{"doi":"10.1093/pm/pnac083","title":"Self-Management of Chronic Pain: Psychologically Guided Core Competencies for Providers","abstract":"Maria has significant, chronic knee pain from osteoarthritis that she feels has worsened through years of bending over and kneeling during her career as a licensed practical nurse. Nothing has successfully offered lasting relief. Medications make her feel woozy or upset her stomach. She doesn’t feel safe outside alone in her neighborhood, so she does not exercise. Maria has heard there might be other options like yoga, mindfulness, and physical therapy, but she doesn’t know how to find these services, doesn’t think she can afford them, and isn’t convinced they will work. In the meantime, Maria powers through her pain because she needs to work. She’s depressed, and pain dominates her life. Millions of people like Maria (a fictitious patient) experience chronic pain and seek help from providers of various types. The dominant biomedical model and longstanding societal norms reinforce the idea that health problems require the attention of a health care provider who can identify the source of the problem and “do something” to eliminate it, typically via medications or surgery. However, the traditional patient–provider encounter is impractical and inefficient for managing multidimensional conditions like chronic pain. The ways individuals manage chronic pain are highly personal and not only are driven by provider-based information and interventions, but also are influenced by a lifetime of internalized views and behaviors, written or online information of variable quality, guidance from family and close social ties, and highly funded marketing efforts that reinforce biomedical approaches to health in general and pain specifically. Self-management of chronic pain reflects intentional, active efforts to manage pain and its effects on physical and emotional function [1]. A patient’s adoption of a self-management approach for chronic pain is predicated on perceptions of self-efficacy: the belief in one’s own capacity for self-management. However, we know that pain self-management is a continuous process that requires the motivation, knowledge, and skills necessary to maintain effective physical and psychosocial function [2]. Ideally, these skills include the use of cognitive, emotional, and behavioral strategies to manage personal, family, and social roles and responsibilities and the emotional consequences of chronic pain. Ultimately, self-management of chronic pain is specific to an individual and controlled by her or him. For this reason, providers of every type must consider factors beyond provider-initiated interventions that have the potential to shape an individual’s ability to manage pain effectively and thus contribute to quality of life in the long term. Previous work has affirmed the value of provider empathy and effective communication about the management of chronic pain and barriers that interfere with such management [3]. Successful self-management of pain thus grows from strong, dynamic, collaborative relationships between individuals with chronic pain and their health care providers—relationships that prioritize patient empowerment, activation, and self-efficacy and that can evolve over time [4]. One example of such a strategy is the Department of Veterans Affairs (VA) Stepped Care Model for Pain Management, which emphasizes general health-promoting behaviors, including nutrition and weight management, exercise and conditioning, sleep quality, engagement in meaningful activities, and family/social support [5]. The VA-based model also provides guidance for the use of patient-controlled pain-reducing activities, such as the use of ice and stretching, mindfulness-based meditation, and relaxation strategies, among other evidence-based modalities. Other resources have been developed by the American Chronic Pain Association and the Centers for Disease Control and Prevention. Clinical practice guidelines promulgated by the American College of Physicians and other entities have also specifically encouraged the use of evidence-b","journal":"Pain Medicine","year":2022,"id":258710,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":17,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9535,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":360884,"name":"Diana J. Burgess","orcid":"0000-0002-3266-1132","position":1,"is_corresponding":false},{"id":330635,"name":"Brian C. Coleman","orcid":"0000-0002-6926-5571","position":2,"is_corresponding":false},{"id":427761,"name":"Chad Cook","orcid":"0000-0001-8622-8361","position":3,"is_corresponding":false},{"id":383346,"name":"Shawn Farrokhi","orcid":"0000-0001-9732-7429","position":4,"is_corresponding":false},{"id":390468,"name":"Julie M. Fritz","orcid":"0000-0002-3599-1057","position":5,"is_corresponding":false},{"id":671287,"name":"Christine Goertz","orcid":"0000-0002-4941-3645","position":6,"is_corresponding":false},{"id":377016,"name":"Alicia A. Heapy","orcid":"0000-0003-1284-8263","position":7,"is_corresponding":false},{"id":411318,"name":"Anthony J. Lisi","orcid":"0000-0003-1153-967X","position":8,"is_corresponding":false},{"id":360893,"name":"Daniel I. Rhon","orcid":"0000-0002-4320-990X","position":9,"is_corresponding":false},{"id":411319,"name":"Robert Vining","orcid":"0000-0003-4672-4613","position":10,"is_corresponding":false},{"id":431791,"name":"Robert D. Kerns","orcid":"0000-0002-3834-973X","position":0,"is_corresponding":true}],"reference_count":17,"raw_metadata":null,"created_at":"2026-07-19T00:25:43.037820Z","pmid":"35642906","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}