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High concentration topical capsaicin for chronic neuropathic pain

We are constantly looking for treatments which may have an application to relieve neuropathic pain.

In 2002 an Australian Doctor Hugh Spencer published his story about utilising capsaicin to cure his own trigeminal neuralgia.  His process required making a mouth guard from an imprint of the patient’s teeth, adding a cloth brushed with capsaicin and rubbing alcohol, and adding to the outside of the guard to have contact to the gums. The process took time and effort and the treatment not very pleasant in the short term,  however his pain receded and eventually disappeared.

In the following years there has been research completed on the benefits of capsaicin.

CapsaicinChemical compound
Capsaicin is an active component of chili peppers, which are plants belonging to the genus Capsicum. It is a chemical irritant and neurotoxin for mammals, including humans, and produces a sensation of burning in any tissue with which it comes into contact. Wikipedia

  • Formula: C18H27NO3
  • Scoville scale: 16,000,000 SHU
  • Heat: Above peak; (pure Capsaicin is toxic)

High concentration topical capsaicin for chronic neuropathic pain

Published by Dr Hanan Khalil May 2017

369 participants included patients with peripheral diabetic neuropathy reported. The study reported that 10% more participants had at least a 30% reduction with high-concentration capsaicin than with placebo at 8 and 12 weeks of treatment.

Four studies included 1,272 participants with post-herpetic pain and found improvement of pain intensity reduction of 30% or greater in favour of the intervention compared to the control group.

Adverse events were common but not significantly different between the control and intervention groups. Withdrawal rates did not differ between the two groups. The treatment was not associated with death. The included studies that reported on pain reduction in favour of the intervention also reported on improvement of sleep, fatigue, depression and quality of life of the participants.


The small number of trials included in this summary found that high concentration of capsaicin was effective in reducing neuropathic pain associated with diabetes, HIV and post-herpetic neuralgia. There was also additional improvement of sleep, fatigue, depression and quality of life amongst the participants using the high concentration of capsaicin.

Implication for practice

High concentration topical capsaicin can be used to relieve neuropathic pain. Further studies on the effects of its long-term use in patients with chronic neuropathic pain are warranted.

DR HANAN KHALIL is the Director of the Centre for Chronic Disease Management, a collaborating centre of the Joanna Briggs Institute, Faculty of Medicine, Nursing and Health Sciences, Monash University, and a reviewer for the consumer group of the Cochrane Collaboration. She is also Editor in Chief of the International Journal of Evidenced Based HealthCare.

The purpose of this evidence summary is to provide the best available evidence for the effectiveness of vitamin E for managing mild cognitive impairment and Alzheimer’s dementia.

For the Full Cochrane review, please refer to: Farina N, Llewellyn D, Isaac MG, Tabet N. Vitamin E for Alzheimer’s dementia and mild cognitive impairment. Cochrane Database of Systematic Reviews 2017, Issue 1. Art. No.: CD002854. DOI: 10.1002/14651858.CD002854. pub4.1 


  1. Derry S, Rice ASC, Cole P, Tan T, Moore RA. Topical capsaicin (high concentration) for chronic neuropathic pain in adults. Cochrane Database of Systematic Reviews 2017, Issue 1. Art. No.: CD007393. DOI: 10.1002/14651858.CD007393.pub4
  2. van Hecke O, Austin SK, Khan RA, Smith BH, Torrance N. Neuropathic pain in the general population: a systematic review of epidemiological studies. Pain 2014;155(4): 654–62. [DOI: 10.1016/j.pain.2013.11.013]
  3. Pergolizzi J, Ahlbeck K, Aldington D, Alon E, Coluzzi F, Dahan A, Huygen F, Kocot-Kępska M, Mangas AC, Mavrocordatos P, Morlion B. The development of chronic pain: physiological CHANGE necessitates a multidisciplinary approach to treatment. Current medical research and opinion. 2013 Sep 1;29(9):1127–35.
  4. Khalil H. Painful diabetic neuropathy management. International Journal of Evidence-Based Healthcare. 2013 Mar 1;11(1):77–9.
  5. Anand P, Bley K. Topical capsaicin for pain management: therapeutic potential and mechanisms of action of the new high-concentration capsaicin 8% patch. British Journal of Anaesthetics 2011;107(4):490–502. [DOI: 10.1093/bja/ aer260]

Other Research

Capsaicin: Current Understanding of Its Mechanisms and Therapy of Pain and Other Pre-Clinical and Clinical Uses

Capsaicin 8% Dermal Patch: A Review in Peripheral Neuropathic Pain

The association does not recommend a particular treatment for trigeminal neuralgia.  Please always consult your medical practitioner to discuss products and options appropriate for your specific care.


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Despite Pain Blog – Talking About Pain

We know there are thousands of people living with trigeminal neuralgia but often their voices go unheard.

However there are pain warriors who are gifted writers, and share their experiences so others may benefit.  Liz the creator of Despite Pain Blog writes about her life with the aim of providing encouragement, education and support and welcomes sharing her thoughts.

Welcome to Despite Pain

Thank you for visiting my blog. My name is Liz and I’ve been living with a few painful conditions for many years so I know first-hand what it’s like to live with chronic pain. You can find a bit more about me here.


Learning to Listen to Your Body When You’re in Pain

Liz slso posts to Instagram  Facebook and Pinterest

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Podcast – What Do Patients Value About Pain

Welcome back to the Healing Pain Podcast with Hayley Leake, PT, PhD

In this episode, we’re talking about pain education and specifically asking the question, “What do patients value learning about pain?” Our expert guest is physiotherapist and pain researcher Hayley Leake. After working clinically for six years, Hayley embarked on a PhD mission at the University of South Australia with Professor Lorimer Moseley’s research group. Her research aims to optimize pain education for adolescents and adults living with chronic pain.

Pain education is a popular treatment approach for treating persistent pain that involves learning a variety of concepts related to pain and is thought to be an important part of recovery. In this episode, we discussed targeted concepts and themes that seem to be the most important of value to those living with chronic pain when delivering a pain education intervention. Without further ado, let’s begin and meet Physiotherapist and Pain Researcher, Hayley Leake.

What Do Patients Value About Pain? With Hayley Leake, PT, PhD

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Webinar – Dr Karen McCloy

We are delighted to announce Dr Karen McCloy of McCloy Dental in Caboolture QLD will be presenting a webinar for our association on August 30th at 7pm QLD time – Trigeminal Neuralgia & Dentistry.

Dr Karen McCloy has fabulous credentials around the challenges faced by people living with trigeminal neuralgia, and those not yet diagnosed who believe their pain is due to dental issues.

A/Prof Liam Caffery will be our chairman for the webinar.

We are looking for a one more panelists to appear on the webinar to tell their dental stories.  If you are confident to in your ability to join the online webinar and tell your story, please email Lyn Donnelly at

Add the date to your calendar and make sure you join us for this webinar the link will be posted here, on our calendar and on our Facebook pages.

Webinar Link

Please note the webinar start time is 7pm QLD time but you may join the waiting room from 6.30 

Dr. Karen McCloy B.D.Sc, MS (Dental Research Tufts), MS Med (Sleep Medicine Sydney), Diplomate American Board of Orofacial Pain

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National Chronic Pain Awareness Week 24-30 July

Every year Carer Australia support National Chronic Pain Awareness Week 24-30 July to raise the profile for all Australians caring for family member, partner or friend who lives with chronic pain.  This organisation is run by volunteers.

We work to improve the health, wellbeing, resilience and financial security of carers and to ensure that caring is a shared responsibility of family, community and government.

We know how important it is to shine a spotlight on the issues that carers have to deal with every day.  People living with trigeminal neuralgia have to cope with chronic pain and having support from a carer is imperative.

We are publishing resources that can be found on Carers Australia web site which we feel will benefit our community.

Factsheet 5: How can I help someone living with pain?

These 6 sessions (plus 2 bonus practices) have been put together by the director of  Simply Mindful – Canberra Mindfulness Center, Megan Layton. They were funded under the program Caring Through Covid by the Department of Health.

Mindfulness on Demand

Our association has its own awareness day on International Trigeminal Neuralgia Awareness Day on October 7th Light Up In Teal.

We recognise that donations are hard to achieve especially with current cost of living pressures.  However we pride ourselves in ensuring our community has easy access to resources which may help them cope with day to day living challenges.

If you would like to recognise National Pain Week amongst your friends and community head to Chronic Pain Australia which published the below article.


National Pain Week 2023 is Australia’s annual awareness event for chronic pain.

Chronic Pain Australia wants to draw attention to the experience of people living with chronic pain and, by doing so, reduce the social and other barriers related to living and managing chronic pain.This year’s theme ‘Let them know how strong you are’ and ‘painchanger’ aims to break down the stigma of talking about and seeking care for people experiencing chronic pain. Many are taught to hide their pain for fear of appearing weak.

The “she’ll be right” attitude is often adopted when addressing individuals chronic pain, leading to worsened, long-term impacts for both themselves, their family, friends, and colleagues.

This National Pain Week, we are encouraging a national conversation around people who live with chronic pain. By creating national conversations, we spread useful resources and tools for those living with chronic pain. We often hear people describe trying a new pain management tool as a ‘gamechanger’, so we have created the theme ‘painchanger’ as a play on words for this year’s theme


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Hints & Tips – Tina Stubbs

Members Corner is our place to interact and pass on hints and tips.

Our association interacts with people living with trigeminal neuralgia online, face to face and by phone.  We often hear stories about how people have learnt methods to cope with day to day management of trigeminal neuralgia.

This month’s tip is provided by Tina Stubbs who lives in Coolum Queensland and is a very talented photographer.  Check out her stunning images on Instagram

I would just like to pass on a couple of tips that are helping me cope at the moment.

I had an MVD in March 2022, had a mild recurrence in October, controlled with 100mg Tegretol, which settled down after a couple of months.
Another flare up in the last couple of months. This one is stronger and not well controlled with 300mg Tegretol. I’m reluctant to take more Tegretol because it affects my sodium levels.
My sensitive areas as usual are my left cheek, nose and upper lip.
I’m coping with frequent use of lignocaine- Numit cream on my sensitive skin and applied with a cotton bud inside my nose. Also oral liquid inside my mouth. I use these before meals, before cleaning my teeth or blowing my nose, or anytime I feel sensitive. It lasts an hour or so. Without this I I would be climbing the wall and would have to increase Tegretol.
The other tip I have discovered by trial and error. I have never seen this mentioned before. Wiping my face from the centre outwards- the normal way I would wash my face or apply moisturiser etc- is a strong trigger. But I have discovered that wiping from the outside of my face towards the centre does not usually trigger the pain. This makes a vast difference in my daily routine! It makes sense when you consider it is wiping down the nerve rather than wiping up from the nerve ends!
Just thought I would like to share, it might help someone else.



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Trigeminal Neuralgia Pain Can Ruin a Life

The following story may contain uncomfortable triggers.  For support, contact Lifeline 13 11 14 or beyondblue 1300 224 636

Trigeminal neuralgia pain can ruin a life. The following story was written by Penelope Debelle for SA Weekend – 21 min read November 14, 2014 – 11:41PM See our LINKS page for mental health organisations

The secret agony of jewellery designer and philanthropist Ann Middleton

JEWELLERY designer Ann Middleton was the life of the party but behind her smile lay a pain she could bear no more.

IT was Friday, July 25. Ann Middleton, the jewellery designer whose Burnside shop, Chez Jewels, has a clientele of a certain kind, checked into a luxury high-rise hotel on the Gold Coast. She had a small bag and told reception she would be there for a night, possibly two. I’ll see how I go, she said.

In her room the airconditioning was up too high so she asked that it be turned down. Then she requested a glass of wine and one was brought up to her room. By the time the concierge clocked off 15 minutes later, someone had jumped from the building. It was Middleton.

“She just got up there and … hmmmm …” Brother Phil McMahon’s voice trails off as he contemplates what his sister went through. Middleton had rung him the night before for a chat which had taken on new significance.

“We talked about a lot of stuff actually,” says McMahon, a real estate identity as well known in his field as Middleton was in hers. “She got really spiritual, that was Thursday night.”

On the day, Middleton told the girl who ran her high-end Gold Coast shop, Marina Mirage Boutique, she had to go to hospital because she was in so much pain. Instead, she went to lunch with a client then checked into the hotel.

“It wouldn’t have been impulsive,” McMahon says. “There’d been signals all the way along. She was always saying ‘I love you’. ‘Yes, I love you too.’ ‘No, I really, really do, you know that don’t you?’ That was said in the last phone call.”

Middleton suffered from face pain brought on by a condition known as trigeminal neuralgia. All neuralgias are bad because they involve paroxysms of pain along a nerve. It isn’t the chronica che of a bad back or the searing, localised hurt of an open wound. It is the agonising exposed pain you get fleetingly when the dentist hits a nerve and sends you almost into shock. An instant of it can leave you gasping. Trigeminal neuralgia, which affects the branching nerves that enclose the face — including the nose, lips, ears, tongue, jaws and teeth — is so severe the sufferer feels as though they are being struck by lightning, again and again. The merest touch of the skin triggers blinding pain.

“I’d wake up in the morning, jump in the shower and just the water on my face would set it off,” says Kent Parkin, a real estate agent based in Mt Barker. “I hate to say it, but I can understand why she jumped.”

It is known as the suicide disease because exhausted sufferers like Middleton choose oblivion over the agony of living. Yet her death was a shock to many. She was the epitome of a successful woman with a resume that went back to being a champion ping pong player, touring with the Australian table tennis team in 1971. She became jewellery maker to the elite, our own Queen of Diamonds who led a dazzling life making stunning, extravagant pieces, some of them worth more than $1 million each. She had a large international clientele and made bespoke items from 20 carat topaz gems or pink sapphires or Argyle diamonds or South Sea pearls for royalty in Brunei, Thailand and Malaysia. Champagne aloft, she was photographed with Bill Clinton, Olivia Newton-John and Ian Thorpe, and was a charity regular and a favourite of the ladies who lunch. In 1994 she was South Australian of the Year and in 2006 she received the Order of Australia, a year after she moved from Adelaide to the Gold Coast.

Three years ago she began to worry that she was sick. Suffering from abdominal bloating and pain, she thought it might be a food allergy. After six months of discomfort she was diagnosed with uterine cancer and had a hysterectomy. She had a longstanding sensitivity to light and not long after the surgery began experiencing early symptoms of trigeminal neuralgia; an intermittent burning sensation at the back of her head and from the forehead down. Fearing the problem was dental — trigeminal neuralgia can be tricky to diagnose — she had a tooth implant removed. As it worsened, she sought help from a range of medical specialists. In Queensland she saw an eye specialist whose injection into her neck seemed to make things worse. Then she saw an Adelaide specialist who drilled in to try and cauterise the trigeminal nerve.

“She came out of that worse,” says McMahon. “After that, any time anyone touched her she was in quite a bit of strife. It had nothing to do with the cancer surgery; that was unrelated.”

She tried not to complain. Whether you are consumed by dire pain or not, there is only so much someone else can do. For two years she hid it as much as she could, flying to Adelaide to see friends and distracting herself with friends and work and dinners.

In 2001 she had sold Chez Jewels to businessman Robert Gerard but kept working as a jewellery designer and ran the store on the Gold Coast. She was ebullient and full of life and worked hard for charity, even when planning her death. She tried pain clinics and spent time practising relaxation techniques at her friend Olivia Newton-John’s retreat. She tried opiates but they made her sick. The pain was always bad but for the last six months became more intense. Towards the end, there was little else she could talk about, at least to close family and friends. She withdrew into herself. Her first husband, the father of her adored son Jamie, supported her and she would stay with him on Adelaide visits. She socialised but her world was shrinking and at its centre was the pain.

“She loved her glass of champagne, it made her feel better, but in the end that didn’t work either,” McMahon says.

Her affliction is not rare but it is uncommon. An Adelaide oral and maxillofacial specialist sees about 500 people a year with face pain, about 50 to 75 of whom will have trigeminal neuralgia. Interestingly, one way to diagnose it is that, unlike toothache, the pain goes quiet at night and doesn’t disrupt sleep. Ninety per cent of cases are successfully treated with antineuralgic medication like Tegretol. It’s not a cure but keeps it under control. With the other 10 per cent, surgical intervention can help.

It is difficult for sufferers to explain just how bad it is. Kent Parkin spent months thinking the source of his pain was dental, visiting specialists and buying mouthguards hoping it was related to a lifelong habit of clenching his teeth. Nothing worked as the pain progressed from occasional bouts to an entrenched agony that left him pressing so hard on his cheek he broke blood vessels. “You can describe it to people but it’s so hard,” he says. “It’s like an electric shock but it doesn’t stop. I say to people, imagine dissecting a nerve out of your face then getting a knife and twisting it. The pain is so bad they call it the suicide disease. When you do research on the net, that’s how people refer to it.”

He was managing a company that supplied GPS equipment to the mining industry and would sit still in meetings, unable to speak while waves of pain coursed through his face. He tried prescription medication and neural dampeners like Endone but nothing touched it. In despair one day he called his sister who took him to a doctor at Brighton.

“I’m sitting there saying ‘I’m going crazy, I’m just going to bloody shoot myself’,” he says.

He was given morphine, which helped for about an hour. Later that night he went to Ashford Hospital and got a bigger dose that let him get home and sleep. The hospital referred him to a maxillofacial surgeon who the next day gave him a neural block that stopped the pain entirely.

“Before he pulled the needle out I said to him, ‘are you going to be embarrassed if I get out of the chair and kiss you?’ Because the pain just went. It numbed the entire bottom of my face.”

It broke the cycle for a couple of days but by now Parkin was convinced he had trigeminal neuralgia. He was referred to a neurosurgeon at the RAH who ordered an MRI. Parkin tore open the notes and read that there was nothing abnormal to be seen.

“I took it in to (the neurosurgeon) and said, ‘they’ve said there’s nothing’. He holds the film up and says ‘bullshit, they don’t know what they’re looking for. That’s your problem’.”

At the base of his brain a blood vessel was rubbing against one of the branched facial nerves, wearing away the nerve’s protective sheath. The specialist recommended surgery to insert a piece of Teflon between them.

Parkin went to Memorial Hospital in July 2012. At 6am the surgeon told him they were going in, in an hour. Three things could happen, he said: You could end up with numbness on the side of your face, you could have a stroke, or it could be a complete disaster and you could die.

“At that point in time, with what I’d been going through, as far as I was concerned I didn’t care what was going to happen as long as I got rid of the bloody pain,” he says. “It was just horrendous.”

The surgery worked although not without complications. With staples in his head, but free of the neuralgic pain, Parkin went home. He was relieved beyond comprehension. Days later he was back in hospital after brain fluid began dripping from his nose. He had a spinal tap that reduced the fluid but four days later it began dripping again. He needed more surgery. When the surgeon sewed up the dura membrane that encloses the brain, a tiny pinhole was left, enough to allow fluid to leak out. He was also becoming sensitive to light.

The pinhole was sealed but two days later he began a course of heavy-duty intravenous antibiotics; he had contracted bacterial meningitis, probably a hospital acquired infection. Six weeks later he was attending meetings with a pump in his pocket discharging intravenous antibiotics. He was unlucky, but grateful. Two years later, he is pain free but can’t say the words without a “touch wood” for luck. He has his life back.

“When they say it’s a suicide disease, I can understand it,” he says. “You can’t live with it. The pain is so intense. What are you going to do? Stay in hospital on a morphine drip?”

Those who loved Middleton are left haunted by the thought of “what if?” What if she had hung in there for another week or month and found a doctor who could help? What if she had found some way of learning how to live with chronic pain?

Professor Lorimer Moseley, who works in clinical neurosciences at UniSA and studies the role of the brain and mind in chronic pain disorders, says he understands that some people feel it is better to die than live with so much pain. In his experience, nerve pain often seems to be the worse. This includes trigeminal neuralgia but also testicular neuritis or pain after a motorbike accident that has damaged peripheral nerves in some way. Sometimes stroke victims also experience unbearable full body pain.

After 20 years of research, he is convinced that when people say “it’s all in your mind” they are more right than they know.

“Pain is not like a disease process where you can see the thickening of the arteries or plaque on the brain,” he says. “Pain is the experience that is produced entirely by the mind. That’s a really difficult thing to conceptualise because it feels so strongly that it’s in the body.”

In Moseley’s view all pain, 100 per cent of the time, is produced by the brain as a way of making you protect that part of your body, even when — as in the case of phantom pain in an amputated limb — there is nothing to protect. An entrenched affliction like trigeminal neuralgia is a prime example of pain being produced when there is nothing tangible for the body to protect. From this flows the potentially fruitful step of training the mind not to produce that pain any more.

“I am one of many people around the world who are trying to work out ways to make it do that,” he says. “We need to train the brain to change its mind over protection.”

In a case of trigeminal neuralgia, the aim would be to train the brain to stop reacting to danger messages from the trigeminal nerve. Moseley says progress has been made in changing the way people think about their pain and helping them understand what their pain means.

It is no magic bullet. There is no cure. It is a process of rehabilitation, not a treatment, and involves a team of people including a physiotherapist and a psychologist who can help teach tricks to get the brain coping differently. For the first time, researchers like Moseley are feeling positive about their hopes for those who suffer from chronic pain, and there are many of them.

Living with pain is not a catastrophe that affects just a small number of people. Moseley says it is the nation’s most burdensome health issue, more costly in lost productivity than cancer and diabetes combined. In the top 10 of the world’s most burdensome diseases, chronic pain disorders occupy the first, fourth and eighth place.

Yet with all the guarded hope that pain research brings, there will still be individuals for whom no help will be found. “There are tragedies everywhere,” Moseley says. “Ann is one person but I could reel off 20 people I have known who have killed themselves because of unbearable pain.”

Her brother wonders if maybe Middleton knew too much, that she went to too many doctors and knew so much about her condition that it drove her down. McMahon would try to be positive and tell her she would get better and the pain wouldn’t kill her, even if it got worse. Other people have recovered and he worries that with Middleton, something was missing.

“My mate’s father had trigeminal neuralgia in his 80s and said to his son ‘kill me’. Then they found a tablet that worked,” he says. “A CIB (policeman) on the Gold Coast told me there was a lady, a devout Christian, who had it and she went to (euthanasia adviser Dr Philip) Nitschke then decided no, it’s against her beliefs. Five days later she found someone who helped.”

He is not critical of the medical profession but thinks there should be a central register where people like Middleton can go for up-to-date, reliable information on best practice treatments. She saw so many doctors yet none of them could help her. “She was looking for a Dr House; we laughed about that,” McMahon says. “I can’t explain any of this. It’s a real mystery to me.”

For support, contact Lifeline 13 11 14 or beyondblue 1300 224 636

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President’s Reflections – May 2023   

The last month since being elected as President has been extreme, to say the least. I’m amazed at how much work there is to be done. I’m also amazed at how much work others do to help our organisation. It’s been a little bit frantic and sometimes overwhelming however, it’s been rewarding. I have learnt to self-manage rather swiftly whilst maintaining a balance between family commitments and maintaining a work relationship between the two passions in my life. Family and Trigeminal Neuralgia with a lot of self-care along the way. 

I’m also excited to say that I undertook a rather documented role with my Droctor.   I am receiving a treatment called Low level Light Therapy, which hasn’t been documented for Trigeminal Neuralgia and so I became the specimen in my Dr’s. journey, and mine I might add. 

 I can say that after two treatments of LLLT I am pain free. Something I never thought was possible however, clinging tightly onto HOPE, I appear to be getting relief from my pain.

This is something that my Doctor and I embarked upon, each making documented journal entries along the way. 

This may be something that we’ve touched upon that others don’t know yet. This has been one of the most rewarding months. This illness has made me humble; it’s shown me what IS important in life. My family deserves a medal for being by my side every step of the way. 

“If we have hope, we have everything.” 

I look forward to working with and providing help and Hope to so many more. 

Watch this space. 


further information on low light therapy can be found here

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President’s Monthly Musings – Mar 2023 The Importance of Making Plans

Make a plan

This month has flown by in a blink of an eye.  We had a carefully laid plan for the month to take our grandchildren on individual camping trips at a local campsite at Hastings Point in Northern NSW.  We had gifted each child a week away individually with us as their Christmas present.  Previous we have taken the weeks spread throughout the year and at different campsites.

This year I had the brainwave that we would set up for the full period at the local site and then just swop children.

Everything went well on the first week, although I was doubting the sanity of our decision to have no break and ploughed on.  By the end of the first week, we were a tad tired, Patricks TN pain was ramping up and we started to worry we would not give the best of ourselves to the second grandchild.

All of those cares were put to one side when we received news that my mother, who resides in an aged care facility near our home, had a stroke on her 87th birthday.  We then juggled her needs with visits up and down the motorway with Patrick taking care of child and holiday management.

It seems to me that although we plan to create quality of life moments, none of us know what is just around the corner.  When things don’t quite go our way, it is very tempting to withdraw, become a bit isolated and have a reluctance to create a plan for the future.  It is easy to justify inaction and no plans by a “what’s the point attitude”.

However, it is so important to have things to look forward to when you are living with chronic pain.  You may worry that an event planned may be too much, that you will not cope, or that you will let your loved ones down by not participating on the date.  I am guilty too often of not evaluating the impact of an event on Patrick’s trigeminal neuralgia pain, but as long as I give him plenty of warning and he can get mentally prepared, he participates and invariably enjoys the activity.  I am getting better at working in his rest periods into the planned timetable too.

During our camping trip we also had a friend who joined us for one of the weekends, she is a huge surfing fan, and she and Patrick spent hours evaluating boards and trying out her current models.   The collaboration not only raised Patricks spirits, but he ultimately bought himself a new board.  Totally not in the plan, but the smile on his face and the enjoyment he derived from surfing the board for the remainder of the holiday was truly wonderful.

Research suggests that support, community engagement and social connection leads to positive wellbeing; heightened self-esteem and self-confidence; improved sense of control and self-efficacy; greater resilience and determination; improved mental and emotional health, including decreased levels of depression and anxiety; greater coping abilities; and may also improve the effectiveness of pain-related treatments.

The 12 Pillars of Wellbeing for Managing Chronic Pain

I am grateful to report that Mum has recovered well with wonderful support from the staff at Gold Coast University Hospital and the Rehab ward at Robina Hospital.  She is due to return home tomorrow.

This is also the last week of my presidency, and I would like to thank everyone who has supported me throughout this year.  I hadn’t planned to become President, but I am hugely proud of the work we have achieved and look forward to supporting the next President in their journey.


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Medical Cannabis and Chronic Pain

The last few years has seen some movement in thinking and research on whether medical cannabis and chronic pain management can work together.   However the  Australian Federal governments last update on the subject was in 2017

Medical Cannabis has been widely accepted by the medical professions in America however the subject is highly politicised and permitted usage is State based – see an article from the Facial Pain Association below

Read article here

The FPA produced two extensive articles in their Fall/Winter 2018 and Spring/Summer 2019 which contain a huge amount of information, although based around American laws, the content and issues are very relevant.

FPA Medical Cannabis Part 1

FPA Medical Cannabis Part 2


The Australian Government advise was issued in 2017  – see below for a portion of the advise.  The full article can be downloaded below

Medical Cannabis: Patient Information

Medicinal cannabis: patient information

Over the past few years, a number of Australians have expressed interest in the use of cannabis for medicinal purposes. The Commonwealth and State and Territory governments have either used their current laws or passed specific laws to allow the prescribing and dispensing of medicinal cannabis products. The Commonwealth, and in some cases, State and Territory governments, have also passed laws allowing cannabis cultivation and manufacture for medicinal purposes.

Currently there is limited evidence about the effectiveness of medicinal cannabis for use in different medical conditions. There is also little known about the most suitable doses of individual cannabis products.

For a particular product to be registered on the ARTG, a sponsor (usually a company) would need to submit a dossier of evidence on the clinical efficacy, safety and manufacturing quality of a particular medicinal cannabis product to the Therapeutic Goods Administration. At this time, the Australian Government does not subsidise the cost of medicinal cannabis products through the Pharmaceutical Benefits Scheme (PBS).

The Australian Government Department of Health and the NSW, Victorian and Queensland state governments commissioned a team from the Universities of New South Wales, Sydney and Queensland under the co-ordination of the National Drug and Alcohol Research Centre (NDARC) to review the available clinical evidence for using medicinal cannabis. The team focused on the five areas for which the largest numbers of studies have been carried out – palliative care, chemotherapy-induced nausea and vomiting, chronic pain, multiple sclerosis and epilepsy in paediatric and adult patients.

The researchers conducted a review of previously published reviews from multiple databases such as Medline, Embase, PsychINFO and EBM Reviews. Searches were guided by a specialist Librarian using specific search terms and were limited to studies published between 1980 and early 2017. Two reviewers independently examined titles and abstracts for relevance and the GRADE (grading of recommendations, assessment, development and evaluation) approach to evaluating the quality of evidence was also applied. The GRADE[1] method is the international standard that applies to weighting of evidence in scientific and medical literature and gives weight to certain evidence based on the level of evidence and strength of recommendation. For example, evidence as a result of randomised control trials (RCTs) are given priority because this study method typically yields more reliable results. RCTs are at the top of the hierarchy of evidence.

This brochure provides a broad overview of the current evidence to support using medicinal cannabis for the above conditions. It also highlights the cautions surrounding treatment, how medicinal cannabis can be prescribed and future research.

The Department of Health will update this brochure as new evidence emerges.


There are companies who have invested in the business of providing Medical Cannabis in Australia.  These companies work within the guidelines of the laws governing the product.

An example is

Our mission is simple. We want to help people feel better.

We believe everyone should have the option to access natural alternatives over conventional medicines, and yet only 5% of Australian doctors are currently prescribing cannabis. We are here to help you get the right care so you can manage pain, anxiety, insomnia, mental health and other conditions, and live a better life. We are setting new standards in cannabis care by connecting thousands of Australians to qualified doctors and support you through our dedicated patient care team.

It is important to educate yourself on the subject and evaluate if Medical Cannabis could be of benefit to you, and always discuss your options with your primary medical practitioners.