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PT and the City

Pain Management

Published September 11, 2013 12:11 PM by Lisa Mueller

I've gotten a few emails from one of our clinic physicians to begin discussing and planning an established pain management program. We are first looking at some of the tools within our EMR to see what function exists for communication and tracking the care of some of our more complicated patients.

I know the need for a pain management program exists. There are too many patients with significant pain issues who end up seeing multiple providers, getting mixed messages and different care provided that can prolong their healing timeline. New programs and initiatives can also be met with some resistance -- providers fear that the added steps and coordination may delay care or complicate relatively simple cases.

To address these concerns as we are in the infancy stages of a pain management group, I'm starting to research the components to an effective program. From the little reading I've done so far, it appears the focus should be on having attainable goals with consistent communication to reduce fragmentation of care. Most programs seem to incorporate medication management, graded physical activity and cognitive training as the major components.

The benefits of pain programs seem to be similar -- reduce a patient's pain and reliance on pain medications, decrease the use of medical resources and return to work and full functional ADLs. I read one article that highlighted the indirect outcome of cost reduction after implementing a pain program -- this kind of data is useful to give quantitative information in addition to other anticipated benefits.

These parts of the program don't address everything (such as the physiological differences of chronic pain patterns compared to acute injuries), but I think it's a good place to start. What about you? Does your physical therapy clinic offer pain management coordination with other providers? What is the most important part of a successful pain management program?

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Fibromyalgia and pain texts are great resources individually or in tandem.


It has been 2 decades since I rotated through the pain management program at a large private hospital in New York, but the most significant part of that program was the psychological counselling and the weekly team meetings where medicine, psych, nursing and PT discussed patient progress and limitations.

There is a movement in Australia, and here in the UK, based upon the teachings of Peter O'Sullivan that pain, back pain in particular, has primarily a psychological origin. John Sarno MD wrote a similar tome about this idea in the US in the late 90's. I can't say I agree with the philosophy, but it seems important to know about as it gains footing.

Dean Metz September 12, 2013 6:09 AM

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