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Comprehensive Pain Management Program

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Mission and Philosophy

Pain is a diverse, muitifactorial
problem, and as varied as the individuals who
suffer., The Comprehensive Pain Management Program (CPMP) is designed to meet the physical, psychosocial
and vocational needs of persons served. This program
uses a transdisciplinary team approach to address the
phenomenon of pain in many levels. The ultimate goal
is the increase function and to diminish pain and its
influence over day to day activities. The treatment
team is goal oriented, well coordinated, integrating
physical, social-behavioral and educational
interventions. Patients are treated in a consistent,
behavior-oriented therapeutic milieu, and are
encouraged to assume maximal responsibility for their
own health care, goal setting and achievement. The
CPMP emphasizes returning patients to work or other
productive life activities, and reducing dependence
upon inappropriate medications and the health care
system. Patients and their family members are
considered part of the team, and are included as an
integral part of the program.

Scope

The scope and intensity of
services varies according to patient needs. Services
commonly offered to all persons served include
screening assessment, appropriate intervention,
education, discharge planning and follow-up.

CPMP utilizes members of the
medical staff, nursing services, psychology services,
physical and occupational therapy, therapeutic
recreation, vocational services, case management and
others in providing the best possible comprehensive
care to the patient. Services are provided on both an
inpatient and outpatient basis according to patient
needs.

Program Goals and
Objectives

Overall goals include:
  • Reduce pain influence on
    general lifestyle
  • Decrease dependence on health
    care systems
  • Successful community reintegration
Enabling objective to meet these goals may
include (but are not limited to):
  • Increase physical capacity,
    endurance, and functional status
  • Educating patient and family
    on effects of pain on interpersonal
    relationships
  • Maximize medical improvement
    while formulating cost-effective maintenance
    program
  • Maximize vocational potential
  • Increasing self-management
    skills

The Comprehensive Pain Management
Program (CPMP) at Northeast Rehabilitation Hospital
is organized in an interdisciplinary manner to
deliver a consistent, coherent, structured schedule
of treatment activities for persons with pain.
Emphasis is placed on education and teaching
self-care measures to prevent recurrence of the pain
syndrome. 

The goals and objectives for this program
are:
  • Provide means/techniques for pain management
  • Improve understanding of pain
    mechanisms and ways to control pain.
  • Establish an appropriate
    therapeutic medication profile.
  • Provide therapeutic
    intervention to reduce soft tissue and
    structural restrictions.
  • Provide a tailored
    stretching, aerobic, and weight strengthening
    exercise program.
  • Provide an appropriate
    relaxation training and stress management,
    (e.g., biofeedback, self-hypnosis, etc.).
  • Improve pacing of activities.
Increase physical capacity and endurance:
  • Increase number of UP hours
    per day (e.g., increase time out of bed and
    off couch or recliner).
  • Increase physical endurance
    for all activities (e.g., increase standing
    tolerance, sitting tolerance, distance and
    time able to walk, and ability to lift and
    carry weights loads).
  • Improve awareness and
    performance of body mechanics in Activities
    of Daily Living (ADL) and work-related tasks.
  • Improve nutritional
    understanding and dietary intake, weight loss
    or gain as appropriate.
  • Provide an appropriate
    relaxation training and stress management,
    (e.g., biofeedback, self-hypnosis, etc.).
  • Improve pacing of activities.
Education and promote -more independent,
appropriate psychosocial functioning as
indicated:
  • Improve understanding of life
    stresses and their relation to pain and pain
    control (e.g., stress management).
  • Improve self-image (e.g.,
    assertive training).
  • Decrease sick-role
    behaviors.
  • Initiate reintegration of the
    patient into an appropriately supportive
    family structure.
  • Improve socializing skills.
  • Reduce depression and
    anxiety.
Promote more self-responsibility and decrease
dependence on health care systems for health
and health care:
  • Decrease visits to
    physicians, physical therapists, etc., for
    pain related problems.
  • Decrease hospitalizations and
    surgical operations for pain related problems
  • Re-integration with
    community via health club and community
    programs as indicated.
Maximize vocational potential and promote
return to substantial, gainful employment or
other meaningful productive life activities:
  • Assess work history and job
    potential as appropriate.
  • Enhance constructive use of
    leisure and recreational activities, as
    appropriate.
  • Provide resources for
    volunteer activities, as appropriate.
Provide cost-effective evaluations and
treatments to address the whole person with
chronic pain syndrome:
  • Provide a comprehensive
    medical evaluation of patients with chronic
    pain to enable appropriate treatment
    decisions to be made.
  • Provide psychological
    screening and therapy as indicated.
  • Provide a "therapeutic
    wellness milieu" with consistent
    guidelines, in order to optimize treatment
    goals.
  • Establish program assessment
    and treatment outcome measures to correlate
    with goals and objectives.
  • Assess treatment costs and
    correlate with treatment outcomes.
  • Establish a follow-up program
    for patients and their families, to promote
    optimal patient follow through and health
    maintenance.

Various treatment options have
been developed to address the special needs of each
population. They share a common approach by teaching
alternative modes of controlling pain and by
providing an interdisciplinary rehabilitation team
that specializes in pain management.

  • Outpatient Services
    that tailors the program specifically to
    patient assessed needs.
  • Medication Trials
  • Psychology Services
  • Specialized Pain
    Procedures by a Pain Anesthesiologist
  • Therapy Services
    Individual and groups. Aquatics also
    available.
  • Inpatient Services
    may be utilized only if the patient needs a
    well structured, closely monitored program
    and/or distance from NRH is such that is
    precludes an outpatient program:
  • 2 week medication
    titration track
  • 4 week
    musculoskeletal injury (benign
    chronic pain)
  • Comprehensive pain
    management track for the illness that
    causes chronic pain.