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Transcript – Programme 18: Growing Older with Pain

How to improve pain man­age­ment for old­er peo­ple, and liv­ing with low­er back pain

To lis­ten to this pro­gramme, please click here.

Pain has often been seen as an inevitable part of get­ting old­er. Air­ing Pain lis­tened in to a pan­el of experts at a ‘Grow­ing Old with Pain: Inno­va­tion, Cre­ativ­i­ty and Devel­op­ment’ con­fer­ence in Edin­burgh to hear how pain treat­ments can dra­mat­i­cal­ly improve the qual­i­ty of life of old­er patients. The impor­tance of fam­i­ly and car­ers tak­ing an active role in the man­age­ment of elder­ly patient’s pain is high­light­ed, along with the impor­tance of rais­ing aware­ness of the best treat­ments for pain in old­er peo­ple among health pro­fes­sion­als. We also hear the inspi­ra­tional sto­ry of Michael and Rose­mary Mor­ri­son who togeth­er have rebuilt their lives around their chron­ic back pain and the ben­e­fits of using com­put­ers and com­put­er games to access infor­ma­tion and exercise.

Issues cov­ered in this pro­gramme include: Elder­ly peo­ple, low­er back pain, fam­i­ly, car­ers, com­put­er games, Nin­ten­do Wii, arthri­tis, depres­sion, iso­la­tion, osteoarthri­tis, osteo­poro­sis, care home, edu­cat­ing health pro­fes­sion­als, mis­di­ag­no­sis, exer­cise and fibromyalgia.

Paul Evans: Hel­lo and wel­come to Air­ing Pain. A pro­gramme brought to you by Pain Con­cern, a UK char­i­ty that pro­vides infor­ma­tion and sup­port for those of us liv­ing with pain. Pain Con­cern was award­ed first prize in the 2009 NAPP Awards in Chron­ic Pain and with addi­tion­al fund­ing from Big Lot­tery awards funds for all pro­gramme and the Vol­un­tary Action Fund Com­mu­ni­ty Chest, this has enabled us to make these programmes.

Prof. Den­nis Mar­tin: Pain in old­er adults has been an unrecog­nised prob­lem and we know that the num­ber of peo­ple who have pain gets greater the old­er the age group you get. But it seems to get less in the very old age groups, and we’re not sure whether that is due to peo­ple not report­ing it because they think pain is a nor­mal part of life and there­fore just take it for granted.

Dr Bev­er­ly Col­lett: We’ve got an aging pop­u­la­tion, so we’re all get­ting old­er – by 2020 we antic­i­pate huge num­bers of old­er peo­ple. And also, in that group, it’s been sug­gest­ed that often pain is not recog­nised and, in the worst case sce­nario neglect­ed, because I think peo­ple assume, ‘It’s part of get­ting old­er so I have to live with it’.

Mar­tin: And that’s the kind of ques­tion we’re want­i­ng to answer because there’s no rea­son why pain should be a nor­mal part of life. It is at least as impor­tant, if not more impor­tant, in old­er adults where the effects are poten­tial­ly more significant.


Evans: Ear­li­er this year, the Roy­al Phar­ma­ceu­ti­cal Soci­ety in Edin­burgh and KT EQUAL – that’s a group of UK researchers ded­i­cat­ed to extend­ing qual­i­ty life for old­er and dis­abled peo­ple – host­ed an event focus­ing on ‘Grow­ing Old­er with Pain through Inno­va­tion, Cre­ativ­i­ty and Devel­op­ment’. I’m Paul Evans and in this edi­tion of Air­ing Pain, I’ll be giv­ing you a flavour of some of the issues raised.

Now, the focus of the evening was a ques­tion-and-answer ses­sion with a dis­tin­guished pan­el of experts. They were: Dr Bev­er­ly Col­lett who is the Head of Chron­ic Pain Coali­tion and Con­sul­tant in Pain Man­age­ment at Nuffield Health Leices­ter Hos­pi­tal; Prof. Den­nis Mar­tin, Direc­tor of the Cen­tre for Reha­bil­i­ta­tion Sci­ences at Teesside Uni­ver­si­ty; Prof. Peter Pass­more, Pro­fes­sor of Aging and Geri­atric Med­i­cine at Queen’s Uni­ver­si­ty Belfast; Dr Pat Schofield, Direc­tor of the Cen­tre for Advanced Stud­ies in Nurs­ing and Cen­tre of Aca­d­e­m­ic Pri­ma­ry Care at the Uni­ver­si­ty of Aberdeen; and, final­ly, there was Dr Kevin Voles, who’s a con­sul­tant clin­i­cal psy­chol­o­gist at Keele Uni­ver­si­ty. The event was chaired by the jour­nal­ist, cam­paign­er and for­mer MSP Dorothy-Grace Elder:

Dorothy-Grace Elder: Katie Green of Arthri­tis Care in Scot­land – her ques­tion, she says: ‘In a recent sur­vey by Arthri­tis Care, more than half – 52 per cent – of the respon­dents aged over 65 stat­ed that they’d often or occa­sion­al­ly expe­ri­enced depres­sion as a result of their arthri­tis pain. Is the pan­el aware of oth­er evi­dence about the psy­cho­log­i­cal impact of pain and how pain man­age­ment inter­ven­tions can address this?’

Dr Kevin Voles: We all know depres­sion is very preva­lent when qual­i­ty of life starts to get low­er. The good treat­ments that are out there, the effec­tive treat­ments that are out there, offer a com­bined approach that get peo­ple back on track. I think that’s just as applic­a­ble to old­er adults who also tend to be more depressed for oth­er rea­sons – of course there’s a lot of depres­sion and it’s very treatable.

Elder: Den­nis, do you want to comment?

Mar­tin: Yeah, I think you can even expand on the con­text of the ques­tion: it’s not just psy­cho­log­i­cal, it’s psy­choso­cial as well. Social iso­la­tion is a very big thing for old­er peo­ple with chron­ic pain and that’s some­thing that can be addressed…

Elder: …in pain management.

Mar­tin: All-around, yes.


Schofield: Com­mon caus­es of pain in the old­er pop­u­la­tion are things like osteoarthri­tis and osteo­poro­sis and then the asso­ci­at­ed prob­lems such as falls, injuries and so on and then they’re left with ongo­ing prob­lems, like chron­ic pain.

Evans: That’s pan­el mem­ber Pat Schofield speak­ing pri­or to this event. She’s Direc­tor for the Cen­ters for Advanced Stud­ies in Nurs­ing and of Aca­d­e­m­ic Pri­ma­ry Care at Aberdeen Uni­ver­si­ty. Now, her field of exper­tise is par­tic­u­lar­ly rel­e­vant to the next question:

Elder: Jeanette Bar­rie from ex-Qual­i­ty Improve­ment Scot­land, who’s done some mar­vel­lous reports and helped com­pile these and push them forward:

Jeanette Bar­rie: My con­cern real­ly is for patients or res­i­dents of care homes. I think Peter men­tioned that 50 per cent of care home res­i­dents report pain. In some of the papers I’ve read it says that it’s 85 per cent [oth­ers gasp]. A quick trawl of our own care homes report­ed that not many [peo­ple had] actu­al­ly been assessed rou­tine­ly, except in the Liv­er­pool Care Path­way stage, in the last few days of life, which is extreme­ly sad.

Schofield: A lot of the pain assess­ment tools that we use for mea­sure pain in the gen­er­al pop­u­la­tion are not nec­es­sar­i­ly appro­pri­ate for the old­er pop­u­la­tion, because they have dif­fi­cul­ty in under­stand­ing the ques­tions that we’re ask­ing. And then you add in things like con­fu­sion and so on, which makes it a lit­tle bit more com­plex. The first pri­or­i­ty real­ly is to actu­al­ly talk to the fam­i­ly who live with that par­tic­u­lar per­son, because they can observe any changes in behav­iour that could be attrib­uted to pain.

Sim­i­lar­ly, I think, if you’re talk­ing about nurs­ing home pop­u­la­tions, the staff who work in those set­tings know the res­i­dents very well and also know if there are any changes in behaviour.

Pain assess­ment is not wide­ly used in care home set­tings, it’s not seen as one of their major pri­or­i­ties, I think. They have so many oth­er things to deal with. And I think what we real­ly need to do is to get those guide­lines read­i­ly accept­ed in all care set­tings includ­ing nurs­ing homes – they can help.

Elder: Onto the next ques­tion. From Ron Marsh, user mem­ber EOPIC, Uni­ver­si­ty of Aberdeen. What’s EOPIC, again?

Ron Marsh: EOPIC is ‘Epic’. EOPIC stands for engag­ing peo­ple in self-man­age­ment of chron­ic pain. Because I’m in it – I’m old­er, so they had to have an ‘O’… [laughs all around]

Evans: Before we go on to Ron’s ques­tion, let’s find out a lit­tle bit more about EOPIC from Blair Smith. He’s a GP and Pro­fes­sor of Pri­ma­ry Care Med­i­cine at the Uni­ver­si­ty of Aberdeen.

Blair Smith: EOPIC is a study fund­ed through the Life­long Health and Well­be­ing Ini­tia­tive by the research coun­cils, main­ly the Med­ical Research Coun­cil. Its aim is to iden­ti­fy and begin to test self-man­age­ment strate­gies for chron­ic pain expe­ri­enced by old­er adults.

I think the impor­tant point about chron­ic pain, just like many oth­er health ques­tions, that a lot of research is being done not specif­i­cal­ly in old­er adults, and in fact a lot of research actu­al­ly excludes old­er adults and peo­ple with oth­er ill­ness­es. One of the impor­tant things is if you’re look­ing at drug tri­als, for exam­ple, almost every drug tri­al has exclud­ed old­er adults. And yet, many con­di­tions… and most of the patients that come in to me at the surgery are old­er adults and there­fore the evi­dence to sup­port their treat­ment is not great.

Now that’s just true when we look at the expe­ri­ence of chron­ic pain. Before we can iden­ti­fy and eval­u­ate self-man­age­ment strate­gies, we need to under­stand what the expe­ri­ence of chron­ic pain is and how peo­ple are man­ag­ing it them­selves already. We know a lit­tle bit about that in younger adults, but the research on old­er adults has not been done thor­ough­ly, so we’re look­ing at that just now.

We have a very active, enthu­si­as­tic and valu­able group of ser­vice users, old­er adults who have expe­ri­enced chron­ic pain them­selves. His­tor­i­cal­ly at Aberdeen, with my col­league Pat Scofield we’ve worked with old­er adults for a con­sid­er­able time and we have a very active users group who’ve helped us to shape the research, to tell us what the research ques­tions are and to help us iden­ti­fy what approach­es to answer­ing these ques­tions might and might not be fea­si­ble. So then when we came to design this par­tic­u­lar study, we had a small­er group of those inputted in to design­ing the pro­to­col right from the begin­ning [who] con­tin­ue to serve on the research team with reg­u­lar meet­ings, input and reviews of mate­ri­als. And we couldn’t do with­out them.

Marsh: Hi, I’m Ron Marsh. I’m a patient that has pain through dia­betes and low­er back pain. We have a very wide remit: we can com­ment on any aspect of the study and we’re wel­comed in doing that. You know, it’s not a case of ‘them and us’ at all; we’re just a group of laypeo­ple and med­ical researchers, med­ical people…

Evans: Can you give me and exam­ple of how you’ve helped, or what input you’ve had into their work?

Marsh: I think we’ve been able to give direct evi­dence of what it is like for an old­er per­son liv­ing with pain.

Evans: Explain to me, as some­body who feels he’s very old – mid-fifties [laughs]– what I can look for­ward to as a per­son in pain, when I’m get­ting a lit­tle bit older.

Marsh: I have tak­en the view that pain is just some­thing that comes with old age. Lis­ten­ing to dis­cus­sions like this tonight, I shouldn’t real­ly be expect­ing pain…

Evans: You shouldn’t lie down and just accept it.

Marsh: Cor­rect.

Elder: Now, your ques­tion is: when will old age with­out pain arrive?

Prof. Pass­more: If I may com­ment – I think it goes back to this sort of accep­tance of pain as part of some­thing that is just going to hap­pen to you and I don’t for a minute believe that! I sup­pose where I work from is: it depends on how far you go in terms of the root cause. So I will chase that.

The wor­ry for me is that if peo­ple don’t deal with the acute pain, the acute pain then becomes chron­ic, which just becomes an enti­ty in itself. So at that stage it’s not rel­e­vant what the root cause was, you’re just in chron­ic pain with the phys­i­ol­o­gy and the way it devel­ops. So in that sit­u­a­tion I think you’re into psy­chol­o­gy, explain­ing about the sit­u­a­tion and what we can do in terms of alle­vi­a­tion. My com­ment to peo­ple who are in that sit­u­a­tion ‘Look, I might not get rid of all of this for you, but [I could] make it bear­able’, you know?

But to go back to your ques­tion – I think the ques­tion for peo­ple who are in pain is a sim­ple ‘Why?’. [And while] we do have a lot of inves­ti­ga­tion­al tech­niques, I think the ques­tion for us is ‘When is it appro­pri­ate and when is it not appro­pri­ate?’ – that is, you’re into a cost effec­tive­ness argu­ment. And you’re also putting the patient through a lot with some of these tests. So that would be the com­ment I would make.

Mar­tin: Ron, I think a direct answer to your ques­tion, when will there be a cure for pain – I wouldn’t put any mon­ey on it for the near future [laughs], but I think what Kevin talked about that is as impor­tant is the effects of pain. I think in terms of old­er peo­ple, there’s cer­tain­ly more research com­ing out now [that is] focused direct­ly on that: the research that we’re doing with EOPIC, the Smart project that Chris is involved in, is focused on old­er peo­ple – so in X num­ber of years in the near future there should be more knowl­edge com­ing out.

Clos­er to this time I think per­haps what’s need­ed is bet­ter edu­ca­tion of health pro­fes­sion­als, so we’re get­ting a more intel­li­gent and thought­ful appli­ca­tion of what we already know for younger groups in order to apply that to old­er peo­ple. There is some good exist­ing knowl­edge which I think could be applied with some effort and thought.

Speak­er 1: Can I just add a point there? I think that the whole real fact that new stu­dents get taught twice as much pain in terms of their train­ing at vet­eri­nary school than med­ical stu­dents do – I don’t know how accu­rate­ly that applies now.

The sec­ond point would be: my expe­ri­ence as a lead in the acute man­age­ment team in the trust where I work is that junior staff and mid­dle staff don’t know any­thing about pain man­age­ment. One of the prob­lems is that we set our­selves up in acute pain teams, in crit­i­cal care liai­son teams and oth­er spe­cial­ist groups. Part­ly through their lack of train­ing, their lack of time on the wards, they don’t know how to do basic care. And some­how a return to man­ag­ing that or giv­ing them a bit more respon­si­bil­i­ty, but I’m not entire­ly sure how you would do that because they just don’t have the skills. I think we real­ly need to reflect on how we’re going to get junior doc­tors to be bet­ter trained, so they can do basic stuff.

Prof. Peter Pass­more: I couldn’t agree – that’s inter­est­ing, because I did men­tion this. For such a chron­ic prob­lem, there’s cer­tain things that are nev­er taught in med­ical school, like man­age­ment of con­sti­pa­tion or of vas­cu­lar or vari­cose ulcers. But even over and above that is pain.

We have the fourth years and we send them out and our sim­ple way of doing this is: they sur­vey a group of drugs, but we always make sure the anal­gesics are on there, so that peo­ple who get the con­sti­pa­tion ones won’t feel like they’ve drawn the short straw. We’ve tried to indi­cate that there are prob­lems and dif­fi­cul­ties with the drugs that are used.

But I don’t know. I think one ought to be able to impact on the GMC – when you think about the preva­lence, etc., and we’ve heard about this – to real­ly look in depth at the under­grad­u­ate cur­ricu­lum and you’ll see that some things, I guess, are being overlooked.

If you look at what’s pre­scribed in the wards, and we’re pub­lished exten­sive­ly on this, 68 per cent of our drugs in the hos­pi­tal are anal­gesics in the geri­atric wards. That’s more than even in the nurs­ing homes. But if that is the case, how can you not train peo­ple about that?

Evans: Pro­fes­sor Peter Pass­more. He’s Pro­fes­sor of Aging and Geri­atric Med­i­cine at Queen’s Uni­ver­si­ty Belfast.

Now, before we con­tin­ue, please bear in mind that while we believe the infor­ma­tion and opin­ions on Air­ing Pain are accu­rate based on the best judge­ments avail­able, you should always con­sult your health pro­fes­sion­al on any mat­ter relat­ed to your health and well-being. He or she is the only one who knows your and your cir­cum­stances, and there­fore the appro­pri­ate action to take on your behalf.

You’re lis­ten­ing to Air­ing Pain with me Paul Evans, and we’re at KT EQUAL ‘Grow­ing Old with Pain: Inno­va­tion, Cre­ativ­i­ty and Devel­op­ment’ event at the Roy­al Phar­ma­ceu­ti­cal Soci­ety in Edinburgh.

Michael Mor­ri­son: My name’s Michael Mor­ri­son, this is my wife Rose­mary. We are involved heav­i­ly with the Pain Asso­ci­a­tion in Scot­land, with the sup­port group up in the Grampian region.

I hurt my back orig­i­nal­ly play­ing crick­et and for ten years I was diag­nosed wrong­ly. I was being treat­ed for sacroil­i­ac prob­lems but what had hap­pened was, I had three bust discs in the base of my spine. So dur­ing those 10 years from ‘81 to ‘91 I was just on painkillers. I always felt that anoth­er week will go by and then I’ll be okay, but then in 1991 I became immo­bile. I just couldn’t walk; I couldn’t put one foot on the floor.

I was in a wheel­chair for 12 years and two and a half years ago a friend of my son who’s a sur­geon at Wood­end Hos­pi­tal – my son said to him ‘My dad’s com­ing to see you. Do a good job!’ [laughs] So he called me in and I explained all that had gone wrong, so he said ‘Anoth­er oper­a­tion might sort things out for you’. So I even­tu­al­ly got a call, I went to the hos­pi­tal, had the oper­a­tion, had all the discs in the low­er spine fused and all the scar­ring tis­sue that had been in there cut away and dis­pensed with.

And when I came through from the recov­ery room, I was in awe because I had no leg pain, no foot pain, noth­ing. I thought well, maybe it’s just the effect of the anaes­thet­ic. But no, it’s last­ed, and now I’m out of my wheel­chair, I don’t use the wheel­chair anymore.

Evans: Tell me how impor­tant Rose­mary was.

M. Mor­ri­son: A lot! I don’t know what else I would have done with­out her! She’s been a rock, as far as I was con­cerned, because she wouldn’t let me get so low. She used to pull me up by the throat and say ‘Right, you’re not get­ting into that sit­u­a­tion!’ She was the one that pushed me and pushed me… because I would have prob­a­bly fall­en at the first hur­dle and said ‘Oh, well, that’s my lot. End of story.’

R. Mor­ri­son: I wouldn’t let you!

M. Mor­ri­son: She wouldn’t have let me, no. So she was very, very supportive.

R. Mor­ri­son: Well, we’ve been mar­ried 40 years this year, and… you know, he was very, very bad. He couldn’t walk, I was lift­ing him [laughs] and how I did it I don’t know! But you do it; you find the strength, you know? I just said to him ‘You are NOT going into depres­sion with this! You may think your life’s over, but it’s not. Mine cer­tain­ly isn’t!’

I was prob­a­bly being rot­ten to him, but it was the only way I could get through to him, because he was going into himself…

M. Mor­ri­son: Once I’d been through all the pre­vi­ous depart­ments at the hos­pi­tal, the sur­geon the third time said to me there was absolute­ly noth­ing else he could sug­gest, apart from going into a res­i­den­tial pain man­age­ment pro­gram. So I was one of the ones who was sent from Scot­land to Man­ches­ter for three weeks. While I was there I got real­ly good advice and it was at that time I felt some­thing need­ed to be put back into the com­mu­ni­ty. That was when our con­nec­tion with Pain Asso­ci­a­tion Scot­land started.

Evans: So tell me about Pain Asso­ci­a­tion Scot­land. What do you do there?

M. Mor­ri­son: We have two meet­ings every month: the first and third Wednes­day of every month. Dur­ing our meet­ings we nor­mal­ly have a ses­sion of light exer­cise, pro­gres­sive. We also a ses­sion on pain man­age­ment tech­niques that peo­ple can use for han­dling their pain – not cur­ing it or what­ev­er, but actu­al­ly being able to man­age their pain and do the things they want to do, with­out hav­ing the stig­ma for days after. And then we fin­ish off with a ses­sion of relax­ation. I think that’s the best part! [chuck­les] I think that’s what every­body comes for.

R. Mor­ri­son: I think when we’re doing the exer­cise, which is very light, they all go ‘Ohhh!’, they groan, but they do it! It’s good to see them! I mean they know that we can’t cure them, because we tell them that right from the start, but we’ve got a good group.

M. Mor­ri­son: They all sup­port each other.

R. Mor­ri­son: Yes, yes they do. It’s amazing.

Evans: But you, Rose­mary, must be a very valu­able part of the group, because you’re not liv­ing with pain but you’ve pulled some­body who was liv­ing with pain through it.

R. Mor­ri­son: Yes, I think because of the way Michael had been, and because I became stronger… I mean, Michael always looked after me – and still does – but at that time, he need­ed me. So it was my turn to help him.

Some of the group some­times like to speak to me and some­times they like to speak to Michael, it just depends. Also, some of them will phone us. We say to them ‘You can phone us at home, if you’re hav­ing a rough time phone us!’

Evans: When you went down to Man­ches­ter, to the pain man­age­ment clin­ic, how far did you have to travel?

M. Mor­ri­son: Maybe about 400 miles each way.

Evans: Well, [iron­ic] that’s easy if you’re in pain!

M. Mor­ri­son: [chuck­les] No. I was in a wheel­chair and I was real­ly struggling.

R. Mor­ri­son: I wasn’t allowed to go down, you see, he had to go down himself.

M. Mor­ri­son: I was flown in. The health board paid for the whole ses­sion, so I was flown into Man­ches­ter and there I was picked up at the air­port. Rose­mary didn’t want to let me go on the plane from Aberdeen.

R. Mor­ri­son: But before they would take you on they were say­ing you had to walk for…

M. Mor­ri­son: …Aye, for 200 yards.

R. Mor­ri­son: For 200 yards. And they said ‘If you can do that then we’ll take you on’.

M. Mor­ri­son: Yeah, I wasn’t accept­ed ini­tial­ly, because my health was so poor. So they gave me cer­tain cri­te­ria and they said ‘If you meet that we’ll put you on the pro­gram’. And I bat­tled, I real­ly bat­tled to get me in the sit­u­a­tion to go down for that course.

R. Mor­ri­son: And he was there for three weeks and it was very, very basic. Oh!

M. Mor­ri­son: Yeah, you had to do every­thing for your­self. You had to make the bed, pre­pare your break­fast, your lunch, your din­ner – all with­in the con­fines of a hos­pi­tal ward at Sal­ford. But the way the pro­gram went about it, they could get a video of how you dealt with sev­en aspects with­in a house sit­u­a­tion; then, at the end of the course, they also video‑d the same thing again. And for me the dif­fer­ence was enor­mous! I didn’t think I was as bad as I was, when I saw the first video, but the sec­ond video was just… Chalk and cheese. There was real­ly such a difference!

Evans: Has the ben­e­fit stayed with you?

R. Mor­ri­son: Yes.

M. Mor­ri­son: Absolute­ly.

Evans: Why did you have to do an 800-mile round trip?

M. Mor­ri­son: There’s noth­ing else in Scot­land. I had two options, one was to Man­ches­ter and the oth­er one was down to Lon­don. Mind you, I’d said no to start with!

R. Mor­ri­son: Yes. You did.

M. Mor­ri­son: I wasn’t pre­pared to go and put myself through that. But she kept at me, she said ‘Don’t give up! You try it! It will maybe do you good’. And it did! [laughs]

Evans: Michael and Rose­mary Morrison.

You’re lis­ten­ing to Air­ing Pain with me, Paul Evans. And we’re eaves­drop­ping at the Roy­al Phar­ma­ceu­ti­cal Soci­ety in Edin­burgh where Dorothy-Grace Elder’s chair­ing the KT EQUAL ques­tion time event on ‘Grow­ing Old­er with Pain: Inno­va­tion, Cre­ativ­i­ty and Development’:

Elder: A lot of elder­ly peo­ple are told by their doc­tors that pain is an inevitable part of aging – some­thing you just have to put up with. What does the pan­el think? Is it inevitable?

You know what, if you’ve led a per­fect life – nev­er smoked, nev­er drank – you’re dying of bore­dom, but nev­er­the­less… [audi­ence laughs] What if you should be in very good con­di­tion, but you’re very old? Well, is it inevitable that you should suf­fer pain?

Mar­tin: I think that dis­abil­i­ty and the suf­fer­ing asso­ci­at­ed with it is not inevitable. It’s man­age­able. The suf­fer­ing and the dis­abil­i­ty asso­ci­at­ed with it, it’s not inevitable, things can be done.

Pass­more: I think preva­lence has been con­vert­ed into inevitabil­i­ty. When you think about it, every­body com­plains about [pain]. That’s a preva­lence sta­tis­tic; it is a real thing. So I think peo­ple now are trans­lat­ing preva­lence into inevitabil­i­ty and that’s not right.


M. Mor­ri­son: I think cer­tain­ly as time goes on – you asked the ques­tion of what can you expect in old­er age from pain – I think you’ll find chal­lenges; you’ll prob­a­bly be chal­lenged to the full. Because between pain in a younger per­son and pain in an old­er per­son, the pain is almost exact­ly the same; it’s how you han­dle it that is com­plete­ly dif­fer­ent. And I think that’s real­ly the way to look at it: you’re cer­tain­ly going to have the chal­lenges, but hope­ful­ly through the group that we are involved with we’d be able to pro­vide you with the tools to meet that challenge.

Evans: Can you just give me a check­list of the tools that you can offer?

M. Mor­ri­son: The tools that we’re look­ing at are: tak­ing a Pain Asso­ci­a­tion pro­gram through the likes of exer­cise ini­tial­ly; then some pain man­age­ment; then relax­ation. What we’d be look­ing at is using IT to the best, and hav­ing peo­ple involved right from when they join Pain Asso­ci­a­tion Scot­land, for exam­ple, for £5 a year or what­ev­er. For that mem­ber­ship you’ll be able to log onto the web­site, then you’ll have a num­ber of med­ical ques­tions asked – very basic med­ical ques­tions – to cal­cu­late what you would be capa­ble of.

We also talked about using the Wii; but the Wii pro­gram type ben­e­fits from using IT. And I think hope­ful­ly over the next two, three years – these things are expand­ing so rapid­ly that we’ll see those [devel­op­ments] I would say prob­a­bly in the next five years.

Evans: OK. I’m quite excit­ed about this because you obvi­ous­ly know about the Nin­ten­do Wii – and I think Sony have brought out some­thing like that as well now. I bought my wife a Wii for Christ­mas. I suf­fer from fibromyal­gia. I have avoid­ed it but obvi­ous­ly you, with pain, and peo­ple in your group have found a way of using it.

M. Mor­ri­son: Even the fibromyal­gia suf­fer­ers in our group have found ben­e­fits from using the Wii. Before they came to the group, they were stressed every day and a lot of them were very angry over what was hap­pen­ing, because the doc­tors in the hos­pi­tal were unable to diag­nose or give them any hope for the future. But now… grand­chil­dren are a great thing as well – you learn to like hav­ing grand­chil­dren who are very involved with com­put­ers and IT and these lit­tle fid­dly phone things. And I think that’s a beam of light as far as get­ting old­er is con­cerned: hav­ing grand­chil­dren who would be able to teach you… And I think as time goes on it will be faster and faster, and every­body hope­ful­ly will do it.

Speak­er 2: Back to the exer­cis­ing side of things: in many instances the Far East are way ahead of us. They have their elder­ly com­ing up to reti­ral. Over a peri­od of time, they will actu­al­ly get them into doing T’ai Chi or what­ev­er, It may be some­thing that we will have to take on board in this coun­try as well.

Pass­more: Oh, in Hyde Park there’s a new area con­vert­ed for old­er people’s exer­cise now. Isn’t that right? Ded­i­cat­ed to it? So I think you’re right, it’s some­thing to take on board. But see­ing the peo­ple cavort­ing around lamp­posts in Hong Kong – it’s a great thing! It’s all about the core and all, absolute­ly. And that in itself will have an effect on pain.


Evans: And that was Pro­fes­sor Peter Pass­more who’s a pan­el­list at the KT Equal event on ‘Grow­ing Old­er with Pain: Inno­va­tion, Cre­ativ­i­ty and Devel­op­ment’ at the Roy­al Phar­ma­ceu­ti­cal Soci­ety in Edin­burgh. And he sad­ly brings to an end not just this edi­tion of Air­ing Pain, but the series. The pro­grams were pro­duced by me, Paul Evans, for Pain Con­cern: the UK char­i­ty pro­vid­ing infor­ma­tion and sup­port for peo­ple who live with pain.

Now, once the pro­gram takes the sum­mer break, please do keep in touch with us. You’ll find all our details at our web­site at and there you’ll find a wealth of infor­ma­tion about man­ag­ing your pain, how to con­tact us about infor­ma­tion on our sis­ter mag­a­zine Pain Mat­ters, and how to down­load or order all our old edi­tions of Air­ing Pain. We’ll be back in the autumn to look at the issues affect­ing 7 mil­lion of us in the UK liv­ing with chron­ic pain, but until then I’ll leave you with a thought for the future from Michael Morrison:

M. Mor­ri­son: Old age, they say, doesn’t come alone. But it comes with a Wii, a wife, so many grand­chil­dren etc. [laugh­ter all around] that you can use to your ben­e­fit in lat­er life.


  • Michael and Rose­mary Mor­ri­son, Pain Asso­ci­a­tion Scotland
  • Ron Marsh, Patient
  • Dorothy-Grace Elder, ex MSP, campaigner
  • Jeanette Bar­rie from ex-Qual­i­ty Improve­ment Scotland
  • Dr Bev­er­ly Collett
  • Pro­fes­sor Den­nis Mar­tin, Direc­tor of Cen­tre for Reha­bil­i­ta­tion Sci­ences, Teesside University
  • Pro­fes­sor Peter Pass­more, Queens Uni­ver­si­ty Belfast
  • Dr Pat Schofield, Direc­tor of Study for Advanced Nurs­ing, Cen­tre of Aca­d­e­m­ic Pri­ma­ry Care
  • Dr Kevin Voles, Con­sul­tant Clin­i­cal Psychologist.


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