Practitioner experience

Practitioner’s experience – Moving from novice to expert

“I started running a pain clinic two days a week approximately two years ago. I felt apprehensive about taking on this role for many reasons. Chronic pain is a complex condition to manage, there is rarely a cure and the symptoms are unpleasant. I felt that consultations were often going to involve difficult conversations, and individuals might not be willing to engage with me. Medication changes could worsen pain when I want to make people feel better, not worse. Did I have enough knowledge in the area to take on this patient cohort?

Often these people feel isolated, not listened to, unbelieved and unsupported. I was pleasantly surprised by how appreciative they were of my reviews. Feedback included:

‘Nobody has taken time to talk me about my condition and medication like this before’

‘Coming off pregabalin has changed my life; I wish I met you years ago’,

‘Thanks for listening and giving me the confidence to trial changing my medication’

and the most commonly heard phrase:

‘I feel more like me again, now that I have reduced my medication’.

Most people feel anxious at the prospect of reducing their medication. However, I always give them full control of any changes, going at their pace, pausing if needed and increasing the dose back to the previous dose if pain worsens (but this has only happened a few times). I remind the individual that if they never trial any changes then they will never know if they could manage on a lower dose or even without the medication completely.

The majority of people with chronic pain have received little or no information on self-management – you don’t need to be a specialist in this area to provide them with resources.

Helping them to reduce the impact of pain on their quality of life by optimising medication and introducing self-management strategies is extremely rewarding.”