Experts Forum: Chronic Pain – An examination of current issues

Date: Thu June 15, 2017 at 18:00 | CPD Hours: 1.5
Location: London Transport Museum, London, United Kingdom

Part two: Chronic Pain – An examination of current issues

This seminar is the second in a series of seminars which explore the expert’s perspective on a range of topics. Part two will look at chronic pain and the current issues surrounding it.


Topics to be discussed will include:


  • What are the main recognised pain diagnoses what will be the impact of ICD 11?
  • What needs to be proved to establish a diagnosis?
  • Are there any investigations which can prove that a Claimant is genuinely suffering from pain?
  • Is a diagnosis in pain medicine helpful in understanding subsequent disability?

Organic vs. Psychological:

  • Does pain result from an underlying organic problem or psychological overlay, or is it always a combination of the two?
  • Is it helpful to attempt to make the distinction between organic and psychological problems in an individual patient?
  • Does the distinction affect treatment and prognosis?

Epidemiology of pain

  • What are the implications of a history of pain on future?


  • Claimants with pain problems often have a history of presenting with unexplained physical problems. Is it possible to determine with any confidence what level of disability such Claimants would have developed in the absence of the accident? e.g. can one say that a claimant with a history of somatisation was going to develop a condition such as fibromyalgia or chronic pain syndrome in any event?

Disability: To what extent does/should pain impact upon someone’s ability to function:

  • Should someone with chronic pain be expected to return to work in circumstances where doing so cannot be demonstrated to cause any damage and may be of psychological benefit?
  • Does the provision of care helps or hinders functional independence?


  • What treatments are available?
  • What works and what doesn’t?
  • Is continuing litigation a bar to effective treatment?


  • What are potential red flags?
  • Does surveillance help?


Dr Rajesh Munglani qualified from St George’s Hospital, University of London, in 1985. Subsequently gaining experience in A&E, paediatric medicine and eventually gaining the Fellowship of the Royal College of Anaesthetists. He developed a strong research interest in the neurobiology of chronic pain states and chronic spinal regional pain syndromes including reflex sympathetic dystrophies. He is an officer for the Interventional Pain Medicine Group of the British Pain Society and is a founding member and of the medicolegal special interest group of the British Pain Society. He also founded the annual Cambridge Medicolegal Conference and co-founded the Cambridge Medicolegal Forum. He is Editor in Chief of the Journal of Observational Pain and is also on the council of the London Pain Forum. He holds clinics in Cambridge and London.

Dr Dinshaw Master trained in psychiatry at The Bethlem Royal and Maudsley Hospitals and Institute of Psychiatry. He was Consultant Liaison Psychiatrist at Guy’s Hospital and Senior Lecturer in Psychiatry at Guy’s, King’s College and St Thomas’ Hospitals Medical and Dental School. He was Medical Director of the Lewisham and Guy’s Mental Health NHS Trust for 5 years and Joint Medical Director of the South London and Maudsley NHS Trust for 3 years. He has a Master of Laws degree from the University of Wales. His specialist clinical expertise is in somatoform disorders (medically unexplained symptoms), chronic pain disorders and chronic fatigue syndrome/myalgic encephalopathy.

Chair: Nigel Spencer Ley is a Barrister at Farrar’s Building, he undertakes clinical negligence, personal injury, and related professional negligence work. Nigel is a regular contributor to a wide variety of legal journals. He has been the co-editor of the Farrar’s Building Personal Injury Newsletter since 2007. He has lectured on personal injury law for the Judicial Studies Board, Cambridge University Board of Continuing Education, for numerous solicitors’ firms and at the annual Farrar’s Building Personal Injury Seminar. He is listed in the Legal 500 as a leading junior.

To download a copy of the full presentation please click here.