There is no cure for the estimated 400,000 who suffer from chronic pain. Sylvia Thompson reports
Ten years ago, Gina Plunkett whacked her head on the headrest of her car seat when someone drove into the back of the car she was driving.
The immediate feeling of numbness in her head soon turned to pain that ran right down her spine. Her doctor prescribed anti-inflammatory medication.
Over the following weeks, the pain escalated but no damage showed up on X-ray. Six months later, the pain was in her face, her neck, her back and down her left side.
Plunkett describes her pain as a "kind of torture - a pain that isn't about healing but is instead a pain that brings you down and breaks your spirit".
She is one of the 400,000 people in Ireland who suffer from chronic pain.
Now defined as a disease in itself, chronic pain is a debilitating, disabling pain for which there is no cure. At best, sufferers can learn techniques that help them manage it. At worse, they suffer in silence, becoming more isolated and mistrusting even their own unrelenting sensation of pain.
After one year of medication, Plunkett saw an orthopaedic surgeon and, yet again, nothing showed up on MRI and CT scans.
"I was vomiting with the pain. Lifting my children was difficult. Sleeping was a nightmare. The tablets were upsetting my stomach and I couldn't garden any longer," she explains.
Two years after the accident, she was referred to a pain clinic. "The first thing the doctor there told me was, 'I want to tell you this is not in your head'," she explains.
For sufferers of chronic pain, attending a pain clinic and learning pain management techniques is the beginning of the rest of their lives.
Sometimes, it is also the start of a long process of trying out surgical treatments, including nerve blocks and neuro-modulation mechanisms.
The Irish Chronic Pain Association (ICPA) offers support and information to people in pain, their families and carers. It holds regular support meetings and self-help workshops in which people can learn pain management techniques.
The ICPA also leads a pain awareness campaign so that chronic pain can be better understood among health professionals and the public.
According to Frances Whelan, chairwoman of the ICPA, there is a serious lack of awareness of chronic pain across all healthcare professions.
"General practitioners need to be aware that chronic pain is a condition in its own right and that it takes time and a number of tests to eliminate other possible causes for the pain such as heart, liver, gall bladder problems or cancer before it can be diagnosed."
She says: "Chronic pain becomes more complex for individuals if diagnosis is delayed. They need to be referred to pain specialists so that they can learn ways to manage their pain."
Whelan says that while most ICPA members have neuropathic pain resulting from an accident, surgery or complications of diabetes, chronic pain is also experienced by those with arthritis, migraine, multiple sclerosis or post-stroke pain.
There has been a resurgence of interest in both the physiological and psychological mechanisms of pain in recent years.
Some researchers suggest that the nerve pathways from the brain to the site of injury are different in acute and chronic pain conditions. Hormones, memory and emotions may all play an important role alongside "pain sensors" which transmit and receive pain messages.
Dr Ray Victory, consultant anaesthetist and pain specialist at St Vincent's Hospital and St Luke's Hospital, Dublin, says pain clinics have expanded in the past five years with new appointments of pain specialists at major Dublin hospitals and in hospitals in Galway, Cork and Waterford.
"There is also a growing awareness of chronic pain through the annual scientific meetings organised by the Irish Pain Society," he says. "The Irish Pain Society is a multidisciplinary group of professionals which include psychologists, physiotherapists as well as physicians."
Meanwhile, two years ago, Gina Plunkett had further treatment in an attempt to reduce her levels of pain. "I had rhisotomy which involves a burning of the nerves to reduce the pain. It took about six months to work but it has improved my quality of life," she explains.
This is European Week Against Pain and the Irish Chronic Pain Association will launch a pain awareness brochure for healthcare professionals today.
The ICPA will also have information stands in the Mater hospital, Beaumont Hospital and the Adelaide, Meath and National Children's Hospital in Tallaght throughout the week. More details on ICPA activities on tel: 01 8047567. See also www.chronicpainireland.org See also www.europeanpainnetwork.org
The Irish Pain Society will hold its annual scientific meeting on chronic pain for healthcare professionals at the Kingsley Hotel, Cork city on Saturday. For booking details, tel: 021 4385700.