Managing Chronic Pain

…by Paige Bartlett, de Tornyay Center for Healthy Aging

According to the CDC, one in five adults has chronic pain. Chronic pain becomes increasingly common as we age. For some, chronic pain can make it hard to function and complete basic daily tasks.

“Think of pain like an alarm system,” a group of UW Accelerated Bachelor of Science in Nursing students wrote in a chronic pain information sheet. “When you are hurt, the alarm system activates and sends a message to the brain that you need to take action. In approximately one in four people, the alarm system does not calm down and stays extra sensitive. This is when pain becomes chronic.”
The students, Maria Cosgrove, Peter Lam and Val Tyler, created the information sheet as a part of their project with Full Life with the aim of helping clients tackle chronic pain. However, the COVID-19 pandemic presented unique challenges to the students’ project. “We never got to actually see our clients,” said Lam. “[So] we wanted to work with the people who were with the clients the most. And that was the care coordination team.”

Health home care coordinators at Full Life work with their clients to connect them with services, plan their care and treatment, and provide health education. During COVID-19, the care coordinators have been meeting with their clients through virtual telehealth appointments.
The students put together a chronic pain fact sheet that care coordinators could share with clients. They also developed an information packet for the care coordinators and a guide for having pain management conversations with their clients. Overall, the project was well received by the coordinators. They were interested in having similar resource materials for other conditions.

The students tailored the content to different levels of readers, as clients may have different first languages and levels of education. The sheet listed different pain management strategies such as exercise, repositioning, physical therapy, breathing exercises and clinical psychology, as well as common myths about chronic pain. One myth was “it’s best to tough it out” when, in fact, pain management can be an important part of being able to complete daily tasks. Another myth was that pain just a part of growing older. “You get some degeneration in your joints and there is natural aging that happens,” said Cosgrove. “But being in consistent chronic pain that is affecting your daily life and your activities is not normal.”

The information packet for the care coordinators included resources on how to access non-pharmacological treatments, such as a free mindfulness-based stress reduction course at palousemindfulness.com, and free acupuncture for veterans at Seattle Acupuncture for Veterans. The packet also had information on local buprenorphine or methadone clinics and how clients can access them.

“We included the Suboxone or Methadone because there’s a lot of evidence to support that long term use of opioids is not a very effective way to deal with chronic pain, and it comes with a lot of risks,” said Tyler. “Instead of taking opioids for a long time, clients can consider Suboxone because it’s a safer option than long-term opioids.”

Many pain management strategies instead of, or in addition to, medication can be effective and safe – although individuals with chronic pain should talk to their health care provider before changing their pain treatment plan.

“It was a little eye opening, the extent of the non-pharmacological interventions [available],” said Cosgrove.