Episode 7: Recovery is possible

Welcome to Episode 7 of the Flippin Pain Formula Podcast. The key message that we are going to cover in this session is that: recovery is possible.

Persistent pain can be a long journey on a seemingly never-ending highway. Along the way, there are often numerous healthcare visit exits that you hope will be the pain-free destination you have been looking for. But unfortunately, they tend to take you back onto the same highway.

These healthcare visits can be an additional challenge on top of the pain itself. The rollercoaster ride that is endless tests and pills and appointments can, in itself, get you down and it can seem that there is no end in sight. It can sometimes feel like recovery is impossible: but the aim of this last episode is to tell you that that is not the case.

Recovery is possible and you can do it. Our alarm system is plastic: it can be moulded and it can change. Just as it became more sensitive to protect you, it has the capacity to become less sensitive as it perceives less danger. It can learn and it can unlearn.

We believe that if you understand your pain better it will put you in the driving seat of your persistent pain condition and help you to re-take 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.

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. Also: 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 be different for different people. For some it is a resolution of their pain. For others, it is being able to go back to work despite the pain, and for others it might simply be about feeling better in themselves and feeling better able to manage their pain.

To show you that recovery is possible, I want to tell you about two different studies. The first is a large-scale review of the scientific literature, which I carried out alongside a team of researchers at Teesside University. We gathered together all of the studies that have tested the effectiveness of pain science education as a treatment, compared to a control condition who did not receive the education.

We found that in the short-to-medium term, pain education can significantly reduce the amount of pain-related worry that people experience. This shows how powerful a simple education session can be in the short-term.

But I know what you are thinking: what about pain, does that change? The answer is a little more complicated. Pain can and does change, but we don’t as yet have enough scientific evidence to show that education can reduce pain consistently for the majority of people. But there are signs in the science that give cause for hope.

This brings me to the second study I want to tell you about. It was performed by a group of pain experts in Australia, where pain science education was delivered to all patients coming through their clinic. Those patients then went on to receive a variety of different high value interventions, including active physical and psychological therapies. They had over 1,400 people through the clinic and measured their clinical outcomes at different points, as well as their understanding of pain. The data gives real cause for optimism.

On average, people with a variety of persistent pain conditions started off with pain rated 5/10 and had had pain for an average of six years.

When it came to people who ‘flipped’ their understanding of pain in line with contemporary pain science, one month later their pain had not really changed. But at six months, things had started to improve, and by 12 months there was a hefty reduction in pain.

However, for those patients who showed no change in their understanding of their pain, their pain levels were unchanged. 

This implies that education to improve understanding of pain as a form of treatment is a slow burner: it does not lead to changes overnight, but it can provide the foundations for real and significant improvement. It shows that recovery is possible, and understanding can be the key that unlocks it (remembering of course that all these patients received a range of different interventions from the high value holistic ‘a la carte menu’).

It could be likened to sowing a seed. The flower does not appear overnight, and there is more to it than just the sowing: it needs sunlight and water and fertile ground. But with enough care and attention, those first roots can appear, and in time it can blossom.

Time for our final task. If you remember back to Episode 1, I asked you to write down the things that struck a chord with you and your life throughout the podcast.

I also asked you to jot down the things that you disagreed with or don’t believe. And to write down questions as you go, saying that some might be answered later on in the podcast and some might not be.

Please take five to ten minutes to look through your notes. Were all your questions answered? If yes, that is awesome! If not, then consider going back through the episodes again to see if looking at it a second time might help. Each session is jam-packed with information and some of it is easy to miss: looking at it for a second time might help you find the answer to your question. If you still can’t find the answer, then check out the FAQ section on the Flippin’ Pain website just in case someone else had the same question: www.flippinpain.co.uk/understanding-pain. Of course, you can also get in touch with us directly at Flippin’ Pain through the website to see if we can point you in the right direction.

I also asked you to write down the answer to the following questions:

·       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?

Can you answer these questions now and then look back at how you answered them at the start? Have your answers changed? How have they changed?

Pause me now for five to ten minutes to address these questions.

You have come to the last part of the last episode of the Flippin’ Pain Formula Podcast. Now we get to the part that my Neighbour Sarah (Don’t worry Sharon I didn’t use your real name), called, “so, what do I do next?”. She loved the podcast, thought it was really helpful and then said: “what do I do next?” I suspect you are thinking the same thing, so this last bit is for you!

It is a great question. We hope having completed the tasks in this podcast that you understand your pain a lot more. Listening to the podcast is in itself a treatment: we know it can change pain-related worry, and in time it also has the potential to facilitate an improvement in pain and disability. Just as importantly, this new information will help you to make more informed choices yourself about your pain and how you might manage it.

You can look at the different treatment options out there and decide which ones, if any, are for you and which ones aren’t. We hope this will help you to choose evidence-based, high value care like active physical and psychological therapies.

In some cases, you can get help with undertaking these therapies from a well-informed health care professional. if you need a bit more help, you can be referred onto pain management programmes that are run throughout the UK, some of which are available online. You can also access many of these therapeutic approaches yourself online through self-management sites and support groups.

The Pain Toolkit (www.paintoolkit.org) is one such example, designed and developed by an expert patient called Pete Moore (you know, the guy from the earlier video who was told his spine was like a digestive biscuit!). Take a look at the resources on the Flippin’ Pain website and you will see lots of useful sites that can help you with choosing the next steps.

Here is a list of the different things that can increase our pain across the biological, psychological and social spectrum:

·       tissue deconditioning

·       genetics

·       traumatic life events

·       anxiety and stress

·       poor diet and lifestyle

·       interrupted sleep

·       reduced social support and work

·       physical inactivity.

Think of each of these adding to one another, negatively influencing Assumpta and keeping the brain’s drug cabinet firmly shut.

Some can’t be modified: you can’t change your genetics, for example, but you can change lots of other things on the list. What if you took some steps towards managing any anxiety and stress in your life through interventions such as relaxation and mindfulness? What if you adjusted your diet to include your five fruit and vegetables a day? What if you started using sleep improvement tactics to get more restful sleep, like minimising blue screen time or caffeine before bed? What if you took up walking to increase your activity level? All of these strategies are there: you just need the right guide to set you on the right path. Again, this path is not easy and it is not quick: but it might be easier and quicker than you think.

Thank you for taking the time to listen to the podcast. Thank you for putting in the effort that it takes to do all those tasks. Like so many things in life, the more you put in, the more you get out. Learning is like that, too. It is an active process and the harder you try, the more you will take on. It’s a lot like learning a new musical instrument: at first the notes are slow and disjointed, and sound like next door’s cat being strangled. But with effort, patience and persistence, learning occurs, and the musical knowledge enriches your life.

I hope you have found this Flippin’ Pain Formula Podcast useful. If so, please do spread the word as we want to help as many people as possible to understand their pain better. I wish you well on the rest of your journey.