People living with ongoing and recurring back often spend years seeking help, and sometimes get stuck in a cycle of visiting different specialists. This means self-management to control the pain and function well can be a lifelong task. 

Self-management is now seen as a collaboration between the person living with the pain and their health professionals. But it’s useful to understand what it is about that patient–professional partnership that can support self-management.

A  review of the research identified 6 themes that can influence patients' ability to self-manage their pain:

Effective communication

The review showed that effective communication was the most important thing that helps patients build self-management skills. 

The most important elements of effective communication were being encouraged by health professionals who took the time to listen to and understand them.

Effective listening was crucial to building a good patient-professional partnership, because:

• it enabled health professionals to understand patients' needs and offer specific treatment and self-management skills
• it helped patients to learn strategies and cooperate better with health professionals to manage their pain. 

Face-to-face communication was preferred over written communication as it made patients feel involved in the treatment process, and telephone contact was considered more as a follow-up.

Effective listening also shapes what patients believe about, and their attitudes towards, persistent back pain management. For example, their ability to accept their condition is the first step to being able to self-manage it.

Training programs that improve health professionals' communication skills were recommended to improve their ability to partner with their patients.

Mutual understanding

The review showed that mutual understanding also helps build partnerships and trust between patients and health professionals.

Patients expect health professionals to understand their pain and life situations. And health professionals want patients to understand their reasons for providing treatment. 

Misunderstandings can arise when health professionals under or over-prescribe pain medication, or when patients don’t take their treatment seriously. This is where effective communication and taking the time to actively listen comes in — it can help improve their understanding of each other's perspectives. 

Roles of health professionals 

The role of health professionals in helping patients self-manage their pain was another theme.

As we’ve seen in many a previous article, patients value the support, empathy and professional manner of health professionals. 

They consider their skills in giving them clear, patient-centred information, looking for solutions, empowering them and helping them build confidence to be integral to their ability to self-manage pain. 

The information they expect includes the cause of their pain, prognosis, treatment options, and self-management strategies to manage their pain. 

And they appreciate clear explanations in lay language, the use of charts, anatomical models and pamphlets. 

Patients reported feeling better when they understood what was wrong with their bodies, even though the information didn’t lessen their pain.

Individualised care

The review also showed that patients with chronic back pain place a high value on receiving personalised treatment plans, self-management strategies, regular communication and motivation and encouragement. 

Spending time assessing the degree of pain patients are experiencing and how able they are to self-manage it is fundamental to designing an individualised care package.

Healthcare services

Patients desire easy and quick access to services like physiotherapy as well as follow-up contact or review sessions. However, limited consultation time made the availability of support from health professionals difficult. 

Understanding the patient’s readiness to change

The review also highlighted that some patients preferred to stick to their old lifestyle rather than adopt self-management strategies. 

In these cases, the health professional could assess the individual's readiness to change by using frameworks like the Transtheoretical Model of Change or motivational interviewing techniques to help patients self-manage their pain. 

Original research

Fu, Y., McNichol, E., Marczewski, K., & Closs, S. J. (2016). Patient–professional partnerships and chronic back pain self‐management: a qualitative systematic review and synthesis. Health & social care in the community, 24(3), 247-259.