Episode 1: Introduction

Hi, my name is Cormac Ryan. I am Professor of Clinical Rehabilitation at Teesside University. I am a pain scientist and over the past 15 years I have spent my life trying to better understand persistent pain: how it works, why we have it, and what can we do to ease it. I am also a Community Pain Champion for the Flippin’ Pain campaign.

Flippin’ Pain is a public health campaign, delivered by Connect Health. We have a clear goal: to change the way people think about, talk about and treat persistent pain. We aim to completely flip your understanding of pain.

Pain can be a wonderful thing. Without it, we would not be here today. It is our body’s natural alarm system, which protects us from all manner of dangers. When you place your hand on a hot surface, it makes you pull back so you don’t burn yourself. When you break your leg during a football match, it stops you from continuing to run and jump on that leg, potentially worsening the injury, and it makes you go to a see a health care professional.

In some very rare cases, there are people born without the ability to feel pain, and such individuals often have really difficult lives, where they repeatedly injure themselves because they lack nature’s protective alarm system, and they often pass away at far too young an age. We need pain for our very survival, and it does a wonderful job of keeping us safe. However, is it not uncommon for the alarm system to go into overdrive, constantly firing, long after normal tissue healing times. This is known as persistent pain. The alarm system thinks it is keeping you safe, and it is in a way, in that you are too sore to do anything that will damage you. But frustratingly, you are also often too sore to do the normal everyday things that keep you healthy and happy. Does this sound familiar to you?

The scientific community has learned a great deal about how pain works over the past 50 years, but very little of this knowledge has filtered through to the average person on the street. This has meant that many people living with persistent pain, and many clinicians treating persistent pain, are basing what they do on an outdated understanding of the condition.

An individual’s understanding of their condition will influence how they go about managing it. If our understanding of persistent pain is incorrect, it means we are more likely to make poor decisions about how to manage it: decisions that are contrary to what the evidence tells us helps.

For example, if your persistent back pain feels better when you lie down, and worse when you move about, it would be understandable for you to think that bed rest is good for your back and exercise is bad for it. Can you relate to this?

However, this understanding of persistent pain is incorrect and unhelpful. The most up-to-date evidence clearly recommends that, if you have persistent pain, you should avoid bed rest and instead keep as active as you can.

We believe that if you understand your pain better, it puts you in the driving seat and helps you to retake control of your life. This will help you to manage your pain more effectively and help you to make better and more informed choices for your health and wellbeing. We believe that understanding your pain is a significant first step on the road to recovery and taking back control of your life, and the evidence agrees.

As you take the first step on this journey, it is important to remember that the road to recovery can be difficult, but it may not be as difficult as you think it will be. It is also important to remember that the road to recovery can be long, but it may not be as long as you think it will be.

Finally, it is important to remember that recovery can look different for different people. For some, it is a resolution of their pain. For others, it is being able to go back to work, and for many others it might simply be about feeling better in themselves and feeling better able to manage their pain.

The purpose of this Flippin’ Pain Formula podcast is to do just what it says on the tin: to flip your understanding of pain so that you understand it the same way the scientists do. You will find some of the information you hear absolutely amazing.

Some of the information you will find difficult to believe, not because it is difficult to understand but because it goes against what you may have thought before. If you find it difficult to believe, don’t worry, you are in good company, I still find parts of it difficult to believe and I have been studying it my entire adult life. If you find the messages difficult, it is a good thing: it shows that you are really engaging with the material and that you are learning. It is like watching a good movie, if you are really into it, then you should experience a range of emotions from joy to sorrow, from delight to anger. If you feel nothing, then it was probably a terrible movie!

You may be thinking that this podcast is not suitable for you for some reason. Maybe because your pain is really bad, or you’ve been told nothing can be done for it, so what’s the point in trying? You may be thinking that the information is relevant to other people but not you. Perhaps you have been given a certain diagnosis, such as neuropathic pain, non-specific low back pain, complex regional pain syndrome, or fibromyalgia, and so you are not sure if the information here applies to you. Here are some quick screening questions to check if this podcast is relevant to you.

Firstly, do you have persistent pain or know someone with persistent pain? Secondly, would you like to understand that pain better? Thirdly, do you have a pulse? If you answer yes to these three questions, then this information is relevant for you.

Listening to this whole podcast and taking in all the information is not a small commitment. It will take about four hours altogether. However, think about how long you have had your persistent pain: four hours is a drop in the ocean. Also think about all the appointments, and investigations and treatments that you have had for your persistent pain so far: how long did they all take? In that context, four hours does not seem very long.

To make it easier, we have broken up the podcast into a series of bitesize chunks. You can progress through these chunks at your own pace, dipping in and out. Don’t rush it, it is not a race. We all learn at different speeds. There will be mini tasks to do along the way, and these require some effort on your part and active engagement. I would strongly encourage you to do these tasks. Learning is an active activity: it requires you to get involved. The more you put into it, the more you will get from it.

It is important for you to ask: what will I get from this podcast? And it is just as important to ask yourself: what am I bringing to it? The more you bring, the more you will get in return. This is the same with any learning activity, from taking up a new musical instrument, to undertaking a car maintenance course.

Before you begin this podcast, there are number of things I would like you to do to get the most out of it.

First get a pen and a note pad.

As you go through the sessions, write down the things in the workbook that strike a chord with you and your life. Also, jot down the things that you disagree with or don’t believe. 

Write down the questions you think of as you go: some might be answered later on in the podcast and some might not be.

For those questions not answered, you can try to find the answers using some of the links on the Flippin’ Pain website: www.flippinpain.co.uk. Or you can get in touch with us directly by emailing info@flippinpain.co.uk to see if we can point you in the right direction.

To begin, I invite you to write out the following four questions and your answers to them on your notepad. Give each of them some thought: spend at least five to ten minutes on this activity. If you are listening with someone else, a friend or a family member, discuss the questions between yourselves. Then pin them up on your wall! When we get to the end of the podcast, we will go back to these questions and see what has changed.

The questions are:

·       what are you hoping to get out of this podcast?

·       what do you think is causing your pain?

·       what do you think the pain is telling you?

·       why do you think you have the pain, what is its purpose?

Pause me now for five to ten minutes to address these questions, then press play when you are ready to move on.

Well done: you have made it to the end of the introduction session of this Flippin’ Pain Formula podcast, and taken your first steps towards a better, more scientific, understanding of your pain.

Now please proceed to Episode 2. Thanks for listening!