What Types Of Pain Centers Are There?


What Types Of Pain Centers Are There?

A pain management center is used to help and individual learn how to effectively cope with their pain as well as to educate the individual to deal more efficiently with their pain. There are 4 kinds of pain control centers. The first is what Gerbershagan (1980) describes as a major comprehensive type that deals with all modalities and all kinds of pain syndromes. The second is a comprehensive inpatient program. The program looks like a hospital in thatit has a large space with beds and a full time professional and supportive staff. This type of program requires an extensive record review before admission, routinely carries out psychological assessments (before admission, during the program and upon discharge from the program), involves consultants of several specialties, organizes educational material, training and research programs and will provide a large variety of therapeutic modalities. The third type is a syndrome-oriented program, which provides a thorough evaluation and treatment of particular pain syndromes such as low back pain, myofacial pain, headaches, etc. These can be mono- and multidisciplinary inpatient and outpatient facilities. The fourth type is a modality oriented center which may also use monoultidisciplinary patient work up schemes and will apply certain limited treatment modalities such as nerve blocks, psychotherapy, transcutaneous electric nerve stimulation (TENS), neurosurgery, etc.

When involved in a pain management program, the patient in pain can either be in the hospital as an inpatient or do their therapy as an outpatient, coming to the hospital or clinic several times a week. The inpatient approach has pros and cons. First, the program can be quite expensive (being hospitalized from 4 to 8 weeks), with a large cost of thousands of dollars. Blackwell (1984)believes that the inpatient approach should be used when an individual requires detoxification from multiple drugs has many physical complaints that require evaluation and assessment has a severe physical impairment; and when the outside environment may impede progress in the program.

Written By Dr Patty

2 Comments

  1. Are these four types of centers claiming to or expect the patient to heal all types of pain causing conditions? Or do they also do symptom managament for those who cannot be healed. The centers here in michigan are only able to treat new onset chronic pain and only chronic pain with minor disability. The attitude is in most if not all here is if you do not get better, if your pain is not removed then you are to blame, that you do not really want to be pain free, that you want drugs or comp or social security or are lazy and do not want to go back to work. I suppose there are some mentally challanged patients that are scamming, that are not really in the pain they say but some of us just want to be better we want help and when these doctors blame us for not improving and group us in with mental cases it causes us to lose all hope. I am willing to bet that is why the sucide rate is so high with chronic and intractable pain disease patients. Some of us need symptom managment as our bodies are so broken or so damaged or we have diseases that cannot be cured. Where do we turn? Where do we get the help and treatment we need?

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    • Such an honest assessment Jeffrey. I didn’t respond to TENs, Neuro Muscular therapy, physical therapy, muscle relaxers, antidepressants, Etc… This was at 14 and after 22 years of suffering, it surely won’t help now. Massage does give me a few minutes respite. That’s about it. I’ve never been truly diagnosed despite all my efforts. Even when asked very direct questions regarding symptoms that pointed directly to Scoliosis two physicians did not bother to run a simple one minute finger trace of my spine. So I went without the brace I desperately needed. I know better now but that damage is done. Note: I was very thin and later my latest physical therapist walked in the patient room as I stood fully clothed to greet her she instantly said you know you have scoliosis, right? I said, no. Looking back why didn’t she educate me? Why didn’t I demand an explanation from my two crappy physicians and demand the proper protocol? There are many reasons. Some of them being I was taught to respect my elders and to be a people pleaser. It was ingrained into my formative years. Plus why wouldn’t our physicians want the best for us? After all, they do declare an oath to do no harm. I don’t even know for sure that a later diagnosis of BiPolar 2 Rage Disorder is accurate. It takes a decade at times to diagnose properly. I couldn’t afford regular psychiatric sessions or any further diagnostic testing. Raleigh Neurology in N.C. Neurologist refused to test me further after concluding that my reflexes were fine after a long recovery from Foot Drop. I walked gingerly, he noted. I thought, Is he implying I am pretending this is how I walk? I walked that way because I had witnessed how soldiers are now taught the crouch and walk technique. I reasoned that this would cause the least amount of impact. I had implemented my own modified version of my observation and it has stuck. I was experiencing intense muscle spasms and could barely manage to wait for my appointment which of course ran late. This exam was during a last ditch effort to find answers and or rule out different disorders and illnesses. Also, it was out of pocket. When I repeated that I wanted further testing he refused and continued with the reply that all my reflexes checked out. He did not run the basic finger trace along my spine, either. I can’t stand to cry in public. I could not stop the near hysterical sobbing that erupted from deep inside. No references were offered. I left feeling completely violated, yet again. I went into a state of shock after sobbing the whole way home. I had extreme exhaustion and trembled uncontrollably for 2 days. I do wonder at times if the symptoms of severe chronic pain, mistreatment and a sense of betrayal and violation made me temporarily appear to have a serious mental illness. After all, why wouldn’t this drive someone to the brink of insanity? It seems logical, possible and probable to wonder and ponder whether I was misunderstood, yet again. I don’t encourage myself or others to ignore a mental health diagnosis. Nor do I believe I would commit suicide due to mental illness. It would be the various traumas from stigma, mistreatment by physicians, the innate need for answers and a 22 year struggle to be heard compounded by the severe chronic pain that has not abated but worsened during the past 22 years.

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