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The painful truth about suffering Brits
7:00am Saturday 24th November 2012 in NewsXtra
As new research suggests that around 70% of the 10 million Britons who suffer from chronic pain don't have ongoing help to ease it, pain management experts explain what treatment options are out there, and why the UK doesn't need to be a nation that 'just puts up with it'.
By Lisa Salmon
Putting on a brave face is something the British are renowned for, and it seems this extends to pain too.
It's estimated that around 10 million Britons suffer with chronic pain, but recent research suggests that many people are soldiering on without help.
A survey by Lloydspharmacy found that 77% of people with chronic pain had suffered for years, and almost half (47%) don't seek regular help from their GP. In addition, two thirds of the 1,000 people surveyed said they had never used a pain clinic or support group.
So what exactly is chronic pain? In simple terms, it's long-term pain, as opposed to acute pain which comes and goes more suddenly.
Though chronic pain is generally defined as lasting more than three months, some people suffer with it for years, even decades.
It can effect any part of the body and may vary in intensity. The causes also vary hugely, ranging from complications following an initial injury or infection, to an ongoing condition such as shingles or arthritis. However, in some cases the exact cause may not be identified.
In contrast, acute pain is usually sharp and warns of disease or a threat to the body, such as a burn, cut or injury. It can be brief or last for a while but not longer than six months, and disappears when the original cause has healed or been treated. Though if it's unrelieved, acute pain can lead to chronic pain.
The Lloydspharmacy figures suggest that a lot of people are suffering in silence - suffering being the operative word. Nearly two thirds (61%) said pain affected their mobility, while 55% said it kept them awake at night and they struggled to carry out everyday tasks, like shopping and cleaning.
As well as the physical implications, chronic pain can have a significant impact on a person's mental wellbeing. Indeed, 47% surveyed admitted to feeling depressed as a result, with nearly one in 10 saying their pain had made them feel suicidal.
Ian Semmons, chairman of the charity Action on Pain, which provides support and advice for sufferers, knows full well the extent to which pain can affect quality of life.
"Many people tell me that chronic pain is dominating their life, affecting not only their social life and family time, but even their ability to hold down a job," he says.
The survey found that over half of those taking part had all but given up, saying they 'didn't feel anything could be done' so it was 'better to just put up with it'.
As understandable as this is, chances are it's causing people to suffer much more than they need to, and Semmons stresses that there are things that can be done to help.
"I would actively encourage people to seek out help - you may feel that there's little hope, but it shouldn't have to be like that. By asking for support and advice you will be making a positive step towards improving your life," he says.
Dr Austin Leach, a pain medicine consultant at Royal Liverpool University Hospital and council member of the British Pain Society, is used to hearing patients say they've been just putting up with chronic pain for ages.
"I'm often amazed at how stoic people are," says Leach. "If you can put unpleasant symptoms on one side and just get on with your life, you can argue that's the human condition. However, it can impact on your quality of life and some sensible advice can really help."
The first step is attempting to identify the cause of the problem, and this means going to see a doctor.
"If you've got new symptoms, getting a diagnosis is obviously a vitally important step, particularly to exclude treatable or potentially serious conditions," says Dr Leach.
"The earlier appropriate treatment's given, the better - it can really improve quality of life."
If a GP or specialist can't resolve or reduce symptoms, patients may be referred to a pain clinic, which can be found at most district general hospitals.
There specialist doctors will combine a medical approach with education and psychological support, as pain is very complex and isn't a straightforward sensory process, explains Leach.
Indeed, it's believed that how we perceive pain, and our attitudes towards it, makes a significant difference.
With chronic pain, psychological factors are especially important.
When pain is detected, different nerves send a number of messages to our brain, such as whether the sensation is heavy, sharp or hot, and how painful it is. A cross-referencing system also kicks in, and past experiences of similar pain in yourself or others you've heard about may affect how you experience it.
So if you've felt a similar pain before and it wasn't serious, you may just take a painkiller, have a rest and wait for it to settle down.
But if you've heard of someone who had a pain in the same area and it turned out to be a serious illness like cancer, the brain's attitude to the pain will be different. Similarly, if you've suffered in the past with a pain that felt the same, and the agony didn't shift for months, you may quickly become worried that the pain's going to last for ages again, which could actually make it worse.
"Conscious attention will be much more focused on pain twinges than it would be if you were more relaxed about the cause of the pain," explains Leach.
"You get a range of responses from patients depending on how frightened they are. To manage pain properly, patients need to be aware of the role psychology plays."
There are a number of drugs options for treating chronic pain - not just conventional painkillers. Finding the best treatment for each individual may take a while, which is why communication with your doctor is vital.
Devices such as a Tens machine, which sends mild electrical impulses into the body, can be vastly effective says Leach, as can relaxation and breathing techniques.
Leach runs a clinic that specialises in chest pain, and explains: "Often episodes of chest pain are very frightening, and if people can control their fear, they can control the impact of their symptoms.
"Learning a relaxation method is almost like self-hypnosis, where you can take yourself into another place. That can be a helpful step if you feel the situation is slipping out of your control."
Acupuncture can also help in some cases, and making a conscious effort to reduce stress levels - through exercise (even if it's extremely gentle), massage, social activities etc - can also make a world of difference.
"It's very rare that there's one thing that's the answer," stresses Leach. "It's usually a combination of things like explanation and education, reassurance, teaching simple techniques like breathing and relaxation methods, and the right medication.
"Often this limits the impact of symptoms to such an extent that people can have a significant improvement in their quality of life.
"Try not to get frightened or angry about it, that always makes it worse."
:: For more information about pain management, visit www.britishpainsociety.org
:: Lloydspharmacy has launched a new free walk-in pain assessment service in which a pharmacist will discuss symptoms, medication and lifestyle with customers. For more information visit www.lloydspharmacy.com
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