Description of Programs

There are extremely effective treatments for acute pain, somewhat effective treatments for cancer pain, but a paucity of effective treatments for chronic pain until recently. Care Center recognized the idea that no single clinician would be able to evaluate and manage all the aspects of the complex chronic pain state. The programs at Care Center are designed to include all the specialists deemed necessary to address the complex consequences of chronic pain. The programs are customized to meet the needs of each patient.

Care Center offers several options for treatment:

• Structured Program
• Modified Unstructured Program
• Modality Program

Structured Program

Comprehensive program. It is recommended for patients who have experienced pain greater than 6 months, it is chronic, pain has significantly affected physical and social functioning and has affected the overall quality of their life. They experience physical deconditioning- reduction muscle tone, strength, endurance, reduction aerobic capacity, chronic sleep deprivation, fear of additional injury. Further they experience Psychological deconditioning- Depression, Anger, Irritability, Anxiety, Anhedonia, Guilt. Many of these individuals are either overmedicated or under medicated. Previous treatment has provided only frustration and relatively little if any improvement. They are not a clear surgical candidate. There is a case manager/program manager assigned to ensure coordination of all aspects of treatment between the professionals, the patients. The Professionals actively treating the patient meet regularly once a week in a rehabilitative conference to discuss and coordinate treatment. The goals and treatment is re-evaluated each week to ensure consistent treatment.

The structured program has three levels, the Center's evaluation determines where the patients program begins.

Level One Program:

Comprehensive Program: The program is goal-directed, coordinated, interdisciplinary and inclusive. 6 hours per day, five days per week, high-moderate to severe deconditioning, and medication dependence. . There is a high-moderate to severe decondition and medication dependence. Treatment is prescribed by the CCRPM physician. This program has a frequency of 6-7 hours per day, five days per week. The duration is usually 6-8 weeks.
Includes:

Level Two Program:

Modified Comprehensive Program: Frequency is 7 hours per day, three days per week. Duration is 8-10 weeks. This type of program is suitable for a patient that requires less supervision, is independent in home practice, and the degree of deconditioning is in the low-moderate range. Treatment is prescribed by the CCRPM physician.

Modified Unstructured Program

This level of program is suitable for a higher functioning patient who does not require structure although benefits from a combination of specific treatment modalities such as aquatics, physical therapy, occupational therapy and acupuncture. The treatment focus is on functional restoration/ physical rehabilitation, usually work hardening. There is usually not a medication issue, minimal reduction in daily activities, patient actively participated in prior treatment and demonstrated good carryover, patient may still be working. Treatment is prescribed by the CCRPM physicians. The frequency is usually 3 times a week, duration 3-4 hours each day.

Modality Program

The patient is not chronic at this time, perhaps post surgical, and is demonstrating some response to their current treatment. There may be a need to expand the treatment. These patients are treated per a recommendation from their referring physician. They are not evaluated by a Care Center physician. As such they may be receiving treatment only in the rehabilitation area, aquatics, massage therapy, or perhaps this is combined with acupuncture. The patient may be in acute rehabilitation somewhere else and the physician would like biofeedback, or psychological support. With the unstructured program, treatment is limited to specific modalities, Not every patient experiencing pain requires the structure of a comprehensive program.