and a big fan of Professor Anthony David’s work (UCL). There are some ways to improve Quality of Life and to even thrive despite pain.
Please reach out if you don’t mind talking to a…Read more
Hi Tamar and Monika,
I too would be happy to link up as I too believe in patient participation and who better to have on board than people who know how such illnesses feel like. Thank you Szara
Hi Tamar and Monika, if I can support from a patients perspective do let me know. Kind regards Cheryl
Hi Tamar, Monika and Cheryl,
I am interested in this area too, especially with regards to analgesia and opiate dependence and seeking person-centred interventions for mental wellbeing. I understand there is a mind-body connection to trauma but I want to know more about how we can help people dependent on opiates.
Best wishes, Alan