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My thoughts

Pain rehabilitation works

2/15/2022

 
Pain rehabilitation goes beyond medicine and medical interventions – and crosses different disciplines. It doesn’t just focus on removing the pain.  It focuses on the patient and how they can play a role in their own pain management - giving them control over the pain instead of letting the pain control them..
 
It’s a proven approach based on the biopsychosocial model of medicine – benefiting patients while reducing costs and reliance on the medical system.  
 
In addition to their general efficacy, these types of programs using interdisciplinary chronic pain rehabilitation can be effective at weaning patients off opioid therapy with long-term improvements in pain, mood, and function.
 
I was fortunate to be able to attend the 3-week interdisciplinary Mayo Clinic Pain Rehabilitation Center – not just once, but twice.  It was both a game-changer and lifesaver for me.  I highly recommend the program to anyone interested in taking an active role in managing their own care.  Read about my Mayo experience in this article.
 
More programs like this are needed to shift the current reliance on biomedical therapy towards a greater reliance on provider-supported patient self-management and true biopsychosocial treatment. .
 
Availability is important but so is accessibility. These programs aren't cheap, and insurance can be hesitant the pay the price tag. What payors need to remember is that these programs are cost-effective with a 68% reduction in medical cost spending.
 
Find links to programs in the U.S. and around the globe.

 
What to look for in a program
A pain rehabilitation program should focus on you as a person, not just your pain.  

Interdisciplinary pain rehabilitation programs that take place in the same facility with health care providers working together with open communication and shared objectives are the gold standard of comprehensive care outperforming medical pain services and less coordinated multidisciplinary programs.
 
A comprehensive pain rehabilitation program typically includes:
  • Medication management – To find the right combination of medicines and taper/stop any unnecessary medications along with better monitoring of patients who are prescribed opioids.
  • Pain education – To help patients better understand the purpose of pain and how best to respond to it – reducing any fears that pain is a symptom of a serious health issue, and that activity will cause more damage.
  • Lifestyle changes – To improve diet and sleep.
  • Psychosocial intervention – To change self-limiting thoughts and provide coping skills using acceptance commitment therapy and cognitive behavioral therapy.
  • Physical therapy/exercise – To build strength and endurance.
  • Occupational therapy – To modify and moderate daily life activities.
  • Relaxation training – To reduce stress on the mind and body – easing the pain experience.
  • Family therapy – To teach loved ones how to help/not help those in pain – encouraging self-efficacy and reducing pain behavior.
 
Learn more about pain rehabilitation
  • Patient Perspective: We Have a Chronic Pain Problem
  • What is a Chronic Pain Rehabilitation Program?
  • On Can't and Able
  • Interdisciplinary Rehabilitation Programs in Chronic Pain Management
  • Interdisciplinary Chronic Pain Management: Past, Present, and Future
  • Focused Review of Interdisciplinary Pain Rehabilitation Programs for Chronic Pain Management
  • Interdisciplinary Chronic Pain Management: International Perspectives
  • Interdisciplinary Chronic Pain Management: Overview and Lessons from the Public Sector
  • Economic Analysis of a Comprehensive Pain Rehabilitation Program: A Collaboration Between Florida Blue and Mayo Clinic Florida
  • Chronic pain affects the whole person – a phenomenological study
  • IASP Pain Management Center – a series of chapters
  • The Resurrection of Interdisciplinary Pain Rehabilitation: Outcomes Across a Veterans Affairs Collaborative
  • A Call for Saving Interdisciplinary Pain Management
  • Evaluation of an interdisciplinary chronic pain program and predictors of readiness for change
  • Predicting Readiness to Attend an Interdisciplinary Pain Management Program: What’s better for Clinical Decision-Making? Clinical Judgment or a Patient Self- Report Questionnaire?
 
Learn more about the Mayo Clinic Pain Rehabilitation Center (PRC)
  • Program information
  • My experience at the PRC
  • Dr. Christopher Sletten explains pain, central sensitization syndrome, and what they do at the PRC (22:19)
  • Dr. Jeannie Sperry explains how the PRC can help those suffering with chronic pain (9:44)
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    Tom Bowen is a chronic pain patient who turned into an advocate, educator, and collaborator.

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