Chronic pain affects millions of Americans. Most people with chronic pain have tried multiple treatment strategies without relief. Pain can interfere with a person’s ability to work, participate in daily and recreational activities and may affect their relationships with family or friends. Over time people with chronic pain may restrict their activities, which in turn, causes them to become less physically fit to the point that even minor activities cause increased pain.
Research over the last 30 years has increasingly shown that acute pain, for example that associated with injury, illness, or surgery) is mostly due to changes in injured tissues. Chronic pain, in contrast, is mostly due to changes in the nervous system that increase its sensitivity to the point that even normal stimulation may be painful. The pain that people experience is largely a result of these neurological changes. People’s ability to function, however, is more determined by general body health/fitness and psychological factors. The same is true of overall suffering. Therefore the program focuses primarily on reconditioning and psychological coping strategies to ensure that chronic pain does not take over a person’s life. When it has already done so, the goal is to restore the person to their maximum level of comfort and function.
Physical and Occupational Therapists at Cleveland Clinic work as part of an interdisciplinary team in the Chronic Pain Rehabilitation Program. The Chronic Pain Rehabilitation Program has a strong exercise focus that helps patients gain strength, endurance, and flexibility. Education is a key component of the program for improving posture and body mechanics so that patients may resume their normal daily activities and regain enjoyment in their life.
Who is chronic pain rehabilitation program for?
Pain from an injury or disease usually subsides following medical care or disappears spontaneously. But for 40 million Americans, there is no relief from the pain, according to the National Institutes of Health. This type of pain is unresponsive to conventional treatments. Living with chronic pain requires a change in mindset so that chronic pain doesn’t evolve into a disability affecting daily activities, attitudes and relationships. The Chronic Pain Rehabilitation Program addresses these issues with a multi-disciplinary team skilled in managing chronic pain.
Common diagnoses/conditions include:
- Low back pain
- Neck pain
- Complex regional pain syndrome (CRPS)
- Nerve damage
- Multiple sclerosis
- Gastrointestinal illness
- Other medical conditions associated with pain that lasts for more than six months or beyond the expected healing time
What does chronic pain rehabilitation program involve?
We create an individualized plan for each person. However, general components of the program include the following:
- Patients participate 7:30 a.m. – 5:00 p.m. Monday through Friday
- Treatment is on a ‘day-care’ basis – that is, evenings are spent at home or other available lodging.
- On average the program lasts three to four weeks
- Psychotherapies aimed at stress reduction, pain coping, and the anxiety and depression that often result from pain and disability
- Daily group physical and occupational therapy exercise classes and individual sessions as appropriate
- Treatment directed by pain management physicians, nurses and therapists
- Medication management typically consists of weaning of unhelpful medications and trials of non-addicting medications shown to help chronic pain
- Biofeedback training
- Vocational rehabilitation
- Chemical dependency counseling
- Nutritional instruction
- Family counseling
- Relaxation training
- Tai chi
How long does the chronic pain rehabilitation program take?
If you are referred to this specialized service, prepare yourself for a unique three-to-four-week course of therapy designed to help those patients whose lives have been seriously harmed. Day-long clinics offer physical rehabilitation, stress and pain control regimens, as well as, medication management.
Collaboration among team members allows us to address all the aspects of the individual’s life that may be affected by chronic pain. The Chronic Pain Rehabilitation Program at the Cleveland Clinic was started in 1979 and since then has helped more than 6,000 people manage their chronic pain.