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Durham University

Wolfson Research Institute for Health and Wellbeing

“It’s a pain” Public engagement Series

In collaboration with the NHS Joint North & South Durham Pain management Groups

Group Leader: Dr Paul L Chazot, SBBS


Following on from highly successful “Well Brain lecture series” (150-200 attendees) over a two year period & previous Public lectures support by the BNA and IAS over last decade, This SIG has set up a themed Public engagement series, on the topic of Long-term pain management, which will be hosted by the University of Durham (both Durham and Queens campus). There are an estimated 200,000 of a total of 650,000 people in County Durham alone who suffer from some form of chronic pain state, through physical and psychological trauma, inflammatory and neurological disease etc. Only 1,400 of these people can be currently treated locally by our excellent specialist long-term pain management programmes.

Upcoming Events

Understanding and coping with chronic pain: drugs and beyond

Dr Frances Cole (Retired GP, former CBT therapist and pain rehabilitation specialist)
Dr Paul Chazot (Associate Professor in Pharmacology, University of Durham)
Ilona Obara (Senior Lecturer in Pharmacology, Newcastle University)
Joanna Quinlan (InHealth Pain Management Solutions)
There is heavy reliance on the use of opioids to manage the symptoms associated with chronic pain but there are limited studies to support their long-term effectiveness. Prolonged use of opioids can also have serious sometimes life-threatening adverse consequences, such as constipation and respiratory failure.

Despite these well-acknowledged negative effects, the prescribing of opioid analgesics continues to increase at a significant and worrying rate. Given this increased use, the inappropriate prescribing (and misuse) of opioids is becoming a significant public health concern, particularly in the NE of England.
We'll have some short talks then an open Q&A to discuss other ways that NHS Pain teams can educate you to cope with pain.

Opioids in the North East of England

Dr Frances Cole (Retired GP, former CBT therapist and pain rehabilitation specialist)
Dr Paul Chazot (Associate Professor in Pharmacology, University of Durham)
Ilona Obara (Senior Lecturer in Pharmacology, Newcastle University)
Joanna Quinlan (InHealth Pain Management Solutions)
There is heavy reliance on the use of opioids to manage the symptoms associated with chronic pain but there are limited studies to support their long-term effectiveness. Prolonged use of opioids can also have serious sometimes life-threatening adverse consequences, such as constipation and respiratory failure.

Despite these well-acknowledged negative effects, the prescribing of opioid analgesics continues to increase at a significant and worrying rate. Given this increased use, the inappropriate prescribing (and misuse) of opioids is becoming a significant public health concern, particularly in the NE of England.
We'll have some short talks then an open Q&A to discuss other ways that NHS Pain teams can educate you to cope with pain.

Its a Pain Workshop, Framwellgate School Durham, October 2012. Far right: Dr David Laird, Durham NHS Trust Pain Management group and Dr Paul L Chazot (Durham University)

The programme

This programme will raise awareness and understanding within the General Public of PAIN, what it is, why it is important for Quality of Life, the multidisciplinary way chronic pain disorders can be managed and ultimately cured and & how we might want to tackle the shortfall in pain management within the health service through self and community (of all ages) pain management. Pain management in sport may inform us in chronic pain management in general. Furthermore, the economics and politics of pain management across the world, particularly in sub-Saharan Africa (the Bishop of Durham will be approached to address this issue), and the history of criminology and pain management will be discussed (eg. use of propofol outside the clinic, cannabis in MS sufferers, ketamine in metastatic cancers etc). 6 x Public sessions (with multiple satellite events in community centres, university colleges, schools, Science Festivals, NHS Trust research centres etc) minimum are planned, comprising specialist lectures (encompassing the multidisciplinary nature of pain management – contributions from expertise in Biomedical, Biophysical, clinical and experimental psychology, physiotherapy, sports science, social science, community, criminology, philosophy, anthropology, health service, national & international politics, economics etc – encompasses all three Faculties within the university), Q&A panel workshops as well as educational activities suitable for local teachers & young people (schools, FE colleges (eg. New College Durham etc). These events will take place at both campuses to engage equally with County Durham and Teesside catchment areas


An Introduction to Living Well with Pain pocket book is a step by step guide through skills to help you stop struggling and cope well with pain. They include

· Goal-setting and rewarding yourself

· Pacing your day to day activities and building in relaxation practice and better fitness

· Managing moods in supportive ways

· Value of acceptance, patience and being less critical of oneself

· Sleeping well again

· Coping with setbacks

Available from booksellers shop and online

ISBN-10: 147213771X ISBN-13: 978-1472137715

Price £4.99 Kindle £2.99

The WRIHW is a partner in the development of this novel resource for clinicians to help them with Pain management. Feedback welcome.

Sunderland Illuminations 2017

Thursday, October 5, 2017 to Sunday, November 5, 2017
Bigger and brighter than ever before, Sunderland Illuminations will take place in Roker Park and along the seafront from 5 October - 5 November .
Roker Park will be transformed into a Festival of Light, with a Disney theme. The Park will be open every Thursday, Friday, Saturday and Sunday, from 5 October to 5 November plus every night at half term, from 5pm – 10pm each night. Last entry into Roker Park will be 9.00pm.
There will be a whole host of sparkling features with family favourites pirates, dinosaurs and fairies, magically mixing with new Disney additions that will surprise and delight.The event will close on 5 November with a spectacular fireworks display at 6pm.
Tickets for Roker Park are available online.
Opening Times: 4pm - 10pm

Public Discussion Forum: How do you cope with persistent pain?

Tuesday 11th April, 3-4pm, Birmingham Rep Theatre

At this event a panel of people from local and national pain support groups (all who suffer from persistent pain themselves) and pain researchers will be waiting to respond to questions from the audience. for more information please click here (pdf).

Cloudy with a chance of pain. An observation research study

This is an observation study so no taking drugs etc. for people with arthritis or other chronic pain. You or someone interested you may know will need to own a smart phone and be prepared to provide data for 6 months .You may see it advertised eventually by your GP practice or on the TV. It’s UK wide.If you feel it applies and are able/ interested it is available to anyone via this link.

Thanks in advance for considering. Please pass it on to anyone interested UK wide.

Study Summary

  • The primary aim of the project is to investigate the association between weather and symptoms in people with arthritis and other chronic pain.
  • It is cohort study of persons aged 17 years and over, who own a smartphone, and have chronic (i.e. lasting for 3 or more months) arthritis or other chronic pain.
  • The project has been advertised via the BBC2 broadcast of Trust Me I’m a Doctor in January 2016, over National radio stations, on HealthUnlocked (an online social network for health), via patient organisations, and through public engagement events, e.g. the European City of Science 2016.
  • Potential participants are directed to the Cloudy with a Chance of Pain Website, and complete 3 brief screening questions; (I have pain and have had it for at least the last three months (yes/no); I am aged 17 years or over (yes/no); I own an Apple or Android smartphone (yes/no)).
  • Patients provide consent online for data collection, access to GPS, linkage to other tracking apps (wearable devices and smartphone-derived e.g. Moves) and sharing of anonymised data.
  • Following consent information will be collected via the app on the patient’s self-reported diagnosis (if known), medication use and their baseline beliefs about the association between weather and pain. Participants then enter daily symptoms for six months (or longer if willing). Data items include: pain severity, morning stiffness, waking up feeling tired, fatigue through the day, patient well-being, and sleep quality. Four additional, potentially confounding factors will be included in the daily scores: mood, physical activity, time spent outside, and interference with work and social activities (all scored 1-5).
  • Recruitment will be open for one year.
  • The primary outcome will be self-reported pain severity. Geolocation data from the device’s GPS system is collected hourly and pulls weather data from the nearest UK Met Office weather station.

Jo Quinlan (Affiliate of the WRIHW Pain Special Interest Group : Its a Pain) publishes an independent validation of the Self-help Pain Management Plan performed within the Durham & Darlington NHS Foundation Trust. Quinlan J, Hughes R and Laird D. Independent validation of the Pain Management Plan in a multi-disciplinary pain team setting British Journal of Pain (early release); (2016, accessed 30th September 2016).

Following on from the 2016 Its a Pain SIG event "Coping with Long-term pain" Questionnaire ready to complete (see Related Links above).

BNA Festival of Neuroscience Symposium organised by Dr Ilona Obara entitled: Opioids revisited: new developments and opportunities for opioid pharmacology (sponsored by the British Pharmacological Society) 12th April 2017
Link to programme:

Dr Ilona Obara is a member of an expert panel for the International Pain Research Forum Webinar entitled "Targeting Translation Control Mechanisms to Ease Chronic Pain" on the 14th January 2014. See

Keynote speaker videos

Please note that these video links will open via Durham University's Youtube Channel.

Strategies to cope with pain - the sufferer's point of view

Understanding and Communicating Pain: An interdisciplinary Approach

How the brain is wired for Pain – Dr Mike Lee (Oxford University)

“Every move you make” The normal Psychology of Pain – Professor Stephen Morley (University of Leeds)

Could medicinal plants manage pain? – Ross Menzies (Hexham Herbal Clinic)

Pain Question time – Chair Baroness Hilary Armstrong, Panel, Dr Kate Bidwell. Dr Robert Song, Mr Ian Simmons, Dr Jo Dunn

Stratified Care for Back Pain- Dr Jonathan Hill (Keele University)

Active Partners in this proposal

Other interested parties include: The Durham University Hospital and Darlington Pain management groups, New College Durham, South Tees NHS Trust Cancer Care group, Parkinson’s UK North & South Durham Branches, Framwellgate School Science & Learning Centre, NE Medicinal Plant Research Group, EU COST ACTION BM0806 etc.

Outputs and Articles

Eldabe, S., et al. (2015). "Dorsal Root Ganglion (DRG) Stimulation in the Treatment of Phantom Limb Pain (PLP)." Neuromodulation (in press)

Obara I. et al. (2015) Inhibition of the mammalian target of rapamycin complex 1 signaling pathway reduces itch behaviour in mice. Pain Aug;156(8):1519-29

Eldabe, S., et al. (2015). "The Effectiveness and Cost-Effectiveness of Spinal Cord Stimulation for Refractory Angina (RASCAL Study): A Pilot Randomized Controlled Trial." Neuromodulation (in press)

Narendran, R. C., et al. (2015). "The need for and provision of intrathecal baclofen therapy for the management of spasticity in England: an assessment of the Hospital Episode Statistics database." BMJ Open 5(6): e007517.

Deckers, K., et al. (2015). "Chronic Low Back Pain: Restoration of Dynamic Stability." Neuromodulation 18(6): 478-486;

Innov-age Magazine Issue 7 Autumn-Winter 2014 (PDF)

Painful truths in Africa (PDF)

Durham University’s “It’s A Pain” events series to tackle modern curse of chronic pain. Published in J Anaesthesia Practice

Pain: Can you feel it? Reference: British Dental Journal214, (2013) 8

Axonal protein synthesis and the regulation of primary afferent function.Obara I, Hunt SP. Dev Neurobiol. 2013 Oct 1. doi: 10.1002/dneu.22133. [Epub ahead of print]

Synthetic self-assembling clostridial chimera for modulation of sensory functions. Ferrari E, Gu C, Niranjan D, Restani L, Rasetti-Escargueil C, Obara I, Geranton SM, Arsenault J, Goetze TA, Harper CB, Nguyen TH, Maywood E, O'Brien J, Schiavo G, Wheeler DW, Meunier FA, Hastings M, Edwardson JM, Sesardic D, Caleo M, Hunt SP, Davletov B. Bioconjug Chem. 2013 Oct 16;24(10):1750-9.

Homers at the Interface between Reward and Pain.Obara I, Goulding SP, Gould AT, Lominac KD, Hu JH, Zhang PW, von Jonquieres G, Dehoff M, Xiao B, Seeburg PH, Worley PF, Klugmann M, Szumlinski KK. Front Psychiatry. 2013 Jun 7;4:39.

Nerve injury-induced changes in Homer/glutamate receptor signaling contribute to the development and maintenance of neuropathic pain.Obara I, Goulding SP, Hu JH, Klugmann M, Worley PF, Szumlinski KK. Pain. 2013 Oct;154(10):1932-45.

Painful Truths. G Lees and PL Chazot 2013 Chemistry & Industry March 9. AAAS News

Recognition of Pain as Another Deficit in Young Males with High Callous-Unemotional Traits. Wolf S, Centifanti LC. Aliment Pharmacol Ther. 2013 Oct;38(8):864-86. doi: 10.1111/apt.12460. Epub 2013 Aug 27.

Can healthy fetuses show facial expressions of "pain" or "distress"? Reissland N, Francis B, Mason J. PLoS One. 2013 Jun 5;8(6):e65530

Systematic review: probiotics in the management of lower gastrointestinal symptoms in clinical practice -- an evidence-based international guide. Hungin AP, Mulligan C, Pot B, Whorwell P, Agréus L, Fracasso P, Lionis C, Mendive J, Philippart de Foy JM, Rubin G, Winchester C, de Wit N; European Society for Primary Care Gastroenterology. Aliment Pharmacol Ther. 2013 Oct;38(8):864-86

Percutaneous Peripheral Neuromodulation Lead Insertion Using a Novel Stimulating Coudé Needle. Goroszeniuk T, Pang D, Shetty A, Eldabe S, O'Keeffe D, Racz G. Neuromodulation. 2013 Nov 1. doi: 10.1111/ner.12126. [Epub ahead of print]

Assessing the effectiveness and cost effectiveness of subcutaneous nerve stimulation in patients with predominant back pain due to failed back surgery syndrome (SubQStim study): study protocol for a multicenter randomized controlled trial.Eldabe S, Kern M, Peul W, Green C, Winterfeldt K, Taylor RS. Trials. 2013 Jun 25;14:189.

The effectiveness and cost-effectiveness of spinal cord stimulation for refractory angina (RASCAL study): study protocol for a pilot randomized controlled trial.Eldabe S, Raphael J, Thomson S, Manca A, de Belder M, Aggarwal R, Banks M, Brookes M, Merotra S, Adeniba R, Davies E, Taylor RS. Trials. 2013 Feb 22;14:57.

Analgesic efficacy of high-frequency spinal cord stimulation: a randomized double-blind placebo-controlled study. Perruchoud C, Eldabe S, Batterham AM, Madzinga G, Brookes M, Durrer A, Rosato M, Bovet N, West S, Bovy M, Rutschmann B, Gulve A, Garner F, Buchser E. Neuromodulation. 2013 Jul-Aug;16(4):363-9



'It's a Pain' SIG Event

Date/Time: Wednesday 22nd June 2016 at 7-9pm at the Calman Lecture Theatre in Durham University (2 hour event with satellite practical workshops run on the same day prior to main event)

Audience: Invite to multi-disciplinary academics within Durham University/ other local sister Universities & Clinical Research Centres, people with long term pain, patients attending local pain management services, ex. Military groups, company representative, local school children, health care professionals and members of the general public.

Overview: This event is a collaboration between Durham University and County Durham and Darlington NHS Foundation Trust and is a follow up from the successful 'It's a Pain' Public Engagement Lecture Series and Public workshop Events run between 2012-2015. The unique feature is that all panel members would be living with pain and have different strategies to cope with their individual pain experience. We are looking to invite people who have a role in leading either a local or national pain charity or support groups. The event will be recorded and added to YouTube for future viewing. Examples of previously recorded events are listed on our Pain SIG website

Understanding and Communicating Pain: an interdisciplinary approach

07 May 2014, 6.00 – 8.00pm Calman Learning Centre, Durham University and 08 May 2014, 9.00 – 3.00pm, Wolfson Research Institute, Durham University

Pain is not just an individual physical or emotional experience. The ways in which it is represented and imagined, and the knowledges, beliefs and values that surround it, have a direct effect on how it is experienced and managed by individuals, families and social groups.

This event takes an interdisciplinary look at how pain is caused, experienced, understood and communicated exploring the following questions:

  • How do different cultural and sub-cultural groups deal with pain: what kinds of beliefs and values do they have about pain; what kinds of rituals and forms of therapy do they employ in managing it; how do they communicate it? What can we learn from diverse cultural and historial perspectives on pain?
  • Pain is represented in the arts in multiple ways: as something to be feared and conquered; as something that offers fascination and drama. What kinds of images of pain do we draw on in the UK? How can images of pain in the visual and literary arts affect people’s experiences of pain and our strategies for managing it?
  • How do beliefs and ideas about pain affect its representation as a social problem, for example in relation to policies providing access to health and social services? What kinds of scientific evidence are required in demonstrating the efficacy of pain management therapies? How do dominant societal ideas about pain affect social and economic policies relating to worklessness and benefits?
  • What is the science behind pain and its perception by people and how is this linked to the social and psychological questions? What is is the basis for the analgesic “placebo” effect? What is the link between pain and addiction/reward? What is the basis of pain experience changes as we age?

The panel

Chair: Professor: Professor Jane Macnaughton


Dr Clare Roques

Is Pain a Problem to be Fixed? An International Perspective

In a briefing note published in 2009, the World Health Organization estimated ‘that 5 billion people... have no or insufficient access to treatment for moderated to severe pain’. Despite widespread initiatives to change this situation, often focussing on improving access to opioid medications such as morphine, in many countries progress has been limited. Dr Clare Roques will present an overview of these initiatives and describe some of the potential reasons for the apparent gap between global policy and local implementation.

Dr Suzannah Biernoff
Iconographies of pain and stoicism

How and when is pain represented in Western art and visual culture? There are certain contexts in which pain has been made visible and communicable: religious iconography; studies of physiognomy and human expression; images of illness and self-portraiture. What is harder to fathom is why certain kinds of pain are imaged while others are not. The example Dr Biernoff will focus on is military medicine, in which cultural ideals of masculinity coincide with a medical gaze that abstracts the symptom, or the injured part, from the patient. In photographs of facial injury from the First World War – and Henry Tonks’ intimate drawings of the same patients – one is confronted by a perplexing absence of pain. This absence can be explained, Dr Biernoff suggests, by contemporary views of both masculinity and medicine. Stoicism – the ‘stiff upper lip’ – limits the expression of pain and while Tonks’ portraits suggest psychological depth, the case photographs are all surface. In this context pain was – and perhaps still is – subsumed by the ideology of repair and rehabilitation.

Dr Rachael Gooberman-Hill
Research into pain: ethnographic and clinical perspectives

In this talk Dr Rachael Gooberman-Hill shall discuss ethnographic and qualitative studies of pain and reflect on how these may relate to concepts used in, and design of, clinical research. This matters because ethnography and qualitative studies provide insight into pain in context, and because clinical research informs current practice in healthcare. She will introduce some key studies of pain, which have variously explored experiences of pain and pain management. By providing insight into pain in context, such studies help us to understand pain as simultaneously individual, social, cultural, structural and political. As an anthropologist working in pain research, Dr Gooberman-Hill often wonders how these insights relate to concepts and practice in clinical research? To answer this we need to unpack concepts used in clinical research and see whether and how they relate to a broader understanding of pain gleaned from ethnography and qualitative studies. Dr Gooberman-Hill shall do this by discussing clinical studies in which she have been involved, including work on long-term musculoskeletal and post-surgical pain, and will conclude with some suggestions for enhanced cross-fertilisation of ideas in the future.