Principles & Practice of Pain Medicine > Part III. Psychological Evaluation and Treatment of Chronic Pain > Chapter 16. Inpatient Model of a Chronic Pain Management Program Richard T. Goldberg

Inpatient Model of a Chronic Pain Management Program: Introduction

"Chronic pain has been defined by Turk^1,2 as a function of a complex interaction among demographic, physical, psychological, social, and economic factors, including age, sex, education, medical status, pain severity, alcohol and substance abuse, beliefs about pain, increased used of medications and of health care services, and a generalized adoption of the sick role. Because chronic pain is multifactorial in nature, the use of any one modality, pharmacologic treatment, alternative medicine, or psychologic approach is bound to fail. Pain management in an inpatient center provides a model of interdisciplinary treatment consisting of medical care, medication management, physical reconditioning, training in body mechanics, meditation, relaxation, biofeedback psychology, and milieu therapy. Patients who are referred to an inpatient chronic pain program commonly experience functional disabilities, social dysfunction, narcotic and alcohol dependency, child abuse history, vocational impairment, dependency on the public welfare system and the workmen's compensation system, and significant psychiatric disorders that are both antecedent to and consequent from chronic pain. Therefore, the objectives, treatment procedures, outcome measures, and long-term success of inpatient chronic pain management are distinct from treatment of acute pain, malignant pain, and postoperative pain...."