I n t e rd i s c i p l i n a r y Rehabilitation Niriksha Malladi,
MD
KEYWORDS Multidisciplinary Interdisciplinary Pain rehabilitation Chronic pain Pain clinic KEY POINTS Interdisciplinary pain rehabilitation programs are infrequently used in the United States in the treatment of chronic pain. Comprehensively addressing the contributors to chronic pain, which include behavioral, psychological and physical dimensions, has shown evidence-based efficacy in improving functioning and reducing pain-related distress. This approach also holds the potential for reducing the escalating costs of chronic pain care.
Interdisciplinary pain rehabilitation programs for the management of chronic pain remain underused in the United States. The reasons for their limited use are numerous, starting with restricted health care coverage for such programs. However, it is worthwhile to revisit a model that has consistently shown evidence-based benefit for patients, and that focuses on the achievable goals of improvement in both function and pain as well as decreased medical and societal costs. It is apparent that traditional medical interventions are not effectively tackling the problem of chronic nonmalignant pain. Deaths from pain-related opioid use are one concern stemming from the present approach. As the prevalence of chronic pain grows, patients increasingly require treatments to reduce their pain, suffering, and disability. Multiple analyses of the most effective ways of reducing chronic nonmalignant pain identify the need for coordinated, comprehensive care, including addressing physical and psychological complications associated with chronic pain syndrome.1,2 An interdisciplinary treatment approach applies to the millions of patients with chronic pain generating nearly 70 million physician office visits annually, and the 130 million outpatient, hospital, and emergency room visits.3,4 There are also indirect costs, including employers dealing with absenteeism and disability costs. The US military, which faces back-related pain as the leading cause of disability, has found a use for this model with veterans.5,6 Despite the different cultural contexts of patients
Pacific Rehabilitation Centers, 2515 140th Avenue Northeast, Suite 110, Bellevue, WA 98005, USA E-mail address: [email protected] Phys Med Rehabil Clin N Am 26 (2015) 349–358 http://dx.doi.org/10.1016/j.pmr.2014.12.008 1047-9651/15/$ – see front matter Ó 2015 Elsevier Inc. All rights reserved.
pmr.theclinics.com
MD
KEYWORDS Multidisciplinary Interdisciplinary Pain rehabilitation Chronic pain Pain clinic KEY POINTS Interdisciplinary pain rehabilitation programs are infrequently used in the United States in the treatment of chronic pain. Comprehensively addressing the contributors to chronic pain, which include behavioral, psychological and physical dimensions, has shown evidence-based efficacy in improving functioning and reducing pain-related distress. This approach also holds the potential for reducing the escalating costs of chronic pain care.
Interdisciplinary pain rehabilitation programs for the management of chronic pain remain underused in the United States. The reasons for their limited use are numerous, starting with restricted health care coverage for such programs. However, it is worthwhile to revisit a model that has consistently shown evidence-based benefit for patients, and that focuses on the achievable goals of improvement in both function and pain as well as decreased medical and societal costs. It is apparent that traditional medical interventions are not effectively tackling the problem of chronic nonmalignant pain. Deaths from pain-related opioid use are one concern stemming from the present approach. As the prevalence of chronic pain grows, patients increasingly require treatments to reduce their pain, suffering, and disability. Multiple analyses of the most effective ways of reducing chronic nonmalignant pain identify the need for coordinated, comprehensive care, including addressing physical and psychological complications associated with chronic pain syndrome.1,2 An interdisciplinary treatment approach applies to the millions of patients with chronic pain generating nearly 70 million physician office visits annually, and the 130 million outpatient, hospital, and emergency room visits.3,4 There are also indirect costs, including employers dealing with absenteeism and disability costs. The US military, which faces back-related pain as the leading cause of disability, has found a use for this model with veterans.5,6 Despite the different cultural contexts of patients
Pacific Rehabilitation Centers, 2515 140th Avenue Northeast, Suite 110, Bellevue, WA 98005, USA E-mail address: [email protected] Phys Med Rehabil Clin N Am 26 (2015) 349–358 http://dx.doi.org/10.1016/j.pmr.2014.12.008 1047-9651/15/$ – see front matter Ó 2015 Elsevier Inc. All rights reserved.
pmr.theclinics.com
