Manage pain for better peace of mind

It hurts a bit as he stretches upright, but it's not too bad, so he gets back to finishing the job at hand.

It might seem innocuous, but rural health organisations and health workers are getting serious about how physical injuries on the land can lead to chronic pain, and then to mental health issues such as depression.

"There's not a great deal of research linking the two together, but there's a logic of why mental health issues would be linked to chronic pain," said Trevor Hazell, executive manager at the Centre for Rural and Remote Mental Health.

"It's on our radar... we have had meetings in the past two months with both Work Cover (at a State level) and Work Safe Australia (at a federal level) about this," he said.

Mr Hazell said when somebody suffered chronic pain, their productivity at work and their level of social interaction was adversely affected, and when this was combined with other pressures of living and working in agriculture, there was a high risk of depression.

At Dudley Private Hospital, in Orange, physiotherapist Mark Nelson and occupational therapist Nicole Green said they had seen the link between chronic pain injuries and depression first hand.

"I think there's a clear link between chronic pain and depression," Ms Green said.

"It important to get these people early when the injury occurs, so the injury doesn't lead to chronic pain," Mr Nelson said.

Mr Nelson said when pain was acute, either from the initial injury or surgery, it was important the person suffering sought appropriate treatment as soon as possible to stop the injury developing into one with chronic pain, which could exist for months or years.

"There is certainly a lot of ongoing back pain in ag communities, and there are some farmers who have come in who have struggled on with a bad hip or knee for years," he said.

"There are a lot of farmers who put up with a lot of pain for a long time."

Mr Nelson and Ms Green both thought the main reason for this was a lack of appropriate multi-disciplinary services in rural areas to treat ongoing chronic pain, including the mental demons it can conjure.

"The main thing about chronic pain is that it takes over your life," Mr Nelson said.

A comprehensive multi-disciplinary service would include a pain specialist, an occupational therapist, a psychologist and a physiotherapist to treat all the problems chronic pain can bring up.

The National Rural Health Alliance suggested another possible reason people working in agriculture might not seek help for chronic pain.

"The self-reliant culture of country people may exacerbate the problem," a report from the health alliance on chronic pain said.

"Their stoic attitude toward adversity means they may silently endure chronic pain and not complain."

The health alliance's report said one in five adults who suffered from severe physical pain would also suffer from depression or other mental disorders.

The report also called for a multi-disciplinary approach to pain management.

Suicide Prevention Australia figures showed physical health problems were implicated in 21 per cent of suicides in Australia.

Mr Hazell said the combination of physical pain and depression were definite risk factors for suicide.

"When you're in pain and it doesn't seem like it's going to end, it could lead to suicidal thoughts," he said.

Mr Hazell said it was vital to remove the stigma of telling people you were struggling mentally, especially in isolated rural areas.

He suggested one way people could bring up the issue of depression caused by a physical injury could be to discuss it with their doctor when seeking treatment for the physical pain.

"They could talk to their doctor about the pain, and also about how the pain makes them feel," he said.

"Otherwise the doctor might not pick up any psychological issues."

For more information on chronic pain visit www.painaustralia.org.au or www.painmanagement.org.au

l To discuss the issue of ongoing physical injuries and chronic pain leading to depression and mental illness, visit www.theland.com.au next Friday, April 4 and take part in our Friday Forum.

Participants can comment and share experiences, ask for advice, or simply read what other people in rural NSW think about the issue.

The forum begins at 2pm.

Anybody who needs help with depression or other mental health issues can contact Beyond Blue on 1300 22 4636.