What is chronic pain?
Your relative or friend will have been diagnosed with a chronic or persistent pain condition. It is important to distinguish between acute pain and chronic pain.
Acute pain is an indication that damage has occurred as a result of injury. It is a helpful alarm system to help us get out of harm’s way and allow our bodies to heal.
Chronic pain is long lasting persistent pain, which has no useful purpose and is not an indication of new or further damage. If you have not done so already you may find it useful to read our booklet “Explaining Pain”, which talks in greater detail about the reasons for chronic pain and some of its maintaining factors.
Why is there a session for friends and relatives?
The management of any long-term condition, such as chronic pain, often involves the close friends and relatives of the individual diagnosed.
We have found that by inviting friends and relatives to attend a session on the PMP it helps to provide a supportive context for any subsequent discussions you may have with your friend or relative.
This might include a discussion about the skills they have learnt, and the support they would like from you to help them continue to implement the pain management approach taught on the PMP. It also gives you a chance to meet the clinicians involved and see the PMP facilities.
Who runs Pain Management Programmes?
PMPs are run by Specialist Physiotherapists, Clinical Psychologists and a Consultant in Pain Management & Anaesthesia.
How will they benefit from a PMP?
Medically
- Understand the physiological mechanisms of chronic pain
- Improve knowledge of pain medications and discuss individual medication regime
- To reduce reliance on healthcare services for chronic pain management
Physically
- Gradually increase the level of physical activity and function
- Improve confidence with exercise and transfer this into rewarding meaningful activities
- Provide advice on maintaining a home exercise programme and improving posture
- Develop pacing skills to reduce over and under activity cycling
- Reduce the use of aids or appliances where appropriate
Psychologically
- To improve stress management techniques and reduce muscle tension
- Learn relaxation skills
- Develop a better understanding of how mood is affected by pain
- Gain a better understanding of how pain influences, thoughts and behaviour
- Develop communication skills
- Learn self-help techniques for sleep improvement
What type of follow-up is there once the PMP is complete?
This is a common question, and we understand that there can be a considerable amount of concern that your friend or relative will be discharged with no aftercare.
There is a formalised follow-up structure once the PMP has been completed:
- 1 month review (group format, half day)
- 3-month review (group format, half day)
- 6 month review (individual appointment, 1 hour)
We aim to discharge PMP patients once they have completed their 6-month review appointment. By then, we hope that your friend or relative will have developed a range of techniques to actively self-manage their chronic pain.
How can I help support my friend/relative?
Support them whilst they are on the PMP
Attending a PMP can be extremely demanding for patients, both in terms of the time commitment and the content of the sessions.
It may be beneficial to have a discussion with your relative or friend about how they would like to be supported during this time.
It might mean that there is less time for them to complete all of their day-to-day chores and activities because of the demands of the PMP.
We have also found that PMP patients have benefited when others have shown an interest in the content of the PMP; time can be set aside after the PMP to go through the full PMP file.
If appropriate, support your friend/relative with their goal areas after the PMP is finished.
PMP patients complete the programme with specific goals that they have identified as areas that they would like to work upon to help them move forward. Often goal areas involve asking friends and family members to alter their behaviour too.
Don’t help too much!
Whilst it can be tempting to “jump in” and help out when someone is struggling it is always best to ask first about whether any help is wanted or needed. Helping too much can be as physically and psychologically detrimental as not helping at all.
Avoid “symptom-focused” discussions
It is natural to enquire how someone is feeling, especially when they look uncomfortable or in distress. However, frequent symptom focused discussions can be counterproductive as they re-focus attention onto pain rather than pain management techniques.
Stay positive and encourage the use of pain management techniques
Chronic pain patients often experience both good and bad days. Try to gently encourage your friend or relative to focus on those techniques that they are able to implement to take better control over their pain. For example, relaxation, stretching exercises or pacing. There may be times when they feel that they are “back at square one”, remind them how much they have achieved in spite of the pain.
What can I do when my friend/relative is having a flare-up?
As part of the PMP we cover “Flare-up Planning”. This involves each PMP patient devising their own personal flare-up plan.
This includes tools and techniques that they find helpful. By planning this in advance it places less pressure on individuals in the midst of a flare-up.
Your role might be to help plan in advance with your friend/ relative to devise a mutually agreeable plan of how you can support them in conjunction with their flare-up plan.
Remember, rest is helpful but not necessarily appropriate for extended lengths of time when dealing with an extremely bad day.
Further Information
Date of Review: July 2023
Date of Next Review: July 2025
Ref No: PI_P_1792 (Salford)