AIBU to think I'm being palmed off?

[Arthuritis]

I have a mixture of inflammatory and osteo arthritis affecting several large joints. In my mid 40s.

I work and do regular exercise to try and strengthen the joints.

Now being sent on a pain management course which appears to comprise of some physiotherapy (I already pay for regular physio) but mainly relaxation, pacing and mindfullness training. Looking this up, it seems that the idea is to help you accept the pain and to live with it, rather than suffer from it.

Aibu to want, actually, to have my pain eased in some way?

I've looked at pacing before - intersperse activity with periods of rest - but it doesn't fit with being at work. I can't rest whenever I want to or vary my tasks.

I also make use of heat or ice packs at home but these are impractical when I am at work or out.

Not wanting to brag, but I don't think that I manage too badly. I still work, i exercise at least 3 times a week, I do the housework but I'm in pain and tired and sometimes just long for a tablet that could take the pain away.

If pain can be taken away by changing your mindset why do we mend broken legs or replace joints? Why don't we get people to "think" away their pain?

I don't want to go on this course being a negative nelly, hence my post here. If someone has experience of it working then please tell me. Do I need to be open minded about this?

I just fear that I am being palmed rather than treat the reasons for my pain.

Firstly, well done on managing so well. It's so difficult dealing with chronic pain. I have suffered from back issues over an extended period so have some idea.

My mother suffers from chronic pain. She does use medication on a daily basis. She has been sent off on a number of those type of courses. They have all been group sessions and she has found them really helpful, not because of the content (she was doing most of it anyway - she's retired so can rest etc) but because meeting others who are in the same boat was useful for sharing ideas, what worked, what doesn't etc.

I would suggest going along to the course and seeing it as a support mechanism. You will meet people in the same boat. You may find the mindfulness etc helps but go in with an open mind.

I'd go along and pay it lip service.

The whole live with your pain is a newish trend and I know it might seem pointless and a bit woo but try it go in with an open mind and if it isn't for you least you tried it. The side effects of my painkillers left me woozy unable to function a bad stomach etc . I did a pain management course a few years ago and it reallyhelped me and i am not popping as many tablets as I used to.

My husband (a GP) used to participate in one of these courses when he was a trainee. He, who would be maybe a natural sceptic about this kind of thing, was really impressed with it, and is planning to deliver the same kind of course once he has his own practice. He said the research underpinning it was very convincing, and there is strong evidence that it works. It does not preclude other medical treatments, obviously, but the reality is that with severe mixed arthritis you are unlikely to ever be completely pain-free, and learning non-pharnaceutical strategies for managing your pain will increase your quality of life. It sounds like you may also be able to offer good support to others on the course, given how well you seem to cope.

Please give it a shot!

Have they told you that they are stopping your prescription pain killers or is the pain clinic in addition to your medication?
I would keep an open mind - chronic pain is difficult to manage and lots of pain killers have side effects when used routinely long term. Give it a try.

Thank you so much everyone for the advice. I really needed to hear these views.

I am currently taking 2 immunosuppressants to suppress the inflammatory arthritis plus a cox 2 inhibitor for the pain and these will continue. I also take co codamol as and when I need it but only take a 15mg tablet plus a paracetamol because anything stronger makes me feel really sick. At most I take this once a month.

I am so glad to hear that this is actually a valid treatment and not just an exercise in fobbing me off.

I guess I feel a bit sceptical because having googled (I know,I know) the case studies talk about someone who was say housebound due to their pain but can now walk to the end of the road or such like. I feel like I already do a half decent job of masking the pain and getting on with it that I want proper help and not to be patronised.

Having heard your advice though I'm going to go with an open mind and see how it goes. Thank you all for explaining it to me .

My disability is the same there isn't a miracle cure especially if you have a chronic pain condition the course just helped me to manage it better mentally iyswim.

That's partly my confusion - I think that I cope well. I'm not sure what more that I could do. All the coping strategies that I've looked at - pacing, relaxation, mindfullness - don't fit in with working.

Physio does accupuncture, massage etc which helps a bit but not long term. Steroid injections help me the most but they seem to be very reluctant to do those more than 1 joint a year.

I just wish that there was a tablet that I could take that would give me just some pain free time.

I'm not sure what more that I could do.

That's why they are sending you on a course - to teach you other stuff you could do.

But if you think you already know everything about pain management - you don't have to go.

Without being a total negative nelly.... I started one of these for my severe back pain, and associated nerve damage and mobility/lifestyle loss. I stopped, as it was actually making my mental health much worse. An awful lot of ‘embracing your pain’, when I really want mine to get to fuck.

I did go in with an open mind, but they were keen for me to give up work, and adjust components of my life that I couldn’t/wouldn’t.
So, just wanted to give you the other viewpoint - but I really hope it works in some way for you.
Chronic severe pain is shit.

It doesn't work or suit everybody my friend walked out of a meditation session saying bugger lovely fields I want a co codamol

@SpandexTutu I don't think that I know it all but I've been dealing with this for 5 years now, spent god knows how much on private physio who has worked through lots and lots of things with me, taken up yoga and pilates (recommended by rheumatologist) and read as much as I possibly can about the management of chronic pain.

Reading up about these courses it seems that they take a multi pronged approach - exercise, pacing and mindfullness. But when they explain it, alongside case studies, they apoear to be aiming to get you back to work (I already work) take up some exercise (I already exercise 3 times a week as well as physio) pacing I just cannot do at work due to my job and mindfullness which appears to be accepting the pain - I don't want to accept it, it hurts! Every minute of my day hurts. Walking hurts because it's in my knees and feet. Picking things up hurt because it's in my fingers and wrists. Getting dressed hurts because it's in my shoulders. I try not to let it get to me. I try to carry on but really how many people just accept pain? If it's so easy why do people take pain killers for a headache or tooth ache?

Part of me thinks it won't help and is a waste of time, quite apart from the worry as to how I will get time off work to go. On the other hand I'm worried that if I refuse to try I'll be discharged from the clinic and left to get on with it.

@HollaHolla I'm sorry you are in the same boat. It is horrible. That is exactly my feeling - I don't want to "embrace my pain" it fucking hurts and I just want it to stop. I feel the same about not being able to change some things - I changed my job because I just couldn't manage the old one but there is no way that I can pace in my current job. It just isn't practical and I can't give up work.

I just can't believe the only option is to just accept it and I don't understand how that works. It would be great if it did. I just can't understand how.

Holla - agreed it won't work for everyone but no harm in trying it.

Pain is created in the brain. So maybe thinking can help. It's worth a try. Anything is worth a try. Currently movement is advocated. Understanding pain science is new. Cold and hot packs they say are placebo. It's always changing what they say is good etc....

Physios are teaching mindfullness, oh this is funny. Because this isn't part of their training. If you are paying for it, i'd say go to yoga classes instead, if it's free try it out....

OP - I'm not having a go at you. Chronic pain is exhausting and you may have already tried everything to resolve it. If that is the case - then don't go. They are just trying to offer you an alternative alongside the pills and physio. I honestly don't think they are fobbing you off.

'Pain is created in the brain' - really?
Because my understanding is that the brain registers pain signals from nerves unless you can say differently.
As someone who suffers a considerable amount of pain due to arthritis I find that comment rather insulting. If indeed my brain is deciding what part of my body hurts, it's having problems deciding which bit.
OP, sorry to derail - I hope the clinic helps.

I can see why you might feel that you are being fobbed off, but I really don't think that is the intention. Pain is incredibly subjective, so even when there is a physical cause, your mindset can have a massive impact on how you perceive it. With chronic pain there can be a vicious circle of pain causing depression, which worsens the pain.

There is a growing body of evidence that mindfulness can make you experience less pain. I haven't used mindfulness for pain, but I have used mindfulness-based stress reduction. I was sceptical, but I have found it powerful. I can see why 'embracing' the pain seems counter-intuitive, but I think you should give it a try with an open mind.

I would be open minded about going - worst case scenario is that it doesn’t help, but you never know. Unfortunately pain relief doesn’t work effectively long term for many people, so psychological strategies can be a useful adjunct. If you have time, look up Nuggets by Filmbilder on YouTube - it does a great animation of the effects of pain relief long term.

Mindfulness definitely can help and can be really useful.

My mother still talks about a very alternative out-there Swiss dentist she had in the 60s who used a mixture of hypnotism and mindfulness to offset pain, and he did several fillings and extractions on her on different occasions with no chemical pain relief. She said it was fine and she never felt anything. 40-50 years later she still uses some of the techniques and says they work with minor joint pain and sometimes when she's had cuts and things.

Mountains The course may well be jointly delivered by physios and psychologists - the one I delivered a few years ago was. The physios do the physio bit and the psychologists do the mindfulness bit.

I totally agree. I never tried hypnobirthing for exactly the same reason - pain is pain and there is a reason why surgeons operate using anaesthetic rather than positive thoughts and controlled breathing...

Pain is created in the brain

Walking around in agony because consultant and physio said there was nothing they could do if I didn't do the physio.

Turned out my pain was deferred pain and I had slipped discs.

Make sure you have the right diagnosis. Mine was from an X-ray. Don't know whose x ray it was. No one would listen to me when I told them I had never had an xray

Should add had my first pain free hour in 7 years was after going to see a private osteopath. Who saw what was wrong within 10 minutes

I'd go along and pay it lip service
That is a horrible thing to do.
It is a waste of your own time, the trainer's time and it takes a space away from someone who might appreciate it. If it's a group, it also negatively affects everyone else in the group.

Mindfulness does work for a lot of people. It's worth giving serious consideration to.

I'm not against going, I just don't understand how it works.

Do you do the mindfullness when you get the pain? So say I'm at work and getting pain do I have to do it then?

I will go and do it but I want to be sure that it will help me and also that the exercises will be at my level. I know it will cause problems at work getting the time off to go and I don't want to do it if it will just be a waste of time.

The mixture of opinions here reflect what I'm thinking - I feel I should give it a go, but can't see how it will work and I'm worried it will make me more focussed on the pain.

I've tried to do pacing before. They worked out my baseline as 5 minutes so I had to be active for 5 minutes and then rest! How on earth does that work? If I went for a walk they said walk for 5 rest for 10 minutes and then walk for 5 minutes. Same with work or housework. Seeing as I do a 6 hour shift at work and get a 15 minute break I'm not sure that working 5 mins followed by a 10 minute break will go down well. But if I say this does that make me too negative?

I understand the rationale for not taking pain killers long term - I purposely don't take opiates more than once a week because I know long term they won't work but as @Extravagant says, there's a reason why they use anaesthetics.

Thank you all for your opinions. It's interesting to read the different views. The positive ones are encouraging and I will give it a go and stay open minded, hopefully it will help. The sceptics are reflecting more how I feel and I feel better knowing I'm not the only one thinking it's a bit woo.