4 minute read
Promoting OT to improve outcomes in chronic pain
For people with chronic pain, a multidisciplinary approach can achieve better quality-of-life outcomes (Vartiainen et al., 2019). This should include occupational therapists, who can help restore, or establish, meaningful occupation for the more than 3.24 million Australians whose lives and livelihoods have been significantly disrupted by chronic pain (Breivik et al., 2006; Dueñas et al., 2016; Economics, 2019). Occupational therapy is well placed to expand its scope and scale within primary care settings (Jordan, 2019), particularly in chronic pain management.
While people with chronic pain can expect better outcomes with timely referral to occupational therapy services , this will only occur if other healthcare providers know what occupational therapy can achieve. We must therefore actively promote, not just explain, occupational therapy.
The role of occupational therapy is not always well-understood. Chronic pain is a current health crisis, and the incidence may increase following the Covid-19 pandemic (Clauw et al., 2020), so it is vital that occupational therapists speak up about the role they can play in chronic pain management.
There has been a recent expansion of physiotherapists and psychologists addressing aspects of chronic pain that occupational therapists could often carry out more instinctively and effectively. This is not to diminish the important role those professions play, but simply to question whether we, as a profession, could do more to educate other health professionals about our unique knowledge and contribution in the chronic pain field.
A recent multidisciplinary, professional development session highlighted the need to better communicate the benefits of occupational therapy. Two experienced, non-occupational therapy professionals reflected with surprise and fascination on their Aha! moment when a client they had been treating for many months suddenly improved dramatically – emotionally, physically and cognitively – when he returned to horse riding (a passion he had before an injury). Of course, the occupational therapists in the audience nodded politely, while screaming internally: “Of course he did! That’s what meaningful occupation can do!”
Many general practitioners (GPs) – often the first point of contact for people with chronic pain – are also unaware of occupational therapy’s unique perspective in chronic pain management. During 2020, a Western Australia training day called “Managing Pain: A Team Approach” was established for GPs. The line-up of presenters on the first occasion included an addiction specialist, anaesthetist, pharmacist, psychologist, physiotherapist and psychiatrist, but no occupational therapist. The psychiatrist spoke strongly about the huge benefit he had seen when his patients attended
Attendees at “Managing Pain: A Team Approach”, November 2021, (left to right) Wey Chan, Katrina Liddiard (presenter), Kym Beanland, Gemma Porter, Elenita Ford and Catherine Yates.
occupational therapy to help restore a sense of meaning in their daily lives.
After some lobbying, these training days now contain a short promotion of occupational therapy. Up to five occupational therapists also attend, to learn and to join the roundtable discussion to engage with GPs and promote their role. It’s a drop in the ocean, of course, but feedback has been positive, with GPs asking: “Where can I source occupational therapy? I have some patients who really need this stuff.”
Complex interactions between social, psychological, and biological factors and contexts are known to create the experience of pain (Carr and Bradshaw, 2014). This makes perfect sense when viewed through an occupational therapy lens. Not all professionals are trained to understand complexity in a client’s system the way we are (Lambert et al., 2007). We need to embrace the phenomenal contribution that meaningful occupation can make in the life of a person with chronic pain (Lagueux et al., 2018); and
to communicate our unique potential and perspective (Breeden and Rowe, 2017). For the benefit of clients, we need to collaborate with other health professionals and adapt the way we communicate with them to place greater emphasis on promoting occupational therapy, rather than simply explaining it.
About the Author Katrina Liddiard graduated as an occupational therapist in 1987 and has worked in broad clinical areas including burns and hand therapy, where she first became interested in pain management. She has helped to establish the use of neurostimulation for an occupation-based approach to pain management. Katrina has represented occupational therapy in an interprofessional working group and established an Occupational Therapy Pain Interest Group in Western Australia. She is a full-time academic at Edith Cowan University and is undertaking a PhD into what people with chronic pain find personally meaningful in their rehabilitation, and to advance the skills of therapists who treat people with chronic pain.
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