Multidisciplinary Chronic Pain Management Program

This program is a multidisciplinary treatment approach to the management of the patient’s pain through physical therapy, psychotherapy, and occupational therapy. The patient is provided with a comprehensive diagnostic evaluation including physical and psychological testing to determine the patient’s needs. Modalities to be provided include medication management consultations, physical therapy, occupational therapy, aquatic therapy, psychological treatment, group counseling sessions, stress management training, coping skills training, biofeedback, self-hypnosis training, relaxation training, vocational assessment, and career counseling.

The multidisciplinary pain management program is provided over four to six weeks with an in-depth treatment protocol emphasizing the independent management of the patient’s chronic pain. In this program, we help the patient learn how to manage their pain and increase their functioning to enable them to return to gainful employment as well as to return to a higher level of recreational and social activity.

Psychological/Behavioral Management of Pain

Psychological treatment is emphasized in our chronic pain program to treat psychological, emotional, social, and personality factors which interfere with the patient’s ability to cope with pain. These underlying psychological concerns often reduce compliance with post surgical restrictions, which could lead to a poor surgical outcomes or re-injury, necessitating additional surgical intervention. In addition to post- surgical compliance, the behavioral medicine program addresses any patient tendency toward unrealistic expectations concerning the medical profession. Frequent patient misperceptions include an expectation of a complete recovery following surgical intervention, an anticipation of total pain relief, and a hope that they will make a full recovery and return to their prior level of physical functioning. The program also addresses patients with pain extending beyond the primary intervention phase of 0-3 months who continue to demonstrate significant impairment in their daily functioning and failure to return to work and/or progress adequately in their healthcare treatment. Additional reasons for referral to the behavioral pain management program include evaluating and treating the patients’ propensity towards overuse of Opioid medication or tendency to self-medicate with alcohol or nonprescription drugs. Psychological intervention also assesses any tendency toward symptom exaggeration, malingering or secondary gain associated with a patient’s injury that may lead to unconscious resistance to treatment.

Physical Management of Pain

When an individual experiences pain, their natural protective response is to immobilize the injured body part to avoid additional trauma. This instinctual reaction helps to allow the damaged tissue to heal. If the pain continues after the tissue has healed, the patient may become sedentary and avoid exercise due to fear of reinjury. This lack of movement leads to muscle guarding and constant bracing. The effected tissue then stiffens and the ligaments and muscles become weak. This interferes with proper functional mobility. The roll of physical therapy is to help the patient regain use of the painful part of their body. This is accomplished through stretching the muscles and ligaments to improve flexibility. Once the patient has begun to regain mobility, physical endurance and conditioning exercises are stressed to help the patient regain an active lifestyle. The patient is provided with a custom made program which addresses both their loss of muscle tone and their deconditioning. Patients are instructed in proper body mechanics to avoid reinjury. Toward the completion of their therapy, they are also offered training concerning a self-directed fitness program and need for an ongoing healthy lifestyle including exercise, proper nutrition and maintaining a healthy weight. Sometimes the patient is unable to progress toward the activities listed above due to the intensity of their pain, swelling, muscle spasms, or tenderness.

If these conditions exist, the following modalities are administered as appropriate:

  1. TENS Units
  2. Heat and Cold Modalities
  3. Electrical Stimulation
  4. Massage
  5. Myofascial Release
  6. Therapeutic Exercise
  7. Educational Materials
  8. After Care Program