Pain management
Weaving art therapy into chronic pain management
For chronic pain patients, pain will always be a part of their life. No effort for pain modulation is 100% curative for these patients, which means a careful balance of support needs to be considered. Liza Tharakan, Consultant in Pain Medicine and Anaesthesia and Lead Clinician for the Chronic Pain Service at the Royal Orthopaedic Hospital in Birmingham, discusses the role of art in holistic pain management for chronic pain patients.
Therapies for pain management include pain modulation with medications, which can often leave patients with a wide range of side effects. Not to mention the impact of long-term medicating and the risk this poses for the patient during future surgical interventions, as well as the risk of addiction. Alongside medication, injections and physiotherapy are often used to support chronic pain patients in managing their condition. While all these options do help patients, they are limited in what they can offer. Pain management in these forms help reduce the physical experience of pain, but leave one large element untouched – the emotional aspect. Chronic pain affects quality of life for patients. They can feel isolated, lack confidence, and often struggle in socialising especially within new groups. As the nervous system is impacted for those suffering with chronic pain, anxiety and depression are commonly reported comorbidities.1 We have to, therefore, look holistically at the patient’s pain (physical and emotional) and provide pain management that is equally holistic.
Alternative therapies for pain management The Department of Health stated, back in 2007, that art should be integral to healthcare to support health and wellbeing.2
Several studies
show that participating in creative art not only has an impact on overall wellbeing, but also contributes to pain management. The Arts Council, for example, looked at 79 studies that measured the impact of an arts-based intervention on pain reduction and found that 58 of them (or 73 percent) reported a statistically significant positive effect.3 Through engaging with art, patients can
control their pain, learn distraction from constant pain, reduce social disconnection, and in some cases prevent or treat substance use
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difficult emotion or the pain they feel inside. It can have a cathartic effect as they momentarily gain control over the pain and express who they are and how their pain makes them feel. In addition, it is a creative approach to distraction and relaxation – as patients get lost in creating a painting, they are temporarily free from their pain.
There’s no one way to ‘do’ art Creative art comes in many forms – dance, music, singing, pottery, painting, drawing – the list goes on. Different art has a different impact for each person experiencing it. Therefore, it’s critical that when art is used as a way to manage pain, it is carefully considered. For example, ceramic art, such as pottery, can
Sue, a Royal Orthopaedic Hospital patient, creates abstract painting during an Art for Health workshop
disorder. For example, art can decrease activity in the hypothalamus-pituitary-adrenal (HPA) axis, the body’s central response system to stress, as well as activate parts of the brain that play a role in descending inhibition of pain.3 This is because creative arts enable individuals
to step outside of the ‘self’. For many, pain is intrapersonal – the way someone experiences pain differs patient to patient, and it can have an effect of focusing inward. Art however, is generally an external experience – physically brushing a swathe of colour across a canvas, moving parts of the body through space in varying shapes to music, or even singing in a round in a group. By its very nature, art forces the individual to focus on something specific that is outside of them, moving them away from the intrapersonal barriers of their pain. It takes the isolation of pain and fosters a physical connection between the person and the art, and those who are engaging with the same art around them. It can also help patients with expressing
improve physical function and promotes joint movement, which can help patients with arthritic symptoms. At the Royal Orthopaedic Hospital, we secured funding from the Royal Orthopaedic Charity to run a series of workshops for chronic pain patients, with sessions focusing on different forms of art to complement their pain management treatment. One session looked at pottery, pinch pots in particular. Pinch pots are a creative and accessible way into this art form without the need for a potter’s wheel (and the accompanying technical skill to wield one). With a pinch pot, the patient makes a ball out of their clay, pushes their thumb into the middle of the ball and with a pinching motion using their thumb and index finger starts to create the shape they desire. Patients can also use tools to help form shapes if they don’t have enough hand strength, such as a tin of soup or other similar weighted rounded object. Dance is another ideal outlet for pain management patients. Movement through dance releases serotonin which is a key component in coping mechanisms,4
and it
can be adapted to the needs of the group. For example, patients who are wheelchair bound or
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