Friday 18 December 2015

Pain, Relief

I used to work as a nurse practitioner in a GP surgery. I would see patients who were complaining of pain which had lasted anything from several hours to several weeks or more. In each case, I would ask what they had tried to help settle their pain. Often, the patient would explain that they hadn’t tried anything, not even a paracetamol. Often, this would then be followed up with “I don’t like taking tablets”, or “nothing works”. I would make suggestions about painkillers, ice, rest, activity, suggest exercises to ease back pain or refer on as required, depending on what type of pain the patient was experiencing, as well as other symptoms.
It is interesting to reflect with patients how they perceive their own pain, how they manage it, and what action they take to relieve it. Examples include those who stoically carry on without taking pain relief or other steps to manage their pain; others, who have tried lots of different medications but found that nothing works; and those who are reliant on their analgesia to get them through the day. As someone who has suffered with chronic back pain resulting from a car accident years ago, I used to fall into the “nothing works” category. I found that my life was dominated by the pain in my back: I had lots of time off sick (working in a hospital as a nurse is hard-going on the spine and one of the worst jobs for back pain and injury), which eventually led to surgery which required more time off, more pain, more medication, subsequently led to me being made redundant and then a subsequent  bout of depression, before finding a job I could manage comfortably. Gradually, I came to the realisation that I could control my pain through the meditation I practised, as well as yoga. Over time my pain management improved through a combination of painkillers, exercise, and meditation, as well as visits to an osteopath or chiropractor.
What I also find interesting is the way in which our NHS and healthcare system is dominated by pharmaceutical interventions to manage pain. In an article for the Mail Online, Dr Mark Abrahams explains the various options for treating pain with medicine and different medical interventions such as spinal blocks for relief, and discusses the dangers of over-reliance on medication to treat pain. He also suggests mindfulness as a method of managing pain. In my job I spend a lot of my time dispensing various pills and administering injections to patients in pain, but recently I have started to teach mindfulness to help with their pain, too. I have found it a very useful and successful tool in helping patients manage their pain, whether it is acute or chronic. I have also discovered that the exercises I teach my patients has altered the outcome of medicated pain relief, because the time I spend with them talking them through the exercise has reduced their pain score and their subsequent medication. I would never advise anyone to completely swap medication for meditation, but I do find that in the ward environment, spending five minutes teaching some simple mindfulness work with a patient who is not due pain relief according to their drug charts, has eased their pain. I see no reason why we can’t use mindfulness as well as painkillers.
As for my own experience, I can say with absolute certainty that mindfulness has helped me overcome pain. I don’t know where I would be without it!

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