General Health Articles

*Watch Dr Ashish Gulve’s webinar here*

How did you become a pain specialist? 

I started developing an interest in pain management when I was a trainee way back in 2002. This led me to subsequently carry out intense training in chronic pain for one year and I went on to work in the pain department of University Hospital. I became a Pain Consultant in 2006. 

Are there different types of pain? 

There are many different causes for pain and it can be differentiated in lots of ways too. The first form of pain is acute pain, this is a warning sign that happens after injury. Generally, this is time-limited, as the injury heals this will get better. 

Pain that lasts for more than three months or pain that exists beyond the normal healing period is chronic pain. This can be categorised into various different types too. One is called nociceptive pain which is caused by inflammation from things like arthritis. Then the other pain is neuropathic pain which is caused by injury or damage to the nervous system. 

Why is there a misunderstanding of these different pains? 

I think it is because often these pains aren’t experienced in black and white. Most of the time patients have mixed pain and it is tricky to differentiate how much of their pain is neuropathic or nociceptive.

Also, people with chronic pain are often confused because they think their pain is a warning sign. When in fact, it is there all the time and it has no link to any former or subsequent acute health issues. 

What is neuromodulation? 

Neuromodulation is a small operation that is used to treat pain, usually when patients have tried medication and it is ineffective for them or they have had adverse reactions to other forms of therapy. The technology acts directly upon nerves by delivering electrical pulses directly to a target area.

How effective is this operation?

As with any operation, patients will feel some new pain when undergoing the treatment. However, it is expected that most patients experience 50% improvement in their pain and consequently an improvement in their function. 

How do you help people manage chronic pain?

I like to ensure that my patients organise their life around their chronic pain rather than concentrating on curing it. Here are my top tips:

1. If you are experiencing pain due to inflammation, you should look into medications first.
2. Gentle exercise will help any type of chronic pain as staying still can cause things to stiffen up. 
3. It doesn’t matter what type of pain you are in, pacing is an important concept. People must ensure they adapt their lifestyles to their pain and not continue to do the same amount of activity, this can lead to a boom and bust cycle. 

How can pain affect your mental health? 

Being in pain can make you tired, anxious, depressed and angry. These emotions can have an impact on relationships, jobs and family life. It is important that patients receive psychological support, not because we think they are making up their pain but to help them cope with the consequences of pain.