Introduction
Living with persistent pain can impact significantly on day-to-day life. Managing long term (sometimes called chronic) pain can be very difficult, and medicines traditionally used to relieve pain are very often unhelpful and can cause many problems if used for too long.
For many years opioids, such as Morphine, Codeine and Tramadol were recommended in the World Health Organisation pain management guidelines. However, more recent advice is that they should only be used for a very short period of time, unless managing pain due to cancer. This is because we now know that they become much less effective if used for more than a few weeks, cause many side effects and can have a negative impact on a number of health conditions. In some cases, they can also actually increase pain (a process called hyperalgesia). They are also addictive and can be very difficult to stop. Studies have shown an increased risk of death (over the last 10 years there have been around 230,000 deaths in the USA from accidental overdoses of opiates).
Other tablets used for nerve pain such as Gabapentin and Pregabalin can cause similar problems.
What are we doing about this?
Pain medication is an important part of managing acute (short term) pain, and some medications such as paracetamol and ibuprofen may be used longer term in some cases. Practices have been working hard over the last several years to ensure that they are used for those patients who can take them safely and will benefit from them.
On the other hand, it is just as important that we work together with patients who have been taking tablets such as opioids for a long time to help them manage their pain better. As we review patients who have been taking medication for pain for a long time, we are finding that many notice no difference in the pain when we help them reduce their dose, showing that they are no longer useful.
I am still in pain, what are the options?
There are lots of ways that persistent pain can be managed to help people regain a better quality of life. GPs and pain specialists are increasingly supporting patients to manage their pain in many different ways.
Understand Your Pain
Knowing why you have persistent pain will help you understand your pain better and this short video explains it well:
Or you might prefer this leaflet to read:
Self-Management
There are many things you can do yourself to help your pain. Medical studies now show that persistent pain is reduced if you learn new ways to manage it, such as stretching and exercise, relaxation and pacing activity e.g. breaking activity down to make it more manageable.
There are many online resources to help you (see below) and advice on suitable stretches and exercise is available from the NHS Choices website:
Physiotherapy
Our local musculoskeletal service TIMS is run by experienced physiotherapists who can give you advice on the right type of exercise and activity for you. Physiotherapy can help you move better, relieve your pain, and make daily tasks and activities, such as walking, going up stairs or getting out of bed easier.
You can find out more information here:
- http://www.tims.nhs.uk
- or call TIMS to arrange an assessment on 0191 445 2643
Community Link workers
Many people with long term pain have other problems in their life too, such as isolation or difficulty going out, financial problems, and other issues that impact on daily life. Our Community Link Workers are experts, trained to help you with many aspects of your life by connecting you with services in your local area that can help your specific issues.
Please contact the surgery for more information or a referral.
Sleep
It’s very common for people to find that poor sleep makes their pain seem worse. They can find themselves in a vicious cycle where pain makes sleeping difficult, and poor sleep worsens pain. The good news is that there are lots of ways to improve your sleep. Thanks to recent research, we now know that sleeping well with pain is possible, with a different approach and maybe a few new skills.
This leaflet helps you to understand your sleep and ways to improve it:
Mental Health
Persistent pain can cause low mood, increased worries and frustration and negative thinking. In turn, your mood can have a negative impact on your pain.
People with persistent pain find that managing their mood changes in positive ways can really help their pain and their lives.
Self-Help can be found online here
Or you can contact Gateshead Talking Therapies by calling 0191 283 2541. Their website is:
The local mental health trust have produced award willing self help guides for a number of mental health problems, including mood, anxiety, stress, and sleep:
Online Resources
There are many online resources to help you understand and manage your pain.
To find out more, go to
or
and check out some of the ideas and techniques.
Gateshead Recovery Partnership
Some medicines, such as opioids, can be unhelpful in persistent pain often people find it very difficult to reduce these medicines, They may have been prescribed by your doctor, or they may be medicines you have been sourcing yourself.
If you want to reduce these medicines, but are finding it difficult, then Gateshead Recovery Partnership may be able to help you.
http://www.changegrowlive.org/recovery-partnership-gateshead/info
You can call them on 0191 594 4721