Dr Deepak Ravindran - The Pain-Free Mindset: 7 Steps to Taking Control and Overcoming Chronic Pain

Dr Deepak Ravindran has 20 years of experience in helping people overcome their pain. He is one of the few consultants in the UK with triple certification in musculoskeletal medicine, pain medicine, and lifestyle medicine. Dr Ravindran is a full time NHS consultant in pain medicine and anaesthesia at the Royal Berkshire NHS Foundation Trust in Reading and the lead for the Pain Service.

In 2015, he helped set up the integrated pain and spinal services (IPASS), which provides community pain services for West Berkshire and has been awarded Emerging Best Practice by the British Society for Rheumatology and was shortlisted for a Health Service Journal award. His team won the Grunenthal National Pain Award for General Patient Education in 2017.

Dr Ravindran has been a visiting lecturer at the University of Reading since 2016 and has authored and contributed multiple chapters in many pain management handbooks for healthcare professionals, and patients support groups.

Dr Ravindran is a University Gold Medallist in anaesthesia and pain medicine from one of Indias prestigious tertiary super-specialist institutes (JIPMER) and has completed anaesthetic training at Oxford and his pain fellowship at UCL, London.

More recently, he has helped establish the Berkshire Longcovid Integrated Service (BLIS) for managing post COVID syndrome for his local health care system. He lives in Berkshire with his wife and 2 kids.

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First published by Vermilion in 2021

Copyright Deepak Ravindran 2021
Illustrations Toby Clarke

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Cover design by Two Associates

ISBN: 978-1-473-58145-6

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For my teacher, Professor Ravishankar, who embodied wisdom, enthusiasm, passion and curiosity.
For inspiring me to deliver value and high-quality care, thank you.

You do not rise to the level of your goals, you fall to the level of your systems.

James Clear, author of Atomic Habits

THE FIRST TIME I met Lucy was with her parents in my private clinic. She was very upset and tearful.

I need you to help me, said Lucy. Ive been to so many doctors before and Ive just had no clear diagnosis and I need something to get rid of the pain!

It was heart-wrenching for me to see this young lady sitting there with her equally distraught and worried parents. What had brought their 23-year-old daughter to this situation?

Lucy continued: I cant believe it. Up until seven months ago, I was working flat out doing 60-hour weeks at a job I loved and then one day it happened, and from then on everything just went downhill. Nothing has been the same and I just feel so tired. I have pain that is present in every part of my body. Every specialist Ive seen gives me a different story and I just want to be put out of this misery.

Its important that I get this sorted out as soon as possible. Im at risk of losing my job. Ive already taken enough time off work and my boss is just not happy with me. Ive got to do better and I am already on notice. This is not worth it. Dr Ravindran you need to help me; you need to fix this problem.

Over the course of the next 30 minutes, I realised that Lucys pain had been gradually building and some opportunities for reducing it early had not been taken. After visiting various specialists, she was not getting any idea of where the problem was, where the pain lay or what could be done to resolve it.

This angst and lack of clarity was what was making it quite difficult for her and her parents. She was at a crisis point and had realised that her job and her life as she knew it, and the quality of life that she used to lead, had all been completely dismantled and taken apart by the pain that was tormenting her all over.

Fast-forward one year and Lucy has just finished her first half-marathon in a very respectable sub-two hours. The work that she did, the support that she had from her parents, and from her larger family and friends, along with the resources that she got from my team, meant that I got the opportunity to witness first-hand something truly transformative.

Lucy was able to achieve all this despite the pain. In fact, she now has a blueprint on how to manage the pain, and look after and pay attention to her body. It was an entirely different Lucy coming to see me in our follow-up appointments or talking on the phone, or even corresponding on social media.

I have now worked with so many patients like Lucy over the last ten years as a NHS consultant practising in a busy district general hospital. I have found a few things that have been instrumental in transforming these patients attitudes towards their pain and giving them the confidence, ability and belief that they can reach the same position as Lucy: they do not let their pain dictate their life, they have reclaimed their way of living, and have found new purpose and meaning by understanding certain important things about their pain.

In this book, you will understand and learn some very important advances around the treatment of pain, especially developments that have taken place in the last 1020 years. Im going to demonstrate that if you can bring these into your life, you could very well achieve the idea of a pain-free existence.

For a large number of you, I am confident that this book will provide the tools to develop a pain-free mindset: an ability to know and understand more about this essential emotion/sensation of pain that exists within all of us, constantly looking out for us, protecting us, but which sometimes works against us in a misguided attempt to keep us safe.

Lucy, despite her ups and downs, has been able to take this advice and put it to the best use for herself and her life, and it is working with patients like her and seeing the transformation that can come about that prompted me to write this book.

Of course, Lucys condition and her diagnosis are unique to her, but her problem isnt. She went to many specialists in the NHS, starting with her GP, and then to various allied healthcare professionals, and finally privately to other professionals and clinicians. Lucy had the private insurance to see me quickly, but a lot of patients dont have this and can often wait three or four months before getting an appointment with a pain specialist like me. Additionally, there are not that many experts and teams around who can provide holistic patient support, expectation management and finally patient empowerment, and this lack of knowledge and access to specialists in pain is a problem that has only got worse in the last few years.