Occupational Therapy for Chronic Pain
Punita V. Solanki
Consultant Occupational Therapist
Aastha Multi Speciality Hospital...
Punita V. Solanki
Occupational Therapist
29th ISSPCON 2014
Navi Mumbai
7th February 2014
Contents:
Link Between Occupation...
Punita V. Solanki
Occupational Therapist
29th ISSPCON 2014
Navi Mumbai
7th February 2014
Person with
Chronic Pain
(Physica...
Punita V. Solanki
Occupational Therapist
29th ISSPCON 2014
Navi Mumbai
7th February 2014
Occupational Therapy in Chronic P...
Punita V. Solanki
Occupational Therapist
29th ISSPCON 2014
Navi Mumbai
7th February 2014
Chronic Neck & Shoulder Girdle Pa...
Punita V. Solanki
Occupational Therapist
29th ISSPCON 2014
Navi Mumbai
7th February 2014
Occupational Therapy Pain Interve...
Punita V. Solanki
Occupational Therapist
29th ISSPCON 2014
Navi Mumbai
7th February 2014
Occupational Therapy Pain Interve...
Punita V. Solanki
Occupational Therapist
29th ISSPCON 2014
Navi Mumbai
7th February 2014
Occupational Therapy Pain Interve...
Punita V. Solanki
Occupational Therapist
29th ISSPCON 2014
Navi Mumbai
7th February 2014
Importance of Integrated Interdis...
Punita V. Solanki
Occupational Therapist
29th ISSPCON 2014
Navi Mumbai
7th February 2014
Occupational Therapist’s valuable...
Punita V. Solanki
Occupational Therapist
29th ISSPCON 2014
Navi Mumbai
7th February 2014
Take Home Message
From an Occupat...
Punita V. Solanki
Occupational Therapist
29th ISSPCON 2014
Navi Mumbai
7th February 2014
References:
 The Canadian Associ...
Punita V. Solanki
Occupational Therapist
29th ISSPCON 2014
Navi Mumbai
7th February 2014
References:
 Chapter 3: The Inte...
Punita V. Solanki
Occupational Therapist
29th ISSPCON 2014
Navi Mumbai
7th February 2014
Acknowledgement:
I take this oppo...
Punita V. Solanki
Occupational Therapist
Occupational Therapy adds life to years.
The best kind of work can be to get othe...
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ISSPCON 2014 - Occupational Therapy for Chronic Pain - Punita V. Solanki

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ISSPCON 2014 - Occupational Therapy for Chronic Pain - Punita V. Solanki

  1. 1. Occupational Therapy for Chronic Pain Punita V. Solanki Consultant Occupational Therapist Aastha Multi Speciality Hospital Kandivali West, Mumbai Mobile: +91-9820621352 Email: therapistindia@gmail.com 29th ISSPCON 2014 Pad. Dr. D. Y. Patil Medical College, Navi Mumbai 7th February 2014, Friday
  2. 2. Punita V. Solanki Occupational Therapist 29th ISSPCON 2014 Navi Mumbai 7th February 2014 Contents: Link Between Occupation, Client and his/her Environment: Core Concept of Occupational Therapy Occupational Therapy Chronic Pain Conditions where OTs have a Role. Role of Occupational Therapy in Chronic Pain. Importance of Integrated Interdisciplinary Team Approach. Preventive Approach Towards Pain Management.
  3. 3. Punita V. Solanki Occupational Therapist 29th ISSPCON 2014 Navi Mumbai 7th February 2014 Person with Chronic Pain (Physical & Psychological aspects of Pain) Physical, Social , Emotional , Cultural Environment Occupation {ADL, Work & Productive Activities, Play & Leisure} An Idle Brain is the Devil’s Workshop Humans are Occupational Beings Occupation: Diversional Therapy
  4. 4. Punita V. Solanki Occupational Therapist 29th ISSPCON 2014 Navi Mumbai 7th February 2014 Occupational Therapy in Chronic Pain Occupational Therapy: Client centered health profession Promotes health and well being through occupation. The primary goal: Enable clients to participate in the activities of everyday life. Occupational Therapists: Work with clients with pain to enhance their ability to engage in the occupations by modifying the occupation or the environment to better support their occupational engagement. Reference: http://www.wfot.org
  5. 5. Punita V. Solanki Occupational Therapist 29th ISSPCON 2014 Navi Mumbai 7th February 2014 Chronic Neck & Shoulder Girdle Pain Chronic Mid & Lower Back Pain Chronic Arthritic Joint Aches & Pain Chronic Bone Aches & Pain Complex Regional Pain Syndrome Chronic Fatigue Syndrome Overuse Syndrome Chronic Pain Conditions
  6. 6. Punita V. Solanki Occupational Therapist 29th ISSPCON 2014 Navi Mumbai 7th February 2014 Occupational Therapy Pain Interventions: Level I: Adjunctive Methods & Level II: Enabling Activities: I: Therapeutic Exercises & II: Enabling Activities Innovative Rx: Stress Loading in CRPS e.g. Carrying, Scrubbing with Dystrophile; Mirror Therapy Positioning with Splinting & Functional Bracing Sensory Stimulations: Desensitization in CRPS Biomechanical Approach
  7. 7. Punita V. Solanki Occupational Therapist 29th ISSPCON 2014 Navi Mumbai 7th February 2014 Occupational Therapy Pain Interventions: Level III: Purposeful Activities & Level IV: Occupational Activities Activities of Daily Living Adaptive Training & Adaptive Equipments Work & Productive Activities Adaptive Training & Adaptive Tools & Environment Play & Leisure Activities Training e.g. Arts, Crafts, Games, Sports. Educational Activities e.g. Environmental Modifications in Schools Rehabilitative & Ergonomic Approach
  8. 8. Punita V. Solanki Occupational Therapist 29th ISSPCON 2014 Navi Mumbai 7th February 2014 Occupational Therapy Pain Interventions: Joint Protection Techniques Work Simplification & Energy Conservation Techniques Time & Stress Management e.g. Relaxation Techniques, CBT Pain Health Literacy & Self Management Programs. Behavioral Learning Approach for Client Education
  9. 9. Punita V. Solanki Occupational Therapist 29th ISSPCON 2014 Navi Mumbai 7th February 2014 Importance of Integrated Interdisciplinary Team Approach Of all approaches to the treatment of chronic pain, none has a stronger evidence basis for efficacy, cost-effectiveness & lack of iatrogenic complications than interdisciplinary care. Most critical is the understanding that chronic pain is a disease of the person, and that a traditional biomedical approach cannot adequately address all of the pain-related problems of this patient population. Reference: 1. Interdisciplinary Chronic Pain Management: International Perspectives. Pain Clinical Updates by International Association for the Study of Pain. December 2012. Vol. XX, Issue 7. 2. Ludeke C Lambeek et. al. Randomised controlled trial of integrated care to reduce disability from chronic low back pain in working and private life. BMJ 2010;340:c1035. doi:10.1136/bmj.c1035
  10. 10. Punita V. Solanki Occupational Therapist 29th ISSPCON 2014 Navi Mumbai 7th February 2014 Occupational Therapist’s valuable efforts are geared towards preventing disability due to acute & sub acute pains - from becoming chronic disability due to chronic persistent pain, by 2° & 3° preventive approaches, online/offline client education and timely return to ADL, Work and Leisure with Work Conditioning & Work Hardening Programs. Preventive Approach Towards Pain Management Reference: B. del Pozo-Cruz et al. J Rehabil Med 2012; 44: 581–587.
  11. 11. Punita V. Solanki Occupational Therapist 29th ISSPCON 2014 Navi Mumbai 7th February 2014 Take Home Message From an Occupational Therapist’s Perspective: Occupation of a Person includes Activities of Daily Living, Work & Productive Activities, Play & Leisure. Occupational Therapists are important Team Members in an Integrated, Interdisciplinary Team Approach towards Chronic Pain Management. (~ International Association for the Study of Pain) Integrated Interdisciplinary Care has a stronger evidence basis for efficacy, cost-effectiveness & lack of iatrogenic complications in the management of Chronic Pain than Traditional Biomedical approaches. Secondary & Tertiary Preventive Approach & Timely return to everyday activities helps prevent acute/sub-acute pain becoming chronic in nature. Do not treat the pain alone but treat the person suffering from pain {Physical, Psychological, Social & Emotional Care}
  12. 12. Punita V. Solanki Occupational Therapist 29th ISSPCON 2014 Navi Mumbai 7th February 2014 References:  The Canadian Association of Occupational Therapists (CAOT) Position Statement: Pain Management and Occupational Therapy. 2012.  Melanie E. Swan: Treating Complex Regional Pain Syndrome: A Guide For Therapy. Reflex Sympathetic Dystrophy Syndrome Association. 06/2004. www.rsds.org  Interdisciplinary Chronic Pain Management: International Perspectives. Pain Clinical Updates by International Association for the Study of Pain. December 2012. Vol. XX, Issue 7.  World Federation of Occupational Therapists (WFOT): http://www.wfot.org  Occupational Therapy and Pain Management: Occupational therapy - Helping people to live life their way. By College of Occupational Therapists: www.COT.org.uk  Recommended guidelines for Pain Management Programmes for adults. A consensus statement prepared on behalf of the British Pain Society. April 2007
  13. 13. Punita V. Solanki Occupational Therapist 29th ISSPCON 2014 Navi Mumbai 7th February 2014 References:  Chapter 3: The Intervention Continuum. In “Occupational Therapy Intervention Resource Manual: A Guide for Occupation-Based Practice” Eds. Denise Chisholm, Cathy Dolhi, Jodi Schreiber. 2004, 1st Edition, 240 pages, Published by Delmar Learning, a division of Thompson Learning Inc. New York, USA. ISBN: 1-4018-1536-7  Ingrid Söderback - Chapter 1: Genesis of the Handbook: Materials and Methods. In “International Handbook of Occupational Therapy Interventions” Eds: Ingrid Söderback .1st Edition, 2nd Printing, XXVIII, 554 pages. 2009; Springer Link, ISBN: 978-0-387-75423-9 (Print) 978-0-387-75424-6 (Online).  Ludeke C Lambeek et. al. Randomised controlled trial of integrated care to reduce disability from chronic low back pain in working and private life. BMJ 2010;340:c1035. doi:10.1136/bmj.c1035.  B. del Pozo-Cruz et al. An occupational , internet-based intervention to prevent chronicity in sub acute lower back pain : a randomized controlled trial . J Rehabil Med 2012; 44: 581–587.  Helen van Huet et. al. Occupational therapists perspectives of factors influencing chronic pain management. Australian Occupational Therapy Journal (2013) 60, 56–65. doi: 10.1111/1440-1630.12011
  14. 14. Punita V. Solanki Occupational Therapist 29th ISSPCON 2014 Navi Mumbai 7th February 2014 Acknowledgement: I take this opportunity to thank following colleagues for their valuable review comments on my presentation: Dr. Sandeep Sonone - Associate Professor in Orthopaedics at Seth G. S. Medical College & K. E. M Hospital Dr. Murali Poduval - Additional Professor in Orthopaedics at JIPMER, Pondicherry
  15. 15. Punita V. Solanki Occupational Therapist Occupational Therapy adds life to years. The best kind of work can be to get others back to theirs. Say Good Bye to Pain 29th ISSPCON 2014. Navi Mumbai. 7th February 2014

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