Page last updated at 00:39 GMT, Saturday, 18 March 2006

'My ulcers left me in constant pain'

By Jane Elliott
BBC News health reporter

Leg ulcer
Leg and foot ulcers are common in diabetics

When Stephen Riches developed leg ulcers on both ankles he assumed they would soon heal.

He was unprepared for the constant pain that dogged him for five years and left him unable to sleep properly.

He said: "It was like someone throwing acid on your leg.

"I tried all the painkillers you could think of and nothing touched it at all.


"Essentially pain is either in the background or right up front. At worst, it was right up front, on a scale of six or seven out of ten and affecting my sleep.

"So I found it was easier to sit up in a chair all night than be in bed. That started an insomnia habit that was difficult to break."

I found the pain got me down. I can quite see how it could tip someone over the edge
Stephen Riches

The problems started for Stephen, a 62-year-old sales director and diabetic, from East Sussex, when he took up in-line skating.

His boots were slightly too small and started to rub, gouging a small hole in each ankle.

"I don't think people realise how much pain is involved with ulcers.

"I am a positive person by nature, but I found the pain got me down. I can quite see how it could tip someone over the edge.

"If you are not feeling well and things are not generally good for you, this sort of pain and lack of healing is extremely difficult to handle."


More than 300,000 people in the UK, like Stephen, have chronic wound pain caused by leg ulcers.

Hundreds of thousands more have them from pressure sores and diabetic foot ulcers.

A chronic wound is classed as a wound which does not heal within three months, but some wounds never heal.

This can be for multiple reasons such as ischaemic disease, infection, oedema - in addition to a range of underlying diseases such as diabetes and rheumatoid arthritis which make healing more difficult.

Patients can suffer intense pain which can lead to insomnia, inactivity, isolation, depression and in some cases even suicide.

Stephen, like many others, feels the condition is often neglected with health professionals unable to help.


Now patients groups such as Pain Concern are joining medical experts to raise awareness of what many believe is a 'forgotten condition'.

Heather Wallace, of Pain Concern, said the problem needs to be tackled now.

"We do regularly get phone calls from people with chronic wound pain. It's a neglected issue that causes real suffering.

"It's surprisingly common, and more needs to be done to alleviate the pain.

"We definitely need better recognition of this condition and better management."

I feel that I, in my research, into the field of pain treatment for chronic wound patients have been very much a lone voice trying to make other people aware of this problem
Dr Michelle Briggs

Dr Michelle Briggs, senior research fellow at Leeds University agreed, adding that she often felt herself a 'lone voice' calling for action.

"People with chronic wounds have severe problems with pain - because they have to live with chronic pain which is there persistently.

"But they often do not get access to chronic pain specialists and adequate pain treatment in the same way that other groups of patients do.

"I feel that I, in my research into the field of pain treatment for chronic wound patients have been very much a lone voice trying to make other people aware of this problem."

Dr Briggs said that doctors tend to focus on healing the wounds, but sometimes do not consider that some might take years to heal, or might never heal and that they should be considering this more closely when treating their patient and dealing with their recovery expectations.

"The focus is on healing. And while we are doing this, dealing with the pain tends to take a back seat.

"I think one of the things that would help in dealing with people with chronic wounds is to treat them as people with a chronic illness such as arthritis or back problems.

"If it is treated like something that can perhaps not be cured then you can look at managing the symptoms and getting the best quality of life."


Professor Patricia Price, director of the wound healing research unit, at Cardiff University, said medics needed better education about handling people with chronic wounds.

"Most nurses and some clinicians recognise that there is a big problem.

"But many people are taught that these wounds aren't painful and it takes quite a lot of new information for them to change their minds. So many do not recognise the extent of the problem."

In fact, Professor Price said research showed that chronic wounds, and the associated pain had a huge impact on quality of life.

Not only was their mobility often compromised, they often to endure unpleasant odours, and were too regularly dependent on others.

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