Pain and Disability: Clinical, Behavioral, and Public Policy Perspectives

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Pain and Disability

Minimum monthly payments are required. Subject to credit approval. See terms - opens in a new window or tab. Back to home page. The nature of work, job loss, and the diagnostic complexities of the psychologically injured worker. Psychiat Ann ; 10— Franzmayr C. Pain acts as a warning bell preventing damage. New Zealand Doctor ; April: An assessment of the efficacy of physical therapy and physical modalities for the control of chronic musculoskeletal pain.

Pain ; 5— The main lumbar spine study, Part 2: 1—Year outcomes of surgical and nonsurgical management of sciatica. Outcome of lumbar fusion in Washington State Workers' compensation. Loeser JD.

How to Apply for Social Security Disability (SSDI)~My Experience~TOS and Chronic Pain

Mitigating the dangers of pursuing care. Turk DC. Neglected factors in chronic pain treatment outcome studies-referral patterns, failure to enter treatment and attrition. Pain ; 7— Taricco A. Perils of payors: A pain center paradigm. Federico JV. The cost of pain centers: Where is the return? The prediction of return to the workplace after multidisciplinary pain center treatment. Clin J Pain ; 9: 3— Prediction of return to work following rehabilitation for chronic low back injury.

NZJOT ; 2—6. Linton SJ. The manager's role in employee's successful return to work following back injury. Work and Stress ; 5: — Tate DG.

Pain and Disability: Clinical, Behavioral, and Public Policy Perspectives

Factors influencing injured employees return-to-work. Appl Rehab Counsel ; 17— Intensive physical and psychosocial training program for patients with chronic low back Pain: A controlled clinical trial. Borrows J, Herbison P. ACC chronic backs study: Report of the evaluation of four treatment programs. Functional restoration with behavioral support: A one-year prospective study of patients with chronic low back pain. Work Hardening: Past, present, and future — The work programs special interest section national work-hardening outcome study.

Am J Occup Ther ; — The rehabilitation of injured workers in New Zealand: A pilot study. NZ Med J ; — Long-term follow-up of patients with chronic back pain treated in a multidisciplinary rehabilitation program. An 18—month follow-up of a secondary prevention program for back pain: Help and hindrance factors related to outcome maintenance. Clin J Pain ; 8: — Oland G, Tveiten G. A trial of modern rehabilitation for chronic low back pain and disability: Vocational outcome and effect of pain modulation. Vocational assessment and rehabilitation outcomes.

Rehab Counsel Bull ; 61— Inpatient vs. Pain ; 13— Philips HC. The effects of behavioral treatment on chronic pain Behav Res Ther ; — Decreased clinic use by chronic back pain patients: Response to behavioral medicine intervention.

Pain and Disability: Clinical, Behavioral, and Public Policy Perspectives - Google Livros

Clin J Pain ; 7: — Decreased clinic utilization by chronic pain patients after behavioral medicine intervention. Hazard RG.


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The multidisciplinary approach to occupational low back pain and disability. Am Acad Orthop Surg ; 2: — Chronic pain management programs exist in a variety of organiza- tional settings and facilities. Many programs are university-based, operated by departments of various medical specialties. As such, they are situated in medical centers, community hospitals, rehabilitation hospitals, and the rehabilitation units of hospitals.

Some are free-. Programs can be voluntary nonprofit , government-run state or federal , or proprietary either as an individual profit-making entity or as part of a regional or national chain. The philosophy of most pain management programs is to Took at the broad aspects of a patient's life, not just at the medical factors. Treatment is oriented toward the patient and family as a unit and concentrates on restoring functional capacity and limiting disability in all spheres of living; in doing so, this approach Reemphasizes disease processes and diagnostic categories. Although pain reduction is a goal, the total alleviation of pain is less important than enabling the patient to function effectively with whatever residual pain exists.

Common criteria for admission to pain management programs include the presence of pain for at least 6 months, that the pain is not due to an active disease process for which other medical or psychiatric treatments are deemed more appropriate, and the patient's agreement to participate actively in the program and to involve his or her family members in the treatment.

These programs usually design individualized patient assessments, treatments, and follow-up plans. Medication reduction, psychological treatment di- rected particularly at depression and anxiety , family counseling, socialization skills, and educational or vocational counseling are emphasized.


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Physical treatment methods e. Even pain management centers oriented to one primary treatment method tend to use supporting approaches as well. Thus, for example, in a program that espouses a "purely" behavioral approach, one is likely also to find occupational and physical therapy. Despite their similar underlying philosophy, chronic pain manage- ment programs or pain clinics vary considerably. They can be roughly classified into three types, each of which may provide inpatient andJor outpatient care.

Pain and Disability : Clinical, Behavioral, and Public Policy Perspectives"

The Need for Standards Accompanying the rapid increase in the number of chronic pain treatment facilities are several problems for those suffering from pain, for health care providers, and for those who pay for such services. As is true of health care facility accreditation in general, accreditation for rehabilitation facil- ities is based on the availability of particular health care professionals and services, not on the quality of treatment. These standards do require individualized treatment programs, but actual performance criteria are lacking.

Performance standards could help to deal with the following three issues. The variation among pain treatment facilities is a substantial problem for the patient who may be inclined to consult the first pain center recommended, assuming that they are all the same. This is especially pertinent because these centers are typically the last resort for sufferers who feel they have tried everything else.