Professor Michael NicholasClinical Psychologist and Director of the Pain Education Unit, University of Sydney, Australia
Michael is a Clinical Psychologist and Director of the Pain Education Unit at the University of Sydney’s Faculty of Medicine and Health (Northern). Clinically, he works at the Pain Management Research Centre at the Royal North Shore Hospital in Sydney, where he directs multidisciplinary pain management programs and maintains active clinical and research roles, with over 300 publications on pain assessment and management.
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He served for 10 years on the IASP council, including 4 years as secretary, and has participated in many IASP task forces and working groups, including the ICD-11 project and the Interdisciplinary Pain Treatment Task Force. He chaired the IASP’s Education Initiatives Working Group for 6 years. He remains an active member of the IASP’s Educational Programs Working Group.
Michael has also contributed to the IASP-supported Southeast Asian Pain Toolkit project in Myanmar, Vietnam and Indonesia, as well as the IASP Pain Camps in Malaysia, Thailand, Kenya, and India to develop interdisciplinary pain management services. His current research interests include the self-management of chronic pain in both the adult and older adult populations, teaching pain self-management methods to health professionals, and early (matched care) psychosocial interventions to prevent long-term pain-related disability in injured workers.
Michael has also contributed to the IASP-supported Southeast Asian Pain Toolkit project in Myanmar, Vietnam and Indonesia, as well as the IASP Pain Camps in Malaysia, Thailand, Kenya, and India to develop interdisciplinary pain management services. His current research interests include the self-management of chronic pain in both the adult and older adult populations, teaching pain self-management methods to health professionals, and early (matched care) psychosocial interventions to prevent long-term pain-related disability in injured workers.
The Right Fit for Each Patient - The Uniformity Myth in Pain Programmes
Clinical pain research is often presented in terms of categories. We have categories for pain, such as pain types and pain sites (e.g., Neuropathic pain, chronic pain, back pain, etc). These often appear in the titles of studies evaluating treatments (e.g., the treatment of neuropathic pain or back pain, etc). But is this adequate? Are we saying that pain entities like these can be isolated or abstracted from the people with these conditions and that everyone with neuropathic pain, for example, shares the same features? How does this fit within a biopsychosocial framework that most pain practitioners say they follow?
Similarly, when we ask whether multidisciplinary pain programmes can help people in chronic pain, are we at risk of assuming everyone with chronic pain is the same? If so, can we take a one-size-fits-all approach? Equally, when we describe a treatment as a ‘pain programme’ are we assuming one programme is much the same as another and the results from one study can be generalised to all ‘pain programmes’?
In addressing these questions this talk will try to shift our focus from thinking about pain in isolation to thinking about a person in pain and how we might tailor our treatment options for that person for better outcomes than ‘one-size-fits-all’ approaches.
Similarly, when we ask whether multidisciplinary pain programmes can help people in chronic pain, are we at risk of assuming everyone with chronic pain is the same? If so, can we take a one-size-fits-all approach? Equally, when we describe a treatment as a ‘pain programme’ are we assuming one programme is much the same as another and the results from one study can be generalised to all ‘pain programmes’?
In addressing these questions this talk will try to shift our focus from thinking about pain in isolation to thinking about a person in pain and how we might tailor our treatment options for that person for better outcomes than ‘one-size-fits-all’ approaches.
Making It A Perfect Fit: Strategies for Adherence to Pain Self-Management
There is widespread agreement that pain self-management is the “treatment of choice” when it comes to advice for people living with chronic pain conditions. Unfortunately, there is less agreement on what that means and how it can be achieved on a long-term basis. As healthcare providers we are usually expected to recommend for (or against) various treatments for our patients with chronic pain. In the main, these treatments tend to be short-term in their effects – maybe a few weeks or months at most. The problem is that chronic pain can last for years and well-beyond the use by date of most treatments. This means we need to explore ways in which we might help our patients over extended periods without burdening them, or the health system, with ongoing costs in terms of time, resources, and funding.
We know the core elements of effective and sustained pain self-management by people living with chronic pain include having an understanding their pain is not a threat and that treatments have limitations, as well as a sense of validation by health care providers and significant others (e.g., family, friends, employer), have personally relevant and meaningful goals that provide a sense of purpose, along with regular physical exercise/activities, high pain self-efficacy beliefs, an ability to self-regulate emotions, a healthy lifestyle habits (sleep, nutrition, etc), supportive social relationships, and low reliance on substances to manage their pain and daily stressors.
This talk will consider the challenge for healthcare providers and the health system in providing services likely to help people achieve these outcomes and minimising the use of low value care.
We know the core elements of effective and sustained pain self-management by people living with chronic pain include having an understanding their pain is not a threat and that treatments have limitations, as well as a sense of validation by health care providers and significant others (e.g., family, friends, employer), have personally relevant and meaningful goals that provide a sense of purpose, along with regular physical exercise/activities, high pain self-efficacy beliefs, an ability to self-regulate emotions, a healthy lifestyle habits (sleep, nutrition, etc), supportive social relationships, and low reliance on substances to manage their pain and daily stressors.
This talk will consider the challenge for healthcare providers and the health system in providing services likely to help people achieve these outcomes and minimising the use of low value care.
