The Australian Women\'s Weekly - June 2018

JUNE 2018 | The Australian Women’s Weekly 155

Health

T

he Federal government’s

recent decision to make

medicines containing codeine

available prescription-only

caused quite a controversy.

My GP colleagues around the country

have been having dificult conversations

with patients who suffer from chronic

pain. These people are now forced

to either ind a new medication, an

alternative to medication or have

to visit their doctor more often to

get prescriptions.

One in ive Australians lives with

chronic pain. That makes it one of the

most common reasons people have to

see their doctor. There have been a lot

of very reasonable questions for us

to answer.

What’s the difference between

acute pain and chronic pain?

The deinition of acute or chronic pain

is not about how severe the pain is. It

is about the timing. Acute pain is recent

in onset. Chronic pain is pain that has

become long term, usually for more than

about six months. For acute pain, the

emphasis is generally on removing

the pain by identifying the cause and

providing pain relief while your

body heals. In many chronic pain

conditions, we may not be able to

identify the underlying cause of the

pain with certainty, or the cause may

not be treatable.

Pain starts with damage to body

tissues. Then a number of secondary

changes in the brain and the nerves in

the body amplify the pain experience.

So the treatment of pain often needs

to address these secondary changes as

well as the origin of the pain.

What are my options?

Go back a few steps. Take this

opportunity to have a case review

with your GP. Was the original

diagnosis of your condition correct?

Have you had all of the appropriate

imaging, such as ultrasounds or MRI

scans, to conirm your condition? Is

there anything else that can be done

to treat the origin of the pain?

Depending on the type of pain

you have, a second opinion may be

reasonable. There are specialised pain

clinics in some major public hospitals

where your condition and treatment

plan can be reassessed. You will need

a referral from your GP.

What non-pharmaceutical pain

management options can I try?

There are many treatments and

techniques that you can use to help

eliminate pain and/or reduce its effect

on your quality of life. You may need

to trial a few different techniques or

combinations to igure out what

works best for you. Here are some

of the most popular:

• Psychological techniques: cognitive
  behavioural therapy, relaxation
  techniques, guided imagery


• Physical and manual therapies:
  physiotherapy, osteopathy


• Exercise techniques: yoga, Tai Chi,
  supervised rehabilitation, hydrotherapy


• Relaxation techniques: meditation
  and mindfulness


• Music therapy


• Art therapy


• Acupuncture


• Low-level laser treatment

Affordability is a real issue for a lot of

people, as there is usually an out-of-

pocket cost for services in the private

sector. Some treatments will be available

in public hospital clinics and other

treatments outside of the public system

are subsidised by Medicare but you

will need to ask your GP if you qualify

for a Chronic Disease Management

Plan. This is a plan to coordinate the

different practitioners and medical

specialists involved in your health care.

Then you can have ive subsidised (not

necessarily free) treatments per year.

These might include acupuncture,

physiotherapy, osteopathy, psychology

and exercise physiology.

When should I seek further medical

attention and prescription medicine

to deal with pain?

If your pain is not well controlled you

need to keep trying to ind solutions.

Consider all aspects of your experience

of pain, whether physical, psychological

or spiritual, and what it means to your

quality of life.

Could it be “all in my head”?

In a word, no. Pain actually caused by

psychological issues is extremely rare.

Psychological factors do contribute to

the intensity and quality of your pain

experience, as well as the way you

behave because of your pain. Mood

problems such as anger, frustration,

anxiety and depression are also very

common consequences of pain. You

will manage your pain better if you

include psychological techniques in

your treatment plan, regardless of the

cause. Your family and friends need to

understand your condition and what

you need to do to feel better. AWW

UAEHT

TS

AR

LI

AN

WOMEN’S

W

EE

LK

• Y

HEALTH

EXPERT

My advice

• Review your pain-
  management plan regularly.


• Find interests and activities
  you are able to do.


• If a medication is prescribed
  temporarily for a specific purpose,
  ask your doctor to provide you with a
  program for reducing and ceasing the
  medication within a reasonable time.


• If you are prescribed opioid
  analgesics, ask if there are less
  addictive options for your pain
  management.


• Non-steroidal anti-inflammatory
  drugs (NSAIDs) should be used at the
  lowest possible dose for the shortest
  possible duration because of
  potential side effects.
  PROFESSOR PHELPS: PHOTOGRAPHY BY YIANNI ASPRADAKIS. GETTY IMAGES.