How Occupational Therapy Can Help with Chronic Pain

If your chronically painful condition has made it hard for you to perform important, meaningful activities in your daily life, you are not alone. An estimated 19.6 million adults in the United States have high-impact pain, which is pain that interferes with daily life or work activities.

There is an entire profession devoted to helping people with challenges like chronic pain successfully engage in everyday life activities— it’s called Occupational Therapy. Occupational Therapy Practitioners (OTs) can help you perform all the “jobs” of your daily existence, from getting dressed and taking care of pets to engaging in meaningful activities like gardening.

According to the American Occupational Therapy Association, “occupational therapy practitioners work to increase clients’ engagement in meaningful and enjoyable occupations, which has been shown to result in reported reductions in pain."

Occupational therapists are experts in utilizing the biopsychosocial model of pain. This model “evaluates the integrated ‘whole person,’ with both the mind and the body together as interconnected entities, recognizing biological, psychological, and social components of pain and illness."

So, how can an occupational therapist help someone with chronic pain caused by a rheumatic disease?

Evaluation

Occupational therapy services start with an evaluation and the creation of an “occupational profile.” This profile includes a description of your daily routines, interests, values, needs, and the results of a physical examination. The evaluation includes both quantitative data (like strength and range of motion assessments) and qualitative data derived from an interview where you can share what’s important to you.

The occupational therapist might ask you to walk them through a day in your life and have you show which daily activities are difficult for you, from brushing your hair to preparing meals to engaging in spiritual or religious activities.

Occupational Therapy Treatment & Goals

Occupational therapists combine an understanding of the biological, psychological, and social factors that might be contributing to your pain to develop a treatment plan to reach your pain management goals.

Treatment is always individualized to your specific life context, goals, and barriers. For example, someone with three small children living in a three-generational home might have very different needs and support available than someone who works as a computer programmer and lives alone.

Self-Management

Occupational therapy treatment for chronic pain often focuses on building your self-management skills. The American Family Physician defines self-management as: “The ability of the patient to deal with all that a chronic illness entails, including symptoms, treatment, physical and social consequences, and lifestyle changes (2005).”

You are expected to be an active participant in therapy. Since you are the one that must live with your condition every day, an occupational therapist will typically use a patient-partner approach, rather than the outdated model of rehabilitation where therapy is something that is “done to” the patient.

Here are examples of how occupational therapy activities and techniques can help you manage living with chronic pain:

• Adaptive Equipment & Environmental Modification: If your goal is to cook independently without pain interference, the occupational therapist may train you in how to use adaptive equipment in the kitchen or help you modify your kitchen set-up to reduce the frequency and duration of pain. They may also instruct you in “joint protection” techniques so that you are not causing additional pain and strain due to how you interact with objects in the kitchen.

• Energy Conservation & Daily Routines: If your goal is to resume your valued hobby of bicycling around your neighborhood, the occupational therapist may instruct you in energy conservation techniques (including activity pacing and therapeutic exercise) that will help you maintain adequate energy, and address any postural concerns that may contribute to pain

• Coping & Self-Regulation: If your goal is to improve your sense of emotional wellbeing while engaging in social interactions with friends or family, an occupational therapist may utilize cognitive–behavioral therapy and acceptance and commitment therapy, which can help reframe your beliefs about pain. These techniques can help reduce how much your thoughts about pain create a barrier to your enjoyment and participation in daily activities.

• Medication Management: If you’re having difficulty remembering to take medications or with performing the physical act of storing medications, occupational therapists can provide training in strategies, such as using a medication organizer, setting up phone alarms, or other tools.

• Adoption of health-promoting routines: If you are struggling to integrate exercise into your daily routine, an occupational therapist can help instruct you on how to build and execute a plan, including tracking your symptoms.

There’s no question that performing daily activities can be difficult for people with rheumatic diseases. Occupational therapists are an important part of the multidisciplinary care team that supports people living with rheumatic diseases and chronic pain.

Sources:

(Dahlhamer et al, 2018)

(Fisher et al., 2007)

(Bevers et al., 2016)