Book review: Your Pain Playbook by Helen Roome

There is an enormous missing link in pain management today. That link is, as I see it, how to translate from theory (decontextualised ideas) to daily life. To my life, to your life, to the unique and varied lives people living with pain had before their pain arrived.

Your Pain Playbook is written by Helen Roome, pain occupational therapist living and working in South Africa. The South African vibe runs through her book, giving this Kiwi a lovely taste of Helen’s country via the metaphors she uses – ever heard of the ‘Go-away bird’? It’s a bird that warns impala of impending danger and Helen uses this as a metaphor for the unhelpful attention-grabbing aspects of pain where pain isn’t necessarily an indication of danger to our tissues.

I love the way Helen brings not only a modern understanding of pain from a ‘brain’-centric perspective, but also weaves in knowledge about the way our entire body ‘eco-system’ is primed to inform us of potential harm. Pain emerges from this eco-system, giving us many options to help settle the experience down. She draws on experiences you and I will most certainly have had (like random bruises appearing without us being aware of how we got them!) to help readers understand their own bodies and how pain can be influenced by many things.

The book is divided into six weeks of seven day brief readings and activities. She starts with a word about goal-setting – and a lovely approach this is, too. Now while I’m not so keen on the old ‘SMART’ goals idea, the way Helen describes the process – including how to handle setbacks – is lovely and clear. She includes ways to tweak goals, both to increase demand, and to reduce the challenge if it’s not working out. And most importantly, she has a focus on doing in YOUR world. So instead of 7 goals, one for each day of the week, she reminds us to look at 5 days as success. Yay!

While it is written as a six-week programme, Helen emphasises that you can choose which chapter to start with. So if you have trouble with sleep, start with chapter 2 all about sleeping better. If you want to focus on moving more – start with chapter 3. Chapter 4 is about stress, and 5 is about looking at rhythms and patterns in daily life to create a sustainable lifestyle that’s going to fit you. Chapter 6 is about being present, or mindfulness and the good things that come from engaging your curiosity and compassion – and doesn’t just look at ‘sit still and breathe’ but also other ways of bringing mindfulness into your life. Each chapter offers options for what you want to look at next, along with some great suggestions for goals that fit with the theme of that chapter.

The final set of resources are practical tools to document your daily routine and manage your flare-ups (because, folks, this is one thing often omitted from pain management books – pain doesn’t always go away completely, it often sneaks back in and sets you back again. A set-back plan is essential so future you is prepared!).

What I love about this book, apart from the things I’ve mentioned above, is that this is an authentic and real approach to learning how to live well with pain. While I think it would be best used alongside a group of others or a clinician (because changing habits is so HARD!), the step-by-step approach written in language that is simple to understand with practical actions and points to ponder is so good.

BTW if you’re a geek as I am, the reference list is delicious!

I read Your Pain Playbook on a Kindle Scribe where the layout on portrait mode is really good. I’m not so sure it would work on the smaller Kindle format, and it can be a little slow to load when moving from page to page. A printed version would be fabulous to have, provided the pages lie flat.

And finally, a word about my reviews. I buy books myself so I can review them without obligation. Helen is a fellow occupational therapist, and it is so good to read someone else writing about the daily doing of supported pain self-management. We need more of this approach not just in books, but in pain management programmes and on social media. Pain self-management is not so much about the ‘did I lift this correctly’ or ‘have I identified and changed my thinking’. It’s not even about ‘did I do the right set of exercises’ or ‘do I understand pain neurobiology’. Living well with pain involves making sense of the weird stuff that happens when pain becomes a hitch-hiker, deciding what really matters and what your life is going to stand for, and then digging in to the details of how you can find your personal wiggle room to be and do the things that matter to you. This means all those daily decisions about how to say no to things, when to move and when to rest, getting a decent night’s sleep, being able to calm a stressed self down, and ways to get energised to do the things that need to be done.

If you’re a pain clinician, you might find the approach Helen’s described in Your Pain Playbook a revolution – please, read it and know that these seemingly small shifts, these habits and practices, these myriad ways to incorporate principles of pain self-management absolutely ARE what we as clinicians need to encourage. Stop dictating to people, and begin exploring and being curious about how we can live well in the presence of pain. Pain will do its thing, meanwhile you’ll be helping people live their life.

Your Pain Playbook: Effective daily strategies for life beyond pain. Helen Roome.

Resources