Patient Treatment Strategies

Each patient will present with different mixtures of functional limitations, pain behaviors, affective disturbance, physical disability, and vocational dysfunction. The original multi-disciplinary pain management programs were all inpatient based. It is now apparent that outpatient programs can be equally successful if they have adequate intensity and duration (Turketal. 1993).

There are no controlled studies to determine the optimal duration of treatment and hours per day, nor does the literature reveal which aspects of the various components are most important for a treatment program. It is clear that the effects of multidisciplinary pain treatment program are greater than the sum of its parts. Common features of all programs include physical therapy, medication management, education about how the body functions, psychological treatment (e.g., coping skills learning, problem solving, communication skill training), vocational assessment, and therapies aimed at improving function and the likelihood of returning to work. The overall length of a program depends in part on unique patient requirements. Typical programs operate 8 h a day, 5 days a week and last 3-4 weeks, although some programs meet less frequently and last for longer periods.

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