Module 1 Surg0135: Pain in Society

Working as an osteopath, I am surrounded by people in varying degrees of pain, and of course, I do what I can to help alleviate this, working indirectly with GPs and physiotherapists where necessary.

However, not all pain is musculoskeletal, and I'm sure there are people suffering types of pain I don't even know about yet out there – despite being in practice for 25 years, I have barely scratched the surface! It was this, in part, that encouraged me to undertake this field of further study. I am particularly interested in the psychological aspects of chronic pain.

The first part of the module discussed mind-body dualism, and how difficult it is to accurately define and describe pain. As every single person will experience pain of some sort at some point in their lives, it's vital to understand how each person will perceive their experiences of pain differently. This should then shape any intervention more appropriately.

Exploring Pain and Culture was interesting. I feel that this has broadened my horizons, as I live in an area lacking in ethnic diversity, and so I generally work within one demographic. I now feel better prepared to understand pain from other points of view, and will be prepared to adapt my clinical practice appropriately. I am now appreciative of patients potentially withholding information from me, for example, if it's been culturally ingrained in them to be stoic and not complain about their pain. I work with the information given to me by the patient to formulate a treatment plan, which then could end up not being effective or worse, not in their best interests.

I feel better prepared now to understand pain from other points of view, and will adapt my practice accordingly. As Osteopaths, we make much about 'treating the whole person, not their symptoms', but it's not until you look past your everyday norm that you realise what you could be potentially missing.

Being mindful of potential stigma, particularly among LGBTQ+ and neurodiverse people is extremely important, as these groups of patients often encounter many barriers to health. Patients for example may hide relevant information due to having bad experiences with other healthcare staff historically.  One small but significant change I made recently was to use practice management software that allows patients to choose their pronouns, and optional boxes to describe their gender assigned at birth and their gender as they feel it is. Small changes can make all the differences in feeling accepted and listened to by the health professional.

I now better understand enacted, perceived, and self-stigma through this part of the module. I would hate to feel that I had let down a patient by failing to at least try to understand their situation.

The economic impact of pain is an important consideration, from the patients that I see in my clinic to their wider use of national healthcare services. I found reading about the extent of the opioid crisis in the USA, and here in the UK, surprising. I am of course aware of patients taking various pain medications, but as osteopaths currently don’t prescribe, I knew very little of how these medications work – this has inspired some further study into the most commonly prescribed pain-relieving medications.

Overall, I have found this module to be very stimulating. I feel my understanding of what pain is, its cultural significance, and the emotional consequences of people suffering from pain have been enhanced.