Jamie O’Hara, UK Haemophilia Society; Hortensia de la Corte Rodriguez, Hospital Universitario La Paz, Madrid; Pier-Luigi Solimeno, University of Milan; Miguel Crato, EHC Steering Committee; Lotte Haverman, Amsterdam UMC; Nathalie Roussel, University of Antwerp; Paul McLaughlin, Royal Free London NHS Foundation Trust

Frank and open Q&A about alternative treatments, physical activity, opioids, physiotherapy; comparing various European models in pain management. As always, focus must be patient-centered and patient must be taken into account. Being paternal does not work.

“There is no bleed without pain but there might be pain without a bleed,” opens Pain Management Round Table from Brussels.

Chronic pain occurs in over 50% of respondents from PROBE study when walking. The truth about pain in haemophilia: Results from the CHESS & PROBE studies w/ Jamie O’Hara, UK Haemophilia

Joint morbidity has significant impact on resource use. Avoiding it has substantial and dramatic impact. – Jamie O’Hara.

The brain interprets pain signals + the brain is plastic = barring real damage, the brain’s interpretation can be altered using physical activity (which reverses ascending & descending pathways). Good news: provides physical activity grants! (retweeted from Amanda Bok)

“Pain is a universal symptom of every condition & it’s management is an art” says Jamie O’Hara at RT on pain management before sharing pain data. (retweeted by Amanda Bok)

Nathalie Roussel beautifully sets the scene of RT on pain management and calls on all clinicians to use a broad biopsychosocial assessment plan with patients. (retweeted by Amanda Bok)

“Most of you think of haemophilia as a bleeding disorder with orthopaedic complications; I see haemophilia as an orthopaedic disorder with bleeding complications” says Luigi Solimeno at RT on pain management, discussing multiple treatment options. (retweeted from Amanda Bok)

Debunking painkiller myths at RT on pain management w/ Hortensia de la Corte Rodriguez.

Painkiller pharmacology is not easy & not well-studied in haemophilia, says Hortensia de la Corte Rodriguez at RT on pain management, walking us through general WHO analgesic ladder instead. (retweeted from Amanda Bok)

Physiotherapist Paul McLaughlin nails it: best evidence: listen, communicate, assess – physical, appropriate outcome measures, educate, motivate, support, facilitate. Patient-centered! Chronic ongoing knee pain? Another x-ray will not help that.

The vicious cycle of haemophilia – the role of the physiotherapist in pain management in haemophilia w/ Paul McLaughlin, Royal Free London NHS Foundation Trust

Focus has been on stopping the bleeding and not so much on stopping the pain. – Paul McLaughlin

Only 30% of patients use physical activity to deal with pain, reports Paul McLaughlin, noting that’s almost as many people as use ice or prayer! Why aren’t more people using physio?! From RT on pain

Respect, candour, accountability, and the primacy of the patient’s lived experience – as usual a wonderfully down-to-earth, pragmatic & empathic talk by Paul McLaughlin at RT on pain management. (retweeted by Amanda Bok)

The pain circle w/ Lotte Haverman, Amsterdam UMC. When to use psychological interventions to manage pain? Dutch model takes into account doctor, social worker, psychologist, physio, nurse.

Holistic and practical exercises for relaxation: foursquare breathing, guided imagery, self-talk, hypnosis, mindful mediation.

Lotte Haverman takes us through psychological aspects & cognitive behavioural therapy approaches to acute & chronic pain at RT on pain management. (retweeted from Amanda Bok)

Image courtesy of Charles Kinney | EHC - European Haemophilia Consortium