Thousands of pain treatment centers in the United States offer programs for people with chronic pain, including back pain. These programs do not aim to cure the cause of pain. Rather, they take advantage of a variety of approaches to reduce or eliminate pain and its negative effects on daily life.
People generally turn to pain treatment centers when they have run out of other options. These facilities can help individuals living with chronic pain to improve both their physical and mental coping skills. The programs focus on managing the following:
- Pain behavior—actions that worsen the quality of life, such as limping, moaning, moving slowly, or using a cane
- Self perception—perceiving oneself as impaired or having a disability
- Pain perception—a discrepancy between how much pain a person feels and how much his or her condition typically produces
- Mental health problems—depression, anxiety, drug or alcohol dependence (some studies have found that approximately 25% of chronic pain sufferers become dependent on pain-control medication), and impaired memory or concentration.
Pain centers are generally not advised for individuals who have unstable medical conditions (for example, uncontrolled high blood pressure or heart failure) or unrealistic expectations (such as finding a total cure) or for those who are unwilling to participate in a formal program.
There are several types of pain clinics. Some focus on a single treatment method, such as acupuncture, while others target pain in a particular region of the body. There are also multidisciplinary pain centers or clinics, which doctors usually prefer because they offer a more comprehensive approach and have shown superior results in medical studies. Multidisciplinary centers view pain as a complex syndrome. Therefore, they provide an integrated treatment team that generally includes a primary care physician, surgeon, psychologist or psychiatrist, nurse, physical therapist, occupational therapist, vocational counselor, and social worker.
Since the quality of care varies from one program to another, finding the right one can take some time. Your physician may be able to recommend a facility, or you can contact the Commission on Accreditation of Rehabilitation Facilities, which will provide a list of accredited programs in your area.
Although accreditation is not required, accredited programs tend to be comprehensive. In addition, some insurance plans cover only accredited facilities. The American Pain Society also can provide information about pain centers in your vicinity. In addition, the following tips may be helpful in your search:
- Programs located in hospitals and rehabilitation centers are most likely to offer comprehensive treatment. For the most specialized care, they should be located in a separate unit specifically set aside for the pain program.
- A good chronic pain program should include most of these features: biofeedback training, individual and family counseling, group therapy, occupational therapy, assertiveness training, regional anesthesia (nerve blocks), physical therapy, relaxation training and stress management, educational programs on medication and other aspects of pain management, and follow-up care after program completion.
- Make sure the program encourages family involvement. Educational sessions and counseling for your family members can help them to better understand your pain and how to support you.
- Find out what services your health insurance policy will reimburse.
- Try to meet with several staff members before you enter a program. The medical director should have board certification and training in pain management. Ask about the physical setup, whether the program is inpatient or outpatient, the duration of the program (and length of any inpatient stay), and whether job retraining is involved. You may also consider asking whether any current participants would be willing to speak to you about their experience.
- Be sure the program reviews your previous medical records and gives you a complete physical exam before entry. Bring copies of your recent medical records.