THE ISSUE IS ... Is Occupational Therapy Adequately Meeting the Needs of People With Chronic Pain? Katie Robinson, Norelee Kennedy, Dominic Harmon KEY WORDS  activities of daily living  evidence-based practice  occupational therapy  pain, intractable Robinson, K., Kennedy, N., & Harmon, D. (2011). The Issue Is—Is occupational therapy adequately meeting the needs of people with chronic pain? American Journal of Occupational Therapy, 65, 106–113. doi: 10.5014/ajot.2011.09160 Katie Robinson, MSc (Disability Management), is Lecturer, Department of Occupational Therapy, University of Limerick, HS2-024, Health Science Building, Castletroy, Limerick, Republic of Ireland; katie. robinson@ul.ie Norelee Kennedy, PhD, is Lecturer, Department of Physiotherapy, University of Limerick, Limerick, Republic of Ireland. Dominic Harmon, MD, is Consultant, Department of Pain Medicine, Mid-Western Regional Hospital, Limerick, Republic of Ireland. T he World Health Organization (2002) has identified chronic conditions such as chronic pain as increasing at an alarming rate. Given the incidence and consequences of chronic pain (Breivik, Collet, Ventafridda, Cohen, & Gallacher, 2006) and occupational therapy’s potential contribution to the quality of life of peo- ple with chronic pain, reviewing contem- porary occupational therapy services for people with chronic pain is warranted. This paper deconstructs contemporary occupational therapy services and chal- lenges current professional philosophy and practice. Ensuring that the Centennial Vision of occupational therapy as a pow- erful, widely recognized, evidence-based profession meeting society’s occupational needs (American Occupational Therapy Association [AOTA], 2007) is realized re- quires discussion to challenge and ulti- mately transform practice. This article discusses contemporary occupational therapy for people with chronic pain with reference to a broad range of literature from many disciplines, and it examines the success of occupational therapy services in meeting the occupational needs of people with chronic pain. It concludes with a call for action that identifies key strategies for the future development of occupational therapy research and services for people with chronic pain. Chronic Pain in Context The International Association for the Study of Pain has defined pain as “an unpleasant sensory and emotional experi- ence associated with actual or potential tissue damage, or described in terms of such damage” (Merskey & Bogduk, 1994, p. 210). The development and delivery of efficacious pain management services are critical, given the human and economic costs of chronic pain. Chronic pain not only affects individuals but also has con- sequences for their family (Strunin & Boden, 2004) and costs for the whole of society. A national survey reported that 25% of American adults had experienced low back pain in the previous 3 mos (Na- tional Center for Health Statistics, 2006). The prevalence of low back pain has risen significantly over recent decades, with continuing high levels of disability and health care utilization (Katz, 2006). The largest survey of chronic pain in Europe (N 5 46,000) revealed that nearly 1 in 5 adults live with chronic pain (Breivik et al., 2006, p. 7). The economic cost of chronic pain, both in health care spending and work force costs, is estimated to be as high as $294.5 billion per year (National Research Council & Institute of Medicine, 2001). Consequences of Chronic Pain for Occupational Performance The consequences of chronic pain for occupational or activity performance are vast: independence, work performance, family and social role fulfillment (Strunin & Boden, 2004), community participation, physical activity (van den Berg-Emons, Schasfoort, de Vos, Bussmann, & Stam, 2007), leisure, sexual relations, roles (Harris, 106 January/February 2011, Volume 65, Number 1 Downloaded from http://ajot.aota.org on 06/04/2020 Terms of use: http://AOTA.org/terms