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Multidisciplinary Pain Management in the Rehabilitation Patient

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Comprehensive Pain Management in the Rehabilitation Patient

Abstract

There are numerous treatment modalities that have demonstrated efficacy in treating chronic pain, including conservative care (e.g., physical therapy, acupuncture, chiropractic care), emotional therapy, interventional treatments (e.g., radiofrequency ablations, epidural steroid injections), implanted device therapy (e.g., spinal cord stimulators, intrathecal therapies), regenerative therapies, and if needed, surgery. Because patients suffering from chronic pain conditions vary in their responsiveness to different treatments, the multidisciplinary approach offers these various modalities to patients within a single practice. A multidisciplinary approach has the potential to provide greater pain relief and/or to reduced costs.

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References

  1. Gaskin DJ, Richard P. The economic costs of pain in the United States. In: Institute of Medicine (US) Committee on Advancing Pain Research, Care, and Education. Relieving Pain in America: a blueprint for transforming prevention, care, education, and research. Washington: National Academies Press;2011. Appendix C. http://www.ncbi.nlm.nih.gov/books/NBK92521/.

  2. Kaiser U, Arnold B, Pfingsten M, Nagel B, Lutz J, Sabatowski R. Multidisciplinary pain management programs. J Pain Res. 2012;5:209–16.

    Google Scholar 

  3. Gatchel RJ, Okifuji A. Evidence-based scientific data documenting the treatment and cost-effectiveness of comprehensive pain programs for chronic nonmalignant pain. J Pain. 2006;7:779–93.

    Article  PubMed  Google Scholar 

  4. Friedrich M, Gittler G, Arendasy M, Friedrich KM. Long-term effect of a combined exercise and motivational program on the level of disability of patients with chronic low back pain. Spine. 2005;30:995–1000.

    Article  PubMed  Google Scholar 

  5. Liliedahl RL, Finch MD, Axene DV, Goertz CM. Cost of care for common back pain conditions initiated with chiropractic doctor vs medical doctor/doctor of osteopathy as first physician: experience of one Tennessee-based general health insurer. J Manipulative Physiol Ther. 2010;33:640–3.

    Article  PubMed  Google Scholar 

  6. Rivero-Arias O, Campbell H, Gray A, Fairbank J, Frost H, Wilson-MacDonald J. Surgical stabilization of the spine compared with a programme of intensive rehabilitation for the management of patients with chronic low back pain: cost utility analysis based on a randomized controlled trial. BMJ. 2005;330:1239.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Flor H, Fydrich T, Turk DC. Efficacy of multidisciplinary pain treatment centers: a meta-analytic review. Pain. 1992;49:221–30.

    Article  PubMed  Google Scholar 

  8. Marra CA, Cibere J, Grubisic M, et al. Pharmacist-initiated intervention trial in osteoarthritis: a multidisciplinary intervention for knee osteoarthritis. Arthritis Care Res. 2012;64:1837–45.

    Article  Google Scholar 

  9. Hooten WM, Townsend CO, Sletten CD, Bruce BK, Rome JD. Treatment outcomes after multidisciplinary pain rehabilitation with analgesic medication withdrawal for patients with fibromyalgia. Pain Med. 2007;8:8–16.

    Article  PubMed  Google Scholar 

  10. Singh G, Willen SN, Boswell MV, Janata JW, Chelimsky TC. The value of interdisciplinary pain management in complex regional pain syndrome type I: a prospective outcome study. Pain Physician. 2004;7:203–9.

    PubMed  Google Scholar 

  11. UK BEAM Trial Team. United Kingdom back pain exercise and manipulation (UK BEAM) randomized trial: effectiveness of physical treatments for back pain in primary care. BMJ. 2004;329:1377.

    Article  PubMed Central  Google Scholar 

  12. Lawrence DJ, Meeker W, Branson R, Bronfort G, Cates JR, Haas M, Haneline M, Micozzi M, Updyke W, Mootz R, Triano JJ, Hawk C. Chiropractic management of low back pain and low back-related leg complaints: a literature synthesis. J Manipulative Physiol Ther. 2008;31:659–74.

    Article  PubMed  Google Scholar 

  13. Gladkowski CA, Medley CL, Nelson HM, Price AT, Harvey M. Opioids versus physical therapy for management of chronic back pain. J Nurse Pract. 2014;10:552–9.

    Article  Google Scholar 

  14. Caboýoglu MT, Neyhan E. The mechanism of acupuncture and clinical applications. Int J Neurosci. 2006;116:115–25.

    Article  Google Scholar 

  15. Vickers AJ, Cronin AM, Maschino AC, et al. Acupuncture for chronic pain: individual patient data meta-analysis. Arch Intern Med. 2012;172(19):1444–53. doi:10.1001/archinternmed.2012.3654.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Weidenhammer W, Linde K, Streng A, Hoppe A, Melchart D. Acupuncture for chronic low back pain in routine care: a multicenter observational study. Clin J Pain. 2007:128–35.

    Google Scholar 

  17. Napadow V, Makris N, Liu J, Kettner NW, Kwong KK, Hui KS. Effects of electroacupuncture versus manual acupuncture on the human brain as measured by fMRI. Hum Brain Mapp. 2005;24:193–205.

    Article  PubMed  Google Scholar 

  18. Linde K, Witt CM, Streng A, Weidenhammer W, Wagenpfeil S, Brinkhaus B, Willich SN, Melchart D. The impact of patient expectations on outcomes in four randomized controlled trials of acupuncture in patients with chronic pain. Pain. 2007;128:264–71.

    Article  PubMed  Google Scholar 

  19. Block AR, Ben-Porath YS, Marek RJ. Psychological risk factors for poor outcome of spine surgery and spinal cord stimulator implant: a review of the literature and their assessment with the MMPI-2-RF. Clin Neuropsychol. 2013;27:81–107.

    Article  PubMed  Google Scholar 

  20. Jepson NA. Applications of biofeedback for patients with chronic pain. Tech Reg Anesth Pain Manag. 2008;12:111–4.

    Article  Google Scholar 

  21. Gatchel RJ, Robinson RC, Pulliam C, Maddrey AM. Biofeedback with pain patients: evidence for its effectiveness. Semin Pain Med. 2003;1:55–66.

    Article  Google Scholar 

  22. Turner JA, Jensen MP. Efficacy of cognitive therapy for chronic low back pain. Pain. 1993;52:169–77.

    Article  PubMed  Google Scholar 

  23. Wolfe F, Zhao S, Lane N. Preference for nonsteroidal anti-inflammatory drugs over acetaminophen by rheumatic disease patients: a survey of 1799 patients with osteoarthritis, rheumatoid arthritis, and fibromyalgia. Arthritis Rheum. 2000;43:378–85.

    Article  CAS  PubMed  Google Scholar 

  24. Pincus T, Swearingen C, Cummins P, Callahan LF. Preference for nonsteroidal anti-inflammatory drugs versus acetaminophen and concomitant use of both types of drugs in patients with osteoarthritis. J Rheumatol. 2000;27:1020–7.

    CAS  PubMed  Google Scholar 

  25. Fishbain D. Evidence-based data on pain relief with antidepressants. Ann Med. 2000;32:305–16.

    Article  CAS  PubMed  Google Scholar 

  26. Tremont-Lukats IW, Megeff C, Backonja MM. Anticonvulsants for neuropathic pain syndromes: mechanisms of action and place in therapy. Drugs. 2000;60:1029–62.

    Article  CAS  PubMed  Google Scholar 

  27. Bloodworth D. Issues in opioid management. Am J Phys Med Rehabil. 2005;84(3 Suppl):S42–55.

    Article  PubMed  Google Scholar 

  28. Manchikanti L, Abdi S, Atluri S, Benyamin RM, Boswell MV, et al. An update of comprehensive evidence-based guidelines for interventional techniques in chronic spinal pain. Part II: guidance and recommendations. Pain Physician. 2013;16:S49–S283.

    PubMed  Google Scholar 

  29. Adams EH, Breiner S, Cicero TJ, Geller A, Inciardi JA, Schnoll SH, Senay EC, Woody GE. A comparison of the abuse liability of tramadol, NSAIDs, and hydrocodone in patients with chronic pain. J Pain Symptom Manage. 2006;31:465–76.

    Article  CAS  PubMed  Google Scholar 

  30. Cohen SP, Bicket MC, Jamison D, Wilkinson I, Rathmell JP. Epidural steroids: a comprehensive, evidence-based review. Reg Anesth Pain Med. 2013;38:175–200.

    Article  CAS  PubMed  Google Scholar 

  31. van Kleef M, Barendse GAM, Kessels A, Voets HM, Weber WE, de Lange S. Randomized trial of radiofrequency lumbar facet denervation for chronic low back pain. Spine (Phila Pa 1976). 1999;24:1937–42.

    Article  PubMed  Google Scholar 

  32. Compton AK, Shah B, Hayek SM. Spinal cord stimulation: a review. Curr Pain Headache Rep. 2012;16:35–42.

    Article  PubMed  Google Scholar 

  33. North RB, Kidd DH, Farrokhi F, Piantadosi SA. Spinal cord stimulation versus repeated lumbosacral spine surgery for chronic pain: a randomized, controlled trial. Neurosurgery. 2005;56:98–106.

    Article  PubMed  Google Scholar 

  34. Filardo G, Kon E, Buda R, Timoncini A, Di Martino A, Cenacchi A, Fornasari PM, Giannini S, Maracacci M. Platelet-rich plasma intra-articular knee injections for the treatment of degenerative cartilage lesions and osteoarthritis. Knee Surg Sports Traumatol Arthrosc. 2011;19:863–4.

    Article  Google Scholar 

  35. Yang JD, Choi DS, Cho YK, Kim TK, Lee JW, Choi KY, Chung HY, Cho BC, Byun JS. Effect of amniotic fluid stem cells and amniotic fluid cells on the wound healing process in a white rat model. Arch Plast Surg. 2013;40:496–504.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Wakitani S, Imoto K, Yamamoto T, Saito M, Murata N, Yoneda M. Human autologous culture expanded bone marrow mesenchymal cell transplantation for repair of cartilage defects in osteoarthritic knees. Osteoarthritis Cartilage. 2002;10:199–206.

    Article  CAS  PubMed  Google Scholar 

  37. Mesoblast Ltd. Announcement [news release]. New York. 29 Jan 2014. Positive spinal disc repair trial results using Mesoblast adult stem cells.

    Google Scholar 

Recommended Reading

  • Becker N, Sjorgren P, Bech P, Olsen AK, Eriksen J. Treatment outcome of chronic non-malignant pain patients managed in a Danish multidisciplinary pain centre compared to general practice: a randomized controlled trial. Pain. 1999;84:203–11.

    Article  Google Scholar 

  • Flor H, Fydrich T, Turk DC. Efficacy of multidisciplinary pain treatment centers: a meta-analytic review. Pain. 1992;49:221–30.

    Article  PubMed  Google Scholar 

  • Gatchel RJ, Okifuji A. Evidence-based scientific data documenting the treatment and cost-effectiveness of comprehensive pain program for chronic nonmalignant pain. J Pain. 2006;7:779–83.

    Article  PubMed  Google Scholar 

  • Stanos SP. Developing an interdisciplinary multidisciplinary chronic pain management program: nuts and bolts. In: Schatman ME, Campbell A, editors. Chronic pain management: a guidebook for multidisciplinary program development. New York: Informa Healthcare; 2007. p. 151–72.

    Google Scholar 

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Author information

Authors and Affiliations

  1. 9787 N. 91st Street, Suite 101, Scottsdale, AZ, 85258, USA

    Tory McJunkin M.D. (Arizona Pain Specialists, Pain Doctor), Edward Swing Ph.D. (Arizona Pain Specialists, Pain Doctor), Kyle Walters B.S. (Arizona Pain Specialists) & Paul Lynch M.D. (Arizona Pain Specialists)

Authors
  1. Tory McJunkin M.D.
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  2. Edward Swing Ph.D.
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  3. Kyle Walters B.S.
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  4. Paul Lynch M.D.
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Corresponding author

Correspondence to Tory McJunkin M.D. .

Editor information

Editors and Affiliations

  1. Department of Neurosurgery, Brown University, Warren Alpert Medical School, Providence, USA

    Alexios Carayannopoulos DO, MPH

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McJunkin, T., Swing, E., Walters, K., Lynch, P. (2017). Multidisciplinary Pain Management in the Rehabilitation Patient. In: Carayannopoulos DO, MPH, A. (eds) Comprehensive Pain Management in the Rehabilitation Patient. Springer, Cham. https://doi.org/10.1007/978-3-319-16784-8_2

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  • DOI: https://doi.org/10.1007/978-3-319-16784-8_2

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-16783-1

  • Online ISBN: 978-3-319-16784-8

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