Focus Groups in Facial Pain Management

Chronic pain (CP) is a common condition causing significant distress and disability. Pain has been defined by the International Association for the Study of Pain (IASP), as 'an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage. Pain remains essential for survival and facilitating medical diagnoses.

However, when acute pain outlasts the normal time of healing, it can become chronic. Chronic or persistent pain has been defined as 'continuous, long term pain of more than 12 weeks or after the time that healing would have been thought to have occurred in pain after trauma or surgery'. The definition of CP underlines the fact that emotional aspects are not additional to the experience of pain but are part of the sensation itself.

Psychological factors influence how people react to and report pain and result in coping strategies which may be helpful or destructive in maintaining function. The complex combination of emotions, thoughts and pain sensation manifests itself as pain behaviour. Pain, as a sensory experience, varies in its severity and life impact according to the individual's subjective meaning associated with a pain situation, his or her emotional responses, the attention given to the pain, and other personal appraisals. There is a strong evidence base for the effectiveness of pain management programmes (PMP's) underpinned by cognitive behavioural approaches in terms of improving patients well-being despite the presence of pain.

However, there is a relative lack of research specifically into cognitive behaviourally informed pain management treatment exclusively aimed at patients diagnosed with chronic facial pain. Some specialist PMP's focus exclusively on specific chronic pain diagnoses such as facial pain, whereas other PMP's offer treatment to patients with a broad range of chronic pain diagnoses. There is also little research into the relative advantages or disadvantages of these more specialist approaches. Systematic reviews have also suggested that further research is required to gain insight into the influence of specific components of PMP treatment on clinical outcomes.

Through gaining insight into service users experience of attending a specialist facial PMP, we hope to build on research in this area. This insight may have implications both for questions regarding the utility of more specialist PMP's and specific aspects of facial PMP's that patients find beneficial. In turn this may help guide our own service provision in future.