Chronic Pain can be described as:

1. Pain that has lasted 6 months
2. Pain that may no longer have a biological protective function
3. Pain that persists after healing of an injury
4. Pain that impairs the function of the individual
5. Pain that dominates the person's life

Chronic pain can be a disabling condition which can change their life from one of activity to one of misery. Even though the injury may be over the body may still generate pain. Recovery from chronic pain may require a combination of medical treatment and medication, physical retraining and conditioning, learning how to reestablish one's role in life and grieving the loss of function from the injury. A multidisciplinary treatment program addresses each of these areas and coordinates the patient's recovery so that he or she both manage the pain and return to a rewarding life.

The need for Chronic Pain Management has become more and more recognized in the past several years both here in S.B and nationally.

Chronic pain commonly happens to people with an active life style or who may work with their bodies for a living. At the heart of the problem of chronic pain is often the reality that the nervous system is continuing to send pain signals after an injury is over. Another part of chronic pain is an injury to a part of ourselves which he have to continue to use and which causes pain in the process of use.

We have come to recognize that it is very difficult for people to fight the illness by themselves, and that people can have a better outcome through the use of a program that meets multiple needs. Chronic pain is not just about a physical injury that happens but how it affects the person’s life style and how it affects their moods. They may become physically dependent on medications that help them function (and may be confused with drug addicts). Or the need for pain medication may have changed but they fear coming off the medication. Patients with chronic pain may also suffer from Mental Health Disorders or Chemical Dependency.

Multidisciplinary treatment of chronic pain has been shown to improve the function of patients with this disorder. For some, it also assists in reducing the level of pain that they experience. The program utilizes structured activities, daily pain logs and cognitive behavioral therapy provided in a group modality. Patients also meet weekly with their counselor to monitor progress towards their goals in their treatment plan. One of the medical directors also meets with the patients weekly regarding medication and medical concerns.

Patients are evaluated for anxiety, mood disorders and other mental health disorders. Referring physicians and therapists may be consulted periodically throughout the program.

Patients are also assessed for addiction. The use of addictive medications in patients with chronic pain needs to be assessed and managed so that the benefits of such medication out weigh any negatives. Treatment plans will be discussed with the referring physician.

Patients normally also participate in physical therapy through outside providers. They may also be referred for biofeedback training, occupational therapy or other modalities provided by other specialists.

THE OBJECTIVES OF THE PROGRAM INCLUDE:

1. Optimization of pain control.
2. Develop skills such as pacing, assertive communication and relaxation.
3. Improvement in depression, anxiety and anger.
4. When stressed the ability to take time out, share and ask for help
5. Reduction in cognitive distortions, increasing function and reducing pain.
6. Addressing chemical dependency issues if present.
7. Involvement of family and friends in learning pain management techniques.

TOPICS FOR EDUCATION GROUPS INCLUDE:

1. Understanding pain.
2. Accepting ownership of pain.
3. Role of medication and pain.
4. Loss and grief.
5. Pacing, problem solving, planning, perfectionism.
6. Depression, anxiety, fear of the future, loss of self-esteem, anger, guilt.
7. Family and pain.
8. Friends, work associates, general public and pain.
9. From Victim to Victor: finding choices.
10. Sleep issues.
11. Sex and pain.
12. Enhancing quality of life with chronic pain.
13. Boundary setting.
14. Communication, assertiveness, active listening.
15. Exercise and nutrition.
16. Relapse prevention and pain flares.

SPECIFIC TECHNIQUES

1. The stress-pain connection.
2. The stress-appraisal connection (threat, loss, challenge.
3. Identification of automatic thoughts and images.
4. Challenging negative distorted thinking.
5. Identify underlying belief systems.
6. Challenge negative, distorted beliefs.
7. Identify pain-related core beliefs.
8. Challenge negative distorted pain-related beliefs.
9. Create positive coping self-statements.
10. Create coping cards.
11. Learn and practice expressive writing.
12. Learn about assertive communication.
13. Plan an assertive communication.

At the end of the program the patient is provided with a discharge plan and is referred back to the referring professional.