From: Subject: 'Boot camps' treat pain sufferers - El Paso Times Date: Mon, 17 Mar 2008 17:13:09 -0500 MIME-Version: 1.0 Content-Type: multipart/related; type="text/html"; boundary="----=_NextPart_000_013C_01C88852.2CBB0910" X-MimeOLE: Produced By Microsoft MimeOLE V6.00.2900.3198 This is a multi-part message in MIME format. ------=_NextPart_000_013C_01C88852.2CBB0910 Content-Type: text/html; charset="utf-8" Content-Transfer-Encoding: quoted-printable Content-Location: http://www.elpasotimes.com/health/ci_8594383 =EF=BB=BF 'Boot camps' treat pain sufferers - El Paso = Times
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'Boot camps' treat pain = sufferers

By CARLA K. JOHNSON = Associated=20 Press Writer
Article = Launched: 03/16/2008=20 10:55:21 AM MDT

CHICAGO=E2=80=94Ballet = teacher Gayle=20 Parseghian thought she might never dance again = after a=20 back injury while moving heavy furniture left = her with=20 unrelenting pain.=20

But an intensive, four-week "boot camp" got = the=20 55-year-old dancer from Toledo, Ohio, back to = the barre.=20 The program at the Rehabilitation Institute of = Chicago=20 taught her to manage the chronic pain that had = tormented=20 her for more than a year.=20

"It affects your relationship with your = spouse, your=20 family, your friends, your boss," she said. = "It's like=20 you're trapped in your body and you can't get = out. It's=20 a feeling of being completely out of control."=20

New research suggests chronic pain affects = the=20 brain's ability to rest, disrupting a system = that=20 normally charges up some brain regions and = powers down=20 others when a person relaxes.=20

"I ask a patient who has had chronic pain for = 10=20 years to put the mind blank, don't think about=20 anything," says Dr. Dante Chialvo, a researcher = at=20 Northwestern University's Feinberg School of = Medicine=20 who is not involved with the boot camp.=20

MRI images show the pain sufferer's brain = lighting=20 up, but not as a normal brain at rest would, he = said.=20 "There is an objective biological difference in = the=20 brain."=20

The early findings could explain the sleep=20 disturbances, decision-making problems and mood = changes=20 that often accompany chronic pain, he said.=20

And they could explain why the boot camp = approach=20 worked for Parseghian.=20

The Chicago program,

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affiliated with Northwestern's medical = school,=20 attacks pain on three fronts=E2=80=94biological, = psychological=20 and social. It doesn't claim to cure chronic = pain, but=20 instead gives patients tools to lessen its hold = on their=20 lives.=20

Patients spend Monday through Friday = stretching,=20 exercising and moving in new ways. They meet = with a=20 physician, an occupational therapist, a physical = therapist, a biofeedback therapist, a clinical=20 psychologist and a movement specialist.=20

They may address depression or sleep problems = or=20 adjust their medications. And they learn from = the other=20 patients in the program.=20

Getting all of these things under one roof = differs=20 from most approaches to treating chronic pain, = said Dr.=20 Steven Stanos, the program's medical director.=20

Patients know the drill. In the fragmented = world of=20 health care, they bounce from internist to = chiropractor=20 to massage therapist to surgeon=E2=80=94with = none of the experts=20 sharing information.=20

"You will try anything and everything to get = out of=20 the pain," Parseghian said. "You discover all of = your=20 efforts are fruitless and you have spent = monumental=20 amounts of money."=20

She tried herbal patches, vitamins, = injections,=20 prescription narcotics and a battery-operated = device=20 that uses electrical impulses to block pain. = Nothing=20 worked.=20

Surgery would have been next. She was in a = surgeon's=20 waiting room when she read an article about the = boot=20 camp.=20

If acute pain is the body's alarm system, = alerting to=20 injury-causing dangers, then chronic pain is an = alarm=20 going haywire, screaming a warning long after = the danger=20 has passed.=20

The American Pain Society estimates millions = of=20 Americans are in chronic pain from backaches, = jaw pain,=20 headaches and fibromyalgia, a mysterious = syndrome marked=20 by muscle pain and fatigue. Sore spines alone = cost=20 billions of dollars each year.=20

In 2005, Americans with aching backs and = necks spent=20 $20 billion on prescription drugs and another = $31=20 billion for outpatient doctor visits, according = to a=20 recent study in the Journal of the American = Medical=20 Association. Total spending on spine treatments=20 increased 65 percent from 1997, adjusted for = inflation.=20 But rising alongside that was the proportion of = people=20 with spine problems who reported limited = function.=20

Such spending with such poor results gets = insurance=20 companies' attention.=20

Chronic pain patients' medical and pharmacy = bills=20 "show up on our radar," said Dr. James Cross, = Aetna's=20 national medical policy chief. The patients are=20 "frustrated and clearly suffering" and "looking = for an=20 answer," he said.=20

Although boot camp-style programs cost up to = $20,000,=20 Cross said that's cost-effective compared to the = procedure and pill merry-go-round. The company = cites=20 studies showing patients who have completed boot = camp=20 programs experience lasting pain reduction and = lower=20 stress. Aetna also believes patients completing = the=20 programs are more likely to return to work and = less=20 likely to seek other expensive treatments.=20

Other insurers also cover the programs, but=20 convincing more companies will take more = evidence, said=20 Dennis Turk, a pain researcher at the University = of=20 Washington in Seattle and a believer in the = approach.=20

It's unclear what combination of therapies = works best=20 for which patients and whether four weeks are = needed for=20 everyone, Turk said. Patients should be cautious = because=20 quality varies, he said.=20

"Anybody out there can put up a sign and say, = 'I'm a=20 comprehensive pain rehabilitation program,'" = Turk said.=20 He recommended programs affiliated with = university=20 medical centers and the nearly 100 = interdisciplinary=20 programs accredited by the Commission on = Accreditation=20 of Rehabilitation Facilities.=20

Two weeks into the boot camp, Parseghian's = husband=20 visited her in Chicago for the weekend. They = toured an=20 art museum and went shopping together. Later, he = phoned=20 her with an observation.=20

"You didn't say one thing about your pain or = the=20 back. That used to monopolize our = conversations," her=20 husband told her.=20

That impressed Parseghian. "I guess I hadn't = realized=20 just how much my back issue had really = manifested itself=20 into our relationship," she said.=20

Two weeks later, she headed home with a = detailed=20 schedule for her first week back, including = plenty of=20 time to relax. She knew the staff would check = with her=20 in another four weeks to see how she was doing.=20

And she was armed with breathing techniques = and=20 phrases to repeat when she suffered a flare-up: = "This=20 has happened before and I have survived it. I'm = going to=20 be OK."=20

During her second week home, she reported, "I = took my=20 first ballet class last week."=20

"I thought that day would never come," she = said.=20 "Little by little, I'm regaining the control in = my life=20 that I thought the injury had robbed me of."=20

=E2=80=94=E2=80=94=E2=80=94=20

On the Net:=20

Commission on Accreditation of Rehabilitation = Facilities: http://www.carf.org/=20

Rehabilitation Institute of Chicago: http://www.ric.org/

Print &nb= sp;=20 Email  =20 Return=20 to Top   =
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