Patients Forum on Disease Recognition for Chronic Pain

In February 2013, a patient forum was held as part of the fifth annual scientific meeting of the Faculty of Medicine, College of Anaesthetists of Ireland.

The remit for the event was to promote education and training in the medical profession in the area of pain management. Since this forum was recorded, chronic pain has been recognised as a disease.

Attendees had the opportunity to hear from various national and international experts and also had the opportunity to have their questions answered.

Speakers included:

• • Professor Hans G.Kress, President of EFIC, Vienna, Austria
  • Professor Michael Cousins, Foundation Professor, Head of Anaesthesia & Pain Management, Sydney Australia
  • Dr Josh Keaveny, Dean of the Faculty of Pain Medicine & Consultant in Anaesthesia & Pain Specialist
  • Dr Camillus Power, Chair of the Scientific Committee, Dublin, Director Pain Medicine, Tallaght Hospital, Dublin
  • Dr Brian McGuire, Director of Centre for Pain Research, Director of Clinical Psychology Training Programme NUIG & Clinical Psychologist University Hospital Galway
  • Ms Gina Plunkett, Chairperson, Chronic Pain Ireland

• • It lifts the burden of proof from the patient and thereby reduces the stress burden of moving from service to service
  • For the doctor, there is specialty recognition and would allow for expansion of other disciplines into the faculty
  • Opportunities for society, science and neuroscience:
    “To understand pain, you have to under neuroscience – you have to understand how the body, the brain, the mind – how it all works together”
  • “In many respects, in pain medicine we offer holistic healthcare, whereas in other disciplines, it is often fragmented healthcare”
  • The challenge is to master this disease

Professor Kress spoke about the European campaign for the recognition of chronic pain as a disease in its own right:

“From the moment of birth, pain is part of our lives. We feel it. We fear it. At the same time it is also our bodyguard, who is vitally protective, who is a biological warning signal that, more or less, helped our species to survive on this unfriendly planet, sometimes at least, unfriendly planet.”

“Pain is what we seek to avoid most, and when this pain becomes persistent, when it becomes chronic, then it is torment. It is torment because it has lost this primary, biological, warning function. In many cases, you don’t see any longer the initial starting point, the initial underlying disease.

So pain is much more – chronic pain in particular – is much more than just the signaling of nociceptive input to the brain. It’s also much more than just the perception of what we call pain by the conscious brain. It is characterized by suffering, and also by pain behaviours shown by the suffering individual but also by suffering in the social environment. Because of this all encompassing nature of chronic pain, we consider chronic pain a disease. This pain is a biopsychosocial phenomenon. All 3 components, more or less from individual patient to individual patient, contribute to what we see then as a persistent or chronic pain. It is a disease in its own right and it should not be considered just a passive symptom.

The problem is that the broad acceptance of this concept of chronic pain as a disease is inadequate. It suffers from an inadequate professional and public awareness of chronic pain as a disease.”

“This is a very important healthcare problem. In Australia, it is the third most costly health problem. $34 billion dollars a year for 20 million people. That’s what makes it number 3. It’s not number 3 in terms of health planning, but it should be. The only way it is going to get there is through the general community.”

“It is a moral imperative. There is nothing else in healthcare like unrelieved pain because it destroys people’s lives completely.”

“It’s data, it’s information to take to the policy makers as evidence from our own country that chronic pain really is a health burden in Ireland.”

Learn more about the statistics from the PRIME study, a study of chronic pain in Ireland.

Gina Plunkett reflects on the forum, Chronic Pain Ireland’s Charter of Rights and the Declaration of Montreal:

“The declaration promulgated that all governments should meet their obligations under the international conventions as they relate to healthcare generally and pain management specifically, and clinicians should view this area as a central part of their professional responsibilities.”