Sep 6 / Kimberly Breeden, Occupational Therapist, Continuing Education Instructor, Coach and Founding Partner

Everyday Actions to Promote OT's Distinct Value and Power in Treating Pain

Chalkboard drawing of a mountain with a path to the top and a flat at the summit
September is Pain Awareness Month.  The purpose of this recognition month is to increase awareness of how pain affects persons, families and communities as well as the nation.  This month is also good time as OT practitioners to consider the devastating impact that pain can have on an individual’s life and if we are providing best practice pain management for our clients. 

The U.S. Pain Foundation conducted a survey in 2022,  over 2,000 individuals living with pain.  The results reflect how pain impacts every aspect of an individual’s life. The study showed that 99% of all respondents reported that their pain has restricted their ability to engage in daily activities, like exercise, household chores, sleeping, and socializing.  (U.S. Pain Foundation, p. 4). And an alarming 71% of those who responded considered themselves to be disabled.  

The statistics that sadden me the most are those regarding the participants’ perceptions and experiences with healthcare.  63% of those who participated in the survey reported they felt stigmatized by healthcare providers.  When asked what they felt was the most important policy issue regarding pain, the top two answers were increased pain education for providers and finding new medications for chronic pain


It is no secret that Niccole and I have a significant interest in occupational therapy and pain management.  Niccole and I have seen the effects that stigma and uninformed pain treatment can have on individuals. For almost 8 years, we have worked to increase awareness and understanding of OT's role in pain management within our profession and among other healthcare practitioners. 
Our journey began when Niccole and I took on the challenge of developing an occupational therapy pain management program.  She and I delved into learning about pain and evidence-based interventions. As time went on, it became abundantly clear to us that as occupational therapy practitioners we had not fully understood the biopsychosocial nature of pain or in other words, pain is more than tissue damage. As I personally reflected on my own practice, I realized that my lack of understanding had most likely resulted in my clients feeling stigmatized or neglected.  Niccole and I also realized that unlike other disciplines, we were already trained in biopsychosocial assessments and interventions. As we applied our occupational therapy training within a biopsychosocial approach to pain, we saw amazing outcomes for our clients. What we did not anticipate was the response from the nurse practitioners, psychologists and physicians who began to recognize the unique value of occupational therapy. Even having them refer to us as "the missing link" in pain treatment.

Being recognized for our value as OT practitioners was gratifying, but the most rewarding experiences came from the abundance of clients who told us things like “you gave me my life back”, “ I feel like I am living again”, or “I can’t believe I can do what I am doing now”.   Our favorite was “ I have hope now”.  

You may be wondering how we learned all of these great strategies.  The answer is we didn’t learn new strategies.   Our training as OT practitioners had already given us the skills and strategies we needed.  We just did not have an accurate understanding of pain and how to best address it.  The next question you may be thinking is, what aspects of our occupational therapy training equipped us to effectively treat pain?  Our answer is almost all of it!

Occupational therapy has always been grounded in a firm understanding of the mind-body-spirit connection for health and wellness.  The evidence indicates that pain should be treated from a biopsychosocial approach, not just a biomedical approach. Our training in psychosocial as well as physical interventions prepares us to provide biopsychosocial interventions within our scope of practice. This is unlike other disciplines who provide psychosocial or physical interventions, but not typically both.  OT practitioners have extensive training in occupational analysis and helping individuals modify activities in order to support individuals to participate in occupations that bring meaning and purpose to their lives.  Pain has been found to be an experience that is unique to the individual; OTs and OTAs are trained to provide client-centered approaches that consider individual client factors. The evidence indicates that a self-management approach is the most effective in treating pain, OTs and OTAs are already training in self-management strategies such as coping skills, pacing, sensory regulation, activity modification and health information management.  The list just goes on!

Niccole and I passionately believe that occupational therapy can improve the lives of individuals with acute and chronic pain.  We believe that OTs and OTAs can break down the barriers that individuals with pain face in accessing effective treatment.  We believe that occupational therapy can help individuals do the things that make their lives meaningful and bring purpose.  It was those very beliefs that led us to our mission of empowering other occupational therapists, occupational therapy assistants, and students with a better understanding of pain and OT's role in treating pain.  We hope that by educating other occupational therapists, occupational therapy assistants, and students it impact as many individuals as we can who are living with pain. This is what led us to start presenting at the local, state, and national level.   We were honored to co-author the AOTA official position statement, "Occupational Therapy's Role in Pain Management" with a group of amazing OT practitioners in hopes to continue to provide OT practitioners with the evidence and knowledge they need to provide best practice pain management.  These efforts are great, but the real impact will come from everyday OTs, OTAs, and students who utilize this information to guide their practice.

Everyday practice is where the real magic happens, it is also the best way to show the real value of what our profession has to offer. 

OT's role in the treatment of pain continues to be under-recognized by those who are in need of our services, those who refer or order our services as well as by policymakers. There is much work to be done, but I do not think it has to start with policy and guideline changes.  I think it starts with everyday OTs, OTAs, and students like you, like Niccole and like me. We do not have to have advanced degrees or credentials. I think that if we as occupational therapists, occupational therapy assistants, and students want to be more recognized for our value in the treatment of pain, we have to make an impact in the settings and organizations we work in. This does not require that we campaign or even try to educate others; it means that we provide valuable occupational therapy services to our clients. It means that we provide evidence based care and report our outcomes. It means that we demonstrate a better understanding of pain and provide pain education to our clients. It means that we help our clients improve self-management of their pain. It means that we do our jobs with better tools in our OT pain management toolkits.  If we do this, lives will be improved.  If we do this, the word will spread.  If we do this, we will have a seat at the table for more change to happen.  If we do this, we will take the lead in pain management.

To read the AOTA Official Position Statement, “Occupational Therapy’s Role in Pain Management”.  Click Here

To read the U.S. Pain Foundation's "A Chronic Pain Crisis: 2022 Survey Report" : https://uspainfoundation.org/wp-content/uploads/2022/07/A-Chronic-Pain-Crisis-US-Pain-2022-FINAL.pdf

Written by Kimberly Breeden, Occupational Therapist, Continuing Education Instructor, Coach and Founding Partner

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