Know Pain e learning experience: A Practical Guide to Developing Your Patient Education Skills.

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I am delighted to announce the release of a Know Pain e learning experience in collaboration with Embodia.

This online learning course aims to help you develop your patient education skills by understanding and applying educational theories to your clinical practice so that you feel better equipped to know what to do when you encounter learning blocks, appreciate the dynamic relationship between how much challenge and how much support to offer people, and develop creative methods to help people find solutions to overcome their problems.

Here is a short video clip from the e learning course…

To discover more, you can now enrol for this online course by clicking the link below…

https://embodiaacademy.com/courses/184-know-pain-a-practical-guide-to-developing-your-patient-education-skills-mike-stewart

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Breaking the Silence About a Silent Disease: One Voice of Chronic Pain

Breaking the Silence About a Silent Disease: One Voice of Chronic Pain

by Leda McDaniel

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“Hey, I can hear you coming from a mile away!”

I sat down gingerly and tried to avoid eye contact with the speaker of that statement and fake a wan smile, but in all honesty I was fighting back tears. The comment came from a classmate of mine in my first year physical therapy class and it was in reference to my use of crutches (and the noise they made) coming down the hallway on my way to class. I had been on crutches for about 4 months at that point and would use them for a full year due to the chronic pain that I had developed in my left knee after complications from two surgeries (I had been diagnosed with complex regional pain syndrome). Hearing a comment like that was not uncommon for me and during the three-year period that I spent coping with chronic knee pain, I experienced many different reactions to my chronic pain and disability.

In some interactions with others, I found solace and was met with loving presence and compassion. Unfortunately, many of the conversations that I had with healthcare professionals, family and friends, and passing acquaintances were filled with openly hostile, hurtful, and critical remarks about my condition.

I am currently a Doctorate of Physical Therapy student at Ohio University and I have experienced both the patient and the health care provider perspectives of chronic pain. I wish to speak out about the stigma and negative stereotypes that I experienced as a chronic pain sufferer with the aim of sparking dialogue and hopefully provoking positive changes in how we treat those with this disease. Here are some examples of how people reacted to me when I was in chronic pain…

Health Care Professionals

How I Was Treated By Healthcare Professionals:

  • As if I was faking my pain or making it up

(The fancy word in the medical field for this is “malingering”):

Multiple doctors: “Since you are so long out of having surgery, you should be just fine. I suggest that you just start to walk you should be able to run too.”

“If you are still having pain: well there’s really no good explanation for it”

“We can’t find a cause for your pain, you should go see a psychologist”

(The best scientific evidence does NOT support psychological risk factors or psychological causes for Complex Regional Pain Syndrome (what I was diagnosed with)1,2

  • As if I was an annoyance/wasting their time:

From one doctor: “There is nothing wrong with your MRI, the surgery went well, and there is not really anything else we can do for you”

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Multiple physical therapists: “you just have to get your quad stronger, are you doing your exercises? Pain is part of having surgery”

(At this point I was well past “quad inhibition” and post-surgical pain, we’re talking 8-12 months after knee surgery).

I have heard from multiple doctors and physical therapists the “joke” of groaning or being unhappy when they see a chronic pain patient on their schedule. When will we acknowledge that this language and attitude is harmful as it perpetuates negative stigma for these patients?

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https://www.jospt.org/doi/full/10.2519/jospt.2018.0610

  • Like a drug seeker

From one doctor: “We can’t give you this pain medication even though it is helping because it may be addictive.”

(I had stated that I had no desire to take medication- but this was the only thing that dulled my pain at one point. I had no history of substance abuse and did not possess the risk factors for opiate addiction)

How I Wanted To Be Treated By Healthcare Professionals:

  • With objectivity and an unbiased assessment of the signs and symptoms of my condition
  • With evidence-based treatment options
  • With compassion and empathy for the human suffering I was going through
  • With appropriate communication/recommendation to other healthcare professionals as needed

Friends and Family

 How I Was Treated By Friends and Family:

  • With Unconditional Love, Encouragement/Support, Empathy

I was blessed to have a few individuals in my life who went to great lengths to demonstrate their love and concern and were constant sources of support and encouragement. These individuals made the effort to spend time with me despite my limitations and to talk with me about my experience despite any discomfort or unpleasantness it may have caused them. I am incredibly grateful for the thoughtful treatment from these few family members and friends.

  • With Disbelief and/or Denial

“Why can’t you just walk?”

“Why don’t you just do ______ (yoga, Pilates, swimming, stretching)?

(The reality was I could not even move or touch my knee without being in severe nerve pain. There was a huge disconnect between what I was experiencing and others’ misunderstanding or inability to differentiate chronic pain from acute pain they had experienced)

“How can you still be in that much pain?”

“I had pain after my knee surgery too, you know”

How I Wanted To Be Treated by Friends and Family:

  • With unconditional love
  • With encouragement and support
  • With empathy (an attempt to understand my suffering)

 Strangers/Acquaintances:

 How I Was Treated by Strangers and Acquaintances

  • With Ridicule/Derision (veiled “joking”)

“I can hear you coming from a mile away” “Hey want to race?” “When are you going to get off of those things?”

(Reactions to seeing me on crutches and the long time I spent on crutches: 1 year total)

“Why aren’t you better by now?”

“At least you get a good parking space” (reaction to my handicap parking sticker)

  • With Comparison Statements

 “Oh yeah, I was on crutches for a week after I sprained my ankle, it was the worst!”

“I was back to playing basketball within a year after ACL surgery, you just have to get your leg strength back”

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How I Wanted To Be Treated by Strangers and Acquaintances:

  • With human decency and kindness, with understanding

Concluding Thoughts:

Treating chronic pain is no easy feat and I want to acknowledge that. However, the negative interactions that I experienced, I believe, were part of a larger marginalization of those with chronic pain that I wish to bring light.

My intent in sharing these interactions is not to criticize one particular person or group of people. Merely, I would like to encourage reflection on the part of individuals who interact with people in chronic pain. I think that we can do better as healthcare providers, friends, family members, and even as a society in bringing thoughtfulness to our language and actions as we work to support these individuals in their pursuit of health and wellbeing.

Leda is a current Doctorate of Physical Therapy (DPT) candidate at Ohio University and upon graduating in May 2019 is interested in working with patients with various chronic pain conditions.

Leda recently published a book about her experience of personal recovery from chronic pain, which you can find on Amazon:

https://www.amazon.com/dp/069212120X?ref_=pe_870760_150889320

You can also find her blogging at:

https://sapiensmoves.wordpress.com/

References:

  1. Harden RN, Oaklander AL, Burton AW, et al. Complex regional pain syndrome: practical diagnostic and treatment guidelines, 4th edition. Pain Med 2013;14:180–229.
  1. Marinus J, Moseley GL, Birklein F, et al. Clinical features and pathophysiology of complex regional pain syndrome. The Lancet Neurology. 2011;10(7):637–648.

 

W.O.W. CHAT @ the San Diego Pain Summit

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I have just returned home after an incredible time at the San Diego Pain Summit. Thanks to everybody for your kind words following my talk at the Summit & a special thanks to all of you who attended the 2 day workshop. 

IMG_E7307Also, a huge thanks to Rajam Roose for setting up such an impressive and much needed event. For those of you who are yet to attend a San Diego Pain Summit, it’s a must for your CPD calendar and San Diego has to be one of the coolest cities on the planet – what are you waiting for?! 

Finally, thanks to Shelly Prosko for inviting me to chat to her. Here’s our pool side W.O.W Chat…

Know Pain is coming to Ghent, Belgium!

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I am both delighted and honoured to be teaching Know Pain in Ghent on the 19th & 20th of April 2018. For more details about this course, and to book your place, please click on the link below: 

https://smarteducation.be/cursus/know-pain/

Here are a couple of short videos to explain how attending this course

will help you to help your patients:

This course is suitable for all healthcare professionals, and is relevant when helping anybody in pain. This includes elite and amateur athletes:

http://bjsm.bmj.com/content/51/17/1259

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FREE KnowPain Webinar!

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I am delighted to announce a FREE KnowPain Webinar with Clinical Edge

on Monday 22nd May. 

The webinar has 5 learning aims:

  1. Provide practical ideas to help people make sense of pain.
  2. Explore an evidence-based understanding of what people in pain want from healthcare professionals.
  3. Provide an introduction to teaching & facilitation skills in order to optimise learning for people in pain.
  4. Explore the role of metaphors within pain reconceptualisation.
  5. Consider the application of pain science education within sport.

To register for this event, simply click the link below:

https://www.clinicaledge.co/blog/free-webinar-how-to-treat-persistent-pain-and-use-the-latest-pain-education-strategies-in-your-treatment-with-mike-stewart?utm_source=ActiveCampaign&utm_medium=newsletter&utm_campaign=ACKnowPainwebinar1&utm_term=ACKnowPainwebinar1&utm_content=ACKnowPainwebinar1&utm_source=ActiveCampaign&utm_medium=email&utm_content=Free+webinar+-+How+to+treat+persistent+pain&utm_campaign=Know+pain+webinar+email+1+nonmembers

 

Meanings of Pain

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I would like to invite you all to like the @Meaningsofpain Facebook page. The page is linked to the forthcoming book, Meanings of Pain (Springer 2016). The book aims to improve understanding of the link between meaning and pain, and to stimulate further research in this area.
 
The isolating and unpredictable nature of pain frequently leads to a chaotic narrative where people seek meaning. Without this sense of meaning, the experience of pain often remains unexplained and invalidated.
 
I am delighted to have been asked to write a book chapter entitled, Seeking Order Amidst the Chaos: The Role of Metaphor Within Pain Reconceptualisation for the forthcoming book, Meanings of Pain.
 
As with the entire book, I hope that this chapter takes you on a journey of discovery. A journey from chaos to order. A journey unlike any other where we’ll attempt to unravel the complexities of communicating and understanding pain & distress.
 
As you’ll discover, it can be an extremely hopeful & optimistic journey. Yet, at the same time, it can also be a terrifying & pessimistic voyage. Metaphors can help or hinder people’s understanding of pain. This chapter will aim to develop your understanding of this dilemma, whilst also highlighting examples from within practice to guide you.
 
Ok. We’re not really going on a journey, nor are we going to unravel anything. Actually, come to think of it, nor are we going to stand underneath anything. Words such as ‘understand’ act as a reminder that metaphors live a concealed existence all around us. They are an essential part of human communication and can be crucial to how we communicate, learn, discover and create meaning.
 
Metaphors are used when conveying experiences most resistant to expression. Pain is one such experience!  

A Practical Guide to Persistent Pain Therapy

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