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Practice Practice Pointer

Chronic pain: supported self-management

ݮƵ 2024; 384 doi: (Published 02 January 2024) Cite this as: ݮƵ 2024;384:e072362
  1. Youngjoo Kang, F2 doctor1,
  2. Louise Trewern, chronic pain patient advocate2 3 4 5,
  3. John Jackman, GP, rheumatology speciality doctor6,
  4. Anushka Irani (nee Soni), senior associate consultant, honorary senior clinical research fellow78,
  5. David McCartney, GP partner, director of graduate entry medicine910
  1. 1Frimley Health NHS Foundation Trust, Slough, UK
  2. 2British Pain Society (patient author)
  3. 3Physiotherapy Pain Association
  4. 4Get-Involved—Evolving Through Patient Experience Committee at Torbay Hospital Pain Service
  5. 5Live Well With Pain
  6. 6Oxford University Hospitals NHS Foundation Trust, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences
  7. 7Division of Rheumatology, Mayo Clinic Florida
  8. 8FMRIB Pain Analgesia/Anaesthesia Imaging Neuroscience group
  9. 9Oxford City Practice
  10. 10Medical Sciences Division, University of Oxford
  1. Correspondence to D McCartney david.mccartney{at}seh.ox.ac.uk

What you need to know

  • Supported self-management is an approach to chronic pain that involves shared decision making, co-production of treatment, and equipping patients with the skills to manage their pain outside of clinical consultations

  • Supported self-management is not an all-or-nothing approach but can be tailored to the individual patient

  • Longer consultation times may be required initially, but successful supported self-management may reduce consultation rates over time

Chronic pain is a common and disabling condition.123 Increasingly, shared decision making and psychological and behavioural self-management are being prioritised in caring for people with chronic pain, with a diminishing number of pharmacological treatments being supported by guidelines.4567 Following a previous article on identifying and diagnosing chronic primary pain,8 this article aims to help clinicians understand what supported self-management involves and shares practical tips on how to work with patients using this approach, considering what the barriers and facilitators to supported self-management might be.

What is supported self-management?

Although no “gold standard” definition of self-management exists in the context of chronic illness, it may be understood as “an individual’s ability to monitor their health condition and effect the behavioural, cognitive, and emotional responses required to support a satisfactory quality of life.”9 Self-management can also be thought of as “a single approach or combination of approaches that can be initially taught by any health professional or learned by an individual to enable patients to minimise the impact their chronic pain can have on everyday life.”10 For example, a patient struggling with chronic pain which has led to a reduction in activities might be empowered by setting goals, an aspect of self-management to identify something specific and achievable that they would like to be able to do. Self-management requires the ability to appraise one’s situation and decide on a course of action to achieve …

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