Resources for physicians
Mayo Clinic's campuses in Arizona, Florida and Minnesota all offer Pain Rehabilitation Center (PRC) programs based on an interdisciplinary cognitive behavioral treatment model with supervised daily physical reconditioning, opioid withdrawal and reduction of polypharmacy. This treatment is based on a proven model of care.
PRC staff members help participants taper off of opioid pain medications and any other medications that are no longer effective in managing pain.
The primary goal of the PRC programs is to restore function and quality of life for people who have chronic pain. People whose chronic pain has negatively affected their moods and overall health or whose pain has caused them to experience a decline in quality of life, personal tasks or work responsibilities may be candidates for the programs.
The programs incorporate discontinuation of pain medications. People not taking opioid analgesics are welcome to attend the program, and they comprise a large proportion of our patient population. Other important goals include:
- Return to regular daily activities
- Increase physical strength, stamina and flexibility
- Eliminate the use of opioid analgesics and reduce the use of muscle relaxants and sedatives
- Minimize behaviors drawing attention to pain
- Learn stress management and relaxation techniques
- Return to gainful employment, school or volunteer activities (if applicable)
- Resume leisure and recreational activities
- Improve interpersonal relationships
- Reduce reliance on health care professionals by improving the ability to self-manage chronic pain
Physician referral is required. The person's primary care provider or referring provider will be responsible for arranging other health care services if need arises. Referring health care professionals can contact the PRC at:
- Arizona campus: 480-342-6240
- Florida campus: 904-956-1780
- Minnesota campus: 507-266-5100
Referring physicians will need to provide the following information:
- Current general medical examination documentation
- Current list of medications
- Medical records pertinent to chronic pain condition
Admission to any of Mayo Clinic's Pain Rehabilitation Center programs begins with an evaluation, during which Pain Rehabilitation Center staff will assess whether a rehabilitation approach is appropriate for the person with chronic pain.
If the pain rehabilitation approach is appropriate, staff will help the person decide which program may be most beneficial. Once a tentative admission date is scheduled, a representative from Patient Account Services will contact the person's insurance carrier, as many health insurance plans require approval prior to admission.
A person may be considered a candidate for admission if he or she has:
- Pain of more than three months duration affecting functioning. If pain duration is less than three months, there must be a clinical indication that the pain will likely develop into a chronic condition.
- Medical clearance to participate in daily aerobic exercise regimen.
- No pending medical work-ups for a pain-related condition. The person is no longer seeking medical cure for pain.
- Psychiatric stability. That means the person has no psychosis, no recent (past six months) suicidal or self-injurious or aggressive behavior, no recent (past three months) psychiatric hospitalization, unless evaluated and approved by PRC consultant staff.
- Willingness to taper opioid medications and other controlled substances, and to participate in all program activities.
Applicants must be able to perform activities of daily living (toileting, dressing and bathing) and the ability to walk or transfer from a wheelchair. They also need to have adequate concentration and memory function to learn and apply new information. Full-day participation is required.
People who are accepted into the three-week Pain Rehabilitation Center program will need a medical clearance for exercise form completed by their medical providers prior to beginning the program.
A person may not be considered a candidate for admission if he or she has:
- Been unwilling to discontinue use of pain medications and other targeted medications affecting cognition or substances that would prevent meaningful participation in the program
- Shown insufficient motivation to participate in medication management, physical and occupational therapy, or group therapy
- An acute physical condition or illness that would prevent his or her adequate participation in the program
- Demonstrated disruptive behavior that prevents that person or other participants from fully benefiting from treatment
Note also that the Minnesota program can not admit patients with an intrathecal opioid delivery system in place (Arizona and Florida programs do allow such systems, but the Minnesota program does not).
Referring provider follow-up
Coordination with providers in each participant's local community is an integral part of a successful return home. A health care provider who has been authorized to receive information will receive a written dismissal summary outlining an individual's care during the program.
This summary will include the person's PRC treatment course, medication changes, laboratory tests and consult notes. It will also outline behavioral strategies the person was taught for coping with chronic pain and offer specific follow-up recommendations.
PRC staff encourages each person's provider to discuss the rehabilitation program with the individual to reinforce the functional goals and progress accomplished during the program.
If indicated, a care conference may be held, either in person or via a telephone conference call. After the three-week program ends, PRC nurse coordinators are available for consultation with individuals and their providers.
Florida PRC director explains program