Each issue we talk to a different occupational therapist to find out more about what their role involves and what they love about their job. This issue we speak to Lucy Zurich who works with InHealth Pain Management Solutions in Tameside and Glossop.

About Lucy
Following the completion of a BSc Psychology Hons degree Lucy discovered a passion for neuroscience and later completed her MSc Occupational Therapy. She has worked in neuro rehab, mental health and community rehab leading to her current post with InHealth Pain Management Solutions in Tameside and Glossop, an interdisciplinary community-based service for NHS MSK patients with chronic pain.

What is your current role?
I’m a clinical specialist OT and I run clinics in GP centres providing one-to-one appointments and co-facilitate pain management programmes focusing on self-management and helping patients move forward with their life despite persistent pain. We see patients for a variety of pain conditions such as lower back pain, fibromyalgia, arthritis and complex regional pain syndrome. A large part of my role is to improve patient’s understanding of pain mechanisms and its multifactorial influences to collaboratively identify the biophysical, social and psychological contributors to their wholly unique pain experience to formulate a treatment plan.

Describe a typical day…
New patient appointments involve functional and psychosocial assessments incorporating the patient’s narrative, reviewing their understanding of pain, explaining the purpose of therapy and briefly introducing the neuromatrix of pain and central sensitisation.

Other clinic appointments remain focused on meaningful occupations and include self-management strategies such as pacing and grading of activities, anxiety management, sleep hygiene, identifying unhelpful thought processes, gentle exercise provision and relaxation methods to redirect the brain’s focus to reframe pain. In a day I might also be; practicing transfers, developing self-advocacy skills, sensory re-education, reviewing the use of a walking aid, improving body movement, graded motor imagery, recommending needs assessment for equipment or minor adaptations to GPs or completing flare-up self-management plans.

What’s the best part of your job?
Having flexibility in interventions and not having to choose between treating either physical or mental health needs in isolation is refreshing. The biggest reward is when a patient feels more in control and have started remembering how it feels to be themselves again, their function improves, and they begin reclaiming their lives.

What’s the hardest part of your job?
Disappointingly the treatment model for chronic pain remains largely biomedical despite the use of early biopsychosocial intervention, alongside the appropriate use of medication, being recommended best practice.

Patients who are referred a year or 20 years+ after the onset of pain are often fearful, disillusioned and disabled through pain following a myriad of ineffective passive treatments, misinformation and unhelpful biomechanical explanations for pain. This culture is slowly changing within the medical community and I’m hopeful that current scientific understandings of pain and treatment become more widely embedded throughout society in the future.

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