What does an occupational therapist do for someone living with chronic pain?

Lisa Klinger and Bonnie Klassen

e were invited by the Canadian Pain Coalition (CPC) do, or are expected to do in the course of a day. So if you have a (http://www.canadianpaincoalition.ca/) to write a regular question about how to do those things, an occupational therapist column in their newsletter to explain what occupational therapy might be the best person to talk to. is and how it can help people manage the challenges of living Some activities can actually stimulate pain, especially if they with daily pain. This was an exciting opportunity for occupational require more effort or range of motion than you have available therapists to reach out to the many different stakeholders who or if they are very repetitive. Occupational therapists can help to read the CPC Newsletter and build bridges for knowledge nd strategies to change the activity so it is not so taxing, or nd exchange and collaboration. CPC generously gave us permission ways to modify the way the environment around the activity is to share the following contents of the rst column we wrote for the built or organized to make the activity more doable. Sometimes newsletter with OT Now readers in this special theme issue. its a question of breaking down the activity into manageable Our description of the occupational therapists role in pain bits with rest breaks in between, which will allow the activity to management was intended to be accessible to an audience of be accomplished. Occupational therapists are good at such people who have pain, their family and friends, a diverse group of activity analysis and their ideas can be very helpful. Occupational health professionals, and other stakeholders. Other occupational therapists are usually also very familiar with all kinds of adaptive therapists may be able to expand devices, and so they may be and further describe aspects able to suggest a device that will Occupational therapists address the issues that get in make the job easier. of practice beyond what we the way of being able to do the things that are imporhave included in this article. It is Some activities may actually hoped that this can be helpful be harmful, as they may be tant, including the activities that allow you to indeas an example from which to placing too great a strain on pendently take care of yourself and your family, and develop your own accessible those activities that give you satisfaction and a sense of joints that are damaged by documents to explain the disease or under stress due to an purpose in life. occupational therapy role in inammatory response. In these your unique practice context. cases, an occupational therapists If you would like to share your pain management expertise from input can help identify potentially dangerous ways of carrying out an occupational therapy perspective, please contact us about an activity and provide suggestions for a safer way. This might submitting an article to the CPC column. involve using more ergonomically correct tools or ways to set up equipment, or might involve ways of carrying, lifting or handling that are biomechanically better. Sometimes its a question of A question was received from a subscriber of the Canadian problem-solving how jobs and tasks are organized (either the order Pain Coalition Newsletter: My family doctor has referred me in which tasks are done or the way that the environment within to an occupational therapist for my chronic pain. I didnt know which the tasks take place is set up), and occupational therapists occupational therapists had a role in chronic pain? What would the generally have a lot of knowledge and experience to help guide occupational therapist do? you to do activities in ways that prevent injury. Occupational therapists are health professionals who receive When you have chronic pain, you often experience a great their training in accredited university programs. They are deal of fatigue, related either to constantly dealing with the pain, concerned about what people do. The occupation in our name side effects of medication or difficulty sleeping. Occupational refers to the general idea of being occupied. So when occupational therapists can suggest ways of structuring your day to reduce therapists talk about occupations, theyre not talking just about the effects of fatigue. Alternatively, they may be able to suggest jobs, but they mean all the activities that can occupy time during sleeping positions that will allow you to get a better nights rest. a day. Occupational therapists address the issues that get in the An occupational therapist may also be able to help you select an way of being able to do the things that are important, including exercise program in your community that meets your needs to the activities that allow you to independently take care of yourself overcome fatigue and feel more refreshed. Helping you nd the and your family, and those activities that give you satisfaction and right activities in your community is also a great way to make sure a sense of purpose in life. Chronic pain takes a major toll on your your family and friends can participate along with you. ability to engage in the activities that you need to do, want to Occupational therapists pride themselves in working in a client6
OCCUPATIONAL THERAPY NOW VOLUME 14.5

centred fashion. This means that we work collaboratively with our clients, sharing ideas and problem-solving together. After all, every person is unique, and no one solution is going to t everyone. Occupational therapists therefore have to be good listeners and often take on more of a coaching or consulting role. Sometimes our best ideas come from what weve learned from all the other clients weve worked with! Living with chronic pain takes a heavy toll emotionally. Occupational therapists have training in counseling skills as well as in some aspects of cognitive behavioural therapy. They may be able to suggest and teach strategies that will make it easier to cope with the feelings of loss, anger and other emotional challenges of dealing with pain every day. Finally, we have to recognize that there is a lot of stigma associated with having chronic pain. Its an invisible disability, and as such, the general public as well as many health professionals (sadly) have difficulty understanding and empathizing. Occupational therapists pride themselves on their role as advocates. As such, therapists usually have a good knowledge of community resources as well as an intimate knowledge of the way that the health and public systems work. An occupational therapist may be able to help you navigate the system or nd the just-right resource. How do you nd an occupational therapist? They are often employed in hospitals, working with both in-patients and out-

patients. In such cases, a physician referral is usually required, so the best way to connect with an occupational therapist would be through your doctor or medical specialist. Occupational therapists also work in clients homes, either through provincial home care providers or through special needs providers like the Arthritis Society. In these situations, a self-referral or referral by a family member may be all that is required. Some occupational therapists are referred through and paid by insurers like long-term disability carriers or auto insurers.

Recommended Resources

For more information about nding an occupational therapist in your community check the Canadian Association of Occupational Therapists website: www.caot.ca/default.asp?pageid=3622. For educational resources on pain management and advocacy see the Canadian Pain Coalition website: www. canadianpaincoalition.ca. For healthcare professional and scientic resources on pain management check the Canadian Pain Society website: www. canadianpainsociety.ca. This article was reprinted with permission from the Canadian Pain Coalition. It originally appeared in the Spring 2011 Canadian Pain Coalition Newletter (Volume 4(2), p. 12).

Image created at www.wordle.net.

Lisa Klinger, MSc, currently works full time as a lecturer at the School of Occupational Therapy at Western University in London, ON. She has more than twenty years of experience as a clinician; working both in the public and private sectors. She completed her undergraduate training in 1979 and her MSc in 1997, both at The University of Western Ontario. Her research interests are in the areas of adaptation to chronic pain and brain injury and accessibility issues for persons with disabilities. She can be contacted at: [email protected]. Bonnie Klassen, MSc(OT), provides occupational therapy consulting services in Edmonton, AB, and works for Alberta Health Services in two chronic pain clinics and the community rehabilitation program in Camrose and Vermilion, AB. She can be contacted at: [email protected].

About the authors

OCCUPATIONAL THERAPY NOW VOLUME 14.5