What is chronic pain?

Chronic pain is pain that lasts or recurs for more than 3 months and is often associated with significant emotional and/or functional challenges. Chronic pain impacts 1 in 5 Canadian adults and has profound adverse impacts on a person’s well-being and multiple areas of life, including social roles and relationships, work, and activities of daily living.

There are many different types of chronic pain. Some examples include chronic widespread pain (e.g., fibromyalgia), chronic musculoskeletal pain (e.g., low back pain), and complex regional pain syndrome. Sometimes pain can start because of an initial injury; other times, it can come on because of a perceived injury, stressful situation, or gradually without a clear cause. Pain can also be due to an underlying health condition, such as rheumatoid arthritis, multiple sclerosis, or spinal cord injury.

Regardless of its cause, pain is always a personal experience and is influenced to varying degrees by biological, psychological, emotional, and social factors, as well as our life experiences (which inform how we interpret and understand our pain). For this reason, no pain ever presents the same!

How is chronic pain treated?

Pain is a unique and personal experience, and its treatment should be too. Current practice guidelines suggest that chronic pain is best managed with a multidisciplinary (team-based) approach using different treatment modalities. “Non-pharmacological” (non-medical or non-surgical) modalities are the suggested first-line treatment for many types of chronic pain. This can include pain education, cognitive-behavioural therapies (e.g., acceptance and commitment therapy), mindfulness techniques, movement-based therapies, somatic tracking, energy conservation techniques, provision of adaptive equipment, and complementary and alternative medicines (e.g., acupuncture and therapeutic massage).

What publicly funded (no-cost) pain services are available for Manitobans?

Many self-management tools for pain management can be found online. Click here for more info.

How can Occupational Therapy help?

Occupational Therapy is a health profession that is focused on function. It is based around helping people with various injuries, illnesses, or disabilities to feel productive and satisfied in their daily life.

Occupational Therapists (OTs) are regulated health professionals that work with individuals to help them perform the activities they need, want, or are expected to do. OTs can work with anyone who is experiencing a disruption to their function. OTs have advanced knowledge and training in a variety of areas, including musculoskeletal conditions, neuroscience, mental health, and group therapy.

OTs view illness as existing in a life, not just in a body. In this way, OTs are well positioned to address the adverse impacts that illness and disease can have across life domains, such as social roles, relationships, and activities of daily living (e.g., self-care, leisure, work, and other roles).

What can Therapy First offer you?

At Therapy First, we believe that pain care is a fundamental human right and that all Manitobans should have reasonable access to proper pain care. We strive to provide services that are accessible, flexible, and person-centred. Click here to learn more about our pain clinicians.

Our services focus on pain management (i.e., improving your ability to manage pain in the long-term, rather than chasing short-term solutions for pain relief). Our approach focuses less on reducing pain intensity, and more on optimizing function and improving quality of life, despite pain.

Our services aim to help you to:

  • Become knowledgeable about your chronic pain diagnosis
  • Feel confident with using various pain management strategies
  • Address life stressors that may be contributing to your pain symptoms
  • Explore important values and establish meaningful goals to work towards
  • Improve overall function and quality of life

Our services may include:

  • Comprehensive pain assessment and goal setting
  • Individualized pain education and treatment planning, which may include:
    • Pain counselling (drawing on Acceptance and Commitment Therapy)
    • Pain Reprocessing Therapy (PRT) – click here to learn more!
    • Stress management
    • Communication skills training
    • Mindfulness and self-compassion coaching
    • Individualized training in activity pacing and energy conservation, muscle/joint protection, flare-up tracking and management, and relaxation and sleep hygiene techniques for pain
  • Home visits for functional assessment (*considered on a case-by-case basis)
    • A home visit allows us to understand your unique living situation and to tailor our interventions specifically to your life. During a home visit, we can assess how you’re managing with daily activities, such as personal care, cooking, housekeeping, home maintenance, and leisure. We provide support and education, which may include recommendations for equipment and/or home health services to help compensate for changing abilities.

Our services do not include:

  • Physical or manual therapy (e.g., manipulations or massage)
  • Medical procedures (e.g., injections)
  • Medication review or consultation
  • Counselling around concerns unrelated to chronic pain

Are Therapy First’s chronic pain services right for you?

We currently offer services to adults living with any type of chronic pain; however, some of our treatments are designed for specific types of pain. We can explore which services are right for you during your initial intake appointment.

Our services may be right for you if:

  • You’ve lived with pain for more than 3 months
  • Your pain is not related to an acute injury or illness that is still healing
  • Your pain is preventing you from doing the things you want and need to do
  • Your pain is contributing to feelings of anxiety and depression
  • You want to learn new ways to manage your pain

What is the referral process?

Distinguishing between types of chronic pain can be challenging. If you’re unsure about the cause of your chronic pain, you should first talk with your primary care provider (e.g., family doctor or nurse practitioner). We also offer a 30-minute $60.00 phone assessment and consultation to help you to determine which services are best for you. Click here to request a 30-minute consultation.

If you’re ready to proceed with our pain services, the next step is to schedule an initial 90-minute intake appointment. Once you’ve submitted this form, you will be contacted by a Therapy First OT to discuss options for your first appointment. Depending on your specific situation, this appointment could be a virtual visit or a home visit. The initial intake appointment will last 90 minutes, and will include a comprehensive pain assessment, targeted goal setting, and individualized treatment planning. All subsequent sessions will be scheduled for 60 minutes and can be done virtually or at your home.

The fee schedule can be found here. Therapy First does not offer direct billing to private insurance; we recommend that you check your insurance plan to see if it includes occupational therapy coverage. Receipts will be provided so that you can seek reimbursement. If you have WCB or MPI coverage, please contact your case manager to see if these services might be considered as part of your compensable injury and therefore eligible for funding. Your case manager can contact Therapy First with questions.

What other private (fee-for-service) services exist?

You may be interested in exploring services offered by other professionals to supplement our work together. Click here for more info.

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