Pain rehabilitation

Pain rehabilitation programs offer nondrug options for managing chronic pain. These may include physical, occupational and psychological therapy.

By Mayo Clinic Staff

Pain rehabilitation programs explore various ways to help control pain and identify factors that contribute to pain. These programs are generally intended for individuals who have experienced a significant decline in daily functioning and quality of life as a result of chronic pain.

In most pain rehabilitation programs, a pain professional, pain psychologist and other specialists work together as an interdisciplinary team.

They incorporate cognitive behavioral therapy techniques to help identify and replace negative thoughts and unhealthy behaviors. This can help you get back to your regular activities and improve your quality of life.

The program might also include physical therapy, occupational therapy, biofeedback, relaxation techniques, stress management and complementary medicine.

Physical therapy

Physical therapy focuses on reducing pain through a regular exercise program that incorporates flexibility, aerobic and strengthening exercises. Physical therapy is primarily based on proper body mechanics — using muscles and joints correctly to limit pain.

Even when you have pain, movement is important. In fact, movement helps speed recovery and might even help prevent acute pain from becoming chronic pain.

Physical therapists can tailor an exercise program to your individual condition and goals. They may also employ nonexercise treatments, such as ultrasound, heat or ice therapy, and massage. Braces, splints and assistive devices also might help.

Occupational therapy

Pain can keep you from taking part in your normal activities, including going to work or having fun with family or friends. Occupational therapy helps provide skills and strategies to help manage pain, so it interferes less with daily life — allowing you to engage in your life even if full pain relief isn't possible.

Occupational therapists may suggest using assistive tools, such as a walking cane or a jar opener, to help compensate for skills that may be impaired by your pain or disability. Sometimes the work or home environment can be changed to make tasks easier.

Changing your mindset

Psychological counselors often can help you view your pain in a different way, which can help you develop better coping skills so that you can feel more in control of your situation.

Tension and stress can exacerbate your pain, so relaxation techniques such as meditation and guided imagery may be useful.

Support groups, either online or in person, provide access to people who are facing similar situations so that you can share concerns and coping strategies. While there is no cure for many forms of chronic pain, you can learn ways to participate more fully in life despite your pain.

Vivien Williams: 50 million. That's how many people in the U.S. suffer from chronic pain. Many turn to opioid painkillers for relief.

Mike Hooten, M.D. (Anesthesiology, Mayo Clinic): The evidence is not all that clear about the efficacy of those drugs long-term for chronic pain.

Vivien Williams: Mayo Clinic pain management specialist Dr. Mike Hooten says what is clear about these painkillers is the risk associated with taking them.

Mike Hooten, M.D.: The problems of addiction, but a related problem of accidental overdose deaths.

Vivien Williams: Morphine, oxycodone and hydrocodone are commonly prescribed opioids. Dr. Hooten says they are very effective when used short-term for pain, for example, after a surgery. For long-term use …

Mike Hooten, M.D.: There are a small group of studies that may show some benefit in in certain highly select groups of patients.

Vivien Williams: But, for many cases of chronic pain, Dr. Hooten says non-opioid pain relievers combined with other therapies, such as stress management can help people manage pain and maintain a high quality of life. For the Mayo Clinic News Network, I'm Vivien Williams.

Vivien Williams: Opioid painkiller addiction can destroy lives. The CDC reports that in 2014, 2 million Americans abused or were dependent on painkillers, such as hydrocodone, oxycodone and methadone.

Mike Hooten, M.D. (Anesthesiology, Mayo Clinic): The most important first step is recognizing you have a problem.

Vivien Williams: Mayo Clinic pain management specialist Dr. Mike Hooten says the second step is to talk to the doctor who prescribed the medication.

Michael Hooten, M.D.: The medication, under medical direction, can be gradually tapered and then at the same time, other pain therapies can be introduced if needed. And, finally, you need to be referred to the appropriate addiction specialist.

Vivien Williams: Dr. Hooten says breaking free from opioids is not easy. But, unlike alcohol withdrawal, which can be life threatening, …

Michael Hooten, M.D.: Acute opioid withdrawal is a non-lethal syndrome. It's very, very uncomfortable, but not necessarily associated with death.

Vivien Williams: Every day 78 people die from an opioid overdose. Experts urge anyone who is addicted to get help. It can save your life. For the Mayo Clinic News network, I'm Vivien Williams.

July 02, 2019

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