“You might look alright and look healthy enough to people who meet you casually - but beneath the surface, you’re in constant pain and you’re always engaged with negative self-talk about your handicap and assessing whether any activity is worth the risk because it might trigger a flare-up,” says Janis.
“I fell when I was ice skating in my 20’s and damaged my coccyx (tailbone) which later caused a degenerative back condition. The chronic pain started a few years after the accident when I had my first child and it got even worse when I had twins (the twins are now aged 23 and her oldest son is aged 27).
“Surgery for a bulging disc in 2013 helped my back a bit, but it didn’t fix it and I found myself on this merry go round of chronic pain, strong opioids, hospital visits, diminishing quality of life and a reduced ability to work.
“It’s physical, emotional and mental turmoil. I found myself going out of the house less frequently over the years. It even became an issue at family gatherings or going to the movies as the thought of sitting for an hour or two and being crippled by pain makes you think twice about doing anything.”
Dr Michelle O’Brien is a specialist pain medicine physician and anaesthetist also working at St Vincent’s with particular interests, including the importance of multidisciplinary team management for chronic pain. Under this model, the patient plays a central role, with an emphasis on evidence based pain education and psychological support, interventional procedures including Spinal Cord Stimulation, and the evolving use of opioids in chronic pain.
“There are many reasons why people experience chronic pain - and pain management can help with all of these. Any part of the body can be affected by chronic pain and there are many different approaches that can be used,” said Dr O’Brien.
“Pain can inhibit or impact on everyday function from the ability to work to full capacity and functionality, right through to completing normal everyday household tasks, physical activity and social engagement that we all take for granted.
“Pain acts as our body’s alarm system and when that alarm is constantly going off this can challenge people’s coping skills and affect important body functions like sleep and mood. Pain signals travel along nerve pathways and our current imaging technology can’t show nerve pain which makes it more challenging to manage.
“It’s important that people who suffer from chronic pain know that there are medical experts who just specialise in managing pain. There are pain services with trained people who can help specifically in pain and there are numerous management options. Patients just need a referral to a pain specialist who can then assess the patient and then come to an agreement about the best approaches.”
St Vincent’s Pain Management Program psychologist Nidhi Gupta says as well as the physical therapy, the program focuses strongly on strategies to assist patients to reclaim some quality of life and a combination of therapies including cognitive behaviour therapy (CBT) and acceptance commitment therapy (ACT). It combines group work with some one-on-one sessions.
Both therapies focus on the patient’s values and what’s important to them and emphasise the importance of accepting their situation and taking control by working towards purpose and achievable goals every day.
“For most patients, their journey with chronic pain has had a profound effect on their lives, costing them jobs, their social life and maybe it’s had a very negative effect on their relationships and their mental health,” says Ms Gupta.
“They can find it hard to ask for help; they experience guilt, loneliness and isolation. A lot of people have lost or forgotten how to have any fun in their life and feel as if they don’t deserve to have fun. They spend a lot of time ‘apologising and explaining’ to those around them. The course provides a support network, helps them return to work in some capacity and resume a social life and leisure activities while promoting mindfulness around their pain levels and what’s manageable in their daily and weekly activities.”
“After I completed the Pain Management Program, I started with the new attitude of “give it a go and see” even though it was initially quite scary with joining the singing group, especially when it comes to performing in competitions,” says Janis.
“You’re on stage for a quite a while and that was initially a concern for me as a year ago I couldn’t even stand on a stage for any period of time, plus there’s a range of actions and musical moves while we’re performing so I had to be a bit careful.”
The group had its finest achievement in May, when the Redland Rhapsody Chorus performed at the prestigious Sweet Adelines International competition held in Brisbane where they won three medals, placed third in Australia and were voted the Most Improved Chorus (the group’s best result in almost three decades).
