This is it! My final post about this year’s World Pain Summit (put on by the Alberta Pain Society) and all that I learned. Make sure to read parts 1 and 2 if you haven’t yet because there is great info in them. Once again, the summit/conference was a 3-day event for (1) physicians, (2) allied healthcare professionals (like me!), and (3) people with lived experience (also like me!). This summit had such amazing info, so here’s what the third day looked like, and some of my key takeaways from it!
If It’s Not Inflammation, Why Do I Hurt? 2 Rheumatologists did presentations, and as someone with an autoimmune disease that sees a rheumatologist, this was a great session for me to attend (with my person with lived experience cap on). Lots of really interesting info. Like first rheumatologists hate ANA tests because they are highly sensitive and not at all specific (in other words, they don’t work). You can also have an autoimmune disease without meeting the classification criteria because even though classification is often used for diagnosis, it is only meant for research. They noted that an absolute answer to the causes of pain isn’t always possible, and that pain should be managed with lifestyle (reduce stress, improve sleep, avoid triggers, and exercise) not just medication. Finally, what they said to the other rheumatologists out there was that they should always help their patients manage pain regardless of diagnosis (is this hope for the field?).
Evidence-Based Tips for Coping with the Emotional Impact of Chronic Disease and Persistent Pain. This was a presentation by a person with lived experience who is also a researcher. After going through all the sciencey mammalian brain stuff (which is important but too long to summarize here), she gave 4 tips for managing emotions and pain: (1) charge your frontal lobe so you can feel more energetic at the end of an activity then when you started (sleep hygiene, healthy eating, hydration, physical activity, nature, social connection); (2) use your “battery” wisely – this refers to the frontal lobe of our brains that controls our behaviours (asking for help, and most importantly pacing – which is keeping activity the same regardless of whether you’re having a good day or a bad day); (3) psychological flexibility (using problem-focused and emotion-focused coping); and (4) build a village (family, friends, technology, healthcare providers, etc. – but only trusting relationships). Also, remember the physical body and psychological body influence each other!
Medical Cannabis for Chronic Pain/Real World Evidence: Helping Canadians Navigate the Cannabis Landscape. This was 2 presentations that had a lot of overlap, and I totally attended this as a person with lived experience who uses medical cannabis. They reviewed the research they conducted through meta-analyses and studies of patients who use medical cannabis for chronic pain. They made “weak” recommendations in favour of offering a trial of medical cannabis for patients interested in trying it. Basically there is about a 10% chance of it significantly reducing pain, but when most chronic pain patients are asked if they would try it knowing there is just a 10% chance, they say yes. This was a session that was mostly directed at physicians who can prescribe. Both researcher-practitioners who presented also have done a lot of research on opioids and seem to be slightly in favour of cannabis over opioids for chronic pain (noting that opioids are better for acute pain). Food for thought!
Being in the Presence of Pain Without Losing Yourself – Kristin Neff keynote. If you’re not familiar with Dr. Kristin Neff, she is the leading researcher on self-compassion. Don’t run away though, because self-compassion has been found to be an evidence-based treatment for chronic pain. There are 3 components of it: kindness, common humanity, and mindfulness. There are also 2 sides of self-compassion that need to be in balance: tender self-compassion (nurturing, healing) and fierce self-compassion (protecting, providing, motivating). Did you know that 75% of people are more compassionate toward others than themselves? Despite the fact that s-c is strongly linked to well-being, improves our physical health (immune responses, sleep, physical symptoms). With chronic pain specifically it increases emotional resilience and coping; decreases depression and anxiety; increases relationship satisfaction; leads to fewer doctor’s visits and prescribed medications; increases acceptance of self and situation; and literally changes our brain responses to pain!! She also reviewed common blocks to self-compassion but I might save those for another post. Check out the self-compassion meditations I have on my YouTube channel (LovingKindness and The Kind Hand).
Courage to Go Deeper: Meeting Suffering Through Compassion and Self-Compassion. The presenter is a person with lived experience and a spiritual counsellor. She discussed the spiritual aspects of healing, including self-compassion that Kristin Neff presented, and tied into some of Gabor Mate’s presentation on trauma. A couple of key takeaways here:
- Pain x Resistance = Suffering (the more we resist pain or hate pain, the more we focus on it, which in turn intensifies the experience of it)
- Pain isn’t “wrong,” it is part of the experience of being human (approaching pain and suffering as a natural part of the human experience facilitates self-compassion and eases suffering)
- Spiritual distress may be understood as the loss of meaning and connection in relation to the self, others, and the Other (for healing to occur, we need to make room for and allow the full range of human feeling and experience).
I found this to be a powerful session (and though I’m not religious, I am spiritual).
Choose Your Own Adventure: Bringing Your Values into Your Practice. This was the last session of the weekend, and was about using Acceptance and Commitment Therapy not with clients, but with ourselves as a practitioner. Obviously there is a ton of overlap with clients, but this really focused on values and values-based living. The presenter, who is the present elect of the Alberta Pain Society as well as a Registered Psychologist, did discuss using ACT for chronic pain. She stated: (1) it is cost effective as a treatment option; (2) it looks at emotional well-being and function; (3) it improves pain acceptance, values-based activity, decreases in pain catastrophizing and pain avoidance, and increases psychological flexibility; (4) it is consistent across SES categories; (5) it works with people who have higher disability, longer duration of illness, older and younger adults, people with previous treatment failures, and people who have neuropathic pain as well as other types of pain and illness; and (6) it literally changes neurobiological mechanisms in the brain – specifically pain processing. In other words, maybe find a therapist who practices this for an alternative treatment option (hey like me!).
That’s a wrap! Whole conference in 3 long posts (I know I’m sorry, I usually don’t write so much). I will definitely be breaking some of this down more in the future for you. In the meantime, keep making the most of it!
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