Chronic Pain

Scope
It is estimated that U.S business and industry lose almost $90 billion annually to sick time, reduced productivity and direct medical and other benefit costs due to pain problems among employees.  Chronic pain afflicts over 86 million Americans to some degree and affects the quality of life and financial stability of both the injured person with paina s well as his or her family.  In addition, chronic pain treatment modealities often involve both physiological and psychological intervention that may be delivered by a myriad of licensed and non-licensed health care providers in a fragmented manner.  These factors canc reate a complex area of medicine where appropriate assessment and management are required to bring long term results tot he injured person, employer and worker's compensation carrier.

Treatment
Despite the frequency and cost of chronic pain in this country, medical treatment often lacks diagnostic calrity, single point of care management and coordination of the treatement plan.  This leads to multiple providers, duplicate treatmentand medication and little or no progression in treatment.  Inidividuals with chronic pain are often left to navigate the medical system with little or no assistance.  This leads to long term chronic pain bahaviors and significant cost to the payer.

Physical and Psychological Consequences
Most individuals suffering from chronic pain have significant physilogical and psychological issues requiring coordination of care.  Many have become sedate due to the pain and a cycle began of additional treatment, fewer results, increased pain, less mobility and depression.

Indicators of Chronic Pain
Every individual with emerging chronic pain or someone already in the pain syndrome cycle is different and indications will vary, but some traits tend to stand out leading us to believe that a comprehensive and systematic program is indicated.  They include, but are not limited to the following:

• Off work due to pain beyond the normal acute healing time (3 to 6 months)
• Prescriptions for pain medication continuing or increasing
• Significant co-morbidities are present
• Prior history of being off work for pain
• Prior drug or alcohol abuse
• Psychological issues are present
• Subjective symptoms greater than objective findings
• Resistance to return to work
• Drug seeking behavior

These traits by themselves, indicate the need for a comprehensive management program.  If an individual is consumed with a request for surgery, implantation or referral to pain management.  A comprehensive evaluation and plan is essential.

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