Airing Pain Airing Pain

This edition of Airing Pain focuses on the treatment of pain, the importance of catering treatment to a person’s individual genetic makeup, and why addressing the psychological dimensions of pain is crucial in treating it effectively. 

The process of finding a medication or treatment that works for a person often involves a lot of trial and error, which can be a frustrating process for someone to go through. This process can be side-stepped through the use of personalised medicine, where information about a person’s genetic makeup is used to tailor and optimise their treatment so it is as effective as possible.

Although medication is oftentimes a vital part of treating pain, incorporating psychological treatment alongside medication can be hugely beneficial when it comes to making pain management better for those living with acute or chronic pain. Changing how someone thinks about pain can enhance their response to the physical components of the treatment they receive.

Our contributors for this edition discuss the ways in which the treatment of pain can be made more effective for people by incorporating personalised medicine or psychological treatments into a person’s care plan. Please leave us a review on this platform or give feedback via our Airing Pain survey.

Contributors:
Professor Tony Dickenson, Professor of Neuropharmacology at University College London.

Dr. Beth Darnall, PhD, Professor of Anesthesiology, Perioperative and Pain Medicine at Stanford University School of Medicine. Director, Stanford Pain Relief Innovations Lab.

Professor Irene Tracey, Vice Chancellor of the University of Oxford and a Professor of Anaesthetic Neuroscience in the Nuffield Department of Clinical Neurosciences.

Read transcript

Thanks:
This edition of was made possible thanks to funding from the Guy Fawkes Charitable Trust and support from the British Pain Society.

Time Stamps:
1:11 Paul introduces Professor Tony Dickenson,who he spoke to at the British Pain Society Annual Scientific Meeting 2022.

3:21 Professor Tony Dickenson discusses ‘precision medicine’, ‘personalised medicine’, and how looking at peoples' genetic makeup can help medical professionals treat pain more effectively. 

14:21 Paul introduces Dr Beth Darnall, who he spoke to at the British Pain Society Annual Scientific Meeting 2023.

14:54 Dr Beth Darnall explains the psychological components of how people experience pain.

20:24 Paul introduces Professor Irene Tracy, who he spoke to at the British Pain Society Annual Scientific Meeting 2023. 

20:57 Dr Irene Tracy discusses the work she's done on neuroimaging and how the human brain constructs the experience of pain. 

23:22 Paul and Dr Tracy talk about what neuroimaging tells us about the multidimensional way the human brain reacts to pain.

26:06 Beginning of discussion about Empowered Relief, a psychology-based intervention that provides people with skills and tools to help manage their acute or chronic pain. 

26:31 Dr Beth Darnall discusses the psychological side of treating pain and how empowered relief is used to help people manage their pain.

29:10 Dr Beth Darnall talks about the psychological tools people learn through Empowered Relief and how they help with pain management.   

Additional Resources:
Airing Pain 100: Glasgow Pain Education Sessions
Empowered Relief 
Pain Matters 80: What treatment really works 

Coming 10 April: This edition of Airing Pain focuses on the treatment of pain, the importance of catering treatment to a person’s individual genetic makeup, and why addressing the psychological dimensions of pain is crucial in treating it effectively.  

Our contributors for this edition discuss the ways in which the treatment of pain can be made more effective for people by incorporating personalised medicine or psychological treatments into a person’s care plan. 

This edition will be funded by the Guy Fawkes Charitable Trust and was created with support from the British Pain Society.

Contributors: 

Professor Tony Dickenson, Professor of Neuropharmacology at University College London 


Dr. Beth Darnall, PhD, Professor of Anesthesiology, Perioperative and Pain Medicine at Stanford University School of Medicine. Director, Stanford Pain Relief Innovations Lab.


Professor Irene Tracey, Vice Chancellor of the University of Oxford and a Professor of Anaesthetic Neuroscience in the Nuffield Department of Clinical Neurosciences. 

In this edition of Airing Pain, Paul investigates the significant inequalities and disparities in treatment among primary care pain management services.

This edition of Airing Pain sheds light on the unique challenges of living with cancer as a child or young adult, and the later impacts of the cancer treatment they underwent during the critical formative years. Airing Pain speaks to experts on the longitudinal impacts of cancer for these age groups; across medical, physical, and psychosocial.  

Pain and fatigue are commonly reported as the most significant negative impact on quality of life when living with cancer. Until quite recently there has been little research in the area of living with cancer and experiencing medical treatments for cancer as a child or young adult during the critical formative years, and even less so on the long-term impacts these treatments can have throughout later adulthood.  

Our contributors discuss a variety of determinants that impact long-term effects such as type of treatment, type of cancer, their personal resilience, and their family and social support networks. We also hear of the opportunities in improving cancer care for these age groups, particularly with the difficult transition from child to adult care units. 

Contributors: 

- Emeritus Professor Sam Ahmedzai, NIHR National Specialty Lead for Cancer 

- Professor Diana Greenfield, Senior Consultant Nurse at Sheffield Teaching Hospitals Trust 

- Ceinwen Giles, Co-CEO, Shine Cancer Support 

Time Stamps: 

0:50 Paul introducing Emeritus Professor Sam Ahmedzai, an internationally recognised pioneer in setting up palliative medicine. 2022 British Pain Society interview.

2:53 Discussion around later hormonal effects of some successful treatments used to eradicate and manage cancer in children and teenagers.

5:54 Professor Diana Greenfield, Senior Consultant Nurse at Sheffield Teaching Hospitals Trust, NHS, on the transition between paediatric to adult cancer care.

13:18 The importance of family-centred care. Defined as a house or unit of care that can be traditional or non-traditional but represents a holistic support network.

18:00 Ceinwen Giles, Co-CEO, Shine Cancer Support, working to provide support for people in their 20s 30s and 40s who have lived with cancer and chronic cancer.

19:00 Ceinwin Giles talking on her personal experience of receiving treatment for non-Hodgkin lymphoma and challenges in finding peers her own age who share her experiences.

21:54 Managing early-life considerations alongside cancer. Career uncertainty, mental health in jobs, as well as fertility, relationships, and dating.

23:00 The difficult transition from child to adult care, in terms of having fewer people and services supporting as an adult. There are opportunities to improve the easing of this transition, especially following the pandemic where services are stretched.

25:20 Invitation to respond to the Airing Pain survey.

26:02 Summary of the key take home messages for children and young adults, and those caring for them.

Additional Resources: 





 Airing Pain 140: Childhood Pain - Adverse Experiences and Parental Relationships

Shine Cancer Support
Families and Children Resource Page 

Airing Pain 118: Pain Management in Young People 

This edition of Airing Pain is on the topic of early childhood experiences.  
(Content warning: includes abuse, neglect, and household dysfunction) 
The World Health Organisation states that ‘adverse childhood experiences (ACE) can have lifelong consequences on a person’s health, and well-being, and can lead to a person developing persistent pain in later life’. A lot of this research is conducted in adults, and of course with changes in attitudes and beliefs surrounding raising children over the years, would they consider events in their childhood to be adverse? 
Listen to learn more about this complex discussion. Find out how this kind of trauma in formative years impacts neurobiologically on the stress response, and causes changes on a structural and functional level in the brain that can predispose young people not only to pain but depression, cardiovascular disease, behaviours with increased health risks, and can have impact on mortality.  
Contributors: 



Dr Katie Birnie, Clinical Psychologist at the University of Calgary, on the importance of validating pain in young people.   

Professor Lesley Colvin, Project Lead at Consortium Against Pain InEquality (CAPE) and Professor of Pain Medicine at the University of Dundee, and consultant in pain services. 

Jen Ford, DRAP Pain Physio & Therapy Lead at Bath Centre for Pain Services & Bristol Paediatric Pain  

Professor Lesley Colvin, Project Lead at Consortium Against Pain InEquality (CAPE) 
 and Professor of Pain Medicine at the University of Dundee, and consultant in pain services. 

Professor Tim Hales, Project Lead at CAPE and a non-clinical Professor of anaethesia at the University of Dundee. 

Dr Lauren Heathcote, Senior Lecturer in health psychology at Kings College London 



Timestamps 
2:06 Prof Tim Hales discusses the impact on ACE on chronic pain and how people respond to treatment. 
7:02 Prof Lesley Colvin Professor on how ACE causes persistent pain. 
16:05 Dr Lauren Heathcote discusses the psychology of pain and symptom perception in young people. 
23:26 Jen Ford on the different approach required when working with children. 
26:05 Dr. Katie Bernie explore the importance of children and family partnerships. 

Related links 
CAPE Consortium Against Pain InEquality 

Health Scotland – Adverse Childhood Experiences
 
TED talk: Carol Dwerk – The Power of Believing you can improve 

Bath Centre for Pain Services 

Airing Pain survey

Pain Concern Children and Families resources 

This edition of Airing Pain was recorded at the Living Well with Persistent Pain in Wales conference during Pain Awareness Month in September 2023. The topic of the conference was the launch of the revised Persistent Pain guidance first published in 2019. 

The COVID-19 pandemic has changed how we live and access services. How are healthcare professionals who treat patients with persistent pain capitalising on this improved digital literacy by using a digital-first approach to improve the patient experience at their clinics? With the aim of this year's conference being to see the person and not the symptoms, how can the patient's voice be heard and kept central to ensure this is done? And finally, how can the Third Sector and the NHS work more cohesively to work towards this goal? Listen or read the transcript to find out more. 

Contributors 
Bethany Davies Health care support worker, Aneurin Bevan University Health Board
Gethin Harries, Physiotherapist, Powys Health Board (Powys Living Well Service). 
Eluned Morgan MS, Health Minister 
Owen Hughes National Clinical Lead for Persistent Pain in Wales 
Stephen Allan, Regional Director New Citizen’s Voice Body for Wales 
Dr Sue Jeffs, National Clinical Lead for Persistent Pain Patient organisation representatives 
Mary Cowern Head of Nation for Cymru Versus Arthritis 
Heather Wallace, Pain Concern 

Representatives of other organisations present at the event, including Health Education for Improvement Wales, Real City Strategy North Wales, Cardiff and Vales University Health Board and Case UK Ltd.

Read Transcript  Feedback survey

Timestamps 
0:35 Eluned Morgan MS welcomes delegates to the launch of the revised Living With Persistent Pain in Wales guidelines. 
3:04 Owen Hughes explains the updates to the guidelines.
6:04 Eluned Morgan MS on the feedback received regarding the guidence and how it can continue to evolve. 
6:35 Representatives from Real City Strategy North Wales and Powys Living Well Service discuss how those living with pain can be supported.
12:48 Eluned Morgan MS and a representative from Cardiff and Vales University Health Board talk about self-management and peer support groups. 
23:59 Mary Cowern, Neil Fowler and Bethany Davies on how the guidelines will impact their organisations. 
37:39 Eluned Morgan MS on the need to reduce ineffective treatments. 
38:35 Information on upskilling for healthcare professionals from Catrin from Health Education and Improvement Wales. 
40:38 The Patient Voice – Stephen Allan, Eluned Morgan MS and Dr Sue Jeffs on the importance of patients informing on the services available. 
48:11 Heather Wallace reflects on the event and a final request about person-centred care from Eluned Morgan MS. 

Additional Resources 



Living with Persistent Pain in Wale Guidance 

eppcymru.org 

All Wales Analgesic Stewardship Guidance  
CaseUK
Versus Arthritis

Airing Pain 109 Fibromyalgia  

Airing Pain 121: Living with Persistent Pain in Wales 

Well-being of Future Generations (Wales) Act 2015