Neuropathic pain is like a silent scream, says BBC presenter

Neuropathic pain is like the “loudest scream that no-one hears”, BBC broadcaster and radio presenter Fiona Talkington told an audience at a key Royal Society of Medicine event this week.

The Radio 3 host gave a vivid and visceral account of her experience of living with painful neuropathies since undergoing chemotherapy to treat breast cancer in 2008.

She was speaking at the RSM’s free clinical masterclass on painful neuropathies on 23 May 2022, which was generously supported by the Alan and Sheila Diamond Charitable Trust.

She described the sensation of “burning coal fires” in her feet and “steel grips” around her legs, likening her limbs to heavy blocks of ice containing a “six-lane motorway”.

She recounted her decade-long search for answers, which has spurred her advocacy and campaigning work. She said: “I would rather go through chemo again than endure the pain of not being understood.”

Neuropathic pain is a complex type of pain caused by a lesion or disease, affecting the central nervous system. It is estimated to affect around one in 20 people in the Western world. There are many causes of neuropathic pain, including viral infection, HIV, chemotherapy, trauma and genetic disorders, but diabetes is the most common, and it is expected that over half of all adults with diabetes will be affected by neuropathy in their lifetime.

Joining Fiona Talkington on the panel were three leading experts in the field:

• Professor David Bennett, Professor of Neurology and Neurobiology and Head of the Division of Neurology at the University of Oxford, who chaired the session;
• Professor Andrew Rice, Professor of Pain Research at Imperial College London and Honorary Consultant in Pain Medicine at Chelsea and Westminster Hospital; 
• And Professor Solomon Tesfaye, Consultant Physician and Honorary Professor of Diabetic Medicine at Sheffield Teaching Hospitals NHS Foundation Trust.

The wide-ranging discussion covered the latest research into painful neuropathies, pain-management approaches, the challenges in diagnosis, and developing a patient-centred approach, focused on understanding how the burden of disease affects individuals.

Professor Tesfaye detailed an innovative model of testing being trialled at four GP hubs in Sheffield, which aims to identify neuropathies in diabetic people much earlier than usual.

The panellists agreed that primary care has a key role to play in diagnosing neuropathy and advised healthcare professionals on the techniques and challenges in identifying and understanding pain. All agreed that listening carefully to patients is key.

The masterclass ended with an audience question-and-answer session, which stimulated discussions on a range of topics, including: the impact of environment on pain, emergent treatments, the role of opioids and cannabinoids, digital technologies and social prescribing.