About 20% of adult Canadians suffer from a persistent pain problem such as chronic musculo-skeletal pain (such as neck, shoulder, back pain, etc.), fibromyalgia, chronic regional pain syndromes, chronic pelvic pain, post-surgical pain that lasts beyond 6 months, neuropathic pain (often caused by trauma), or neuralgias (such as post-herpetic pain, and trigeminal neuralgia), and post stroke or central pain. Pain is also a significant symptom in many chronic illnesses such as arthritis, Crohn’s disease, irritable bowel syndrome, diabetic neuropathy, and in some forms of multiple sclerosis.
Living with persistent pain can result in deep psychological distress and presents significant disruption to normal everyday activities including personal, family, social, and work activities. Because pain is often a part of everyday experience, the person with chronic pain must not only understand the medical aspects of the condition but also deal with all the consequences that are part and parcel of a persistent or chronic health problem. These consequences can include changes to lifestyle, changes to life goals including family, work and financial goals, emotional changes, and physical limitations. So unlike short-term health conditions that will get better, chronic conditions may demand major life readjustments for the long term. For many people, these changes were unexpected and they are unprepared for how to deal with them.
This is where self-management and self-management education comes in. Broadly defined, self management is a person’s ability to actively manage the symptoms, treatments, physical and social consequences and lifestyle changes that are part of living with a chronic condition day-to-day. In terms of chronic pain, a self-management approach means that the person must be willing to learn about and take responsibility for the daily management of their chronic pain. This requires time, patience, support and motivation. There are three main tasks in self-management. First is taking care of your own health. While you may have chronic pain, your overall health and wellness is critical. Taking care of ‘you’ will help with managing your chronic pain. Second, carry on with normal activities such as household chores, family, social and work activities. You may have to scale back or modify activities, but you can still live a rewarding life. Third, an active self-manager works on managing the emotional changes that accompany a condition like chronic pain.
Self-management education programs have been developed to provide people with the skills to live a healthy, active and meaningful life even with a chronic condition. Self-management programs provide information about the chronic condition but even more importantly teach people the skills to deal with the consequences of their condition. These skills include: problem-solving skills, decision-making skills, how to find and use appropriate resources, how to partner with your health care team, and how to take action to improve your life. Self management programs provide the opportunity for people to practice different approaches to managing everyday problems and concerns. This results in people being more confident in their abilities to manage their condition. Research has shown that people who are actively involved, who have the skills to deal with the consequences of their condition, and who believe in their ability to do so, have better physical and psychological health outcomes.