Approximately 400 patients are admitted to the Mayo Clinic Pain Rehabilitation Center (PRC) three-week program every year. The vast majority of those (85 percent) complete the program. Some facts about PRC patients:
- More females (74 percent) than males (26 percent) enter the program.
- The average age of patients is 45, with ages ranging from 12 to 86. No age criteria exist for admission to the program.
- Patients come from across the United States and around the world.
- Patients have typically suffered from pain for more than nine years, although the range is three months to several decades.
- Almost 60 percent of patients are taking opioid pain medications daily and have been taking them for almost four years, on average.
Prior to coming to the PRC, most patients have participated in numerous pain interventions, medications and surgeries with little or no benefit to pain or function. Approximately 75 percent of patients have participated in physical therapy, which is usually focused on the site of pain. Mayo's program is unique because it focuses on a comprehensive physical therapy program to improve overall physical strength and endurance to regain function.
Patients who enter the program have varying types of chronic pain. Common pain diagnoses include:
- Chronic back pain
- Chronic headaches/migraines
- Generalized pain or in multiple areas
- Abdominal pain
Pain is also seen routinely in other areas of the body, such as the upper or lower extremity, chest wall, jaw or face, pelvis and joint(s), as well as postmastectomy or neuropathic pain. The PRC also treats some non-chronic pain disorders, including chronic fatigue syndrome and postural orthostatic tachycardia syndrome (POTS).
One of the PRC's goals is to eliminate the use of pain medication. Research shows that patients who participate in the PRC and are tapered from pain medications demonstrate significant improvements in functioning and mood, as well as decreased pain severity. Before rehabilitation, most patients have undergone multiple pharmacological trials, including nonsteroidal anti-inflammatory drugs (NSAIDs), opioids and adjuvant medications, as well as extensive physical therapies, interventional pain treatments and often surgery for painful conditions. Unfortunately, chronic use of opioid or other pain medications may actually do little to reduce discomfort from chronic conditions. Some analgesics can be habit-forming or cause long-term health problems.
Many patients with chronic pain also have depression or anxiety disorders. Depression is most often associated with the loss of functioning and sense of control patients with chronic pain experience. The most common anxiety disorders seen in PRC are panic disorder and post-traumatic stress disorder. The combination of anxiety and pain can make both conditions worse. In addition to assessing for psychological conditions, PRC psychologists provide cognitive-behavioral treatment for panic disorder and help identify a cognitive-behaviorally trained therapist close to the patient's home for care after program completion.