Why we use solution-focused coaching in pain management?

Sometime during COVID, I decided to attend the solution-focused coaching training with Debbie Hogan. My main interest was to learn more about effective change, and how we can integrate this into how we work with our clients.

Very often we know what is required for us to be healthier. The problem is really is in executing the solution. Take for example someone with a higher BMI score. They know that they need to change their diet and exercise. But getting down to actually doing so is a completely different ballgame.

As a chiropractor, I work a lot with chronic pain sufferers. Most persistent pain patients can identify the “problems” in their life. Not enough sleep, poor stress management, sedentary lifestyle, etc. The problem, again, is not in that you don’t know what is wrong. The problem is in being able to find a long-term solution for yourself.

How does coaching help with chronic pain?

solution focused coaching singapore
One amazing thing about coaching is that it’s universal. You can use it with professional athletes to pain management. At its gist, coaching is about bringing a person from point A to point B (i.e., goal state).

I had the pleasure of meeting clinical psychologist Jane Tuomola yesterday for dinner. Like myself, she also use a solution-focused methodology in her work. Sometime during dinner, she asked about how I integrate chiropractic with solution-focused coaching.

If you have never worked with us before, it’s very hard to imagine how solution-focused coaching can be useful in clinical context. Most chiropractors find a “problem” in your spine, often through x-rays, then use chiropractic adjustments to help you “fix” the problems. Within this framework, it’s very hard for a chiropractor to use solution-focused coaching in practice. Because in crack-and-go chiropractic services, there’s little to no talking involved.

instant pain solution, chiropractic adjustment
The thing about instant pain relief is that your pain will likely come back. From massages to chiropractic adjustments, you hear practitioners asking their clients to come back for maintenance. If they can deliver true long-term results, you won’t be requiring treatments for life!

At Square One Active Recovery, we are NOT a crack-on-demand service provider. We exclusively work with our clients to develop long-term pain solutions. Remember, our mission is to make ourselves redundant to you.

We are able to deliver long-term results through exercise and coaching. We use exercise to make your body more robust and resilient. We use coaching to help you make the necessary lifestyle shifts so you can enjoy a pain-free life.

For the past 15 years I have been going for the usual chiropractic adjustment for my neck and back pain and I was seeking a long-term sustainable solution when I came upon Square One Active Recovery. I decided to sign up for the program as it ticks all the boxes – no chiropractic adjustments, don’t need to depend on anyone and don’t have to keep coming back.
I am very happy with the results of the program as I am now free from chiropractic adjustment, my overall strength and endurance have improved and I am better able to perform many day-to-day tasks.


No, this is not about manifesting positive energy. No, it’s not about “positive vibes only”. It is hard change. It takes effort. The upside is that you get incredible results.

What makes solution focused coaching so special?

international coaching federation singapore
Solution-focused coaching is a lot of making small incremental steps towards your idea future. Unlike other problem solving approaches, we focus more on what can you do to help yourself.

The mindset shift in solution-focused coaching is probably what makes it so effective. In chronic pain management, people often talk about their problems and people often want to find out what’s wrong. While we totally appreciate where you are coming from, having answers to these questions don’t actually help you achieve a full recovery.

As we have alluded to earlier, knowing is not half the battle won! Knowing that you need to exercise more is not going to make you exercise more. Knowing that exercise is good for you doesn’t mean you will start exercising.

Sure, we think we will do the right thing for ourselves only we know that’s wrong. If that was true, nobody will be overweight and nobody will be sedentary anymore! I think you will be hard pressed to find someone in Singapore who doesn’t know that exercise is good for you.

So, solution-focused coaching, as the name suggests, focus on solutions. It emphasise on having clarity of what is your perfect future. It also emphasise on taking small, meaningful steps towards your ideal goal.

I just want to be pain-free

pain-free, pain management
A lot of people conflate being pain-free as recovery. However, the truth is that being pain-free alone doesn’t mean your body is ready to go back to your usual lifestyle.

Wanting to be pain-free is not a good recovery goal. Pain is highly contextual and without being specific to how your perfect pain-free life would like, it’s impossible for you to get rid of your aches and pains.

Assuming you have knee pain while climbing stairs. After seeking treatment, your knee pain completely resolved. You have more confidence in your knee and you decided to run a 10km run. At the end of the run, you started experiencing knee pain again.

Sounds familiar? Most chronic pain sufferers don’t experience good treatment outcomes because there is no clarity to what their recovered state is like.

If you have clarity to what your recovered state is like, you may set a recovery goal of being able to train and run for a marathon without knee pain. With this specific goal in mind, we can actually help you work towards running a marathon without injuring your knee!

If your recovery goal is to run a marathon pain-free, but you decide to try squatting 100kg, don’t be surprised if your knee pain returns. Pain is contextual. Yes, you can work in your recovery to squat 100kg. That’s not the problem. The problem is when you attempt to do something that your body is not prepared for.

Yes, we get that you want to be pain-free. But pain-free doing what? Or pain-free living what sort of lifestyle? Without this clarity, you will not achieve good recovery outcomes.

Making small changes can help you achieve a big change

small change to big change
Not entirely unique to solution-focused coaching but 100% important to consider when trying to make any meaningful change.

In recovery and sports science, we refer to this as cumulative effect. It refers to that small things can add together to result in a big change.

Smoking a cigarette for a day may not be a big deal. Smoking a cigarette everyday for a decade is going to significantly increase your risk of lung cancer!

Small changes accumulating to a big change is a double-edge sword. Like how it can help you achieve great results, it can also lead to massive health issues.

Solution-focused coaching emphasise on making small changes. This is helpful for chronic pain because living with persistent pain is often overwhelming. There is so much that needs to get done and there’s so much that cannot be done because of your pain.

Choosing to focus on making small changes without letting the problems overwhelm you makes a big difference. Sure, putting your phone away an hour before bedtime may not seem like much but practising good health behaviour will make practising other health behaviours easier. The most important step is always in getting started.

I want to be freed from pain!

If you have been going for treatments and you are simply not getting the results are you are hoping for, drop us a message to learn more about how we can help you help yourself find true freedom from pain. While the process may be difficult and challenging, we will be there every step of the way to help you navigate your pain experience!


Frustrated by the lack of results-driven and ethical chiropractic clinics in Singapore, Chiropractor Jesse Cai found Square One Active Recovery to deliver meaningful and sustainable pain solutions.

Our goal? To make our own services redundant to you.

*We do not offer temporary pain relief such as chiropractic adjustments, dry needling, or any form of soft tissue therapy.