Self-Management in Chronic Pain: Widely Recommended, Rarely Embedded

Session Title: Self-Management in Chronic Pain: Widely Recommended, Rarely Embedded

Topic: CLINICAL SCIENCE

Description: Pain conditions, including chronic musculoskeletal pain, are among the leading causes of disability worldwide. Their global burden is projected to continue increasing, especially in low-and middle-income countries (LMICs). Additionally, people with chronic musculoskeletal pain are often multimorbid, commonly presenting with mental and metabolic conditions. These factors further intensify pressure on healthcare systems through increased utilization. Despite biomedical advances, traditional provider-driven models fall short of addressing the complex, multifaceted nature of these patients, underscoring the need for sustainable, effective approaches.

While international guidelines consistently recommend person-centered and biopsychosocial approaches, the implementation of self-management and self-management support in clinical practice and across systems remains a challenge. This topical workshop focuses on self-management as a fundamental element of contemporary chronic pain management and consists of four presentations designed to spark critical reflections and dialogue on the state of self-management support for people with painful conditions.

The session begins with a presentation about person-centered self-management support for musculoskeletal pain conditions (Hutting, Eur J Physiother, 2024) and a practical framework for implementing person-centered self-management in musculoskeletal pain (Hutting et al., Musculoskelet Sci Pract, 2022). Moreover, practical tools and instruments, such as the Musculoskeletal Self-Management Questionnaire (Hutting et al., Musculoskelet Sci Pract, 2025), will be introduced. These and other tools help clinicians translate theoretical biopsychosocial principles into individualized, meaningful and measurable self-management support.

The second presentation will explore how interpersonal dynamics within pain consultations can meaningfully enhance patient self-management. It will highlight how validating communication from clinicians builds trust and legitimises pain experiences, laying essential groundwork for shared-decision making and patient agency in self management. The presentation also explores patient perspectives from multiple studies, including experiences of medication self-management when using antidepressants for chronic pain, and discusses how individuals understand and can self-manage the psychosocial impacts of living with pain.

Building on a programme of co-designed research with people with lived experience (Hale et al., J Pain, 2025) and Māori (the Indigenous population of Aotearoa New Zealand) with chronic pain (Davies et al., J Pain, 2024), the third presentation will focus on the role of integrating lived experience expertise in supporting pain self-management. This evidence-informed talk will provide novel insights on the concepts of “self-management” from a non-Western perspective and enable the audience to critically reflect on the possibilities for meaningful engagement with lived experience experts.

The final presentation focuses on self-management among individuals with low health literacy, using insights from the European Digi4MSK project (https://digi4msk.eu) and related research that highlights the importance of identifying and addressing patients’ pain literacy to provide tailored education and support self-management. This part explores how digital and blended education strategies can improve accessibility, inclusiveness and sustainability of self-management support for people with chronic pain.

Together, these four presentations provide a coherent overview of how self-management can be implemented as a cornerstone of person-centered pain management across diverse contexts and populations. Participants will gain an updated conceptual foundation and practical insights to strengthen self-management support in their own settings, contributing to more equitable, collaborative and sustainable pain care worldwide.

Speakers

Nathan Hutting HAN University of Applied Sciences
Netherlands

Dr. Nathan Hutting is a physiotherapist and manual therapist. He currently works in the Netherlands as an Associate Professor at HAN University of Applied Sciences. In addition to his academic role, he also practices as a physiotherapist and manual therapist in private practice.

Nathan serves as Vice President of the International Federation of Manual and Musculoskeletal Physical Therapists (IFOMPT), a specialty group of World Physiotherapy. He has been actively involved in numerous working groups and committees within the field of physiotherapy and is a member of the Lancet Global Health Commission on People-Centered Care for Universal Health Coverage.

Nathan has published approximately 75 peer-reviewed articles and is internationally recognised for his expertise in person-centred care and self-management. He has delivered numerous international keynote lectures and conference presentations across Europe, North America, South America, Africa, Asia, and Oceania. He is also Deputy Editor of Musculoskeletal Science and Practice, a peer-reviewed scientific journal.

Steffan Christensen Aalborg University
Denmark

Steffan Wittrup McPhee Christensen is an Associate Professor at the Department of Health Science and Technology, Aalborg University, Denmark, and an Associate Lecturer at the University College of Northern Denmark. He is a musculoskeletal physiotherapist with a PhD in Clinical Science and Biomedicine from Aalborg University, and he teaches and conducts research at both institutions.
His research focuses on understanding musculoskeletal disorders, with a particular interest in spine-related pain conditions and how these can be influenced. He is part of Digi4MSK, a European project developing digital resources to support musculoskeletal health literacy and pain management.
Steffan has published extensively in the field of musculoskeletal pain, contributed to clinical guidelines, and is actively involved in several international collaborations within the musculoskeletal field. He serves on the Ethical Review Board of the International Association for the Study of Pain (IASP) and has chaired the IASP Digital Strategy and Content Working Group for three consecutive terms. He has more than 20 years of clinical experience and remains clinically active, treating patients with complex pain conditions.

Hollie Birkinshaw University of Southampton
United Kingdom

Hollie is an experienced researcher in chronic pain, focusing particularly on musculoskeletal pain and the integration of psychology in pain and health services research. Hollie has mixed methods expertise in an array of primary care and pain research, including:

- Leading a Cochrane review and network meta-analysis on the efficacy and safety of antidepressants for chronic pain.

-Exploring pain-related distress in chronic musculoskeletal pain through qualitative interviews and surveys, and developing a patient-centred intervention.

- Working within primary care randomised controlled trials for stratified care and clinician decision support systems.

- Exploring psychosocial mechanisms that predict pain transitions, as part of the Advanced Pain Discovery Platform's CRIISP consortium.

- Involving patients and members of the public in the research process from design to delivery.

Hollie’s NIHR School for Primary Care post-doctoral fellowship was awarded the Elizabeth Murray award, and explores the development of pain related distress in musculoskeletal pain, and first contact physiotherapists’ experiences of assessing and managing this.

Hemakumar Devan University of Otago, New Zealand & Capital, Coast and Hutt Valley, Health New Zealand
New Zealand

Dr Hemakumar Devan (he/his) is a clinical academic in pain management from New Zealand, working as a Senior Lecturer at the Rehabilitation Teaching and Research Unit (RTRU), University of Otago and as a Pain Management Physiotherapist at the Wellington Regional Pain Service, Te Whatu Ora Capital, Coast and Hutt Valley.

With equity and valuing lived experience expertise at the centre, Dr Devan’s research programme aims to foster self-management support to empower people with persistent pain and their whānau (family and significant others). He currently co-leads a HRC Health Delivery Project Grant to co-develop and implement a story-based, whānau-focused, opioid tapering intervention for people with chronic non-cancer pain. Strategically, his goal is to address health inequities and improve health outcomes for people with persistent pain and their whānau.

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