Chronic Pain, Neuroplasticity and Trauma-Informed Pain Care

Trauma-Informed Pain Care

Evie and Deepak from discuss trauma-informed care and other topics.

Dr. Deepak Ravindran is a pain medicine consultant, Fellow of the Faculty of Pain Medicine of Royal College of Anaesthetists. Dr Ravindran has over 20 years of experience in acute and chronic pain management. He is the clinical lead for pain medicine at the Royal Berkshire Hospital, Reading. He firmly believes that pain conditions should be treated as early as possible, with the appropriate use of multidisciplinary techniques to improve patient quality of life.

In this discussion, Deepak and Evie discuss many topics including:

  • How and why Deepak chose a career in pain medicine
  • 4 min: The changes he has seen in the field of pain medicine in the past 5-8 years. Quoting Paul Ingraham “The cutting edge of pain science is blunt and rusty”
  • 5.30 min: Progress in the field of pain management. Establishing the causes of persistent pain, and the principles of supported self management. Should we consider pain to be “socio-psycho-biological” instead of “biopsychosocial”?
  • 10 min: Nociplastic pain and neuroplasticity. “How can we explain to patients that neuroplasticity be a helpful phenomenon for those who are suffering from persistent pain?”.
    We talk about the importance of habit formation, and recent books by B.J. Fogg and James Clear.

“You do not rise to the level of your goals, you fall to the level of your systems.” – James Clear

We also discuss some recent comments by Dr. Amanda Williams on Joe Tatta’s podcast. Dr. Williams was on the podcast to discuss her most recent Cochrane review of psychological therapies for chronic pain, and shared her thoughts that remote consultations could be beneficial in the ongoing management of people with persistent pain.

  • 23.30 min: Trauma-Informed Care. Deepak describes what is currently know about the proven correlation between adverse childhood events or trauma, and symptoms of chronic and persistent pain conditions.

Evie plays “devils advocate” and wonders whether a patient who has experienced adverse childhood events might have some reservations about health care professionals being aware of the ACE’s for fear of their pain being judged as psychosocially-mediated.

Deepak talks about the importance of clinicians being trauma-aware and communicating the possible effects of trauma to their patients. He talks about the benefits of both patients and clinicians including this knowledge in their joint clinical decision-making processes.


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