We have also produced a Pain Toolkit Handbook, specifically for Healthcare Professionals which can be obtained by ordering via the store.
Last updated 28th June 2023
Last updated 28th June 2023
It can be useful to use the two questions below to help identify more complex pain.
During the past month, has it often been too painful to do many of your day-to-day activities?
During the past month, has your pain been bad enough to often make you feel worried or low in mood?
Ask the patient to circle 2-3 main problems they have at the moment, then jointly write a shared action plan.
A collaborative person centred approach focused on the individual’s physical, emotional and life issues is starting point.
This can identify factors likely to predict persistent pain, disability and distress.
Non modifiable factors
A useful tool is the Persistent Pain Cycle tool, which helps both clinicians and patients explore currently the way pain is affecting the person and their life in many ways. It helps shift the conversation for some patients from a “seek, fix and cure” to a more “cope, control and manage” approach. This applies to those with emerging risk of persistent pain where using the Start Tool and the identified psychosocial factors means taking an active approach in enabling the person to:
The Patient Health Questionnaire (PHQ-9) is also a useful tool for assessing depression.
It can be very difficult in the short consultation to identify when pain is already or becoming a major health problem. Many patients are managing their pain and their health well and we do not want to over-medicalise them. However, there are many who will require additional help to support them to minimise the risks of long-term pain.
Experienced GP’s share that several consultations are needed. These then gives continuity and emphasis on empathy, therapeutic relationship and coaching / supporting self-management which makes the difference to patient outcomes. Research evidence from patients say exactly the same thing and it leads to up to 50% reduction in GP consultations and attendance in the long term.
Dr Tim Williams a GP and Community Pain Specialist from Sheffield has developed video called ‘Top Ten Tips for Primary Care Management’ to support GP’s & Health care professionals. Tim’s tips are to help the GP when seeing patients with pain.
This is a “tricky” condition to explain to patients, as changes in the pain nerve system function are multiple.
The Explain Pain leaflet is a good resource to give patients, to help them understand why pain persists. It and can be downloaded here.
A useful video to recommend to the patient is the “Understanding Pain:” It is has a very simple messages about how pain works, and what to do about it. Many clinicians have found viewing this resource themselves is informative. It is useful as it enables a common and clear understanding between clinician and patient of the faulty neural processing system problems in persistent pain. It can form a common consistent language to help manage the complexity of pain.
Within the patient section of this site are same video links so patients can see to learn more about processing problems of faulty pain systems. Here is a useful video based explanation about faulty pain systems by Lorimer Moseley ‘Body in mind - the role of the brain in chronic pain’.
Self-management of course also includes:
A useful resource to guide management of persistent pain is the Ten Top Tips summary by GP Dr Tim Williams who has special interest in managing pain.
Pain & Self-Management Videos for patients (these are really good short engaging videos to show or signpost patients to)
Pain self management should be about team work, working together to form a partnership
Pain self management is about learning new (or using old) skills, trying them out and to see what works for you. Pain is like a finger print, so each person may need to have individual skills to suit them.