Pain Rehabilitation Center in Minnesota

Treatment Outcomes

The Mayo Clinic Pain Rehabilitation Center conducts ongoing treatment research to better understand how to help people with chronic pain. PRC treatment outcomes are discussed below.

Patient Satisfaction

Upon completion of the program, information regarding the usefulness of the program is gathered from the patients. When asked if they would recommend the program to a friend, 94 percent indicated they "definitely would recommend" or "probably would recommend" PRC. The majority (91 percent) rated the care they received while in PRC as "excellent" or "very good." In addition, the majority of patients (91 percent) indicated they "strongly agreed" or "agreed" with the statement that PRC was beneficial in helping the patient learn how to live well in spite of chronic pain. Ninety-five percent "strongly agreed" or "agreed" that physical therapy helped to increase their strength, endurance and flexibility.

Medication

Medication reduction was found to be a successful component of the program. At discharge, 4 percent of patients were taking opioid medication, a significant decrease from admissions data indicating that 45 percent of patients used opioids daily. At admission, 46 percent of patients were taking nonsteroidal anti-inflammatory drugs (NSAIDs), compared to 23 percent taking NSAIDs at discharge. At admission, 17 percent of patients were taking muscle relaxants; only 3 percent of patients were taking these drugs at discharge. Patient-reported data indicate that immediately following completion of the PRC program, patients with severe and disabling pain at admission experience significant improvement in physical and emotional functioning with decreased pain severity despite tapering these medications. Patients who tapered these medications experience the same improved function as patients who completed rehabilitation but did not take opioid analgesic medications.

Depression

Depression scores on the Center for Epidemiological Studies - Depression scale (CES-D) at discharge indicate that 35 percent of patients reported depressive symptoms, a reduction from 70 percent at admission. Furthermore, only 11 percent of patients indicated major depression at discharge, down from 42 percent at admission. Overall, the CES-D scores indicate that 79 percent of patients experienced a decrease in depressive symptoms upon completion of the program. This improvement in mood is often associated with patients' increased perception of control over their lives and pain and improved quality of life.

Physical Therapy

In the physical therapy part of the program, patients are assessed for aerobic activity levels (activities such as walking or riding a bike) as well as strength training as they work to improve their overall physical strength and endurance. Based on differences between admission and discharge performance, 75 percent of patients completing the program had at least a 50 percent gain in aerobic activity level. Furthermore, more than 20 percent of patients experienced a gain of 75 percent or more in activity level. Given the sedentary lifestyle many chronic pain patients had developed prior to treatment, this difference is significant and underscores why physical therapy is such an important part of patients' progress when they return home.

Pain Severity

In rehabilitation, pain reduction is not a program goal, and there are no medical or surgical procedures to specifically reduce pain. However, because patients learn coping strategies for managing pain while improving their quality of life, 73 percent of the patients completing the program report a reduction in pain severity at dismissal from the PRC.

Other Measures

The Multidimensional Pain Inventory (MPI) is used to assess function before and after the program. Pain interference in daily life decreased for 87 percent of the patients. Seventy-eight percent of patients reported increases in general activity levels, and 84 percent noted increased feelings of control over pain and life events.

Pain catastrophizing, an extremely negative way of thinking about actual or anticipated pain experiences, is often associated with disability, greater use of pain medication and greater use of health care services. At program completion, pain catastrophizing decreased for 75 percent of patients as measured by the Pain Catastrophizing Scale.

Nearly 81 percent of the patients reported an increase in energy or vitality on the SF-36 Health Survey upon completion of the program. In addition, 74 percent of patients reported an improvement in the perception of their overall health. Nearly 86 percent reported improved physical functioning.