| Rationale
For The “Path Out Of Pain” Program
If pain from an injury does not resolve within
4-6 months, a cycle of chronic pain can become established. Once
a chronic pain cycle is established, a purely physical treatment
regime rarely resolves the problem. Chronic pain has an impact
on the person, their family, and their lifestyle. Unless these
issues are addressed, the situation frequently deteriorates, and
the pain persists. Research has demonstrated that an integrated
or multi-disciplinary approach to management is essential. This
may include physical therapy, exercise therapy, psychology, occupational
therapy, and a return-to-work rehabilitation program. The following
references provide background to the need for, and value of, such
an approach:
“The Challenge of Pain” (R.
Melzack & P. Wall)
“The Psychology of Pain” (Richard A. Sternbach [Ed.])
“Psychological Control of Pain” (D. Elton et al.)
This program includes relaxation training to release muscular
tension, which can be a major source of pain. Good body use is
taught, as
well as body awareness, so that old patterns of muscular tension
and pain can be released. Specific Pain Control techniques are
introduced once basic relaxation has been mastered. Attitudes
to the injury
and pain are explored and attitudes which promote healing of the
injury and resolution of related emotional issues are developed.
Assistance with return to work is an integral part of the program,
whether the worker has commenced a graduated return to work, or
is as yet "unable to resume work". Education about
chronic pain is provided to help reduce anxiety and fear about
the injury
and the future. This can be critical to a successful return to
work. Group pain management provides motivation, inspiration
and support.
Without this, many injured workers struggle to recover, and some
fail to recover. Finally, exercise and fitness programs are developed
to prepare the worker for a successful return to work. For details
see McIndoe (1994) and McIndoe and Littlejohn (1995).
References
- McIndoe R 1994 “A behavioural approach to the management
of chronic pain: A self-management perspective. Australian Family
Physician” 23:
2284-2292.
- McIndoe R, Littlejohn G 1995 “Managment of fibromyalgia
and regional pain syndromes.” Modern Medicine 38: 56-69.
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