Health & wellbeing

Managing chronic pain: Understanding its impact on mental health and taking steps forward

05 Dec 2023 | Written by Nurul Ahad

This article was authored by Mr. Nurul Ahad, Clinical Director of Orthopaedic Surgery for Practice Plus Group. With over 15 years of experience in orthopaedic surgery, he is a meticulous, patient-focused surgeon with a proven track record for delivering an excellent quality of service.

Studies have shown that, if not managed correctly, the stress of chronic and persistent pain over a long period of time can lead to feelings of depression, loneliness and anxiety. If your chronic pain is negatively impacting your concentration, ability to work, relationships with loved ones or your sleep, it’s time to take steps to protect your mental wellbeing.


When experiencing chronic pain, sleep can be significantly interrupted. A reduction in sleeping hours and a lack of good quality sleep can have a detrimental effect on mood, so having a plan to manage this can make a significant change to mental health.

There are sleeping positions you can adopt that may help if you are struggling to get a full night’s sleep because of hip or knee pain:

  • Hips: Side sleepers should lie on the hip that isn’t painful, and place one or more pillows between the legs. When lying on your back, place a pillow or rolled-up blanket beneath your knees and possibly another under the small of your back, but make sure your back isn’t too arched as this can cause back discomfort.
  • Knees: When sleeping on your back, place pillows beneath your knees. When sleeping on your side, place one or more pillows between your knees.

Note: A pillow placed under the knee for prolonged periods of time may make it more difficult to straighten the knee later, as the posterior (rear) knee structures adapt to being shorter and less flexible.

  • If possible, take a short walk or take a bath before going to bed, as this can help relax your muscles.
  • Read a book or listen to music before going to bed and minimise screen time for at least an hour before you sleep.


Exercise is a great way to improve mental health, but chronic joint pain can limit your mobility. You may lose confidence with knowing what you can and can’t do when it comes to fitness, leading to feelings of anxiety around making the pain worse. Osteoarthritis is one such condition that can take both a mental and physical toll on us, leading to a lack of confidence when it comes to exercise. Here are some strategies we can employ to exercise safely:

  • Speak to your class instructor – many personal trainers or class instructors have knowledge and understanding of osteoarthritis.
  • Use a static bike, with a high seat and low resistance, can provide a fitness option for osteoarthritis.
  • Try a cross trainer – using the principles of pacing, this low-impact exercise tool can be a useful option at the gym.
  • Use strengthening apparatus under supervision to improve quadriceps, hamstring and gluteal strength.
  • Try hydrotherapy and aqua-fit – these are great ways to reduce joint loading during exercise and there are usually sessions available at a local swimming pool.
  • Explore Pilates or other low-impact workouts that utilise elastic bands or free weights – these can be the answer for chronic pain, too.
  • Speak to your GP. They may refer you to a Physiotherapist, who will be trained to help you find ways to exercise with any chronic pain.

When to see a doctor 

Looking out for the early signs that you may need a knee or hip replacement can help you on the route to a faster recovery and enable you to get back to your active everyday activities.

With this in mind, here are some symptoms to look out for that may indicate that you need to speak to a medical professional:

  • Consistent pain: 24-hour severe pain in the knee and the surrounding area, or elsewhere such as the hip or ankle, which impacts your daily activities even when you are resting.
  • Noticeable changes: Swelling and inflammation of the knee, which no longer responds to medication.
  • Limited movement: You’re experiencing stiffness or immobility in the knee or hip.
  • Difficulty or discomfort when exercising.
  • Your medication is no longer working: Non-steroidal anti-inflammatory drugs (such as Ibuprofen) no longer provide relief from pain.

Regardless of the reason, if you feel like you’re struggling with your mental health, always seek support. Your GP is there to help you to manage your pain and to support you in managing the impact of that pain on your mental health. 

If you are joining exercise classes with The Joy Club and you’re managing chronic pain of any kind, do let the instructors know at the beginning of the session and they will be able to offer adaptations to help you.

A note from The Joy Club: This article was provided by Mr. Nurul Ahad and the Practice Plus Group. We know that health and wellbeing is extremely important to our members and that you would like to see more health-focused content within The Joy Club community. That’s why we are very excited to partner with Practice Plus Group – an outstanding healthcare provider – to bring you high-quality, expert-led health content.

What’s more, Practice Plus Group is offering members of The Joy Club a specially discounted consultation, giving you the opportunity to explore a health condition with one of Practice Plus Group’s experienced consultants, should you so wish.

An initial appointment with Practice Plus Group normally costs £95, but members of The Joy Club can benefit from a first-class consultation – including blood tests, swabs and x-rays (as required) – for a flat fee of just £50, saving £45.

Read on to find out more about how the consultation works, what conditions Practice Plus Group can help you with, how to make your booking and more.

What does the consultation involve?

The Practice Plus Group consultation includes your initial consultation with a surgeon, a pre-operative nurse assessment (if needed) and any required blood tests, swabs and x-rays.

How much does the consultation cost?

A consultation with Practice Plus Group normally costs £95, but thanks to our special discount, members of The Joy Club pay just £50, saving £45. There is no additional cost for any blood tests, swabs or x-rays conducted as part of the consultation. The only additional costs you may incur are those for diagnostic imaging (other than x-ray), if required. Otherwise, everything is included in the flat fee of £50.

Are consultations held online or in person?

All consultations take place face-to-face.

How much time should I allow for the consultation?

The initial consultation with the surgeon should take between 20-30 minutes. Should you require any blood tests, x-rays or a pre-operative nurse assessment, you should allow up to 3-hours to cover everything in one visit.

Would there be any follow-up consultations and, if so, how many would there be and how much would they cost?

Should you wish to proceed with a surgical treatment with Practice Plus Group, follow-up consultations may be required. At this point, you will be given a quote for the full price of your treatment. Practice Plus Group’s treatment price includes any follow-up consultation costs, the surgery itself, anaesthetic, any overnight stays (if clinically appropriate), suitable follow ups, medication, equipment and physiotherapy, as required. There are no hidden extras – the price you are quoted for your treatment is the price you pay.

What health conditions can I explore with a Practice Plus Group consultant?

Practice Plus Group specialises in treatment of hip, knee and eye conditions, but offers a comprehensive range of affordable private medical treatments covering a wide variety of conditions. You can explore the full range of treatments that they offer here.

Can I request an expert in a particular field?

If you have a particular consultant you would like to see, please let Practice Plus Group know when making your enquiry and they will try their best to accommodate.

How do I book my specially discounted consultation?

To book your consultation, simply call Practice Plus Group on 03301 620 730, email them on PrivatePatient@practiceplusgroup.com or submit an enquiry via the online form on the Practice Plus Group website to receive a call back. Make sure to quote code JOY45, when prompted, in order to redeem your special discount.

Practice Plus Group is one of England’s largest independent providers of private, insured and NHS healthcare. They are passionate about what they do and believe that anyone should be able to access excellent care.

Practice Plus Group is committed to providing positive experiences and excellent clinical outcomes. The Care Quality Commission, an independent regulator of health and social care in England, rated all of Practice Plus Group’s hospitals as ‘Outstanding’ or ‘Good’, meaning you can feel assured that their services are safe, reliable and personalised.