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 practicesOverall, 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.43639Authors: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: @konradjacobsContactPlease email Glyn and Konrad with comments and feedback: whatapainpodcast@gmail.comFollow Konrad on twitter: @konradjacobsPodcast 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 for more information.

Podcast Notes: Chronic pain in the classroomHosted by Glyn Williams and Konrad JacobsIn 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 CareerImpact of Chronic Pain on School FunctioningDevelopmental DifferencesPredictors of School FunctioningPain-Related FactorsSchool AccommodationsHow parents and schools can help participationGuardian 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-insteadAuthors: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: @konradjacobsContactPlease email Glyn and Konrad with comments and feedback: whatapainpodcast@gmail.com. Hosted on Acast. See acast.com/privacy for more information.

Podcast Notes: Autism and Pain: Breaking Down Barriers to Understanding and TreatmentHosted by Glyn Williams and Konrad JacobsGuests: Bethany Donaghy and David Moore from Liverpool John Moores UniversityIn 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: @konradjacobsContactPlease email Glyn and Konrad with comments : whatapainpodcast@gmail.com. Hosted on Acast. See acast.com/privacy for more information.

Dr. Fiona Campbell, an anesthesiologist and pain specialist from The Hospital for Sick Children in Toronto, sheds light on chronic post-surgical pain in pediatric patients. She discusses the alarming rise in prevalence and the psychological factors like anxiety that can complicate recovery. Dr. Campbell emphasizes the importance of validating children's pain and using metaphors to explain it. Additionally, she advocates for early interventions and a multidisciplinary approach to enhance treatment outcomes, addressing disparities in healthcare access.

Unraveling the Mystery of Chronic Pelvic Pain in TeenagersKonrad 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.S439452Book:Hilary Mantel, Bad BloodAuthors: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: @konradjacobsContactPlease email Glyn and Konrad with comments and feedback: whatapainpodcast@gmail.comFollow Konrad on twitter: @konradjacobs Hosted on Acast. See acast.com/privacy for more information.

This is the season-ending 12th episode of the What a Pain Podcast. Glyn and Konrad are each other's special guests! They discuss their favourite place on earth, their pet hates (for Glyn this is people who say 'my bad', for Konrad it is the term 'medically unexplained symptoms'), their favourite articles/books, how they got into working in pain, and what they enjoy about their work. They also discuss some of the themes from the previous episodes, and their plans for the next season. Join us for this last episode of the season!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: @konradjacobsContactPlease email Glyn and Konrad with comments and feedback: whatapainpodcast@gmail.comFollow Konrad on twitter: @konradjacobsPodcast reference (APA style):Jacobs, K. and Williams, G. (Hosts). (2024, February 26). What a Pain. (No.12) [Audio podcast episode].Season 1 Finale. Hosted on Acast. See acast.com/privacy for more information.

Professor Chris Eccleston, an esteemed academic from Bath University and a contributor to the Lancet Commission, dives into the complexities of pain management. He discusses the urgent need for a paradigm shift in chronic pain perception and advocates for the visibility and understanding of personal pain experiences. The conversation highlights innovative approaches to pediatric pain management, emphasizing the integration of mental health and the role of technology in shaping future treatment. Collaboration across disciplines and community support are vital for advancing pain research and improving patient care.

In this episode, Konrad initially explains why he is an idiot. He then talks about a symposium he attended at the ISPP conference in Halifax about the use of virtual reality in chronic pain. He explains why he remains to be convinced.The main guest is Dr Jane McNicholas, a clinical psychologist at Great Ormond Street hospital in London who has experience working in a mental health unit as well as the pain service at Great Ormond Street. She talks about her favourite book (by Russ Harris), mental health issues in chronic pain and the way she feels our services should be organised. A fascinating discussion about where pain management ends and the treatment of mental health begins ensues.INOVATE - Interdisciplinary Network on Virtual and Augmented Technologies for Pain managementLogan DE, Simons LE, Caruso TJ, Gold JI, Greenleaf W, Griffin A, King CD, Menendez M, Olbrecht VA, Rodriguez S, Silvia M, Stinson JN, Wang E, Williams SE, Wilson L. Leveraging Virtual Reality and Augmented Reality to Combat Chronic Pain in Youth: Position Paper From the Interdisciplinary Network on Virtual and Augmented Technologies for Pain Management. J Med Internet Res. 2021 Apr 26;23(4):e25916. doi: 10.2196/25916. PMID: 33667177; PMCID: PMC8111507.Book mentioned by Jane McNicholasSteve Hayes - A liberated MindAuthors: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: @konradjacobsContactPlease email Glyn and Konrad with comments and feedback: whatapainpodcast@gmail.comFollow Konrad on twitter: @konradjacobsPodcast reference (APA style):Jacobs, K. and Williams, G. (Hosts). (2023, December 12). What a Pain. (No.10) [Audio podcast episode].Chronic pain and mental health. Hosted on Acast. See acast.com/privacy for more information.

In this episode, Glyn and Konrad initially discuss a symposium in Halifax, Canada they both attended about readiness for change prior to attending a pain management programme. Many young people find it difficult to make the transition from thinking about their chronic pain as an acute problem to a chronic problem. The strategies for dealing with either are very different. Not all young people are ready to make such a change in their thinking. The question is how we prepare young people better for their intensive rehabilitation programmes. Glyn talks about one of the studies that has one of the potential solutions.Following on from this, we talk to Navil Sethna, who is the Clinical Director, Mayo Family Pediatric Pain Rehabilitation Center and Professor of Anesthesiology Harvard Medical School Boston Children’s Hospital. Navil talks about how he got involved in pain, how he set up the first interdisciplinary pain management service for children in the world, some of the basic requirements of pain management programmes, and which children are more likely to benefit from programmes.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: @konradjacobsContactPlease email Glyn and Konrad with comments and feedback: whatapainpodcast@gmail.comFollow Konrad on twitter: @konradjacobsPodcast reference (APA style):Jacobs, K. and Williams, G. (Hosts). (2023, November 15). What a Pain. (No.9) [Audio podcast episode].Interdisciplinary pain programmes. Hosted on Acast. See acast.com/privacy for more information.

Glyn and Konrad are at an international conference about pain in children and adolescents in Halifax, Canada. First, they discuss some of the talks they found interesting. Their main guest is Dr Susmita Kashikar-Zuck, from Cincinnatti Children's Hospital and the university of Cincinnatti. They talk about 3 of the most interesting findings from her own research, and then discuss what happens to children and young people with chronic pain when they are adults. At the end, Glyn and Konrad argue about who is paying for beers.Dr Kashikar-Zuck's publication about the long-term outcomes of chronic pain:Kashikar-Zuck, S; Cunningham, N; Peugh, J; Black, WR; Nelson, S; Lynch-Jordan, AM; Pfeiffer, M; Tran, ST; Ting, TV; Arnold, LM; et al. Long-term outcomes of adolescents with juvenile-onset fibromyalgia into adulthood and impact of depressive symptoms on functioning over time. PAIN. 2019; 160:433-441.Books mentioned by Dr Kashikar-Zuck:Zeltzer L.K., Zeltzer P. Pain in Children and Young Adults: The Journey Back to Normal. Two Pediatricians’ Mind-Body Guide for Parents. Shilysca Press; Encino, CA, USA: 2016. Zeltzer, L. K., & Schlank, C. B. (2005). Conquering your child's chronic pain: a pediatrician's guide for reclaiming a normal childhood. New York, NY: HarperCollinsZoffness, Rachel; Schumacher, Mark A. (2020). The Pain Management Workbook: Powerful CBT and Mindfulness Skills to Take Control of Pain and Reclaim Your Life. Oakland, New Harbinger Publications.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: @konradjacobsContactPlease email Glyn and Konrad with comments and feedback: whatapainpodcast@gmail.comFollow Konrad on twitter: @konradjacobsPodcast reference (APA style):Jacobs, K. and Williams, G. (Hosts). (2023, October 19). What a Pain. (No.8) [Audio podcast episode]. What happens to young people with chronic pain when they are adults? Hosted on Acast. See acast.com/privacy for more information.