The Complexities of Pain Management: More Than Just Self-Management
For years, the term ‘management’ has been a significant part of my vocabulary, but not in the traditional sense of middle management in healthcare. Instead, I have been fascinated by concepts like ‘pain management’ and ‘supported self-management.’ The core question that arises for me is: what are we really managing?
Is it pain? Not quite. Pain is a complex phenomenon that cannot simply be reduced to a numerical value. While medication can be beneficial when used appropriately, focusing solely on pain reduction overlooks the broader aspects of living a fulfilling life despite pain. The relationship between pain intensity, functional limitations, and quality of life is multifaceted, reminding us that a pain-free existence is unattainable.
If it’s not pain, then what does pain management entail? Pain management involves a series of actions aimed at enabling individuals to engage in activities that are meaningful to them, minimize the impact of pain on daily life, and restore a sense of normalcy.
However, there is a discrepancy in the language surrounding pain self-management. While there is a trend towards emphasizing individual responsibility, self-management often entails managing external expectations while seeking accommodations from those in our environment to facilitate the self-management process.
Take, for example, a scenario where an individual seeks help for their neck pain. The treatment plan may include pain education, physical exercises, mindfulness practices, and goal setting. While these interventions are effective, they need to be integrated into the individual’s existing life context.
The challenge arises when individuals juggle their self-management activities with pre-existing responsibilities such as work, caring for family members, and other commitments. How do they negotiate these new demands with their current obligations? Do they seek support from those around them, or do they carry the burden alone in the name of self-management?
Furthermore, for individuals with complex lives, such as those working multiple jobs, caring for dependents, and managing other health conditions, self-management becomes a daunting task. How does one accommodate self-management practices within an already demanding routine, and how do they communicate their needs to others?
Self-management, therefore, extends beyond individual actions to encompass the broader social context in which one lives. It is about making adjustments within the constraints of one’s environment while striving to pursue meaningful activities.
Thus, self-management is not merely about managing pain; it is about managing life itself. It involves navigating the expectations of others, seeking support from various stakeholders, and advocating for one’s needs within societal structures.
Health professionals play a crucial role in supporting individuals in their self-management journey. It is not just about providing medical interventions but also about empowering individuals to live well within their unique circumstances. This may entail advocating for changes in policies, challenging existing power dynamics, and promoting effective communication among all involved parties.
Ultimately, ‘pain management’ should be viewed as ‘life management,’ with a strong emphasis on social interactions and support systems. By recognizing the complexities of self-management and addressing the social determinants of health, we can truly enhance the quality of life for individuals living with pain.
Ballantyne, J. C., & Sullivan, M. D. (2015). Intensity of Chronic Pain — The Wrong Metric? New England Journal of Medicine, 373(22), 2098-2099. https://doi.org/10.1056/NEJMp1507136
Cutler, D. M., & Glaeser, E. L. (2021). When innovation goes wrong: Technological regress and the opioid epidemic. Journal of Economic Perspectives, 35(4), 171-196.
