What do occupational therapists add to pain management?
I’ve struggled with professional identity from time to time, but after completing my PhD thesis looking at how people live well with pain, I’ve developed a new understanding of how occupational therapists add value in this area of practice.
Occupational therapists joke that “no-one knows what an occupational therapist does” – and sadly, that’s true. It’s not because what we do isn’t important, it’s because our view of people and the way we work with people differs from most health professions. Occupational therapists don’t treat disease per se, we work with peo...
Source: HealthSkills Weblog - September 27, 2020 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: Chronic pain Occupational therapy Professional topics Resilience Science in practice Source Type: blogs
On values, culture and health
This week is Te Wiki o te Maori – and the theme is Kia Kaha te Reo Maori. For those readers not familiar with te reo, kia kaha translates to “be strong.” It’s a word people from Otautahi (Christchurch) have used a lot since 2010 and the first of the many events that have shaken (literally) our world since then. Te Wiki o te Maori is a week dedicated to celebrating and strengthening the use of Maori language in New Zealand.
While the week celebrates the language of Aotearoa, it also helps us tangata tiriti, or people of the Treaty of Waitangi, remember that we have a place in this whenua (land). ...
Source: HealthSkills Weblog - September 13, 2020 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: Chronic pain Pain conditions Professional topics Research Resilience/Health Science in practice respect values Source Type: blogs
What to do when one size does not fit all
Alert: rant ahead.
Early in my career working in persistent pain management, it was thought that “chronic pain is chronic pain is chronic pain” and pretty much anything that helped one person would help the next. Over time we’ve learned a lot more about persistent pain: the mechanisms differ a lot between neuropathic mechanisms and nociplastic mechanisms. Even within these groups, the mechanisms are very different. We’ve also learned a lot more about the psychosocial variables that are associated with prolonged disability and distress when pain persists. Some of the earliest work by Turk and coll...
Source: HealthSkills Weblog - September 6, 2020 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: Chronic pain Groupwork Interdisciplinary teams Pain conditions Research Science in practice Source Type: blogs
The hardly hidden costs
Chronic/persistent pain management is not sexy. No-one gets a magic cure. Lives are not saved – at least not in a way that mortality statistics show. Chronic pain management is under-funded.
And now: buried in a list of other proposed service cuts in the local health board’s plan to save millions of dollars, is a proposal to “save” $650,000 from the pain clinic. You’ll note also reductions in community services, GP support for vulnerable, and healthy lifestyles programmes.
https://www.stuff.co.nz/national/health/122558278/hundreds-of-staff-nurses-and-services-may-be-axed-at-canterbury-d...
Source: HealthSkills Weblog - August 30, 2020 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: Chronic pain Interdisciplinary teams News Pain conditions Research Science in practice Uncategorized Source Type: blogs
Whose life is it anyway?
A couple of weeks back I posted about my concerns that exercise is often over-hyped, has limited effects on pain and disability, and therefore people going through a rehabilitation programme will likely dump doing the exercises as soon as the programme ends. Well, that was an interesting conversation starter! TBH I expected the response. On the one hand we have avid strength and conditioning people (including a whole bunch of physiotherapists) saying it’s crucial to get strong and fit because it’s good for health and longevity, while on the other hand we have a large group of “others” who think life...
Source: HealthSkills Weblog - August 23, 2020 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: Chronic pain Clinical reasoning Pain conditions Professional topics Research Science in practice goal setting Source Type: blogs
A lot can happen in a week …
This time last week I had this mad idea to share some of my thoughts about “exercise” – not thinking that post would create such a stir! Is it really so radical to recognise that not everyone likes That Word? And that for some, the benefits of exercise aren’t as valued as other important parts of life? And that movements, like people, come in all shapes and sizes so what YOU like might not be something I like?
In New Zealand we’ve also had a new emergence of Covid19 in the community, after 102 days without any community-based cases. This has been very scary for some of us, a real frustratio...
Source: HealthSkills Weblog - August 16, 2020 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: Off topic diversity feminism professional behaviour Source Type: blogs
Is exercise the new snake oil? or just a dirty word?
If you haven’t heard about the health benefits of exercise in the last 10 years or longer, then you’ve probably been a hermit! Exercise can do all these wonderful things – help you lose weight, reduce heart disease, moderate insulin and blood glucose levels, improve your mental health, and yes! reduce pain and disability when you’re sore. (check this list out)
The claims sound suspiciously similar to the claims made by old snake oil merchants – or the amazing White Cross Electric Vibrator!
Well perhaps there’s a little more research supporting claims for exercise… but ar...
Source: HealthSkills Weblog - August 9, 2020 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: Chronic pain Coping strategies Motivation Professional topics Resilience/Health Science in practice exercise movement persistent pain Source Type: blogs
Pain may not be what a person fears most
We all have typical ways of going about our daily routines and solving problems. Mostly these work – until we encounter a situation where they don’t. If we’re flexible enough, we’ll figure out a way to change what we do in that instance, and this will become another strategy to draw on, and might even become another habit that works – until it doesn’t.
In pain rehabilitation, there are certain patterns of activity that have received a lot of research attention. Activity avoidance is one of them, while task persistence is given rather less air time (though it’s emerging as an int...
Source: HealthSkills Weblog - July 26, 2020 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: ACT - Acceptance & Commitment Therapy Chronic pain Coping Skills Coping strategies Occupational therapy Pain conditions living well persistent pain Source Type: blogs
That elephant in the room thing
This weekend I was incredibly fortunate to speak at Le Pub Scientifique (the next one is the super intelligent Tasha Stanton!) about one part of our pain conversation that’s absent: how do we have a conversation about when pain persists and doesn’t respond to any treatments?
I still don’t have any research to show how we might broach this topic in a way that respects the person with pain, acknowledges just how poorly our treatments do, and provides a framework for us to collaborate. It’s like this big bogey sitting in our clinics that we pretend isn’t there.
Why do we need to have this c...
Source: HealthSkills Weblog - July 19, 2020 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: ACT - Acceptance & Commitment Therapy Chronic pain Coping strategies Pain conditions Science in practice Therapeutic approaches Clinical reasoning empathy persistent pain self-compassion Source Type: blogs
Le Pub Home Brew
Now I’m the kinda woman who enjoys a bevvie or two – and I do love to talk! Combine them both with my favourite topic of pain, and you end up with Le Pub Home brew…and I’m speaking THIS SATURDAY!!
My topic? Let’s stop focusing on pain, because we have a few elephants in the room we need to discuss.
Come and join me as I poke and prod at assumptions made about why people come asking for help with their pain, why clinicians often focus on the wrong thing, why we need to listen to the messages buried beneath the “take my pain away” call – and why the skills clinicians hav...
Source: HealthSkills Weblog - July 15, 2020 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: Uncategorized Source Type: blogs
Secondary gain: really?
One of my most popular posts ever is one I wrote many years ago on malingering. Secondary gain, like malingering or symptom magnification is one of those terms used by people who don’t live with persistent pain, and commonly used when a person with pain doesn’t seem to be progressing “as expected”. The term is an old one, originating in the psychoanalytic literature, brought into compensation and insurance environments but never really examined (Fishbain, Rosomoff, Cutler & Rosomoff, 1995) until well after it had become a popular label.
Freud first identified the potential for gains from bei...
Source: HealthSkills Weblog - July 12, 2020 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: Assessment Chronic pain Professional topics Research malingering secondary gain stigma Source Type: blogs
International Chronic Pain Virtual Summit 2020
I am so happy to be part of this virtual summit especially under our current COVID19 disruptions! It’s FREE and more than 20 speakers from around the world are talking about the things that matter in pain rehabilitation and management. I might even drop in a word or two about occupational therapy….!Click the link and find out more! – click
Just to give you an idea of the speakers involved, you’ll get to hear from:
Professor Peter O’Sullivan
Professor Tasha Stanton
Lissanthea Taylor
Vidyamala Burch
Dr Stephen Grinstead
Kathy Hubble
Pete Moore
Prof Kim Burton
Prof A...
Source: HealthSkills Weblog - June 14, 2020 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: Uncategorized Source Type: blogs
Knowledge translation: beyond the peer reviewed papers
Oh the risks and pitfalls of trying to get research into clinical practice! There’s an often-cited figure estimating it takes around 17 years for a new practice to enter routine clinical care (Dilling, Swensen, Hoover, Dankbar, Donahoe-Anshus, Murad & Mueller, 2013) – that’s a long time!
There are many reasons for this delay:
Inertia – change is hard!Systems – often support the status quo, may not fund new or innovative practicePeer pressure – to keep on doing the same as everyone elseQuestioning whether the benefits are truly thereBusy clinical practice making it difficult to...
Source: HealthSkills Weblog - May 24, 2020 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: Professional topics knowledge translation musing research into practice Source Type: blogs
5 Things I Learned from Lock-down
As New Zealand emerges from the most severe lock-down levels to greater freedom (but still not back to life as usual) I’ve been reflecting on what I’ve learned – no, not a new language, new baking skills, or sudden competence in using R (see here for a great tutorial), but things about myself. Odd though it may seem, I’m leaving lock-down with a sense of wistfulness. You see, the time from the end of March to end of April has been a lovely time for me.
I’m lucky, I have a good job, my work hasn’t changed much (well, a bit), my family are safe, I live close to the beach and a park, an...
Source: HealthSkills Weblog - May 17, 2020 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: Pain conditions Professional topics Resilience/Health Uncategorized COVID19 Source Type: blogs
On labels and boundaries
What we call a disease matters. It matters to the person because a diagnosis is a marker: this problem is known, it’s recognised, it’s real (Mengshoel, Sim, Ahlsen & Madden, 2017). It matters to the clinician, particularly medical practitioners, but also those clinicians working within a largely “disease-oriented” framework (for example, physiotherapists, osteopaths) (Haskins, Osmotherly, Rivett, 2015; Kennedy, 2017). It matters also to insurance companies, or funding providers – who is in, and who is out.
The diagnostic label itself hides a great many assumptions. The ways in which dia...
Source: HealthSkills Weblog - April 6, 2020 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: Assessment Chronic pain Clinical reasoning Coping strategies Pain conditions Professional topics Uncategorized Source Type: blogs
