Ashley I. Simpson
Consultant Peripheral Nerve Surgeon
Chronic pain affects an estimated 28 million people in the UK,1 yet alongside patients’ suffering lies another hidden burden: clinicians struggling to manage an increasingly complex condition.
Pain UK’s survey of clinicians at the 2024 Royal College of GPs Annual Conference revealed frustration and helplessness, tempered by empathy, as dominant experiences in managing patients with chronic pain. Many report emotional exhaustion and isolation, knowing they often lack the tools and resources to ease their patients’ suffering adequately. This relentless pressure contributes significantly to clinician burnout, creating an unsustainable cycle that ultimately diminishes patient care.
Worrying gap between clinical guidelines and everyday practice
A worrying gap exists between clinical guidelines and everyday practice. Recent surveys highlight a crisis of confidence among healthcare professionals tasked with managing chronic pain. Despite updated guidelines promoting holistic, multidisciplinary approaches, clinicians often feel ill-equipped and under-trained. Pain management remains severely underrepresented in medical training, leaving many professionals unsure how best to approach patient care beyond medication. Consequently, providers are left juggling conflicting pressures: adhering to best practices versus managing patient expectations and practical constraints.
Chronic pain’s invisibility frequently
strains patient-provider relationships.
Relationships in crisis
Chronic pain’s invisibility frequently strains patient-provider relationships. Patients can feel misunderstood, disbelieved or dismissed, eroding trust and making meaningful dialogue increasingly difficult. Clinicians, on their part, frequently express exasperation and guilt, sensing they fail their patients despite best intentions. Consultations can devolve into emotionally charged encounters, worsening outcomes for both patient and provider. Yet, evidence consistently demonstrates that strong, empathic relationships significantly enhance chronic pain outcomes, highlighting the critical need for continuity, compassion and open communication.
Systemic changes to address chronic pain
Clinicians urgently need better training, equipping them with confidence and competence in managing complex, chronic conditions. Crucially, the healthcare system must prioritise genuine multidisciplinary approaches, enhancing timely access to specialists, psychological support and physiotherapy services. Redefining chronic pain management requires investing in relationships, safeguarding continuity of care and fostering open dialogue between clinicians and patients. By confronting these hidden burdens and investing in tangible support for healthcare providers, we can transform chronic pain care into a more sustainable, compassionate and effective process for all.
[1] BMJ Open. 2016 May 25;6(6):e010364. doi: 10.1136/bmjopen-2015-010364.
