Self assessing pain – insights from Dr Frances Cole

Live Well with Pain’s Health and Wellbeing tool allows a person with pain to focus on their own self-defined needs due to the impact of pain on their health and wellbeing. It is designed to help the individual understand their mental health, their level of confidence to self-manage and prioritise their needs in their life at present. In the first year, 2,474 people completed the tool.

So what were the results and what do they mean for us as practitioners?

One of the most striking things for me came from the question which asks users to select ‘other difficulties’ which may be affecting their life (figure 1).

Sleep and fatigue was the most frequently selected difficulty, with over two thousand people choosing this issue.

Second came ‘moving more, and lack of fitness or stamina’, while ‘managing moods’ such as anger or anxiety was third most commonly experienced issue.

Perhaps surprisingly, ‘pain relief’ did not feature in the top three, and was in fact only the fifth most frequently cited difficulty. For me this highlights the importance of listening and exploring what are the self-expressed health needs of people with this health condition.

It may explain why we as clinicians regularly fail to support those with chronic pain effectively. We may focus on just the pain symptoms rather than looking at the bigger person-centred picture and the ‘controllables’ in this challenging health condition.

While many of the need areas in the Health and Wellbeing tool are ‘changeable factors’ with a range of evidence-based options that can be offered to help, chronic pain is not very responsive to the usual acute pain medicines treatments.

All the other health needs respond well to a combination of treatment /self-management support: sleep, getting physically stronger and fitter, and managing moods with kindness are all useful here. We could also add in nutrition and making changes to one’s diet as a changeable and controllable option.

A common feedback issue from people with pain is that clinicians do not listen. Could this be why we give more pills (or people with pain choose to take more pills), despite the often harmful side effects and risk of dependency?

Why do we not focus on more practical joint self-care plans, for example to help the person to have a better night’s sleep?

Is now the time to ask ourselves what we can do that will make a difference to the person and their health? By starting from what people themselves are telling us we can jointly develop self-care approaches that sustain health, limit the impact of pain and can help many regain their purpose in life.

 

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Remember, useful tools and tips
for self-managing pain are only a few clicks away. Explore our resources for people with pain here.

And for practitioners, you can learn new techniques to support people in our dedicated practitioners’ resources area, here.

Fig. 1

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