GEP Medicine in Society Guide 2023/24

6. Themed Days - Primary Care

6.4. Back pain and other chronic pain

Preparatory work

In preparation students should have:

Reviewed some of the resources on healthtalk.org about chronic pain and used this to find a definition of chronic pain as well as listening to some of the descriptions of the effects of chronic pain on individuals.
Watched “Understanding Pain: Brainman chooses”, it’s also interesting to read the public comments (with caution).
Read the NHS inform’s resource for patients on chronic pain
Considered questions to ask a healthcare professional or a patient about dealing with chronic pain.

Aims

To introduce students to this common multifactorial condition, its effects on individuals, families and societies, and to the management approaches for this condition.

Learning outcomes

By the end of the day, the student should be able to:

Describe the factors that are important in development of chronic, disabling back pain or other pain.
Summarise the socio-economic impact of these conditions on individuals, society and the health service.
Identify pharmacological and non-pharmacological treatment options for chronic pain.
Discuss the effect of chronic pain on the doctor patient relationship.
Practise interview skills.

Example timetable

9.30 – 10.30	Tutorial on chronic pain
10.30 – 10.45	Tea break
10.45 – 11.45	Prepare for patient/healthcare professional encounters Plan questions and observations Interview patient/s with a chronic pain condition and/or a professional providing care for these patients
11.45 – 12.30	Group debrief of patient encounters Discuss with group challenges of dealing with/living with chronic pain Set up afternoon activity; Student-led research – in 2 groups, search clinical guidelines for chronic pain then each group researches either pharmacological or non-pharmacological treatment options for management chronic pain, consider pros/cons of each and local access to these options. Prepare brief presentation.
12.30 – 13.15	Lunch
13.30 – 14.45	Student-led research Includes tea break
14.45 – 16.00	Student presentations & group discussion Set homework for next session

Suggested activities

Tutorial on chronic pain– could include definition of chronic pain, discuss possible causes, outline various treatment options, challenges faced by patients and health services, local pain services, current ‘hot topics’ e.g. opiate prescribing and medical cannabinoids, NICE guidance on chronic pain.
Student-led research – in 2 groups, search clinical guidelines for chronic pain then each group researches either pharmacological or non-pharmacological treatment options for management chronic pain, consider pros/cons of each and local access to these options. Prepare brief presentation.
In small groups/pairs, plan interview with a GP or a patient about chronic pain (if possible, please arrange for some students to interview a GP and some a patient so they can compare findings when they meet again as a group).

Questions for students to consider

How did dealing with patients with chronic pain affect the health care professional you interviewed? How did they feel about patients with chronic pain? How do you think you would deal with this situation?
How did you feel meeting a patient with chronic pain? How did you think they were coping with their situation? What sources of support were they drawing on?