Hope Found in Persistent Pain and Suffering

One in five people live with chronic pain, that is, pain that can’t be cured. This figure rises to one in four people over the age of 65. Chronic pain is both a complex health issue, in part because it's invisible, and a costly one—socially and economically— for our society. In 2012, the cost to the Australian economy exceeded $55 billion. Yet, despite its prevalence and its economic impact, chronic pain management is one of the most neglected aspects of health care. “Our failure to adequately address chronic pain is a major driver of its economic and social cost,” says Rebecca McCabe rsm.

Sr Rebecca is no stranger to pain. Ranked in the top ten swimmers in the world as a teenager, her promising swimming career, with the opportunity to represent Australia in the Olympics in 1984 ended as a result of injury. While training to become a physiotherapist she became intrigued by the area of persistent pain and suffering. "I began asking myself - what contribution could I make to this 'hidden epidemic' in our society?"

Today Rebecca works in private practice and in pain research in the Department of Pain Management, HammondCare Greenwich Hospital, Greenwich, NSW, as part of a multidisciplinary team of health professionals, including medical specialists, physiotherapists, clinical psychologists, nursing and administrative staff and researchers. Dedicated to improving the quality of life of her clients and to understanding how pain works, she has co-authored two books on persisting pain and presented her research at many world and national conferences.

Her current area of research is the exploration of spiritual and existential factors in the assessment and treatment of chronic pain.

There has been increasing interest in addressing spiritual and existential aspects as a component of health care. Despite widespread acceptance in related fields such as palliative care, these aspects receive comparatively little attention in the pain community. "Recent findings that we presented at the World Pain Conference in Milan in 2014 demonstrated that people with chronic pain have levels of spiritual distress that are equal to or higher than people with cancer or HIV/AIDS," said Rebecca.

"We are now looking at the subject of post traumatic growth (PTG). There have been patients who make us sit back and ask 'why is it that some people are able to take on such extraordinary suffering yet able to grow subsequently?'

It is not the opposite of post-traumatic stress. We are observing something different here.

Current research is this area would suggest that PTG seems to be the result of reprioritising the important things in life after traumas such as retrenchment, injury, burns, cancer, domestic and personal abuse.

We believe that some people living with chronic pain fit here too!

I work with a team that wants to do something about it. We hope to develop other treatments to ease people’s suffering. We are designing a new program with four elements: exercise, medication, supportive relationships and connection with the spiritual. We are hoping to implement and research this program this year."

Working with a team is critical says Rebecca. "The subject of pain is so complex that in order to treat it more effectively we need to see the problem through many different professional and personal lenses. Unfortunately, it’s estimated that less than 20% of people with chronic pain receive coordinated multidisciplinary care.

For me post traumatic growth resonates with my faith framework. My faith acts like an undercurrent that carries me through the tough times; the possibility that through suffering our lives can be reshaped; that hope and love can emerge through despair and isolation - the Paschal Mystery in action."

Download: Spiritual and existential factors predict pain relief in a pain management program with a meaning-based component (2018)
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