Before beginning the Pain Management Program, evaluations by a member of our clinical staff is necessary. Evaluation will determine whether the individual’s condition warrants treatment in the four-week program or individual therapies such as physical therapy or psychological counseling.
To participate the following criteria needs to be met:
- pain is of a chronic, stable, non-malignant nature
- other medical and psychiatric treatments are not considered more appropriate
- desired participation in the pain management program
- agreement to involve a family member or significant other for a one-time meeting
- financial arrangements have been completed
Program Components
The primary purpose of the program is to help patients remove or reduce disabilities and cope more effectively with pain-related problems. Specifically, treatment involves three components, which are provided simultaneously:
Exercise/physical therapy
Daily exercise programs and physical activities are gradually and progressively increased in a manner appropriate for a person’s age, medical and physical status.
Medical intervention
Medications used currently for pain are evaluated. The physician and nurse will design a new medication program with the intention to gradually reduce and ideally eliminate the medications currently used in relationship to the chronic pain.
Psychological counseling
Psychological and social issues related to or caused by the pain are identified and treated. General topics will be covered in a group setting, while individual sessions address the participant’s specific issues.
Exercise/Physical Therapy
The primary goal of exercise and physical therapy is to increase physical function while reducing and/or eliminating physical disabilities consistent and appropriate with the patient’s medical status, age and coping abilities. The emphasis is on addressing individual needs and learning how to maximize physical capabilities to improve overall quality of life. Individuals will work on flexibility, endurance, coordination and strength.
Initial measurements of flexibility, endurance and activity performance will be used as a baseline by which improvements are measured and tracked. All activities and exercises are increased according to the results of the initial and weekly evaluations. Each patient will work with the physical therapy staff to document changes and take part in physical therapy treatment goals and decisions. Exercise programs are completed individually and in groups. Each patient will also participate in individual physical therapy sessions to address specific needs.
Medication Programs/ Nursing
At the beginning of the Pain Management Program, a thorough review of your medication usage is conducted by nursing and medical staff. Most pain-related medications are discontinued by tapering them over a three-week period (for example, narcotics, muscle relaxers, anti-inflammatory medications) and are given in liquid form on a scheduled basis. Regular doses provide steady levels of medication. Medications taken for additional medical problems (such as high blood pressure, diabetes) are not disguised and are taken according to the primary physician’s prescription. The use of tranquilizers, mood elevators and sleep medications are evaluated on an individual basis.
Social Issues/Psychology
All psychological assessment and treatment services are provided by licensed psychologists. Services are provided individually and in groups. Typically, patients will participate in five groups and have two or three individual sessions per week. Psychologists generally address the following areas:
Many persons with chronic pain find themselves trapped in a vicious cycle. Pain causes increased stress, which causes muscles to tighten, which produces more pain, leading to more stress, causing more tension, and the cycle continues. At the Pain Management Program, patients are taught pain and stress management on three fronts.
First, potential sources of stress in the environment are identified. Once an individual is aware of the sources of stress, appropriate behavioral and environmental changes can be made.
Second, adaptive thinking skills are taught. In addition, potentially damaging thoughts and assumptions are identified and changed.
Third, a variety of relaxation skills are taught. Relaxation is an active process utilizing specific techniques, which require practice and refinement in order to be effective. Daily relaxation exercises are an effective means of preventing muscle tightness and pain. Biofeedback may also be used in conjunction with relaxation training.
Family involvement
Often family members may feel helpless because they don’t know how to respond to behavior or inadvertently encourage inactivity and helpless behavior. The primary focus of family involvement is to educate the family as to how they can be helpful to the person experiencing chronic pain and be supportive of healthy and active behavior. We will also assess how communication and relationship patterns impact and are impacted by pain.
Communications skills
Faulty communications skills and an inability to express emotions and needs can lead to relationship problems as well as stress, tension and subsequently, an increase in pain. Recent advances in pain management have demonstrated that successful communication can decrease the impact of chronic pain. As a result, patients will be provided instruction on communication skills in individual sessions, group lecture and role-playing situations.
Emotional issues
Many individuals with chronic pain are depressed or anxious. Individual counseling sessions are designed to help improve mood. If necessary, psychotropic medication management will be coordinated through the patient’s psychiatrist or physician. Individual therapy sessions are also available for dealing with behavioral and sexual issues related to the pain problem.
