Managing chronic pain with occupational therapy was the subject of a recent article on the AOTA home page:
Persons with chronic pain face more than their fair share of obstacles. Within the context of chronic pain, occupational therapists evaluate the pain’s impact on a client’s desired activities and quality of life, and equip him or her with the skills and strategies to manage the pain. Read the full text here.
Do you work with client's with chronic pain? What are your thoughts and comments on this article?
I agree with the content of this article. The sooner clients are equiped with ways to manage their thinking about pain and its control, or resolution, and helping to establish that they are in the "drivers seat" (so to speak) by giving them education on pain management techniques. Since pain and its intensity are subjective, we can provide the client with the support and compassion they deserve.
I found the article right on target with my experience with home health patients. Many are totally pain focused and their lives seem to revolve around it. We have worked with quite a few patients with chronic shoulder pain and decreased their pain levels with various treatments including modalities. They really haven't responded that well to trying relaxation techniques.
I have actually experienced managing some pain with changing my thinking so I know it is possible. However, I find it hard to describe to someone else. I guess it is like disassociating the pain from my mind. Sort of like I know the pain is there, but I work at relaxing my body and thinking about other things. Does anyone else know what I mean. Maybe there is a term for this.
Chris Smith OTR/L
I am an OT student at Dominican College in Orangeburg NY working on my final year of a masters degree. I have an upcoming assignment that requires me to obtain multiple assessments that may be useful in obtaining further information from a gentleman with Chronic low back pain that I have recently interviewed. Judging from the information I have already gathered, the NIH Activity Record (ACTRE) which includes the record of pain, would be the ideal assessment. So far I have not been able to locate a copy of this assessment, If you have any ideas on how I may obtain a copy, or if you have an available copy you could provide, please contact me either through this post or by email at DaniBaltrusaitis@Yahoo.com Thank you for your time
I am an OT student at Dominican College in Orangeburg NY working on my final year of a masters degree. I have an upcoming assignment that requires me to obtain multiple assessments that may be useful in obtaining further information from a gentleman with Chronic low back pain that I have recently interviewed. Judging from the information I have already gathered, the NIH Activity Record (ACTRE) which includes the record of pain, would be the ideal assessment. So far I have not been able to locate a copy of this assessment, If you have any ideas on how I may obtain a copy, or if you have an available copy you could provide, please contact me either through this post or by email at DaniBaltrusaitis@Yahoo.com
Thank you for your time
That is why I decided to work in acute care. After starting my career in work rehab I became discouraged seeing patients dealing with chronic pain. Sometimes the smallest insult in an acute care environment would make them hold onto their pain like a badge.Once they started going down that road there was very little we could do to get them back into a productive life.
I vowed to be the person that would prevent that from happening to patients in the acute care setting by advocating for and creating change to support the healing process early on. To give the patient in internal vs external locus of control.
Here are some comments I heard
"the doctor would not give me more or different pain medications after my surgery because he said that it could not possibly hurt that badly"
(psychosocially they internalize that to an unconscious inner statement I'll prove to them my pain is real, by being disabled)"
"my employer said that if I didn't get back to work right away they would fire me even though my doctor told me I am not ready to return to work"
(and they internalize that to a subconsious, I'll show them, I'll sue them- or I will not go back to work until I am 100% pain free)
"the nurse laughed at me when I told her my pain was out of control"
(and they develop mis-trust of health care professionals)
"the nurse didn't give me pain meds for 8 hours and by that time it took a whole day to get the pain back in control" (and they develop anxiety over their pain med issues and possibly begin to take too many pain meds fearful of that one time the pain got out of control)
"the nurse laughed at me when I fell on the floor as I didn't realize my legs were numb after the surgery"
(and they develop anxiety, fear and depression over their condition)
"the PT told me "no pain - no gain""
there is a good site that will send you emails to review research on CAM's for chronic pain:
Pain PLUS c/o CRL 125 McMaster University 1280 Main Street West HAMILTON ON L8S 4K1 CANADA Tel: 905-525-9140 x22255 Fax: 905-546-0401
That is why I decided to work in acute care. After starting my career in work rehab I became discouraged seeing patients dealing with chronic pain. Sometimes the smallest insult in an acute care environment would make them hold onto their pain like a badge.Once they started going down that road there was very little we could do to get them back into a productive life.I vowed to be the person that would prevent that from happening to patients in the acute care setting by advocating for and creating change to support the healing process early on. To give the patient in internal vs external locus of control.Here are some comments I heard"the doctor would not give me more or different pain medications after my surgery because he said that it could not possibly hurt that badly" (psychosocially they internalize that to an unconscious inner statement I'll prove to them my pain is real, by being disabled)""my employer said that if I didn't get back to work right away they would fire me even though my doctor told me I am not ready to return to work" (and they internalize that to a subconsious, I'll show them, I'll sue them- or I will not go back to work until I am 100% pain free)"the nurse laughed at me when I told her my pain was out of control" (and they develop mis-trust of health care professionals)"the nurse didn't give me pain meds for 8 hours and by that time it took a whole day to get the pain back in control" (and they develop anxiety over their pain med issues and possibly begin to take too many pain meds fearful of that one time the pain got out of control)"the nurse laughed at me when I fell on the floor as I didn't realize my legs were numb after the surgery"(and they develop anxiety, fear and depression over their condition)"the PT told me "no pain - no gain""there is a good site that will send you emails to review research on CAM's for chronic pain: Pain PLUS c/o CRL 125 McMaster University 1280 Main Street West HAMILTON ON L8S 4K1 CANADA Tel: 905-525-9140 x22255 Fax: 905-546-0401 From: deb9367 <bounce-deb9367@aota.org>Sent: 11/26/2008 11:03:44 AMI agree with the content of this article. The sooner clients are equiped with ways to manage their thinking about pain and its control, or resolution, and helping to establish that they are in the "drivers seat" (so to speak) by giving them education on pain management techniques. Since pain and its intensity are subjective, we can provide the client with the support and compassion they deserve.>
From: deb9367 <bounce-deb9367@aota.org>Sent: 11/26/2008 11:03:44 AM
I received a response from Bonnie Hodsdon, very exciting, she sent many documents regarding instructions, scoring, and so forth, thank you for your help
Can these be shared on the listserv?
From: onlinearticles [mailto:onlinearticles@aota.org] On Behalf Of DaniB0731Sent: Wednesday, January 25, 2012 9:45 AMTo: Skinner, SarahSubject: Re: [onlinearticles] Managing Chronic Pain
From: DaniB0731 <bounce-DaniB0731@aota.org>Sent: 1/24/2012 4:25:24 PM
Thank you for the guidance, I will look into it right away!
On Jan 24, 2012, at 3:17 PM, meredith wrote:
That is why I decided to work in acute care. After starting my career in work rehab I became discouraged seeing patients dealing with chronic pain. Sometimes the smallest insult in an acute care environment would make them hold onto their pain like a badge.Once they started going down that road there was very little we could do to get them back into a productive life.I vowed to be the person that would prevent that from happening to patients in the acute care setting by advocating for and creating change to support the healing process early on. To give the patient in internal vs external locus of control.Here are some comments I heard"the doctor would not give me more or different pain medications after my surgery because he said that it could not possibly hurt that badly" (psychosocially they internalize that to an unconscious inner statement I'll prove to them my pain is real, by being disabled)""my employer said that if I didn't get back to work right away they would fire me even though my doctor told me I am not ready to return to work"(and they internalize that to a subconsious, I'll show them, I'll sue them- or I will not go back to work until I am 100% pain free)"the nurse laughed at me when I told her my pain was out of control" (and they develop mis-trust of health care professionals)"the nurse didn't give me pain meds for 8 hours and by that time it took a whole day to get the pain back in control" (and they develop anxiety over their pain med issues and possibly begin to take too many pain meds fearful of that one time the pain got out of control)"the nurse laughed at me when I fell on the floor as I didn't realize my legs were numb after the surgery"(and they develop anxiety, fear and depression over their condition)"the PT told me "no pain - no gain""there is a good site that will send you emails to review research on CAM's for chronic pain:Pain PLUS c/oCRL 125McMaster University1280 Main Street WestHAMILTON ON L8S 4K1CANADATel: 905-525-9140 x22255Fax: 905-546-0401 From: deb9367 <bounce-deb9367@aota.org>Sent: 11/26/2008 11:03:44 AMI agree with the content of this article. The sooner clients are equiped with ways to manage their thinking about pain and its control, or resolution, and helping to establish that they are in the "drivers seat" (so to speak) by giving them education on pain management techniques. Since pain and its intensity are subjective, we can provide the client with the support and compassion they deserve.>
Pain PLUS c/oCRL 125McMaster University1280 Main Street WestHAMILTON ON L8S 4K1CANADATel: 905-525-9140 x22255Fax: 905-546-0401
>