Occupational therapists can play a key role in helping their patients manage chronic pain. Learn how a well-designed self-management program empowers patients to take an active role in their recovery.
Contributing authors: Chris Lasek & Jared Zimmerman
Chronic pain is one of the most prevalent and disabling conditions in the U.S. health care system. Defined as pain occurring on most days for three months or more, it affects approximately 23.4% of U.S. adults, with 8.5% experiencing high-impact chronic pain that significantly limits participation in work, self-care and leisure activities.
Beyond its physical toll, chronic pain is associated with emotional and psychosocial challenges, including fatigue, depression, anxiety and social isolation. It also carries a substantial economic burden, costing an estimated $635 billion annually in healthcare expenses, lost productivity and disability payments.
Occupational therapy practitioners (OTPs) are uniquely positioned to address the multifaceted impact of chronic pain. Through a holistic, client-centered approach, OTPs can support individuals in developing self-management strategies that promote engagement in meaningful occupations and improve quality of life.
A well-designed self-management program empowers patients to take an active role in their recovery.
By focusing on the person—not just the pain—OTPs can help patients identify personal goals, build adaptive skills and re-engage in valued activities.
When to start OT services
Consider occupational therapy intervention when a client demonstrates:
- Reduced ability to participate in daily routines, roles or employment due to persistent pain.
- Limited understanding of pain triggers or ineffective coping strategies.
- Difficulty implementing or sustaining self-management techniques.
Core components of OT led self-management programs
OTPs can design individualized or group-based interventions that address the following areas:
- Pain trigger identification: Teaching patients to recognize and modify activities or environments that exacerbate symptoms.
- Stress management: Incorporating relaxation techniques, mindfulness and cognitive-behavioral strategies to reduce pain-related stress.
- Nutrition education: Collaborating with dietitians or providing basic guidance on anti-inflammatory diets to support mood, energy and healing.
- Sleep hygiene: Promoting routines and environmental modifications that enhance restorative sleep and cognitive function.
- Social support: Facilitating the development of support networks to buffer pain intensity and improve emotional resilience.
- Medication management: Reinforcing adherence to prescribed regimens and educating on safe use to minimize side effects and misuse.
- Physical activity and graded exercise: Encouraging safe, progressive movement to improve endurance, strength, and pain tolerance.
- Engagement in meaningful occupations: Supporting participation in valued activities to enhance motivation, mood, and overall function.
- Task and environmental modification: Adapting tasks or home and work environments to reduce strain and promote independence.
Clinical example
An OTP can help someone who struggles with chronic knee pain by educating them on pain-management strategies and helping them to incorporate several of these into their life.
They can look at what tasks cause one’s knee pain to flare up or what activities they’re no longer able to do and help them find practical solutions. If they enjoy gardening but can no longer bend over or get on the ground, an OTP can suggest raised gardening beds or using a rolling gardening chair. If they tend to eat out a lot due to lack of time, an OTP can recommend picking up pre-made fresh meals or helping them to make meal prep easier in the kitchen.
An OTP can also help them incorporate a low-impact exercise program, such as walking and lifting light weights to improve their cardiovascular health, range of motion, and strength.
Why it matters
Addressing chronic musculoskeletal pain through occupational therapy is essential for improving function, reducing disability and enhancing quality of life. By integrating evidence-based self-management strategies into practice, OTPs can help patients control, build resilience and return to the activities that matter most.
References
- Lucas JW, Sohi I. (2024). Chronic pain and high-impact chronic pain in U.S. adults, 2023. NCHS Data Brief, no 518. Hyattsville, MD: National Center for Health Statistics. https://dx.doi.org/10.15620/cdc/169630
- U.S. Pain Foundation. (2024). Chronic Pain Fact Sheet. https://uspainfoundation.org/wp-content/uploads/2024/08/FINAL.2024-CHRONIC-PAIN-FACT-SHEET.pdf