Occupational Therapy in the Treatment of the Patient with Chronic Pain

Abstract

This paper discusses the role of the occupational therapist in the treatment of chronic pain. It begins with a critical evaluation of our current theoretical understanding of pain, concentrating on the link between physical and psychological factors. A unit for the treatment of patients with chronic pain is described and assessment and practical treatment approaches are outlined. Emphasis is placed on a functional approach which maximizes the individual's control over his own pain.

Occupational therapists' assessments of adults with long‐term pain: the Swedish experience

“…Therapists also noted the goal(s) and area(s) for the intervention(s) based on their assessment of the patient. The lists of areas and interventions were constructed on the basis of the contents of Tables 1 and 3 Giles and Allen, 1986;Carruthers, 1997 Increase independence Fishman Borelli andWarfield, 1986;Strong, 1989;Strong et al, 1994;Ventura and Flinn-Wagner, 1997 Increase own responsibility Strong, 1989 Increase pain control Strong, 1989 Increase pain tolerance Heck, 1988 Increase self-esteem Fishman Borelli andWarfield, 1986;Strong, 1989;Klayman-Callahan, 1993;Scudds andSolomon, 1995 Maintain /re-establish Johnson, 1984;Fishman Borelli and Warfield, 1986;competence Strong, 1989;Strong et al, 1994 Maintain / re-establish roles Johnson, 1984;Strong, 1989;Klayman-Callahan, 1993;Strong et al, 1994;Scudds and Solomon, 1995;Ventura and Flinn-Wagner, 1997;Maximize function Johnson, 1984Strong, 1989;Strong et al, 1994;Fast, 1995;Scudds and Solomon, 1995 Regain balance in daily activities Blakeney, 1984;Johnson, 1984 Regain control Johnson, 1984;Strong, 1989;Strong et al, 1994;Carruthers, 1997 Restore self-efficacy Scudds and Solomon, 1995 Activity tolerance/endurance Flower et al, 1981;…”

Adaptive Equipment: Its Effectiveness for People with Chronic Lower Back Pain

“…Such tasks often aggravate pain to the extent that the individual is unable to perform them (Bettencourt, Carlstrom, Brown, Lindau, & Long, 1986;Flower et al, 1981;Strong, 1987). The occupational therapist takes preventive measures to reduce pain and increase independent functioning (Giles & Allen, 1986). Assistive devices and adaptive equipment are provided, life tasks are adapted, and the work simplification techniques are applied to improve the ability to independently perform daily life tasks (Bettencourt et al, 1986;Flower et al, 1981;Giles & Allen, 1986).…”

“…Correct seating, therefore, is essential as a preventive measure to reduce lower back pain that is aggravated and perpetuated by poor lumbar support and incorrect posture (Mangiamele, 1984;Majeske & Buchanan, 1984). The prescription of adaptive seating and back support cushions is one major element of the occupational therapy process for this group of chronic pain patients (Bettencourt et al, 1986;Giles & Allen, 1986). One objective of this study was to evaluate the perceived benefit and use of chairs and back support cushions prescribed for the sample group.…”

Students' knowledge of pain: a survey of four schools

“…Sakamoto and Warner (1975) discussed the concepts of life space, mastery, responsibility and life tasks in the treatment of chronic pain patients. Giles and Allen (1986) used the gate control theory of pain (Melzack and Wall, 1988) as an explanation for the possible mechanisms for reduced pain perception when engaged in prescribed activities within occupational therapy. The gate control theory proposes that pain perception may be modified by a number of different physiological (for example, muscle tension, fatigue, medication, activity level) and psychological factors (for example, meaning of the pain, mood state, beliefs).…”