Airing Pain

Airing Pain 146: Irritable Bowel Syndrome & Inflammatory Bowel Disease   

  

This edition of Airing Pain focuses on two conditions affecting the gut: Irritable Bowel Syndrome (IBS) and Inflammatory Bowel Disease (IBD). Both affect the digestive system, and both cause pain. In this episode we learn about what separates these outwardly similar sounding conditions, how they are diagnosed, and what treatments might be available. 

  

Dr David Bulmer discusses the key differences and distinguishing features of IBS and IBD, the latest research into these conditions, and potential medicinal treatments for managing the pain they cause.  

Professor Rona Moss-Morris sheds light on remission, pain, and symptom management for IBS and IBD, and the challenges these conditions present. We hear about research into the use of Cognitive Behavioural Therapies designed specifically to help manage IBS and IBD symptoms.

The interviews were recorded at the British Pain Society’s Annual Scientific Meeting, 2024. 

Contributors: 

Dr David Bulmer, Associate Professor at Cambridge University, specialising in visceral pain and gastrointestinal disease, with a special interest in IBS, IBD, and pain.  

Prof. Rona Moss-Morris, Professor of Psychology as Applied to Medicine and Head of the Department of Psychology at the Institute of Psychology, Psychiatry and Neuroscience, King’s College London. Lead for Digital Therapies at the NIHR Maudsley Biomedical Research Centre. She has a special interest in factors that affect symptom experience and adjusting to chronic medical conditions. 

Time Stamps: 

01:29 Paul Evans introduces Dr David Bulmer, Associate Professor at the Department of Pharmacology at Cambridge University. 

01:46 Dr David Bulmer explains the difference between Irritable Bowel Syndrome and Inflammatory Bowel Disease and how they are diagnosed. 

02:50 Bulmer discusses research into the potential causes of IBS and IBD, including localised allergic response and potential genetic markers. 

06:18 Bulmer describes a study into the use of antidepressants for the treatment of IBS.  

07:29 Bulmer discusses new treatments for Inflammatory Bowel Disease, and how far these impact the actual pain experienced. 

12:17 Bulmer explains the ‘Low FODMAP’ diet treatment. 

14:17 Evans introduces Professor Rona Moss-Morris, Professor of Psychology as Applied to Medicine and Head of the Department of Psychology at King’s College London. 

14:22 Moss-Morris explains the term ‘remission’ and how it is applied to IBS and IBD. 

16:33 Moss-Morris discusses clinical trials using Cognitive Behavioural Therapy (CBT) for those with IBS and IBD symptoms. 

18:53 Moss-Morris explains what CBT is and how it is used. 

23:16 Moss-Morris discusses the use of apps and digital approaches to treatment. 

27:55 Moss-Morris gives a final message on pain.  

If you have any feedback about Airing Pain, you can leave us a review via our Airing Pain survey  

Coming 9th October:  This edition of Airing Pain focuses on Irritable Bowel Syndrome (IBS) and Inflammatory Bowel Disease (IBD) – two outwardly similar sounding conditions, but the devil is in the details. 

Our contributors are experts on visceral pain, gastrointestinal disease, and psychological factors affecting chronic conditions; find out what they have to say in the latest edition of Airing Pain, coming soon.   

The interviews were recorded at the British Pain Society’s Annual Scientific Meeting, 2024.  

Contributors: 

Dr David Bulmer, Associate Professor at Cambridge University, specialising in visceral pain and gastrointestinal disease, with a special interest in IBS, IBD, and pain.  

Prof. Rona Moss-Morris, Professor of Psychology as Applied to Medicine and Head of the Department of Psychology at the Institute of Psychology, Psychiatry and Neuroscience, King’s College London. Lead for Digital Therapies at the NIHR Maudsley Biomedical Research Centre. She has a special in interest factors that affect symptom experience and adjusting to chronic medical conditions.

If you have any feedback about Airing Pain, you can leave us a review via our Airing Pain survey  

Airing Pain 145 Rethinking Pain: Pain Management in the Community 

This edition of Airing Pain centres on rethinking the traditional clinician-patient relationship in pain management and exploring alternative approaches to bringing pain management back into the community.  

Dr Barbara Phipps, GP and Lifestyle Medicine expert, discusses the development and benefits of group consultations for pain management. 

Dr Jackie Walumbe sheds light on the pervasive inequalities in chronic pain services, highlighting the value of communities and member-led collaboratives in building and shaping self-management. 

Prof. Mark Johnson, Dr Kate Thompson, and Kerry Page talk through the benefits of de-medicalising pain management, shifting the focus to a community setting. 

We hear about the fantastic work of Rethinking Pain, a community-based pain support service in Bradford and Craven, and the inspiration this can serve for future chronic pain services and self-management initiatives. 

The interviews were recorded at the British Pain Society’s Annual Scientific Meeting, 2024. 

Contributors: 

Dr Barbara Phipps, Practising NHS GP and Teaching Fellow at the University of Edinburgh, currently running a community based Chronic Pain management service within the NHS. Barbara has a special interest in Lifestyle Medicine, and is a trustee of the British Society of Lifestyle Medicine. 

Dr Jackie Walumbe, Clinical Academic Advance Practice Physiotherapist in the Complex Pain Team at University College London Hospitals NHS Foundation Trust and Honorary Research Fellow at University of Oxford. 

Professor Mark Johnson, Professor of Pain and Analgesia and Director of the Leeds Beckett Pain Team (Centre for Pain Research) at Leeds Beckett University. 

Dr Kate Thompson, Senior Lecturer and Researcher at Leeds Beckett University, with a background in physiotherapy and special interest in pain research. 

Kerry Page, Programme Lead for Rethinking Pain, the chronic pain community service based in Bradford District and Craven. 

Time Stamps: 

01:58 Paul introduces Dr Barbara Phipps, Practising NHS GP and Teaching Fellow at the University of Edinburgh, currently running a community based Chronic Pain management service within the NHS. Barbara has a special interest in Lifestyle Medicine, is and is a trustee of the British Society of Lifestyle Medicine. 

02:27 Dr Barbara Phipps discusses the development of group consultations for people with long-term primary pain. 

07:28 Paul and Barbara discuss the importance of people being believed about their pain, perception of pain experiences, and detection on functional MRI scans. 

10:41 Paul draws upon issues the funding in pain management services and who decides whether a treatment programme is value for money or not. 

10:53 Paul introduces Dr Jackie Walumbe, Clinical Academic Advance Practice Physiotherapist in the Complex Pain Team at University College London Hospitals NHS Foundation Trust and Honorary Research Fellow at University of Oxford. 

11:04 Dr Jackie Walumbe discusses her research on understanding how the term and practice of Self-Management is understood and acted on by people living with chronic pain, particularly those who don’t have ongoing contact or access with specialist pain services, and the relationship between this and policy makers’ decisions. 

14:42 Paul and Jackie discuss key findings regarding issues of inequality, and a report by Versus Arthritis (Unseen, Unequal and Unfair: Chronic Pain in England), reflecting issues of policy and politics and the importance of other communities in filling the gaps.  

18:09 Paul introduces Rethinking Pain, a community-based service for adults living with long-term pain, in Bradford District and Craven.  

18:28 Paul introduces Dr Mark Johnson, Professor of Pain and Analgesia and Director of the Leeds Beckett Pain Team (Centre for Pain Research) at Leeds Beckett University.  

18:37 Paul introduces Dr Kate Thompson, Senior Lecturer and Researcher at Leeds Beckett University, with a background in physiotherapy and special interest in pain research. 

18:40 Paul introduces Kerry Page, Programme Lead for Rethinking Pain, the chronic pain community service based in Bradford District and Craven. 

18:47 Kerry Page discusses the Rethinking Pain service, its background, services, and success. 

19:57 Dr Kate Thompson explains how Rethinking Pain’s approach differs from other community pain management programmes 

20:58 Dr Mark Johnson talks about how pain is a context driven experience, and the importance of understanding how the narrative matters when it comes to managing pain. 

25:49 Kerry Page recalls the importance of giving time to listen to the pain community and those living with chronic pain, and the way that Rethinking Pain’s initiative provides this through Health Coaches.  

35:53 Kerry page discusses how pain management services can help to reach more people and connect people and organisations from across the pain community.  

Additional Resources: 

Rethinking Pain  

Inequalities in Chronic Pain Report - Versus Arthritis 

If you have any feedback about Airing Pain, you can leave us a review via our Airing Pain survey  

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Coming 14th August: This edition of Airing Pain centres on rethinking the traditional clinician-patient relationship in pain management and exploring alternative approaches to bringing pain management back into the community.  

Is the 1-to-1 doctor-patient consultation the best we can do? How can we help people to feel more empowered in managing their own pain? Our contributors are experts in pain management, research, and community engagement; find out what they have to say in the latest edition of Airing Pain, coming soon.  

The interviews were recorded at the British Pain Society’s Annual Scientific Meeting, 2024. 

Contributors: 

Dr Barbara Phipps, Practising NHS GP and Teaching Fellow at the University of Edinburgh, currently running a community based Chronic Pain management service within the NHS. Barbara has a special interest in Lifestyle Medicine, and is a trustee of the British Society of Lifestyle Medicine. 

Dr Jackie Walumbe, Clinical Academic Advance Practice Physiotherapist in the Complex Pain Team at University College London Hospitals NHS Foundation Trust and Honorary Research Fellow at University of Oxford. 

Professor Mark Johnson, Professor of Pain and Analgesia and Director of the Leeds Beckett Pain Team (Centre for Pain Research) at Leeds Beckett University. 

Dr Kate Thompson, Senior Lecturer and Researcher at Leeds Beckett University, with a background in physiotherapy and special interest in pain research. 

Kerry Page, Programme Lead for Rethinking Pain, the chronic pain community service based in Bradford District and Craven. 

If you have any feedback about Airing Pain, you can leave us a review via our Airing Pain survey  

Airing Pain 144: Dilemmas in Pain Research 

This episode of Airing Pain focuses on the challenges that researchers must overcome when researching pain and developing new treatment approaches. Many questions remain unanswered in the field of pain research. For example, we might know that a treatment works for some people living with pain, but we might not know how it works or why some people benefit and some do not. 

So, there is a lot of research being done to try to better understand pain. This leads to another problem: how to cope with the amount of new information emerging from research and trials? It is important that new research data is made more accessible for clinicians, healthcare workers, patients, and researchers. Data is no use unless it can be assessed and summarized so that doctors can understand how to use it to benefit their patients. 

Our contributors for this edition are leaders in this field and they discuss some of the issues they have encountered whilst conducting their research into pain and how to treat it. 

The interviews were recorded at the British Pain Society’s Annual Scientific Meeting, 2023. 

Contributors: 

Professor Robert Brownstone, Brain Research UK Chair of Neurosurgery, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology. 

Dr Neil O'Connell, Reader in Physiotherapy, Brunel University, Chair of the International Association for the Study of Pain (IASP) Methods, Evidence Synthesis and Implementation Special Interest Group. He is an advisor to Pain Concern. 

Dr Kirsty Bannister, Neuroscientist and Associate Professor at King’s College London. 

Time Stamps: 

1:22 Paul introduces Professor Robert Brownstone, Brain Research UK Chair of Neurosurgery at University College London. 

1:32 Prof. Brownstone explains what a spinal cord stimulator is, the lack of progress made with this form of treatment, the varied results the treatment gets, and why some people experience long-term pain following back surgery. 

7:40 Paul talks about Cochrane, a global independent network of health practitioners, researchers, and patient advocates who review research findings to provide a more precise estimate of the effects of a treatment. 

7:54 Paul introduces Dr Neil O’Connell, a Reader at Brunel University who was the Co-ordinating editor of the Cochrane Pain, Palliative and Supportive Care (PaPaS) group. 

8:35 Dr O’Connell discusses how Cochrane reviews research and clinical trials, and the complexities involved in gathering and interpreting evidence when developing interventions. 

17:04 Paul introduces Dr Kirsty Bannister, a neuroscientist and Associate Professor at King’s College London who specialises in neuropharmacology and runs a research group that uses animals to examine the mechanisms of pain processing. 

17:22 Dr Bannister talks about why animal models are useful for researching the responses people may have to different pain processes and researching chronic pain by measuring neuronal responses to pain. 

21:44 Paul and Dr Bannister discuss the limitations of using animals to research chronic pain. 

23:48 Paul and Dr Bannister explore why looking at a patient's experience of pain first can better inform lab research on animal models for understanding and researching pain. 

30:03 Prof. Brownstone gives some advice for those considering a spinal cord stimulator as an intervention they want to try. 

Additional Resources: 

Cochrane 

Pain Matters 73: Neuropathic pain issue 

Pain Matters 79: Navigating pathways to live well with pain 

Pain Matters 80: What treatment really works 

Neuropathic Pain 

If you have any feedback about Airing Pain, you can leave us a review via our Airing Pain survey  

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Coming 12 June: This edition of Airing Pain focuses on the dilemmas and roadblocks that researchers encounter when researching pain and developing interventions, how they may overcome them, and why systematic reviews of research are so important.

Our contributors for this edition are leaders in this field and they discuss some of the issues they have encountered whilst conducting their research into pain and how to treat it. 

Interviews in this edition were recorded at the British Pain Society Annual Scientific Meeting.

Professor Robert Brownstone is a Professor and Head of Neurosurgery at University College London.

Dr Neil O’Connell is a Reader in the Physiotherapy Division of the Department of Health Sciences at Brunel University London. He is also a member of Cochrane's central editorial board. 

Dr Kirsty Bannister is an Associate Professor of Neuroscience/Neuropharmacology at King’s College London.

This edition of Airing Pain focuses on the treatment of pain, the importance of catering treatment to a person’s individual genetic makeup, and why addressing the psychological dimensions of pain is crucial in treating it effectively. 

The process of finding a medication or treatment that works for a person often involves a lot of trial and error, which can be a frustrating process for someone to go through. This process can be side-stepped through the use of personalised medicine, where information about a person’s genetic makeup is used to tailor and optimise their treatment so it is as effective as possible.

Although medication is oftentimes a vital part of treating pain, incorporating psychological treatment alongside medication can be hugely beneficial when it comes to making pain management better for those living with acute or chronic pain. Changing how someone thinks about pain can enhance their response to the physical components of the treatment they receive.

Our contributors for this edition discuss the ways in which the treatment of pain can be made more effective for people by incorporating personalised medicine or psychological treatments into a person’s care plan. Please leave us a review on this platform or give feedback via our Airing Pain survey.

Contributors:

Professor Tony Dickenson, Professor of Neuropharmacology at University College London.

Dr. Beth Darnall, PhD, Professor of Anesthesiology, Perioperative and Pain Medicine at Stanford University School of Medicine. Director, Stanford Pain Relief Innovations Lab.

Professor Irene Tracey, Vice Chancellor of the University of Oxford and a Professor of Anaesthetic Neuroscience in the Nuffield Department of Clinical Neurosciences.

Read transcript

Thanks:

This edition of was made possible thanks to funding from the Guy Fawkes Charitable Trust and support from the British Pain Society.

1:11 Paul introduces Professor Tony Dickenson,who he spoke to at the British Pain Society Annual Scientific Meeting 2022.

3:21 Professor Tony Dickenson discusses ‘precision medicine’, ‘personalised medicine’, and how looking at peoples' genetic makeup can help medical professionals treat pain more effectively. 

14:21 Paul introduces Dr Beth Darnall, who he spoke to at the British Pain Society Annual Scientific Meeting 2023.

14:54 Dr Beth Darnall explains the psychological components of how people experience pain.

20:24 Paul introduces Professor Irene Tracy, who he spoke to at the British Pain Society Annual Scientific Meeting 2023. 

20:57 Dr Irene Tracy discusses the work she's done on neuroimaging and how the human brain constructs the experience of pain. 

23:22 Paul and Dr Tracy talk about what neuroimaging tells us about the multidimensional way the human brain reacts to pain.

26:06 Beginning of discussion about Empowered Relief, a psychology-based intervention that provides people with skills and tools to help manage their acute or chronic pain. 

26:31 Dr Beth Darnall discusses the psychological side of treating pain and how empowered relief is used to help people manage their pain.

29:10 Dr Beth Darnall talks about the psychological tools people learn through Empowered Relief and how they help with pain management.   

Airing Pain 100: Glasgow Pain Education Sessions

Empowered Relief 

Pain Matters 80: What treatment really works 

Coming 10 April: This edition of Airing Pain focuses on the treatment of pain, the importance of catering treatment to a person’s individual genetic makeup, and why addressing the psychological dimensions of pain is crucial in treating it effectively.  

Our contributors for this edition discuss the ways in which the treatment of pain can be made more effective for people by incorporating personalised medicine or psychological treatments into a person’s care plan. 

This edition will be funded by the Guy Fawkes Charitable Trust and was created with support from the British Pain Society.

Contributors: 

Professor Tony Dickenson, Professor of Neuropharmacology at University College London 

Dr. Beth Darnall, PhD, Professor of Anesthesiology, Perioperative and Pain Medicine at Stanford University School of Medicine. Director, Stanford Pain Relief Innovations Lab.

Professor Irene Tracey, Vice Chancellor of the University of Oxford and a Professor of Anaesthetic Neuroscience in the Nuffield Department of Clinical Neurosciences. 

Pain Concern would like to remind listeners that the topic of chronic pain can be uncomfortable for those with lived experience of chronic pain. Please read the description for information about this edition's content. 

In a 2020 US study, it was found that ‘Implicit bias remains a contributor to healthcare disparities.’ This can be based on gender, ethnicity, disability or locality, and has the potential to affect somebody no matter their background.   

In Airing Pain 142, we begin with specific references to disparities in Musculoskeletal (MSK) treatment, and how we can learn from other healthcare fields to increase patient satisfaction; we then focus on how both internal and external stigma can lead to discrimination in treatment; before ending with a discussion about why ethnic minorities are being inadvertently discriminated against in the pain management setting.  

If you enjoyed this episode of Airing Pain, why not subscribe?  You can also leave us a review via our Airing Pain survey

Read Transcript

Contributors: 

Professor Jonathan Hill is the Director of Research for the School of Allied Health Professionals, and a Professor of Physiotherapy, in the Keele School of Medicine. 

Dr Ama Kissi is a post-doctoral fellow at the University of Ghent and a Clinical Psychologist.  

Dr Whitney Scott is a clinical psychologist who lectures at Kings College London and is the research lead at the INPUT Pain Management Unit at Guy’s & St Thomas’ Hospital.  

Time Stamps: 

1:30: Professor Jonathan Hill speaks about the disparities in musculoskeletal pain treatment in primary care. 

6:04: Sharing their experiences and research, Paul and Jonathan discuss the differences between Pain Management and Diabetes care.  

9:59: Jonathan Hill highlights the importance of differentiating between people accessing pain management care frequently and infrequently.   

15:26: Jonathan Hill alludes to the ‘Restore’ trial in Australia, and the success of integrating physiotherapists into the pain management care system.  

18:44: Dr Whitney Scott talks about the stigma and discrimination of people living with pain. 

24:44: Whitney Scott discusses the way that health care professionals can work with people in pain who feel stigmatised.  

26:01: Paul and Dr Ama Kissi discuss the disparities in pain management for different ethnicities and hypothesise why this might be the case.  

31:17: Ama Kissi shares her own experiences as a black woman in the healthcare environment - this segment discussed childbirth.

This edition of Airing Pain was possible thanks to support from the British Pain Society 

If you’re looking for more information and support on managing pain visit painconcern.org.uk. 

Additional Resources: 

Pain Matters 84 - This magazine issue focuses on inequalities in public health.  

Stigma and Pain Management - US Department of Health and Human Services. 

‘Stigma and Chronic Pain’ - A research article published in ‘Pain and Therapy’.

Further information on the Restore Trial 

This edition of Airing Pain sheds light on the unique challenges of living with cancer as a child or young adult, and the later impacts of the cancer treatment they underwent during the critical formative years. Airing Pain speaks to experts on the longitudinal impacts of cancer for these age groups; across medical, physical, and psychosocial.  

Pain and fatigue are commonly reported as the most significant negative impact on quality of life when living with cancer. Until quite recently there has been little research in the area of living with cancer and experiencing medical treatments for cancer as a child or young adult during the critical formative years, and even less so on the long-term impacts these treatments can have throughout later adulthood.  

Our contributors discuss a variety of determinants that impact long-term effects such as type of treatment, type of cancer, their personal resilience, and their family and social support networks. We also hear of the opportunities in improving cancer care for these age groups, particularly with the difficult transition from child to adult care units. 

Contributors: 

- Emeritus Professor Sam Ahmedzai, NIHR National Specialty Lead for Cancer 

- Professor Diana Greenfield, Senior Consultant Nurse at Sheffield Teaching Hospitals Trust 

- Ceinwen Giles, Co-CEO, Shine Cancer Support 

Time Stamps: 

0:50 Paul introducing Emeritus Professor Sam Ahmedzai, an internationally recognised pioneer in setting up palliative medicine. 2022 British Pain Society interview.

2:53 Discussion around later hormonal effects of some successful treatments used to eradicate and manage cancer in children and teenagers.

5:54 Professor Diana Greenfield, Senior Consultant Nurse at Sheffield Teaching Hospitals Trust, NHS, on the transition between paediatric to adult cancer care.

13:18 The importance of family-centred care. Defined as a house or unit of care that can be traditional or non-traditional but represents a holistic support network.

18:00 Ceinwen Giles, Co-CEO, Shine Cancer Support, working to provide support for people in their 20s 30s and 40s who have lived with cancer and chronic cancer.

19:00 Ceinwin Giles talking on her personal experience of receiving treatment for non-Hodgkin lymphoma and challenges in finding peers her own age who share her experiences.

21:54 Managing early-life considerations alongside cancer. Career uncertainty, mental health in jobs, as well as fertility, relationships, and dating.

23:00 The difficult transition from child to adult care, in terms of having fewer people and services supporting as an adult. There are opportunities to improve the easing of this transition, especially following the pandemic where services are stretched.

25:20 Invitation to respond to the Airing Pain survey.

26:02 Summary of the key take home messages for children and young adults, and those caring for them.

Additional Resources: 

Airing Pain 118: Pain Management in Young People