Chronic pain is an epidemic affecting one in five Australians. Many relying on opioids to get through the day.
But, relying on these highly addictive medications for years on end does nothing to tackle the underlying cause or help people live with their pain.
At the ACT Pain Centre in Canberra which opened its doors in 2018, Dr Romil Jain is practising a very different approach - one that helps patients reduce reliance on their medications with life-changing results.
Dr Jain, founder and director of the ACT Pain Centre at the Calvary Clinic in Bruce, spoke to Catholic Health Australia to mark National Pain Week. (27 July to Aug 2).
“There has been a real rise in the number of people with chronic pain in Australia across the last eight to ten years. It's estimated that one in five Australians live with chronic pain, and that rises to one in three for older people. That's a huge proportion of the population. Many of these people have been living with pain since a young age - that could be 50 to 70 years.
“The majority of people who come to us are relying on medications - on opioids and other sedatives which are the leading cause of accidental death in Australia.
“At the ACT Pain Centre, we try and teach people how to manage their pain - through pain education, through exercise and through specialist treatments.
“Most people we see have back and neck problems, a lot of people have arthritis, whilst we also help people who have pain after surgery. Any operation runs the risk of leaving someone with chronic pain - even a simple hernia operation ends up with 8-10% of people in chronic pain afterwards.
“Many people we see are scared about coming off their medications as they have been on them for years. But we ask them to give it a try and actually most people come off medications without any major issue. They mostly say how fantastic they feel - how they feel as if their brains have cleared. They still have the pain, but are now in a much better mental state to deal with the pain and how to manage it.”
“Anxiety and depression go hand in hand with chronic pain. Our team, which includes a pain psychologist, helps them with active coping strategies for chronic pain. We give control back to the patient and help them not to rely on medications.
“For instance, if you've been in pain for years, your body is hypersensitised. You might feel that you cannot exercise - that exercise contributes to flare ups. By working with our qualified pain physiotherapist and exercise physiologist, we teach them that there is difference between hurt vs harm.The pain we feel from exercising muscles which may not have moved for years, is not harming the tissues and is not a danger signal. With reconditioning and muscle strength, we can help people start exercising again and living their lives.
“My speciality area is helping people who have had back surgery - with many people having a negative result than an expected positive outcome. At the ACT Pain Centre,we perform many interventional pain procedures including the spinal cord simulation procedure, which delivers a very high success rate.
“It works by inserting a device which interrupts the pain signal to brain.
“We do a test run first to make sure that people actually see an improvement before we commit to a permanent implant. We want to be sure their pain subsides by at least half, that they sleep better and they can reduce their medications. If that all looks good we then go ahead with inserting the permanent implant. Unlike surgery, there's no change to any part of the anatomy and whilst it's meant to stay in place, it actually is completely reversible and can be removed easily. There's a lot of research in this area showing the benefits of this procedure, and we will be presenting our findings later in the year which show that around 80-90% of patients get a significant benefit.
“In Australia, there are a lot of very good pain centres like ours. But you have to be living in the main cities and towns to access them. For instance,there is nothing on the NSW South Coast or west of Penrith.
“We try to help by running a clinic once a month in Wagga Wagga. But realistically there are millions of people living with chronic pain who are relying solely on medications.
“We also try and reach people who don't have private health insurance. We offer heavily subsidised services to people who are disadvantaged and who couldn't normally afford our services. These include low intensity pain education programs.
“We do what we can, it's our contribution to society, and it fits in with the Calvary ethos too.”
Dr Jain is a qualified Specialist Pain Medicine Physician and Interventional Pain Specialist.