Scoop of the Day: How Pain Influences your Daily Life

  Activities of Daily Living (ADL’s) refer to the duties we perform on a daily basis as part of our routine or for survival. These activities are highly individualized as no two people are alike. Many different things may influence which duties are expected of us on a daily basis. For example, a mother of four may be expected to cook dinner and wash the babies every day, while a single elderly cat-lady is only expected to pour food into her darling’s bowls and give a nice scratch here and there.

  To read more about Activities of Daily Living and what may influence it, read this Blogpost.

  Now, how PAIN ties in with ADL’s, is individual to each person. Pain may influence our ability to perform our daily duties to its full extent. Imagine an athlete, for who it forms part of their daily routine to jog ten kilometres, fracturing his ankle. Immediately, his ADL’s would change! He may not be able to jog for a while, but still needs to mobilize in the house. It’s important that your clinician takes note of your ADL’s, as the aim is always to get you back to your previous level of function.

  It’s also a good measurement tool to see to which extent pain influences one’s life. If one is unable to attend work due to pain, the aim would be to alleviate the pain by getting to the source of the pain. In many, if not most instances, a doctor would prescribe pain medication without tending to the source of the pain… In this way, they also create their own return-business: they know full well you’ll be back as soon as your prescription’s up! The same goes for Physiotherapists who only treats trigger points (tight bands of muscle) instead of providing rehabilitative techniques to fix the source of said trigger points.

  It’s important for the patient to understand their current level of function versus their previous one and versus their expected level. I’ve seen many patients who could never do mountain climbing, but expects intervention to suddenly qualify them as professional mountaineers. The outcome of intervention should be a continuous discussion between the two parties. The aim of intervention should be to facilitate return to the previous level of function, that is to say, to enable the patient to be able to perform the same daily tasks as before.

  In some instances, this may not be possible unfortunately. A person, for example, that was an avid scuba diver who sustained a spinal fracture, will most probably never be able to return to his previous level of function. That means that his ADL’s will be changed permanently; that is NOT to say that it will not improve, but it needs to be adapted. While scuba diving may be out of the question, such a patient can be taught to eat, dress, drive and even work by themselves.

  The ADL most commonly influenced by pain, is a person’s ability to work. Together with pain directly, no matter the origin, a person’s mental state may be altered as well. We’ve all been a bit grumpy if we have stomach cramps or snagged a toe on a dresser! Pain may lead to some depressive symptoms and social withdrawal, which further implicates one’s ADL’s; some people would get depressed to the point where they do not want to get better… This is much more common than we give it credit for… We have millions of people on social welfare due to the extensive influences of pain.

  Medical intervention and therapy should always be centred not only on the malady at hand, but mostly about the person experiencing the malady.

  There’s an old saying in medicine going something like: Treat the patient as a whole, not just the hole in the patient…