Changing the conversation about health

BEYOND PILLS CAMPAIGN: How the South West’s pain cafes are helping chronic pain sufferers – without drugs

Our latest Beyond Pills Campaign article looks at how an initiative in the South West is helping chronic pain sufferers find respite using a range of different strategies…

Instead of reaching for a bottle of painkillers, chronic pain sufferers in Cornwall now have a powerful non-drug resource. At local pain cafés, trained ‘pain baristas’ help them manage their pain through a ‘skills not pills’ approach using self-management techniques. One patient told a researcher: “I have several methods to manage my pain now, like doing movement, meditation and breathing.”

College of Medicine member Sean Jennings, now 63, was a mechanical engineer with the Royal Navy when a routine hernia operation left him suffering chronic pain. For the next 25 years he was prescribed ever-increasing amounts of opioids, gabapentins and antidepressants. Now a passionate advocate for non-drug pain management, Sean has now been free of medication for over six years, thanks to distraction and mindfulness techniques along with exercise and movement.
 
The concept of pain cafés came about through the combined experience and efforts of expert patients like Sean Jennings and concerned clinicians.

Sean Jennings was prescribed various drugs over a period of 25 years to treat his chronic pain; six years ago he managed to become drug free via other techniques including distraction, mindfulness, exercise and movement

There are now 13 pain cafes across Cornwall, with plans for more in the pipeline

Five years ago, GP Dr Jim Huddy started working with Dr Keith Mitchell, consultant in pain management at Royal Cornwall Hospital, writing advice and guidance for doctors about the dangers of opioid medicines. That led both doctors to a change of direction towards raising awareness and availability of non-medical alternatives.

Although pills sometimes make a great difference to people’s lives, Dr Huddy says that patients “do need to know that pills are not the only strategy and that high doses often cause more harm than good”.

The Cornwall Connected By Pain project was developed by the Imagine If partnership, a social enterprise led by Kevin Feaviour, which creates community and socially based approaches to health and wellbeing. Seed funding came from the Queens Nursing Innovation Fund and NHS Cornwall and Isles of Scilly (COIS) Integrated Care Board.

The Perranporth pain cafe; those attending try a chair yoga session

In the video above, Jennings, a former Royal Navy mechanical engineer, speaks about why he’s now an advocate for using non-drug resources for chronic pain

The support and information on techniques for managing chronic pain are based on Ten Footsteps to Living Well With Pain, a free resource founded in 2014 by former GP Dr Frances Cole and a group of health professionals.

Deborah O’Nyons, clinical lead for personalised care and supported self management for NHS Cornwall and Isles of Scilly ICB, is part of the cross service team working in partnership with Imagine If to develop the pain café model.

Deborah says “The pain cafés are a brilliant example of embedding supported self management in line with the NHS long term plan. They provide a supportive environment, which enables people to become
skilled in understanding their pain and exploring new ways to live well.

Running the cafés also enables healthcare professionals to develop their skills in community practice, and ensures sustainability.”
 
There are now 13 pain cafés in Cornwall, and Sean Jennings says it looks as if there’s a need for about 28, rather than the 15 originally planned. As word of the success spreads, the concept is spreading across the country. The team is also working with Help for Heroes, the national charity.
 
An initial one-year outcome study by Imagine If from six cafés showed that 64 per cent of the first 48 patients decreased their opioid medication. While 28% stayed on the same level of medication, some commented that staying on the same level was better than increasing the dose, which had happened before.

Participants in the survey reported that having somewhere to meet and share experiences with others really helped and was central to the success of this biopsychosocial approach. One patient explained that the Pain Café was a place where they were “able to discuss [problems] – to be listened to. Hearing people moan about pain must be very boring but to have someone listen and support is a great help.”
For more information, visit the Pain Cafe website: https://pain.cafe