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Claims Experts Eye Program to Manage Chronic Pain |
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Pain has been recognized as the symptom that most commonly causes people to seek health care. Pain is normally temporary. If no significant tissue damage is present, pain may persist until the healing process is complete, but it is typical for pain to resolve itself. Some people, however, experience a persistent, intractable sensation known as “chronic pain.” It is a part of their daily lives. Chronic pain continues a month or more beyond the usual recovery period of an illness or injury, or continues for months or years as a result of a chronic condition. It may be continuous or it may come and go. An affliction that disables millions of Americans, it is a source of frustration for many health care professionals seeking to provide care and assistance to their patients. It is a condition that affects the quality of life and the economic security of not only the person with pain, but also his or her family. Its economic costs are high with estimates that U.S. businesses lose about $90 billion annually to sick time, reduced productivity, direct medical costs, and other benefits costs due to chronic pain among their employees. Millions of people suffer the effects of chronic pain. A recent news poll found that one in every five Americans reports suffering from some form of chronic pain, and seven in 10 say it interferes with their daily lives. Unlike acute pain, in which the body’s alarm system signals that something is wrong, chronic pain serves no such purpose but it causes untold misery to its sufferers and their families. The first pain doctors were anesthetists, because they were trained to do epidural injections that blocked the nerves carrying the pain messages. In the late 1940s and early 1950s the first pain clinics began springing up in the United States. University College Hospital set up the first nerve block clinic in 1948. Since modern medicine was saving more lives, more people were surviving longer, but often they were in pain. Many patients had permanent changes in their body as a result of an illness or injury and they suffered from chronic pain that was untouched by the best pain-killing drugs of the time. Today, many still live in pain, even after attending pain clinics. With varying degrees and causes of chronic pain, both known, and unknown, more research is needed into the causes and treatments for this insidious affliction. In the United States, back pain is probably the most common form of chronic pain, responsible for the loss of millions of workdays a year. Back pain has many causes. Many suffer from acute back pain which comes on suddenly. This can usually be treated with a few days of bed rest, followed by an early, but gradual, return to work. Frequently, chronic back pain is treated with anti-inflammatory drugs, however, sometimes if the pain persists, epidural injections are considered. Learning how to cope with chronic pain may become a reality for many. At some point most chronic pain sufferers are told simply, “Learn to live with it.” For many the solution may be found in practicing pain management. Sound pain management techniques help by focusing on reducing the sense of suffering experienced by the person with the chronic pain. It blends physical, emotional, intellectual and social skills in such a way as to help chronic pain sufferers regain control of their lives, thus enhancing the quality and pleasure of life. Although the pain may never go away, it is possible to reduce it substantially, and more importantly, to improve the quality of life. Many who have tried every available medical intervention without success, have found that a comprehensive pain management program can provide them with the necessary skills, medical interventions, and direction to effectively cope with chronic pain. What to look for when choosing a pain management program? First, contact local health care facilities and rehabilitation centers and have them send information to you about their pain management programs. Once you have all the facts, review each program to determine which one best meets your needs. Be sure to consider the following:
To prevent duplicate testing, obtain copies of your medical records. Talk with both present and past program participants to get feedback about the program. Most people rarely think about pain until it affects them or someone close to them – then they are unable to think of anything else. Working within a pain management program can be difficult, but pain management can make a significant difference in one’s life. In an effort to address pain management issues that are of concern to both employers and the medical community, California’s State Compensation Insurance Fund worked with Kaiser Permanente to create the Delayed Recovery Center (DRC). They wanted to address such issues as:
The goal of the DRC is both to find answers to these questions and to develop effective ways of treating the problem of delayed recovery (chronic pain) so that patients can return to productive employment and live satisfying lives. The DRC bases its approach on the latest neuroscientific research into the workings of the brain and nervous system. Tremendous advances have been made in understanding the biological underpinnings of human behavior and how pain signals are conducted to and processed by the brain. The DRC has used this information to understand why disability persists in some individuals and to shape the approach to therapy with these patients. Initially, 90 percent of the patients referred to the DRC were off work at the time they were referred to the program. Following the program, 80 percent of the participants were either working or going through vocational rehabilitation and they reported a dramatic decrease in pain as well as less use of medication. More than 35 percent reported no need for continued medical treatment for the injury. Tom Herington, MD, is the Medical Director of DRC. Dr. Herington is Board Certified in Occupational Medicine and Internal Medicine. He has a Master’s Degree in psychology and is completing his doctorate. Dr. Herington will be a featured speaker this October at the Claims/Rehabilitation Workshop in San Francisco. Download complete newsletter in PDF format
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By
Ann Seibel, Oklahoma
