Why patients with back pain are never at the front of the queue

People in the UK wait an average of three years for a diagnosis and a further three before their pain is adequately managed, according to new research. This is longer than most other EU countries, and UK patients wait for diagnosis twice as long as sufferers in France, Italy and Belgium.

The research was gathered across Europe for the Pain Proposal European Consensus Report, which calls for changes to healthcare systems that would improve the lives of those affected and also make economic sense.

Chronic pain affects one in five people in Europe and eight million people in the UK. People can be so badly affected by their condition that it prevents them from doing their job for a third of the day and four in 10 are unable to work at all. More than half of those surveyed said their condition was compounded by others not taking it seriously. A separate UK report said many sufferers are unable to do everyday activities including household chores; nor can they socialise and a quarter of those affected have experienced depression, with some feeling so bad that they say they have wanted to die. Eight out of 10 of us will have back pain at some point in our lives, so no wonder the NHS is creaking beneath the weight.

Chronic pain accounts for 4.6m GP appointments annually, at a cost of 69m. Back pain alone is estimated to cost the economy 12.3bn in direct and indirect costs, including absence from work.

Arising from the pan-European report is the campaign Can You Feel My Pain? which is being run in association with chronic pain patient associations. It calls for improved management of pain, access to early interventions, pain management and recognition of the rights of those who live with pain.

Despite the statistics on how long UK patients wait for diagnosis and help with their condition, the Consensus Report does recognise pockets of excellence around the country. The Sheffield Back Pain Initiative is cited as an example of best practice in the UK, and is a "clinic" operated across seven GP practices in the city.

"Chronic back pain has been a Cinderella subject for so long," says Dr Ollie Hart. One of the family doctors specialising in management of chronic pain, he's based at the Sloan Practice in Meersbrook.

"Really all GPs should know more chronic pain management, because it's such a common problem. We created a Back Pain Pathway in 2009 to help people to get the right help as quickly as possible and also a website for those with pain, their families, employers and health professionals."

Given good advice early on, many patients need never actually see a doctor, says Dr Hart. The website offers various tools for management of pain, including examination of lifestyle, self-help resources such as exercises, and explanations of different types of therapy. It also carries video material of people sharing their stories.

"A crucial message we're trying to get across is that it really matters how you think about back pain," says Dr Hart.

"Many people say it makes them feel very frightened, as though their life will never be normal again. Others assume they should lie or sit

down as much as possible, when in fact it's very important to

carry on moving around as much as you can.

"Traditionally most of the medical help for back problems only focused on drugs; now we realise it's very important to address the social and psychological aspects of it. If you believe it will get better it's likely that it will. Of course there are degrees of severity and some people will still need help such as surgery, but it is very helpful in changing people's mindset about pain if you explain to them they can still live their life.

"If you liken the pain to a Rottweiler, the dog can drag you out for a walk or you can keep it on a tight leash and be in control."

Fiaz Sadiq, a 38-year-old IT director, used the Sheffield Back Pain website for help after he twisted his back badly during a game of basketball.

"I was carried off the court and spent the weekend lying down in excruciating pain. The GP then gave me painkillers and told me about the website. I found other people's stories really useful and gentle exercises I could do straight away to try and ease the pain. It's kosher advice because it's written by healthcare professionals, and you can even ask questions.

"It helped me to get over the pain in the following weeks,

and I go to the website about once a week now to check on new information about keeping my back healthy. I think I might have injured myself more, needing more treatment and time off if I hadn't found such expert help so quickly."

[email protected]

www.sheffieldbackpain.com

Can You Feel My Pain? campaign: www.action-on-pain.co.uk