Major study launched into treatment of chronic pain
More than 5,500 patients in north east London, Essex, Cambridgeshire, and Hertfordshire, are to take part in a major study which aims to improve the treatment of chronic muscle and joint pain - one of the most common reasons for visiting the doctor.
Thousands of people with undiagnosed aches and pains such as chronic back and shoulder pain visit their GP every year. But the type of care and treatment they receive varies enormously - and there is usually little that can be done for them.
Others may visit a chiropractor or an osteopath or be referred to a physiotherapist, but often their pain persists.
Now a multi-disciplinary team of two doctors, a chiropractor, a physiotherapist, and osteopath and a psychologist have been awarded £131, 630 grant from the Arthritis Research Campaign over three years to look at why patients' expectations are often not met by their GPs or therapists - and what can be done about it.
The team will recruit patients suffering from chronic pain from 18 GP practices in north east London, Essex, Cambridgeshire, and Hertfordshire to take part in a series of in-depth interviews. Focus groups and interviews will also be held with GPs and therapists.
"There's a big difference between what patients with these conditions expect from a visit to a GP or a therapist, and what the GP or therapist expects, and these differences create barriers, " explained team leader Dr Martin Underwood, senior lecturer in the department of general practice and primary care at Queen Mary's Hospital in Mile End.
"A lot of studies have been done looking at how we treat patients with chronic pain, but none have sufficiently addressed the concerns and interests of patients. So we want to find out what patients really want. Currently, the treatment offered for these conditions is pretty poor, and doesn't address patients' needs."
"Traditionally, the medical profession has taken the view that chronic pain is a physical problem, but we have begun to realise more and more that there isn't a physical cause for the pain - or rather there might have been a long time ago, but we can no longer find it," explained another member of the research team, physiotherapist Dr Nadine Foster from Keele University.
"We've also begun to realise that the kind of treatment we offer, such as physiotherapy, is not particularly effective for a lot of patients. That could be because we're not looking at the problem in the right way, and that it's not enough to simply look at a physical cause. We need to start treating patients more holistically."
"Patients expectation - that their GP or therapist will be able to get rid of their pain - has been fostered by the medical profession itself - which has encouraged them to think they will be given an X-ray or a scan, and offered treatment which clears up the problem," added Dr Foster. "They expect GPs and therapists to sort them out. When this doesn't happen they feel let down.
GPs, on the other hand, are often not very confident in treating patients with chronic musculo-skeletal pain, because there is no established treatment regime they can fall back on, and because most symptoms of chronic pain are depression and disability, rather than the pain itself.
Treatment effectiveness may be related to the expectations and beliefs of both patients and their clinicians."
