Date Presented 4/20/2018
This qualitative study explored occupational therapy interventions to treat pain via an online survey of open-ended questions. Occupational therapy has tools to provide nonopioid pain interventions to help society deal with the opioid crisis.
Primary Author and Speaker: Anthony Lucio
Additional Authors and Speakers: John Laney, Stirling Lake, Barbara Kornblau, Sarah Mbiza
PURPOSE AND BACKGROUND: As society deals with an opioid crisis, occupational therapy practitioners possess tools to treat pain. However, there is a dearth of research on occupational therapy’s role in treating pain and use of these tools (Robinson et al., 2011; Van den Berg-Emons et al., 2007). The purpose of this study was to look at how occupational therapists treat pain conditions in their clinical setting.
METHOD: This qualitative study used an online survey of open-ended questions using Qualtrics (Provo, UT). Participants were recruited from several closed Facebook communities, including Pain4OT and OT4OT, and through word of mouth and Twitter. Inclusion criteria were as follows: self-reported registered occupational therapist, over age 18, and practicing in the United States. A link to the survey was distributed through the Facebook groups, word of mouth, and Twitter. Participants clicked on the link, and after acknowledging informed consent, they answered a series of demographic questions followed by five open-ended, qualitative questions.
A team of three researchers analyzed qualitative data and used content analysis until saturation was reached. An experienced qualitative researcher reviewed the data analysis. Multiple researchers and data collection from multiple sources ensured triangulation, rigor, and trustworthiness of the data.
RESULTS: Thematic analysis showed that the most common theme was that pain management interventions were not addressed enough in occupational therapy school. Several secondary themes were also identified. Participants felt the need to seek additional training in pain management, and they gained invaluable insight on treating pain from their experience dealing with their own pain. Impact on occupations could vary greatly depending on the location of the pain. Activities of daily living, social participation, and meaningful activities were the most limited by pain.
Participants noted that clients were unsure about occupational therapy’s role in pain management, although they were appreciative of occupational therapy; clients also saw the value of increased functioning after receiving occupational therapy services. Participants indicated that their clients found sensory and physical modalities, cognitive–behavioral strategies, and client-centered mixed modalities to be the most effective in treating their pain. Participants also reported that their clients found pharmaceutical drug interventions effective for their pain.
CONCLUSION: The finding that conventional occupational therapy programs do not adequately prepare practitioners for treating clients with pain has far-reaching implications. With the current declaration of an opioid epidemic, the Centers for Disease Control and Prevention protocol change, and the shift in public opinion toward nonpharmaceutical drug interventions, occupational therapy has an opportunity to provide nonopioid pain interventions.
IMPACT STATEMENT: This study provides a glimpse into how occupational therapists currently treat pain. Adjusting the academic curriculum to include pain treatment can position occupational therapy practitioners as an alternative to help address the opioid epidemic with occupation-based pain interventions.
References
Dowell, D., Haegerich, T. M., & Chou, R. (2016). CDC guideline for prescribing opioids for chronic pain—United States, 2016. MMWR, 65(1), 1–49. https://doi.org/10.15585/mmwr.rr6501e1
National Research Council, & Institute of Medicine. (2001). Musculoskeletal disorders and the workplace: Low back pain and upper extremities. Washington, DC: National Academies Press. https://doi.org/10.17226/10032
Robinson, K., Kennedy, N., & Harmon, D. (2011). The Issue Is—Is occupational therapy adequately meeting the needs of people with chronic pain? American Journal of Occupational Therapy, 65, 106–113. https://doi.org/10.5014/ajot.2011.09160
Van den Berg-Emons, R. J., Schasfoort, F. C., de Vos, L. A., Bussmann, J. B., & Stam, H. J. (2007). Impact of chronic pain on everyday physical activity. European Journal of Pain, 11, 587–593. https://doi.org/10.1016/j.ejpain.2006.09.003
