Work effectively with people who have chronic pain and hypersensitivity

By: Loolwa Khazzoom, Founder, Dancing with Pain

May 20th, 2010 • Patient AdvocacyPrint Print

If you are a healthcare professional, be sure that you identify ahead of time who has chronic pain and hypersensitivity. Then be sure that you work with these clients in a way that is safe for them:

  1. Check in with them before touching them. Let them know what kind of touch you need to do and why, and see if there is anything you need to know about special sensitivities in that area. Keep in mind that in addition to being careful about the quality of touch itself, you need to be careful about how you approach the client. Past trauma may make a client tense up just knowing that a touch is coming. Hearing your extra step of care and heads-up, which seriously is a matter of maybe 30 seconds, will make a world of difference
  2. Let the client know that you invite feedback about the quality of touch – if the pressure is to firm or the touch is too quick, for example.
  3. Move extra slowly and gently, as if you are working with a frail elderly person, even if that client is young and looks strong and healthy. Remember that the nervous system of someone with chronic pain and hypersensitivity can be shot. Any jerking or jarring motions, or any trigger of the fight-or-flight response, can exacerbate pain – not just in the moment, but for days to come. Begin by gently laying your hands on top of the patient’s skin, then if necessary for the examination, very slowly and softly increasing pressure – giving the client time to adjust and inform you if the pressure becomes too much.
  4. Check in again, as you work with the client, and especially as you increase pressure. The combination of past healthcare practitioner invalidation and general social conditioning may make a client afraid of speaking up. Your encouragement can help the client overcome that fear hurdle and communicate honestly, making the examination effective.
  5. Question whether it is truly necessary to poke and prod around a client’s body, to determine pain zones. Perhaps this information is already in the client’s chart somewhere. Or perhaps the client can inform you of these pain zones herself. If you do determine, together, that it is important for you to test out the comfortable and painful areas on a client’s body, do so with rigorous attention to the safety steps outlined above.

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