Pain rehabilitation programs can help patients break the cycle of worsening pain: Mayo Clinic Health Letter

Chronic pain -- whether from headaches, back pain or conditions such as fibromyalgia -- can interfere with work, day-to-day activities and relationships. All too often, pain relief treatments are ineffective and can lead to a downward spiral of frustration, decreased functioning, stress, isolation -- and worsening pain.

The May 2010 issue of Mayo Clinic Health Letter covers comprehensive pain rehabilitation and how this approach can help patients break the cycle of worsening pain.

Pain rehabilitation centers and programs vary widely in scope and focus. Offerings may include a series of classes that last a few days to a few weeks. Some programs are residential; others are day programs. A common denominator across programs is a team approach, including physician specialists, psychologists, nurses, physical and occupational therapists and, in many cases, dietitians, social workers and chaplains. The team works to develop an individualized plan to address the many far-reaching effects that chronic pain has on the patient and family members.

Pain rehabilitation programs often include:

- A thorough up-front evaluation -- A review of physical and psychological conditions, medications, work status and relationships is used to develop a pain management approach.

- Medication management -- Many patients with chronic pain end up on opioids which, over the long term, may worsen pain, decrease pain tolerance or cause other side effects. Reducing or eliminating some medications often is beneficial.

- Physical therapy -- Physical deconditioning, including weight gain and loss of strength and stamina, often occur with chronic pain, making daily activities difficult. Physical therapists can assist with several approaches to manage pain, including safely improving fitness levels, improving posture and determining ways to move the body more efficiently.

- Stress management -- Relaxation methods such as meditation might be taught. Another option is biofeedback, where a computerized instrument displays a patient's physical response to stress. Through the feedback, patients can learn to better control physical responses to stress. Psychological care, lifestyle management, group therapy, family counseling, acupuncture or hypnosis may be offered, too.

While a pain rehabilitation plan usually can't eliminate the pain, care from a team of pain management specialists can help patients change their focus from living with pain to living a more fulfilling life.