Hansard

As many others have said today, chronic pain encompasses a wide range of conditions. For some, there are well-known progression and treatment options, but for others there is little predictability and some way to go before specific treatments are developed. All the conditions have a huge impact on the person experiencing the pain, as well as their loved ones and carers.

Chronic pain affects as much as a third of the population, with one in 10 experiencing high-impact pain. Most chronic pain is caused by musculoskeletal conditions. About eight in every 10 people with chronic pain report that at least some of the pain is in their neck, shoulders, back, limbs or extremities.

The impact of chronic pain is unequal and unfair. A recent Versus Arthritis report shows that certain groups in our society, such as people who live in deprived areas, people in minority ethnic groups, women and older people, experience greater life stress, disadvantage and discrimination and are more likely to have chronic pain. The Versus Arthritis report also says that improved parity with other long-term health conditions needs to be achieved.

Today’s debate is important in pressing for the best possible services for people with chronic pain and in ensuring that we have a medical and social culture that treats pain seriously and does not dismiss or diminish chronic pain as something that everyone gets. I commend Versus Arthritis, the Pain Association and the cross-party group on chronic pain for their work and advocacy on the issue.

I want to share the story of a friend’s journey with chronic pain following an assault. Again, I advocate for shared patient records to ensure that no one has to continue to repeat their story and describe their mechanism of injury. Following the assault, my friend was assessed by maxillofacial surgeons and it was concluded that a nerve in their face was damaged. As a result, they often had issues with pain and a loss of control and numbness in one side of their face. For trigeminal neuralgia, which is what they were diagnosed with, the treatment options were limited. They could choose either to have surgery that would completely sever the nerve, with the risk of more complications, or to take anticonvulsant medication to try to stop the pain.

Anticonvulsants have a number of side effects and require people to be careful with alcohol consumption—people even have to be careful about eating things such as grapefruit. For a young woman, constant pain, numbness and difficulty in controlling one side of their face was bad enough, but for there to be lifestyle impacts and implications added insult to injury. There was no pain clinic referral to talk about other options, nor were there offers to trial other medication. We need to improve that situation not just for people who experience chronic pain as a result of trauma, but, as many others have said, for people with back pain, joint pain or chronic pain that is caused by conditions such as endometriosis.

There should also be good mental health support for people with chronic pain. There are some days when the pain is manageable; there are other days when the frustration and stress are all consuming. For my friend with trigeminal neuralgia, it sometimes feels as though their eye is on fire, which is a constant reminder of the assault.

Experiencing chronic pain, whether it relates to musculoskeletal conditions, nerve pain or idiopathic pain, changes the way that people have to deal with their day-to-day life. For some whose condition might be progressive, the stress and mental toll that that takes cannot be overestimated; that in itself is often a traumatising experience. We need to ensure that people with chronic pain can get the help that they need to navigate their diagnosis. For many chronic pain sufferers, stress has the potential to flare up their condition, so we need to ensure that patients have the right tools and support to be able to manage stress as well as possible in order to prevent exacerbating their condition.

For the rest of my speech, I will focus on how we ensure that people with idiopathic pain are treated with the same compassion and care as those who have obvious mechanisms for dealing with their pain. As I said earlier, and as anyone with chronic pain will know, it is far too easy for people to say, “Get over it,” “Take some paracetamol,” or—that old chestnut—“Everyone gets a bit sore sometimes.” For people with idiopathic pain, there is the added complication of not feeling believed, because there is no obvious cause of their pain. It is no less sore than anyone else’s pain, and it is no less debilitating. It is exhausting to be put through test after test to rule out conditions and to be left with no more answers or with treatment options that are not always entirely suitable. Further research into idiopathic pain presentations is needed, and patient voices need to be heard to ensure that services reflect what sufferers need.

There is an important reflection about chronic pain on the Chest, Heart and Stroke Scotland website. Chronic pain is one of the conditions that people can potentially suffer from in the aftermath of a stroke, and it has various presentations. Chest, Heart and Stroke Scotland recommends that chronic pain sufferers know what their pain feels like and how it manifests, and that they take notes about it if they need to do so. We need to know when our body is telling us that something is wrong, and knowing one’s pain and how it presents could be very important depending on where and when it occurs.

Chronic pain can affect any of us in our lifetime. The effects can be debilitating and can impact on our wider health and our ability to do the basic thing of enjoying our lives. Our healthcare professionals are doing a wonderful job in addressing the root causes of pain. As we have done with other forms of healthcare, we are becoming more person centred, but we need to continue to listen to those people who experience pain and to build on their experiences.