In 1974, psychiatrist David W. Swanson, M.D., along with a team of professionals, developed the Pain Management Center (PMC), a treatment program for people with chronic pain that integrated behavioral approaches and physical therapy. The PMC started as an inpatient hospital program with about eight patients, typically completing the program in three weeks. One of the most exceptional aspects of the program was the perception of the patient as an essential part of the treatment team long before this concept became common.
From the start, a major goal of the PMC was — and continues to be — helping
patients to withdraw from pain medications while improving functionality. All
patients who were taking opioids, benzodiazepines or even over-the-counter pain
medications were asked to complete a medication taper. Although most patients
were nervous about tapering off of their pain medications, most succeeded in
this endeavor and were pleased to learn that they could manage their chronic
pain without medication. Physical and occupational therapies played a major
role in the program, helping patients to develop the physical strength and conditioning
and teaching new ways to approach activities of daily living despite chronic
In the early 1990s, the program underwent major transitions, including a name
change to the Pain Rehabilitation Center (PRC) and a shift from being an inpatient
program to an outpatient practice. Also during this time the nursing role changed
to a case manager model, including contact with the referring physician along
with assisting patients in setting goals and facilitating patients' participation
in multidisciplinary rounds.
Behavioral medicine therapists also played a large role in the program, running stress management groups and teaching relaxation therapy. Physical therapists worked with patients to develop flexibility, endurance and strength. All patients participated in range-of-motion exercises led by a physical therapist every morning, strength training in the afternoon and aerobic exercise a minimum of twice per day. Occupational therapists focused on developing leisure skills, time management skills, and weekend meal planning. As a result of pressure to address work-related activities, over time the focus shifted to work simulation activities and eventually to the current goal of improving overall functional activities.
In 1993, all psychiatric programs moved into the new Generose Building on the
Saint Marys Hospital campus. Eventually, the PRC grew from averaging eight to
10 patients to a capacity of 26 patients, organized into two teams of approximately
12 members that run simultaneously. In August 2002, the program moved from the
main floor of the Generose Building to its present location, the second floor
The PRC has grown over the years, and its staff now includes a physician, psychologists, nurse manager, clinical nurse specialists, nurse care coordinators, physical therapists, pharmacist, occupational therapists and support staff. The program serves approximately 400 patients annually and is currently one of the largest pain rehabilitation programs in the world.