Learn how to take back control of your pain

The definition of chronic pain is pain that has persisted for over three months. The most recent Irish research into this topic – a PRIME study by the Centre for Pain Research in NUI Galway back in 2011 – found that one in three of the adults surveyed were experiencing chronic pain, with those aged over 65 most affected.

While that study put the figure at one in three in Ireland, one in five is the overall figure used throughout Europe, Christina Donnelly, executive director of Chronic Pain Ireland (CPI) says.

“The real figure, in Ireland, is somewhere between those figures,” she says.

“Without a national chronic pain registry [database] in Ireland, the figures here are not definite, but we know that 20-40% of primary neuropathic [nerve-related] conditions have chronic pain as a component.

"There are also approximately 140 health conditions where chronic pain can be a factor. A national registry would help guide policy and resource allocation.”

There are only 27 pain consultants in the public health system for the whole of Ireland, Christina states. “That’s 0.55 consultants per 100,000 people, far below the recommended target of one per 100,000.”

Delays in accessing pain management appointments and programmes can leave patients struggling with unmanaged pain, leading to reduced quality of life, heightened emotional distress and, in some cases, over-reliance on medications.

She also points out that there are only five public pain management programmes in the entire country at present, with three of these located in Dublin.

“People in some regions have no access to these programmes at all,” she says. “Waiting times [for initial consultation] can be years and waiting times between appointments can be months.”

Cost can be a barrier for rural people too.

“If you have to travel to a hospital in Dublin to attend a consultant or a pain management programme, you have transport and overnight accommodation costs to cope with as well,” she says. “However, a lot of work is going on at present to improve services.”

All in your head

CPI was set up 33 years ago, in 1991, by a pain specialist, a psychologist, and some of their patients.

“Back then ‘all in your head’ was the general public consensus around chronic pain,” Christina says. “Pain medicine is now recognised as a medical speciality, but there is a long way to go.”

Chronic pain is much more complex than acute pain, she points out.

“With chronic pain, the systems that a person has to dampen down pain transmission are no longer working as effectively as they normally would. Multi-disciplinary, patient-centred care that includes a range of strategies and specialist treatment is therefore essential for treating chronic pain.”

Empathy is scarce

Empathy and sympathy for those with chronic pain can often be scarce, however. This in turn can unfortunately lead to social isolation.

“There is a lot of stigma because it’s often an invisible illness,” she adds. “If someone is moving around with a neck brace, it’s obvious they aren’t well, but not if it’s an invisible condition. Chronic pain can impact every aspect of life – physical and emotional and can take a very heavy toll on mental health.”

Chronic pain advice

Christina Donnelly has this advice for those who suffer with chronic pain, including farmers.

“Empower yourself to become more health literate. Learn about the role of self-management and take back control. One of the principles of self-management is pacing eg, when having a good day, don’t overdo it as that can add to flare-ups. Pacing is about adapting to change and accepting the need to work differently, to stay within your limits,” she advises.

“As well as exploring what machines and ergonomic tools may assist, also try breaking your tasks into smaller or more manageable chunks in order to reduce pain flare-ups.”

Chronic pain shouldn’t stop you doing what you love, she believes. “Accessing support services can help you feel less isolated, while learning self-management strategies that can help.”

Maintaining physical fitness, looking after your mental health, practising good sleep hygiene and seeking medical support is also important.

“A specialist can help develop a tailored pain management plan,” she advises. “That could include medication, physiotherapy, psychology and holistic treatments like meditation.

“Low mood or depression can also be a consequence of chronic pain and availing of counselling provided by the counselling in primary care service can also be helpful,” she says.

Joining a support group or organisation like CPI can be transformative. “As well as the full range of services we offer, we can signpost supports in your area – for example, the HSE’s free, six-week Living Well with Chronic Illness programme. You can also find the HSE list of upcoming ‘Living Well’ courses on hse.ie,” she adds.

“These are available free online and in communities. You can also subscribe to the CPI E-zine to be kept informed via chronicpain.ie/newsletters.”

It costs €22 to join Chronic Pain Ireland to access their support services.

CPI core costs (staff and overheads) are funded by Pobal and the Department of Rural and Community Development.

Christine Donaldson is 49 and lives in Portlaoise, Co Laois. She is married with four children ranging in age from 11 to 22.

She runs two childcare businesses in the town but has suffered with chronic back pain, on and off, for 22 years. More recently, the pain has been constant.

“I pulled something in my lower back lifting my first child from the cot,” she says. “It got better, but then the pain would come back and go again.

“Over the years it became worse, lasting longer each time.”

Her first MRI, five years ago, showed that she had bulging discs in her lower back.

“I have had injections which did help for a good while,” she says, “but 2024 has been difficult for me as I have also been diagnosed with fibromyalgia.

“It means that I have pain in many places – back, shoulders, arms, hips, even my wrists. Pain can get you down and it’s tough not being able to do all that you want to do.”

Christine is now waiting on a nuclear bone scan that will give a wide-ranging picture of her overall health.

Coping with the pain currently means taking medication, doing gentle yoga and having physio if pain permits. She is also receiving counselling.

“This helps me deal with all the emotions around having chronic pain and not being able to do the things I want to do,” she says.

She has no choice but to depend on pain relief at times.

“The pain can be unbearable, particularly at night. This year it has been 24/7 because of the fibromyalgia on top of the back pain.”

Christine reached out to CPI for help this year.

“It was for support and to know that I’m not going crazy as well,” she says.

She has taken part in online pain management courses with CPI since.

“The courses help you to identify what makes the pain worse and live your life in the best way you can.”

Christine has experienced a lack of sympathy sometimes, she says.

“My family would be very supportive, but I am not sure they understand totally,” she tells Irish Country Living.

“Chronic pain is a tough thing to have and to explain to people. I don’t mention the pain unless it’s unbearable.”

Christine remembers an upsetting incident in the past where a woman in a shopping centre questioned why she was going into a disabled toilet.

“I didn’t have a walking stick, but I knew I needed the grab bars for support. Being questioned made me feel awful,” she says.

“You don’t need to have a walking stick or a wheelchair to have a disability.”

Christine now uses a stick for short walks and a rollator with a seat for longer excursions.

Her advice to readers who may be experiencing chronic pain is to reach out for help.

“Life can be difficult with pain but proper support can make things easier,” she says.

Read more

'Choose the contraception method that’s right for you'

Keep asthma at bay and breathe easy this winter