What a Pain

In this episode of the podcast, we are joined by Abbie Jordan, a psychologist and researcher from Bath University, who has made significant contributions to the field of chronic pain research, particularly in paediatric settings. Abbie’s work is highly regarded for its originality and its close link to clinical practice, making it both impactful and relevant. A key topic of discussion is diagnostic uncertainty, a situation where there is a lack of a clear diagnosis or explanation for pain, or where the provided diagnosis is not accepted by the patient or their family. Abbie explains the complexities of this issue, noting that it can cause significant anxiety for both clinicians and families. She highlights the importance of validating pain experiences and building trust with patients and their families, which is crucial for effective pain management. Abbie also delves into the impact of diagnostic uncertainty on families, citing research that indicates it is relatively common, affecting about a third of young people and their parents. This uncertainty can lead to increased pain intensity, reduced quality of life, and greater interference in daily activities. She stresses the importance of involving parents in the diagnostic and treatment process, as their support is essential for effective pain management. For clinicians, Abbie offers practical recommendations. These strategies can help build trust and reduce anxiety, which are critical for successful pain management. For families, Abbie’s insights provide validation and support, emphasizing that feelings of uncertainty and anxiety are common and valid. She encourages families to communicate effectively with clinicians and advocate for their child's needs. Looking to the future, Abbie suggests the need for more integrated research that involves clinicians, children, and parents in real clinical settings. She highlights the importance of studying diagnostic uncertainty in real-time consultations to better understand its impact and improve clinical practices Overall, this podcast offers valuable perspectives on the challenges and opportunities in managing chronic pain in children. It is a must-listen for both clinicians seeking to enhance their understanding and improve their practice, and for families navigating the complexities of chronic pain. Article discussed by Konrad: Paladini, A., Barrientos Penaloza, J., Plancarte Sanchez, R., Ergönenç, T., & Varrassi, G. (2023). Bridging old and new in pain medicine: An historical review. Cureus, 15(8), e43639. https://doi.org/10.7759/cureus.43639 [https://doi.org/10.7759/cureus.43639] Authors: Dr Glyn Williams is a Consultant paediatric anaesthetist and lead for the pain management service at Great Ormond Street Hospital, London. Dr Konrad Jacobs is a Consultant clinical psychologist and rehabilitation lead for the Oxford Centre for Children and Young People in Pain. Twitter: @konradjacobs Contact Please email Glyn and Konrad with comments and feedback: whatapainpodcast@gmail.com Follow Konrad on twitter: @konradjacobs Podcast reference (APA style): Jacobs, K. and Williams, G. (Hosts). (2024, January 8). What a Pain. (Season 2, Number 5) [Audio podcast episode].Understanding Diagnostic Uncertainty in Chronic Pain. ---------------------------------------- Hosted on Acast. See acast.com/privacy [https://acast.com/privacy] for more information.

Podcast Notes:  CHRONIC PAIN IN THE CLASSROOM Hosted by Glyn Williams and Konrad Jacobs In the introduction, Glyn and Konrad discuss Jonathan Haidt’s book ‘The Anxious Generation’. In this episode, we welcome Dr. Deirdre Logan, a pediatric psychologist from Boston Children's Hospital as our special guest, to discuss the impact of chronic pain on school functioning in children and adolescents. Here are the key points from our conversation: * Background and Career * Impact of Chronic Pain on School Functioning * Developmental Differences * Predictors of School Functioning * Pain-Related Factors * School Accommodations * How parents and schools can help participation Guardian article mentioned by Konrad: https://www.theguardian.com/books/article/2024/jun/15/im-an-expert-on-adolescence-heres-why-a-smartphone-ban-isnt-the-answer-and-what-we-should-do-instead Authors: Dr Glyn Williams is a Consultant paediatric anaesthetist and lead for the pain management service at Great Ormond Street Hospital, London. Dr Konrad Jacobs is a Consultant clinical psychologist and rehabilitation lead for the Oxford Centre for Children and Young People in Pain. Twitter: @konradjacobs Contact Please email Glyn and Konrad with comments and feedback: whatapainpodcast@gmail.com. ---------------------------------------- Hosted on Acast. See acast.com/privacy [https://acast.com/privacy] for more information.

Podcast Notes:  AUTISM AND PAIN: BREAKING DOWN BARRIERS TO UNDERSTANDING AND TREATMENT Hosted by Glyn Williams and Konrad Jacobs Guests: Bethany Donaghy and David Moore from Liverpool John Moores University In the podcast introduction, Glyn discusses Mast Cell Activation Syndrome (MCAS), an immunological condition. He notes that MCAS has gained attention from a pain perspective, particularly with a noticeable rise in young patients presenting with this syndrome in our clinics. It is postulated that the syndrome is associated with pain diagnoses such as headache, abdominal pain and neuropathic pain. Glyn raises concerns about how MCAS and pain diagnosis are sometimes considered to have a causal relationship without clear scientific backing, drawing parallels to past controversies with conditions like Ehlers-Danlos syndrome. He highlights the need for more research to understand MCAS’s impact on pain, as well as the importance of not letting diagnostic labels deter patients from engaging in effective pain management. Key Topics & Insights from the interview: Bethany’s Unique Perspective on Autism and Pain: Bethany Donahue shares her invaluable perspective as both a researcher and an autistic individual, shedding light on how autistic people uniquely experience and process pain. She candidly explains how recognising and interpreting pain can be challenging, as autistic individuals may need support to identify and articulate their experiences. The Complexity of Pain and Autism: David and Bethany discuss the need for clinicians to approach pain assessment and management in autistic patients with flexibility and a tailored approach. In their research, they found no significant difference in the baseline pain threshold between autistic and non-autistic individuals. However, they noted higher anxiety and fear related to pain in autistic patients. Communication and Emotional Regulation: Bethany shares that an effective clinical approach should include time to build rapport, such as asking about the patient’s interests to create an immediate connection. The Role of Co-Creation in Pain Research and Healthcare Design: Bethany and David advocate for incorporating autistic voices directly in research design, emphasising co-creation to better address the real needs and experiences of the autistic community. They also explore the idea of creating sensory-friendly healthcare environments and question whether traditional hospital settings are ideal for treating autistic patients. Group Support for Neurodivergent Youth with Chronic Pain: David touches on the potential benefits of group therapy for neurodivergent young people, noting that when group settings are safe and inclusive, they can provide essential social support. Future Research and Clinical Recommendations: Bethany advocates for more research on autistic perspectives of pain and the efficacy of current treatment models, urging that these studies start from the lived experiences of autistic individuals. David suggests that focusing on individuals' strengths, can lead to better adherence and outcomes for autistic patients. Authors: Dr Glyn Williams is a Consultant paediatric anaesthetist and lead for the pain management service at Great Ormond Street Hospital, London. Dr Konrad Jacobs is a Consultant clinical psychologist and rehabilitation lead for the Oxford Centre for Children and Young People in Pain. Twitter: @konradjacobs Contact Please email Glyn and Konrad with comments : whatapainpodcast@gmail.com. ---------------------------------------- Hosted on Acast. See acast.com/privacy [https://acast.com/privacy] for more information.

Understanding Chronic Post-Surgical Pain in Children: A Multidimensional Approach Chronic pain after surgery is a significant issue that can profoundly impact the lives of children and their families. In this insightful episode of the "What a Pain" podcast, Dr. Fiona Campbell, an anesthesiologist and pain specialist from The Hospital for Sick Children in Toronto, shares her expertise on persistent post-surgical pain in pediatric patients. Through engaging discussions, Dr. Campbell explores the prevalence and risk factors associated with chronic post-surgical pain, shedding light on the often-overlooked psychological aspects of this condition. She emphasizes the importance of recognizing chronic pain as a distinct diagnosis, reducing stigma, and promoting a holistic approach to pain management. Key topics covered in this episode include: * The alarming prevalence of chronic post-surgical pain in children and the intriguing increase in prevalence over time after surgery. * Psychological risk factors, such as pre-existing anxiety and parental catastrophising, that can contribute to the development of persistent pain. * The role of validation, reframing negative pain experiences, and fostering resilience in mitigating chronic pain. * Strategies for prevention and early intervention, including preoperative psychological screening and multidisciplinary collaboration. * The use of analogies and metaphors to help children and families understand the complexities of chronic pain. * The future of post-surgical pain: will we ever be without it? Whether you are a healthcare professional, a patient, or a family member navigating the challenges of chronic post-surgical pain, this podcast offers invaluable insights and practical strategies. Join Dr. Campbell as she delves into the multidimensional nature of this condition. Articles mentioned by Professor Campbell: * Treede RD, Rief W, Barke A, Aziz Q, Bennett MI, Benoliel R, Cohen M, Evers S, Finnerup NB, First MB, Giamberardino MA, Kaasa S, Kosek E, Lavand'homme P, Nicholas M, Perrot S, Scholz J, Schug S, Smith BH, Svensson P, Vlaeyen JWS, Wang SJ. A classification of chronic pain for ICD-11. Pain. 2015 Jun;156(6):1003-1007. * Coakley R, Schechter N. Chronic pain is like… The clinical use of analogy and metaphor in the treatment of chronic pain in children. Pediatric Pain Letter 2013;15(1):1-8. www.childpain.org/ppl [http://www.childpain.org/ppl]  Article discussed by Konrad: Kitschen A, Wahidie D, Meyer D, Rau LM, Ruhe AK, Wager J, Zernikow B, Sauerland D. Cost-of-illness and Economic Evaluation of Interventions in Children and Adolescents With Chronic Pain: A Systematic Review. Clin J Pain. 2024 May 1;40(5):306-319. Authors: Dr Glyn Williams is a Consultant paediatric anaesthetist and lead for the pain management service at Great Ormond Street Hospital, London. Dr Konrad Jacobs is a Consultant clinical psychologist and rehabilitation lead for the Oxford Centre for Children and Young People in Pain. Twitter: @konradjacobs Contact Please email Glyn and Konrad with comments and feedback: whatapainpodcast@gmail.com Follow Konrad on twitter: @konradjacobs ---------------------------------------- Hosted on Acast. See acast.com/privacy [https://acast.com/privacy] for more information.

Unraveling the Mystery of Chronic Pelvic Pain in Teenagers Konrad starts the podcast by discussing an article that was published recently that discussed how artificial intelligence may be used in pain management. Chronic pelvic pain is a debilitating condition that affects a significant number of adolescent girls, often leading to missed school days, social isolation, and a profound impact on their quality of life. In this insightful podcast, Dr. Katie Vincent, a leading gynecologist with expertise in adolescent gynecology, sheds light on this complex issue. Dr. Vincent delves into the multifaceted nature of chronic pelvic pain, emphasizing the importance of a multidisciplinary approach involving gynecologists, pain specialists, physiotherapists, and psychologists. She discusses the challenges of assessing pelvic pain in adolescents, which requires sensitive questioning about periods, sex, and body image. The podcast also explores the increasing recognition of neurodiversity and gender dysphoria in patients with chronic pelvic pain, highlighting the need for a personalised and inclusive approach. Additionally, Dr. Vincent shares her thoughts on the evolving role of surgery in managing chronic pelvic pain, citing the ongoing trial led by Professor Andrew Horne in Edinburgh. Whether you are a healthcare professional seeking insights into this complex condition, a patient or family member navigating the challenges of chronic pelvic pain, or simply interested in women's health, this podcast offers a wealth of information and perspectives. Join Dr. Vincent as she navigates the intricate world of chronic pelvic pain in adolescents, providing a comprehensive understanding of the condition and the multidisciplinary approach to its management. Article: Robinson, C. L., D’Souza, R. S., Yazdi, C., Diejomaoh, E. M., Schatman, M. E., Emerick, T., & Orhurhu, V. (2024). Reviewing the Potential Role of Artificial Intelligence in Delivering Personalized and Interactive Pain Medicine Education for Chronic Pain Patients. Journal of Pain Research, 17, 923–929. https://doi.org/10.2147/JPR.S439452 Book: Hilary Mantel, Bad Blood Authors: Dr Glyn Williams is a Consultant paediatric anaesthetist and lead for the pain management service at Great Ormond Street Hospital, London. Dr Konrad Jacobs is a Consultant clinical psychologist and rehabilitation lead for the Oxford Centre for Children and Young People in Pain. Twitter: @konradjacobs Contact Please email Glyn and Konrad with comments and feedback: whatapainpodcast@gmail.com Follow Konrad on twitter: @konradjacobs ---------------------------------------- Hosted on Acast. See acast.com/privacy [https://acast.com/privacy] for more information.