A shift from pills to understanding
For years, Julie-Ann Walkden relied on pills and injections to cope with chronic pain. But she credits an understanding of her condition, gained through a pain rehabilitation programme, with helping her get her life back. "I didn't want to take strong medication which made me feel ill, not in control and often so confused that I felt I'd dementia," she said. Walkden, now 58, was prescribed strong pain medication a decade ago for a long-standing stomach injury, but said it only provided short-term relief and made her feel worse.
She was among more than 100 patients who have completed the programme, which uses exercise, talking, and psychological therapies to help them understand the source of their pain. The approach is a departure from relying on medication, instead teaching psychological techniques to manage pain. After attending a three-week intensive programme at Knockbracken Health Care Park in Belfast, Walkden said she found new ways of coping.
The tools have allowed me to become the boss of the pain instead of it controlling me," she said. "I am not afraid to exercise, especially to walk. I even talk to the pain but I no longer allow it to prevent me from living a life. Understanding the source of my pain and what it is doing to me mentally, never mind physically, has been life changing."
The study and its stark findings
The programme at Knockbracken is part of a new study from Queen's University Belfast (QUB) and the Belfast Health Trust. While more than 100 people within the Belfast Trust physically took part, the research also analysed data from 491 patients living with chronic pain across Northern Ireland. It found that 42% of those were living in the most deprived areas.
The research, led by Professor Kevin Vowles of QUB, revealed that people in the most deprived socio-economic areas are at higher risk of chronic pain and are up to three times more likely to face pain-related mental health, social, and physical disability issues compared to the least deprived. Vowles said he was "genuinely shocked" by the findings. The disparity highlights the broader consequences of inequality, going beyond the physical pain itself.
Dr Rory Maguire, a consultant in pain medicined, said the programme marks a change from relying on medication and procedures. His comments echo the approach taken by colleagues at the Belfast Trust, and they are part of the broader medical community's reassessment of how chronic pain can be managed.
A Councillor's experience
Frank McCoubrey, a Belfast City Councillor who has lived with spine pain for more than 15 years, shared his own experience with the condition. At times, his pain caused him to curl into the foetal position and stay in bed. Medication often made him drowsy, nauseous, and disturbed his sleep, adding to the burden. His account underscores the physical and psychological toll that chronic pain takes, even on those with access to treatment.
The cost of chronic pain
Chronic pain costs the UK an estimated £10 billion annually in healthcare and lost productivity, according to the statistics cited in the reports. The new study's findings.
While the programme has given hope to patients like Walkden, the deprivation gap we identify suggests that systemic inequalities remain a significant barrier. The statistics paint a concerning picture that the health burden of chronic pain is not distributed equitably across society.
A Path Forward
The programme's success with over 100 patients offers a potential model for other health trusts. By teaching patients to understand and manage their pain psychologically, rather than relying solely on pills and injections, it provides a way to give patients like Walkden more control. "I am now part of the pain that controls me," she said, reversing the focus from a life controlled by pain to one where she is in charge.