Key points 

• Chronic pain is a significant issue affecting around one in five people in New Zealand, impacting daily life, employment, and quality of life.
• Occupational therapy takes a biopsychosocial approach to managing chronic pain, considering physical, emotional, environmental, social, cultural and cognitive factors.
• Occupational therapists in New Zealand complete assessments and develop individualised interventions to address the needs of individuals or whanau.
• Occupational therapists use “occupations” or the things that ‘occupy our time’ or real world activities as a therapeutic medium to elicit skill development and performance. Occupational therapists empower people through skill-building, coping strategies, and resilience training to better manage chronic pain.
• Occupational therapy plays a vital role in workplace wellness in New Zealand by assessing and recommending adjustments to prevent chronic pain, including ergonomic improvements, safety measures, and promoting employee well-being. 

Introduction

Chronic pain, a pervasive issue impacting approximately one in every five New Zealanders, poses a number of challenges that extend beyond personal discomfort.  It has profound implications for daily life, employment – and overall well-being. Let’s explore the role of occupational therapy in managing chronic pain, focusing on innovative approaches that enhance the quality of life for people impacted with this condition.

Chronic pain and its impact on daily life

In New Zealand, where workplaces often involve physically demanding tasks, chronic pain stemming from injuries is distressingly common. The Accident Compensation Corporation (ACC) Scheme plays a vital role in supporting people who sustain an injury due to an accident. However, the long-term effects of chronic pain transcend medical treatment and financial compensation.

People dealing with chronic pain face an array of daily challenges that include difficulty completing personal and household tasks, driving, care of others, reduced productivity, frequent absenteeism, difficulty engaging in community activities and a diminished quality of life. The ramifications of chronic pain are not confined to personal struggles; they ultimately impact businesses as well.

As a result; employers, health and safety teams, executive management, and human resources professionals all have a vested interest in finding solutions to alleviate chronic pain and enhance employee well-being.

Occupational therapy: A holistic approach

“Occupational therapy is where science, creativity and compassion collide”.

Occupational therapy is a holistic profession which addresses chronic pain management by assisting people to develop valued goals for the future and working with them to achieve these goals. It recognises that pain encompasses not only physical sensations but also complex interactions with emotional, social, psychological, relational and cognitive factors.  

Occupational therapists in New Zealand are adept at assisting people to set goals and tailoring interventions to address the unique goals of people with chronic pain.

Customised interventions: tailoring OT for chronic pain management

The adaptability of occupational therapy stands out as one of its core strengths. Occupational therapists collaborate closely with patients to craft customised interventions that specifically target their unique lifestyle. Complex and sometimes challenging to manage, the goal of addressing chronic pain is to discover ways to support people experiencing it and minimise its impact on their life. Occupational therapists use occupations (activities)  to assist people to develop skills and the flexibility to use them to achieve their goals. 

This approach proves particularly effective in New Zealand, given the diverse range of injuries leading to chronic pain. Occupational therapists work with people in their homes and local community to assist them to achieve their goals and return to everyday life.

Example: John's journey to relief from chronic pain

John, a construction worker from Auckland, suffered a debilitating back injury that placed his livelihood and well-being in jeopardy. Thanks to the assistance of an occupational therapist, John received personalised interventions. These interventions included ergonomic enhancements in his workplace, effective pain management strategies, and much-needed emotional support. 

Today, John is back on the construction site, a testament to the tailored approach of occupational therapy that facilitated his journey towards regaining functionality.

Restoring functionality is a key element of occupational therapy

Occupational therapy extends beyond pain management; it centres on the restoration of function or assisting people to live life well despite their pain. In New Zealand, this holds particular significance for individuals seeking to return to their jobs and daily activities while effectively managing chronic pain.

Sarah, a nurse from Wellington, grappled with chronic pain following a workplace injury that demanded prolonged hours on her feet. Occupational therapy proved instrumental in her recovery, providing her with specialised exercises, ergonomic guidance, and invaluable emotional support. Sarah not only achieved a return to work but also discovered newfound resilience, an asset that continues to serve her well.

Empowering patients: building coping skills and resilience

Personal empowerment lies at the core of occupational therapy. In New Zealand, occupational therapists empower people to take an active role in managing their chronic pain. Through education, skill-building exercises, effective coping strategies, and resilience training, people become better equipped to confront the challenges posed by chronic pain.

Chronic pain in New Zealand: a local perspective

In New Zealand, chronic pain is a serious issue that profoundly affects people, the workforce and communities across the nation. With industries ranging from agriculture and construction to healthcare and manufacturing (and everything in between), injuries leading to chronic pain can manifest in various settings. It’s vital to comprehend the local context and the role that occupational therapy plays in addressing this issue. 

The ACC Scheme: a lifeline for injured workers

The ACC scheme in New Zealand plays a pivotal role in providing support to people who have sustained injuries, including those resulting in chronic pain. The scheme offers essential coverage, encompassing medical care, rehabilitation services, and financial assistance to those affected. However, while the ACC scheme is a lifeline for many, it is often occupational therapy that bridges the gap between injury and a successful return to daily life activities and work.

Tim, a farm worker, experienced a severe leg injury while operating heavy machinery. The ACC Scheme furnished him with medical care and compensation during his recovery. Nevertheless, the targeted interventions delivered by his occupational therapist that empowered Tim to regain the physical and mental strength essential for his return to his day to day activities and demanding job. This example serves as an illustration of the collaborative efforts between the ACC Scheme and occupational therapy in assisting people to overcome chronic pain and resume their livelihoods.

Occupational therapy's role in workplace wellness

In the workplace, safeguarding the well-being of employees is not solely a moral imperative but also a strategic necessity. Healthy employees tend to be more productive, engaged, and less prone to experiencing chronic pain-related absenteeism. Occupational therapy holds the potential to play a pivotal role in fostering workplace wellness.

What’s involved in an occupational therapy assessment?

Occupational therapists assess workplaces and recommend adjustments that can make a substantial difference in preventing chronic pain. These assessments can include:

• Ergonomics:  Evaluate workstation setups, including chair and desk ergonomics, to ensure employees have proper posture and reduce the risk of musculoskeletal issues.
• Physical environment:  Assess lighting, temperature, ventilation, and noise levels to create a comfortable and productive workspace.
• Safety:  Identify and mitigate safety hazards, ensure fire safety measures are in place, and provide first aid resources.
• Accessibility:  Ensure the workplace is accessible for all, including individuals with disabilities, by checking for ramps, elevators, and accessible restrooms.
• Job demands and well-being:  Analyse job tasks and their physical and mental demands, promote employee well-being through health and wellness programs, and assess workplace culture.

Summary

Chronic pain management is a pressing concern for employers, health and safety teams, executive management, and human resources professionals in New Zealand. Occupational therapy provides a multifaceted approach to addressing this issue. 

By customising interventions, restoring functionality, and empowering patients, occupational therapy offers a path toward improved quality of life, and enhanced workplace productivity. In a country where injuries and employment are closely intertwined, the biopsychosocial  approach of occupational therapy is making a significant difference in the lives of those living with chronic pain.

Reviewed by:  Claire Quin