Physiotherapy Pain Specialist

What is Physiotherapy and how might Diarmuid help me with my pain?

Physiotherapy is the name for a profession that specialises in helping people to reduce the impact of pain, illness, injury, and disability. Physiotherapy aims to help people to remain independent, to return to function, and to live the best quality of life possible. 

Physiotherapy is a protected title and physiotherapists have to complete degree level training and supervised practise before being able to qualify. Physiotherapists who pass this training are eligible to be registered with the Health and Care Professions Council (HCPC) and I am registered with the HCPC. The HCPC ensures that those registered are trained properly and maintain their fitness to practise. 

There are titles that are sometimes used in the UK and Ireland, that sound similar to physiotherapy such as physical therapist, sports therapist, and PT, but these are not subject to the same high standards of training. 

Physiotherapists can specialise in a number of different areas (just like doctors can). I am a specialist in pain management and also in musculoskeletal care (sometimes called MSK). This means I have undertaken additional training and experience such as my masters in neuro-musculoskeletal physiotherapy (including eligibility to be a member of the MACP). I am trained in mindfulness, and have extensive experience working with other pain specialists including anaesthetists and psychologists. 

Pain Specialist Physiotherapists work with people to help them to reduce the impact pain has on their life, and especially their ability to function, using a number of different approaches. The approaches and treatments that pain specialist physiotherapists use are often different to what people expect and often include:

• Making sense of the pain and how it affects their lives by exploring current evidence and thinking on pain in a way that helps to make sense of what is going on 

• Identifying areas to work on usually in the form of goals that are meaningful to you and are related to your life and your core values

• Working out your current level of ability or function, or your "starting point", and setting out a plan to build upon this in a way that is workable, safe, and related to your goal(s)

• Learning strategies and tips to help you with this work including things like pacing activity and new ways to approach movement and function

• Thinking about how these approaches can help you to be as independent as you want to be and to do the things that are important to you (like household chores and self care, activities with your family and friends, leisure activities and hobbies and anything that you enjoy or would like to be able to do)

• Helping you to develop strategies to manage setbacks and flare ups when they occur

In general the best available evidence suggests that treatments like massage, electrical therapy, and manual therapy do not offer long term relief for persisting pain and because of this I do not offer these types of treatments when working with you to manage your pain. 

Understanding Pain & Getting Started

To help you understand my approach you can watch these two short videos I made when I worked in the NHS. They will give you a sense of how I understand pain and where we might start if you choose to work with me:

Diarmuid's Physiotherapy training and experience

I trained as a physiotherapist in Trinity College Dublin, Ireland, and graduated in 1995. Since that time I have had varied and interesting clinical experience in Ireland, Australia, and (for most of my career) London. I am a specialist in complex and persistent (also known as chronic) pain. I have expertise in musculoskeletal care (being eligible for MACP), outcomes, digital delivery and tech applications in pain care.

Clinical: I am currently a consultant physio for Leva pain management clinic. I was lead physio at the Pain Management Centre, University College London Hospitals for over 16 years (a large multi professional specialised pain clinic). This is where I honed my pain management skills working with a diverse range of people attending the centre for help with their pain conditions as well as working with a range of other health care professionals. 

I have a wealth of experience working with people who live with chronic pain both as their physiotherapist, and also as colleagues in the various advocacy and co-production roles I do. I have significant experience with complex pain conditions including working with people who have Chronic Primary Pain (CPP), Fibromyalgia, Widespread pain conditions, CRPS, hEDS and hyper-mobility spectrum disorder (HSD), Facial Pain, Pelvic pain, and Functional Neurological conditions. I am an advanced clinical practitioner physiotherapist and independent prescriber (this means I undertook additional training for 6 months in university to qualify in prescribing medication for pain; more information an be found on prescribing physiotherapists here).

Research:  I have published in peer reviewed journals in topics related to chronic pain and  including psychologically informed practice  (which basically means drawing upon skills related to communication and awareness of thoughts and emotions and how they are relevant with all physical health conditions including pain), systematic reviews of several types, and book chapters. 

I am currently doing a PhD (part time) at Brunel University (Economic and Social Research Council Fellowship awardee). My research topic is persisting pain and it explores the space/place between receiving healthcare (treatment) and living with pain using liminality as a lens. I am doing this research with people living with pain using participatory action research methods. I previously completed NIHR pre-doctoral fellowship. I am interested in clinical-academic roles for physiotherapists, and in psychologically informed practice.

Education: I have considerable experience in education including teaching multi-professional groups. I have experience teaching in degree and masters programmes at Brighton, University College London, and Brunel universities. I developed and ran a module for the UCL MSc in pain for two years called Strategies for the Self-Management of Pain. I have been invited to speak at both national and international conferences in topics related to pain management.

I was previously a lecturer-practitioner at London South Bank University. I currently co-teaches the Live Well with Pain 10 footsteps programme to multi-professional groups. I facilitate peer reflecting sessions on behalf of the Physiotherapy Pain Association (PPA) supporting clinicians to develop their communication skills. I am also trained in Narrative medicine/Conversations Inviting Change. I led on development of a co-produced Psychologically informed collaborative conversations training programme (PIC-C) for health care professionals.

Leadership: I led a large physio team at a large multi-professional secondary/tertiary care service. I represented physiotherapy and pain in many committees. Until 2023 I was chair and then co-chair of the Physiotherapy Pain Association (PPA), an organisation for physiotherapists with a special interest in pain in the UK. I was a committee member for the NICE chronic pain guidelines (NG193), and committee member of CRPS UK. I also led on development of accreditation credentialing and advanced practice roles for physios in MSK and pain settings in secondary/tertiary care.  

I am passionate about advocacy and involvement and I am a committee member of the Footsteps Festival, a co-produced collective of people who live with and/or work with people who live with pain, providing free online events and support for those with pain. I am also a member of Livewell pain, supporting clinicians and people living with pain, and the Global Alliance of Partners for Pain Advocacy (GAPPA) which is creating partnerships between people with lived experience of pain, patient advocates, researchers, and clinicians around the world, to advance the study, understanding, and treatment of pain.