Chronic Pain
Welcome to the webpage of the NHS Dumfries and Galloway chronic pain service. This site is for people living with chronic pain and their families/carers although there is information that professionals working within chronic pain may find useful, too.
Chances are you have landed here because you or someone you know is living with chronic pain and you want to know more about the condition and how to manage it. A quick internet search can result in an overwhelming amount of information on chronic pain. It can be difficult to know where to begin or who to trust.
This page aims to give some shape and structure to your research and share information from trusted sources. It includes information on what chronic pain is, guidance on how to live well with pain, local services that could be of use, and information on the NHS Dumfries and Galloway chronic pain service.
Click on the blue text below to jump to different sections of this page.
- What is chronic pain?
- Understanding pain
- Rethinking persistent pain
- Use of scans in chronic pain
- Important information on opioid medication
- The experience of chronic pain
- Stigma and chronic pain
- Living well through self-management
- Pacing your activity
- Posture
- Exercise
- Stress and anxiety
- Sleep
- Goal setting
What is Chronic Pain?
Pain often occurs following an injury, surgery or as a symptom of an underlying health condition. Pain symptoms often reduce over time. However, for some, the pain continues long after the underlying cause of the pain has been treated. It lasts longer than 3 months despite medication or treatment. This is chronic pain.
Chronic pain is common and if it is something that you live with, then you are most definitely not on your own. Approximately 1 in 5 people in Scotland experience it. It is recognised as a long-term condition. It shares a lot of characteristics with other such conditions including diabetes, asthma, epilepsy and high blood pressure. In these examples, the symptoms can be managed but cannot be cured.
In chronic pain, pain killers and surgery may have a role to play in curing or managing symptoms but there is a limit to what they can do and sometimes they do not work. There are risks associated with them as well and occasionally they can make matters worse. Likewise, there are occasions when imaging, like CT scans or MRI scans, can be useful but there are also times when they do not add anything to the treatment plan and could be detrimental.
As chronic pain can affect all aspects of life, chronic pain management must also address all aspects of life. Effective management includes approaches such as lifestyle changes, physical therapy, activity pacing and social contact. This approach is all about living well with the condition and maintaining quality of life. It is an approach that is backed up by science and research, so we know that it works.
To learn more about chronic pain and this approach to pain management, take a look at these videos:
Understanding Pain (YouTube video)
Tame The Beast — It’s time to rethink persistent pain (youtube.com) (Subtitles and translations available in multiple languages)
The links below explain more about pain killer medication and scans in chronic pain:
Use of scans in chronic pain – Anatomy of the back and imaging in back pain (video)
This video is also available as a PDF document – click here to download Anatomy of the back and imaging in back pain (pdf)
Not Just Painkillers (pdf)
Understanding Pain: Brainman stops his opioids (video, subtitles available in multiple languages)
Experience of Chronic Pain
Your experience of pain is affected by a number of factors. This includes physiological factors like nerves and muscles, psychological factors like thoughts about pain and mood, and physical factors like activity and rest. These three categories interact with each other and together create an experience of pain that is unique to each person. The videos below give examples of how pain affects you as a person.
Pain Experience (video)
This video is also available as a PDF document – click here to download Pain Experience (pdf)
Pain and Me: Tamar Pincus talks about chronic pain, acceptance and commitment – YouTube (subtitles available in multiple languages)
To hear more about how thoughts and feelings can connect to chronic pain, watch this clip.
Back pain and negative stigma (video)
This video is also available as a PDF document – click here to download Back pain and negative stigma (pdf)
Living well through self-management
If you live with chronic pain then you are an expert on what you are going through. You know what it is like to live with this condition, and you have control over how you spend your time to manage your symptoms.The self-management of chronic pain recognises this expertise and encourages active engagement in living well with the condition. Self-management means looking after the whole of you, and not just managing your pain symptoms. This may seem unusual given how pain can demand so much attention, but we know that pain experience is affected by lots of things including activity, contact with friends and family, rest, lifestyle choices and exercise.
Self-management includes having knowledge about your condition. Knowledge brings with it confidence in the choices you make about living with your pain experience. This section of the website pulls together useful resources from trusted providers to increase knowledge and skills in self-management.
Click on the blue text below to access the websites and links.
This video, Ten Footsteps to Living Well with Pain, is a good place to start as it covers a lot of the issues key to self-management. Ten Footsteps to Living Well with Pain – Live Well with Pain.
The Pain Toolkit website also has a number of valuable resources to support self-management 12 Practical Pain Self-management Tools – Pain Toolkit.
The D&G Clinical Health Psychology team has developed a Resource Pack for people with chronic health conditions which contains useful guidance on living well with a long-term health condition, including chronic pain. It features topics including sleep, managing stress and uncertainty, and planning and pacing your activity. It can be found over on the Clinical Health Psychology website in the Useful Documents section: https://dghscp.co.uk/clinical-health-psychology/
The resources below dig a little deeper into topics relevant to self-management.
Pacing your activity – Watch this video to learn how your feelings and thoughts can hook you into doing too much or too little activity, and why this can be a problem for pain management NHS Highland-Zone of Pain Tolerance. See also Footstep 3 of Living Well with Pain.
Posture – Your Posture Matters (NES) – a guide on why posture matters 24 hours a day including hints and tips and when to seek advice. Click download to view the leaflet.
Exercise (YouTube video)– Dr Mike Evans 23 and 1/2 hours – What is the single best thing we can do for our health
Stress and anxiety – Dr Mike Evans (YouTube video)
Sleep – Follow these links for some top tips on how to give yourself the best chance to have a restful sleep: How to sleep better
Goal setting – Look through these links for guidance on how to take a big goal and break it down into manageable, achievable pieces.
Caring for someone living with chronic pain
As mentioned elsewhere, the experience of chronic pain goes far beyond damage done to nerves, muscles and ligaments. It affects many aspects of day-to-day living. That can include important relationships. If you live with or near to a family member who has chronic pain, you may end up taking on a role that involves providing support, be it emotional or practical. All of the resources and guidance on this page can be useful to those caring for a friend or relative, but the resources below are specifically directed at carers.
DG Carers – Dumfries and Galloway Carers Centre provides information and support to anyone who cares for a relative or friend.
Carers hub leaflet (pdf)
Live Well With Pain 10 Steps – Created by two people who have experience of caring for someone with persistent pain.
What services are there for people living with chronic pain?
On-line
As well as the websites and videos that we have linked to throughout this page, there are a number of other useful apps and platforms to support you
SilverCloud offer a wide variety of online Cognitive Behavioural Therapy programmes to help improve and maintain your wellbeing. Many of these are available to be accessed right away, including on topics such as stress, sleep and resilience. Others, including a topics dedicated to chronic pain and rheumatoid arthritis, will require a referral from your GP, physio or hospital doctor.
Sleepio is an evidenced-based app that uses cognitive behavioural techniques to help improve poor sleep. It is available for free
Daylight is an app that provides help to people experiencing symptoms of worry and anxiety, using evidence-based cognitive behavioural techniques. This is also available free of charge
Community
Community Link – Community Link Workers understand that you may be feeling anxious about making changes and are not sure where to start or where to get help.
Community Link Workers understand that non-medical concerns can have an impact on your health and wellbeing. For example; caring responsibilities, worries about the cost of living or feeling isolated.
They can help you to connect to the people, places and resources in the community that may help.
For example:
• Local activities and social groups
• Self-help and support groups
• Money and benefit advice, debt management and budgeting
• Care services and carers support groups
• Volunteering opportunities
• Getting into work, training and education
If you think support from a Community Link Worker would be helpful for you or for someone you know, please telephone 030 33 33 3001. A friend, carer or family member can make the call on your behalf, with your permission.
The team who answer the phone will ask some questions to help us make sure we get you to the right people to support you in your local area.
If you need help or support to get in touch, your GP or Health Professional can refer you directly to a Community Link Worker with your consent.
DG Locator – Find a service/activity in Dumfries and Galloway by searching the Third Sector D&G listings
Pain Association – Pain Association Scotland is a national charity that delivers professionally led self-management pain education in the community.
DG Doing More provides a one stop shop for physical activity in Dumfries and Galloway.
The website provides lots of practical advice to support adults across Dumfries and Galloway to move a bit more as part of their everyday lives. The website and Facebook page provide up to date local information on:
• Where to be active including Active Communities Classes
Hospital
Introducing the Pain Team – this video introduces you to some of the professions that you may meet if you are referred to the Pain Team at the hospital.
Visit the Dumfries and Galloway Health & Social Care Clinical Health Psychology webpage to find out more about the team and the support they offer.
Useful Links
If you would like further information about chronic pain, the links in blue text below will take you to websites with additional tools and resources.
We would welcome your feedback on the NHS Dumfries & Galloway Chronic Pain webpage.