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Calls for a new way of dealing with pain -

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ELEANOR HALL: It affects the lives of millions of Australians and is estimated to cost the economy
tens of billions of dollars. But Australian health authorities don't have an official strategy when
it comes to dealing with chronic pain.

Now an expert committee is working to change that by calling for chronic pain to be treated as a
disease in its own right rather than just a symptom, as Simon Lauder reports.

SIMON LAUDER: Fifty-three-year-old Mandy Sedgewick has lived with chronic pain since the mid 1980s.
It seemed to be brought on by hours of holding a phone to her ear with her shoulder at work and the
pain got so bad she couldn't function normally anymore.

MANDY SEDGEWICK: I virtually just got more pain as it went on over the months and then I couldn't
drive my car, couldn't look after my kids. Found that the doctors couldn't work out what was wrong
with me and it took three years for a doctor to work out that I had been born with extra ribs and
I'd actually crushed them on all the thoracic outlets.

SIMON LAUDER: Ms Sedgewick was eventually diagnosed with chronic regional pain syndrome, but she
says it was a struggle to find the right help.

MANDY SEDGEWICK: I'd go in and someone would say to me, well you look alright and I'd say yeah,
well my arms are swollen and all this and that and they'd say well, we can't find anything wrong
with you. They'd look at me and with nerve damage and with pain, you can't see it and unless you
have done something very bad to yourself, you are not going to be swollen enough to even be able to
prove that.

SIMON LAUDER: Chronic pain is classed as constant pain that sticks around for three months or more.
It can be caused by an accident, an underlying problem or it can appear after surgery. An estimated
three million Australians have it and an Access Economics report estimates the cost to the
Australian economy at $34.4 billion dollars per year.

But internationally renowned pain specialist, Professor Michael Cousins, says the enigma of a
medical problem which can't be seen has led to great stigma for sufferers.

MICHAEL COUSINS: There are a lot of myths out there about chronic pain. You know, it is all in your
head. You are just trying to get strong painkillers. You are just trying to get off work and myths,
of course, are very, very difficult to dispel.

SIMON LAUDER: Professor Michael Cousins is the chairman of the National Pain Summit steering
committee. It's just finished drafting a National Pain Strategy recommending major changes to the
way pain is dealt with by the medical profession.

One of the recommendations is for more effort to be made to destigmatise pain, in the same way that
publicity campaigns have focussed on depression.

Professor Cousins says people need to acknowledge that pain itself can change people.

MICHAEL COUSINS: When pain goes on for more than about three months we believe, it starts to
produce changes in the individual which are physical, psychological and even environmental and all
of these add up to a disease entity just the same as any other disease.

SIMON LAUDER: The draft National Pain Strategy calls for chronic pain to be recognised as a disease
in its own right. Professor Cousins says brain-imaging technology has recently brought insights
into how the brain can be altered by chronic pain.

MICHAEL COUSINS: We've started to see that there are changes in the part of the cortex of the
brain, that is right on the surface of the brain, that deals with sensation and also with,
interestingly enough, with motor function and what has been found is that there are really quite
dramatic changes there in the anatomy and even sometime pathological changes that are associated
with some of the really nasty chronic pain conditions.

For example pain after spinal cord injury, pain associated with amputation and when one starts to
see these changes in humans, it becomes a lot easier for people to believe that regardless of the
condition that started the pain, and that might be for example spinal cord injury, that additional
pathology occurs in the nervous system which represents the disease of chronic pain.

SIMON LAUDER: The National Pain Summit steering committee says pain should become one of the vital
signs measured by hospitals when patients are admitted and the management of pain should be
addressed as part of the Federal Government's national health reforms.

The draft guidelines have the support of the Australian Medical Association. It's vice president,
Dr Steve Hambleton, says pain is one of the most difficult things for GPs to deal with.

STEVE HAMBLETON: And it is associated with depression. It is certainly associated with disability.
With our aging population we are seeing more pain sufferers all the time and a focus on this area
is certainly needed.

SIMON LAUDER: The National Pain Strategy will be finalised at a meeting of experts next year.

ELEANOR HALL: Simon Lauder with that report.