Occupational therapy shown to improve lives of people in chronic pain

A new study from the USC Chan Division of Occupational Science and Occupational Therapy shows that lifestyle-based occupational therapy treatment significantly improves the experiences of people living with chronic pain.

“Having quantitative evidence for occupational therapy’s effectiveness in chronic pain management is really valuable,” said Ashley Uyeshiro Simon ’08, MA ’10, OTD ’11, the study’s lead author and an assistant clinical professor at USC.

Uyeshiro Simon and her colleague, associate clinical professor Chantelle Collins ’07, MA ’08, OTD ’09, analyzed data gathered from people who completed a round of outpatient Lifestyle Redesign at the USC Occupational Therapy Faculty Practice. Lifestyle Redesign is an individualized treatment process through which an occupational therapist and patient focus together on weekly topics such as physical activity, body mechanics and planning for pain flare-ups. Week by week, the therapist guides the patient by exploring a given problem, gaining motivation, identifying potential solutions and building healthy habits and daily routines.

The study, which was published in the latest issue of the American Journal of Occupational Therapy, found that the Lifestyle Redesign treatment significantly improved patients’ quality of life, confidence and functional abilities. The most common diagnoses in this study included lumbar back pain, complex regional pain syndrome and myalgia, including fibromyalgia.

These types of diagnoses are long-term, difficult to manage and can’t just be fixed quickly.

Ashley Uyeshiro Simon

“These types of diagnoses are long-term, difficult to manage and can’t just be fixed quickly,” Uyeshiro Simon said. “It’s in these types of cases, where the physician scratches their head without an immediate solution, that our lifestyle-based intervention can really help.”

Quantitative effects

The study is believed to be the first of its kind to directly demonstrate quantitative positive effects of a lifestyle-based treatment model delivered exclusively by occupational therapists. Although occupational therapy literature has discussed issues surrounding chronic pain since the early 1980s, a 2011 review found little evidence for occupation-based practice in chronic pain and a heavy reliance on evidence developed in disciplines outside of occupational therapy.

Uyeshiro Simon sees the study as an important contribution to expanding the profession’s body of evidence and to supporting occupational therapy practitioners in a variety of health care settings.

“A lot of occupational therapists work in chronic pain without realizing it — you might not be labeling it ‘chronic pain,’ but you are still treating a person’s pain from an occupational perspective.”

Affirming lifestyle-based treatments

Outcomes research is also frequently used to support claims for reimbursement from third-party payers like insurance companies, and lifestyle-based treatments can be incorporated into treatment plans for patients with chronic pain even if that pain is secondary to their primary reason for referral to occupational therapy.

With more than 100 million Americans living in chronic pain — a statistic that is intimately tied to what the Centers for Disease Control and Prevention calls an ongoing “epidemic” of nationwide opioid medication overdoses — the study affirms the value of lifestyle-based treatments as part of a multidisciplinary care plan to successfully manage chronic pain.

“The annual costs of pain management, both from direct medical expenses and from lost workforce productivity, run in the hundreds of billions of dollars,” Uyeshiro Simon said. “We’ve shown that occupational therapy can ease that burden by helping to improve everyday function and quality of life, one patient at a time.”