Women's health should be a priority in society. In fact, women's health is vital for society. In terms of persisting (chronic) pain, women seem to suffer more than men. We have some understanding as to why this could be and hence we must address the problem. Chronic pain is one of the largest global health burdens. If pain were understood, the suffering would undoubtedly be eased. My aim is to help society understand pain. Here is my talk tonight, to 'Inspired Women in Medicine'. For further information or if you would like me to talk at your practice or business, please contact me. Pain Coach 1:1 mentoring is also available for clinicians and therapists who want to develop their knowledge and skills in chronic pain. e ~ painphysiolondon@gmail.com
2. What is the issue?
What is pain?
Illustration
What can we do?
3. …one of your patients
A women suffering
pain
What was the story?
How did she present?
What were the
problems?
4. Pain causes suffering
2nd arrow
Pain limits our choices
At home
At work
Socially
Pain affects
Our thinking
Emotions
Perceptions
Sense of self
5. Visit doctor more than men
Use more pain relief
Suffer more pain ailments
IBS, TMD, fibromyalgia
Report more clinical pain
6. There are sex differences
Biologically
e.g./ hormones
Perception of women in pain
Different treatment
Time to receive Rx
Much of the research in males
This MUST change
7. Chronic pain & depression => top 2 global
health burdens
Figures
100 million Americans
20% of the population
1:5 children
8. Medical school
Healthcare professional training
Postgraduate training
CPD
9. Pain huge global
health burden
Main reason why
people see doctor or
healthcare
professional
Poor understanding
of pain
Outcomes?
11. Lack of compassion for self
Perfectionist
Giving to others but not self
Minimal or no recharge time
Frequent feelings of anxiety & worry
Feelings of guilt
12. Starts with musculoskeletal pain
Often a ‘physical’ focus
The story emerges:
Aches and pains ~ gradually worsening
Various life events
Other health problems, e.g./
Sensitive gut
Headaches, migraines
Pelvic pain, vulvodynia, menstrual pain
Fertility issues
13. Perception of our situation
The story we tell ourselves
All those annoyances and frustrations
Hard on self
Nearer the protect line
Inflammation
Off the agenda
Having children
Digesting food
16. Overarching biological changes ~ sensitivity
We need to join the dots
Switch to protect mode ~ survive mode
More common in women
Gradual decrease in activities
Increase suffering ~ loss of sense of self
17. Proposed sex differences
Evolved more sensitive systems to protect
Detect threat more easily
Empathy ~ more sensitive to children’s pain
Temporal summation
Gradual build up; fits chronic pain
Change at puberty ~ a time to monitor
18. ? The change that is important
Systems detect change and update self model
Salient network
More sensitive just before period
Low oestrogen
19. A brief look at a complex social phenomena
Society needs women to be healthy
Huge economical costs of pain
Including substandard treatment
More likely to seek help
Perceived role
Beliefs about themselves, life, role ~ conflict?
Concern for society
21. Protection from a perceived threat
Many body systems
No pain centre or signals
Is it salient? Is it a threat?
Prediction that we need protecting
Predictive coding (processing)
Poorly related to injury
Phantom limb pain
23. Anything that is a threat to the self
Pressure on self ~ worries ~ frustrations
Poor sleep
Stress ~ unique perception
Anxiety (about….)
Environment
Prior experience
Genetics
Context ~ situation
24. Change is definite ~ which way?
Continual updating
Circular causality
Pain
Without any external stimulus
Context
Learning
Updates = on-going protection
25. Treat the person
Person feels pain, person gets better
Understand pain
As a society
If people understood pain, suffering would decrease
Deliver the right messages
Give patients the knowledge and skills
Coach themselves; ‘Pain Coach’
Understanding, resilience, motivation
26. Right messages about change
Desired outcome
Am I heading towards it?
Am I distracted?
Programme to follow
Day to day, moment to moment
Unified experience of perception, action & thinking
27. Develop working knowledge
Reduce fear, engage with living
Create new healthy habits
Normalise body sense and movement
Specific sensorimotor training
Refresh & renew
Movement through the day
Motion is lotion ~ nourishing
28. Mindful practice
Create calm
Focus
See things for what they are
Compassion ~ self & others
Gradual increase in desired activities
Gain confidence with good experiences
29. Pain is a huge societal and global problem
Pain in women in a societal problem
This must ne addressed
Starting with understanding pain