01 Nov 2010
For 38 years, Madam Li Wai Sum endured a persistent pain in her lower back. Caused by an accident at home when she was 16, the discomfort was at times so severe she could neither sit nor stand.
By the time she saw a specialist at Singapore General Hospital (SGH) in 2006, she was despondent and frustrated that the many treatments she had tried had provided little relief.
“The pain didn’t allow me to sit for long. When I did, I struggled to stand up. I also had problems sleeping. It didn’t help that my job then as a salesgirl required me to stack heavy items,” said the 56- year-old homemaker.
She was referred to SGH’s Pain Management Centre, where a team of specialists, nurses, physiotherapists and psychologists taught her to manage her chronic pain. A year later, Mdm Li was a new woman.
“The centre turned my miserable life around,” she said. Although there is no cure for her pain, she has learnt to manage it so she can lead a more normal life.
“I know what stretching exercises to do when the pain comes and how to distract myself from the pain. I’m also able to sleep better, walk and swim regularly, and even enjoy watching movies again,” she said.
Although teaching patients to manage chronic pain is an established treatment in countries such as the US and Australia, the approach is relatively new in Singapore.
It only took off five years ago, said Dr Tan Kian Hian, Director of the Pain Management Centre and Consultant, Department of Anaesthesiology, SGH.
“No one solution can effectively manage pain. The programme at our centre has proven useful as it focuses on the entire wellbeing of the patient – body and mind,” said Dr Tan.
“Patients who come to the centre are usually those who may not need or want surgery, elderly people who are not suitable for surgery, or others who have undergone surgery but still suffer from chronic pain. Very often, they complain of persistent back and neck pain,” he said.
Patients referred to the Centre by SGH specialists or GPs are given a questionnaire to help pain specialists assess the level of discomfort and how it affects their daily activities and lifestyle.
Treatment may include pain injections and intervention procedures. Patients can also participate in a nine-day Cognitive Behaviour Therapy Programme similar to the one Mdm Li underwent.
“We empower patients by teaching them cognitive and coping skills to lower their anxiety,” said Ms Esther Tan, Principal Psychologist, Department of Psychiatry, SGH, and a member of the team at the centre.
Quality of life improves as patients learn to calm down when they feel pain.
Whether it is daily household chores, exercise or social activities, teaching patients relaxation, desensitisation, sleep hygiene and other techniques to control their pain gives them “a positive mindset so their ability to cope is better,” said Ms Tan.
“The programme is about management, not cure.”
Learning the exercises isn’t enough.
Patients must have realistic, achievable goals so they don’t get disheartened when they are unable to meet the targets because they are too difficult or take too long. What’s important, said Ms Tan, is that they don’t give up and do their exercises regularly to relax, de-stress and build physical strength.
Patients must also learn to communicate their pain to family members for their support. According to Ms Tan Choon Yen, Nurse Clinician, SGH, and Programme Coordinator at the Centre: “Pain affects the emotions too, and those who cannot manage their pain get depressed.
It is important that family members understand the pain patients feel. Everyone needs to play their part in pain management.”
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Dept of Pain Management Centre
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