Self-management of chronic pain means giving patients not just the information but also the skills necessary to manage their pain and remain active in day-to-day life. This requires more than just telling your patients how to do an exercise: it entails ongoing support and guidance to help them master those skills and establish certain corrective habits and routines in response to flare-ups.

An ideal self-management program should meet the following criteria:

• Personalization – Every person is different. Their pain is in different places, has different triggers, manifests to different degrees of strength; their muscles are different, their circumstances are different, their psychosocial factors are different, they were raised to react to pain differently, their bodies react to exercises differently, they progress in different ways. Therefore, it’s imperative to treat the individual, not just the symptom, and continue to adjust to his/her needs on ongoing basis.
• The right tools at the right time – Use techniques with demonstrated effectiveness, and continue to build on those techniques as you continue to work with the patient, building confidence and skill over time.
• Address emotional factors – Emotions have a huge effect on chronic pain. People with chronic pain have increased anxiety and fear, they withdraw from activities they want to participate in, and they’re caught in a loop of negative thinking. Addressing and treating these emotions can expedite treatment.
• Reinforcement of patient responsibility – For a self-management program to be effective, it’s critical that the patient take an active role, not only doing the prescribed exercises but also monitoring and reporting accurate information to the physician. A strong experience of partnership between patient and provider is critical in effectively treating pain in the long run.

A self-management program that meets these criteria will offer vastly improved outcomes in treating patients with chronic pain. Most primary care providers don’t have the means to employ all these elements, but a pain specialist focuses exclusively on performing these functions and can ensure they are carried out to maximum benefit.