From: Subject: 'Boot Camps' Treat Pain Sufferers - Forbes.com Date: Mon, 17 Mar 2008 17:09:47 -0500 MIME-Version: 1.0 Content-Type: multipart/related; type="text/html"; boundary="----=_NextPart_000_00B1_01C88851.B43C7A50" X-MimeOLE: Produced By Microsoft MimeOLE V6.00.2900.3198 This is a multi-part message in MIME format. ------=_NextPart_000_00B1_01C88851.B43C7A50 Content-Type: text/html; charset="iso-8859-1" Content-Transfer-Encoding: quoted-printable Content-Location: http://www.forbes.com/feeds/ap/2008/03/16/ap4777875.html 'Boot Camps' Treat Pain Sufferers - = Forbes.com
  
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'Boot Camps' Treat = Pain=20 Sufferers
By CARLA K. JOHNSON 03.16.08, 12:53 PM ET



CHICAGO -

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Copyright 2008 Associated Press. All rights reserved. This = material=20 may not be published broadcast, rewritten, or redistributed =


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e(tempSearchPrev);=0A= }=0A= =0A= document.getElementById(panels[i]).style.display =3D (name =3D=3D = panels[i]) ? 'block':'none';=0A= =0A= if(name=3D=3Dpanels[i] && name=3D=3D'panel3' && = document.SearchVideo.MT.value !=3D""){=0A= document.SearchVideo.submit();=0A= return true;=0A= } else if(name=3D=3Dpanels[i] && name=3D=3D'panel4' && = document.SearchWeb.MT.value !=3D""){=0A= document.SearchWeb.submit();=0A= return true;=0A= }else if(name=3D=3Dpanels[i] && name=3D=3D'panel5' = && document.SearchBlog.MT.value !=3D""){=0A= document.SearchBlog.submit();=0A= return true;=0A= }else if(name=3D=3Dpanels[i] && name=3D=3D'panel2' = && document.searchHedform.Symbol.value !=3D"" && = document.searchHedform.Symbol.value !=3D"Symbol"){=0A= return submitTkr('searchHedform');=0A= }else if(name=3D=3Dpanels[i] && name=3D=3D'panel1' = && document.SearchMain.MT.value !=3D"" && !isFromPanel6){=0A= document.SearchMain.submit();=0A= return true;=0A= }=0A= =0A= }=0A= }=0A= // return false;=0A= }=0A= }=0A= function mouseoutTab() {=0A= if ((navigator.appName =3D=3D "Microsoft Internet Explorer") && = (getExplorerVersion() < 4.5))=0A= return true;=0A= showPanel(this, 'panel1');=0A= return true;=0A= }=0A= function setoutside(out) {=0A= outside =3D out;=0A= }=0A= function hideSearchPanel() {=0A= isFromPanel6=3Dtrue;=0A= showPanel(document.getElementById('panel6'), 'panel1');=0A= isFormPanel6=3Dfalse;=0A= if (outside) outside =3D 0;=0A= searchTab =3D 0;=0A= showAd();=0A= }=0A= =0A= function popitVar(url, popWidth, popHeight) {=0A= newWin =3D window.open(url, 'neWindow', "width=3D" + popWidth + = ",height=3D" + popHeight + ",toolbar=3D0,resizable=3D1,scrollbars=3D1");=0A= newWin.focus()=0A= }=0A= =0A= =0A= function clearInputField(aField){=0A= =0A= if(aField.value =3D=3D "mm/dd/yyyy")=0A= aField.value =3D "";=0A= }=0A= =0A= function clearTextField(inputField1,inputField2) {=0A= inputField1.value =3D "";=0A= if (inputField2 !=3D "none") {=0A= inputField2.value =3D "";=0A= }=0A= }=0A= =0A= function B4Window(url,w,h,scrl) {=0A= AppWindow =3D window.open(url, 'b4utrade', 'width=3D' + w + = ',height=3D' + h + = ',toolbar=3D0,location=3D0,directories=3D0,status=3D1,menubar=3D0,scrollb= ars=3D' + scrl + ',resizable=3D1')=0A= AppWindow.focus();=0A= }=0A= =0A= function submitTkr(thisForm) {=0A= =0A= var userInput =3D escape( document[thisForm].Symbol.value );=0A= =0A= if( (userInput =3D=3D null) || (userInput =3D=3D "") ) {=0A= return false;=0A= } =0A= else {=0A= // Possible destinations in drop-down=0A= var lookups =3D new Array();=0A= // Quote=0A= lookups[0] =3D "";=0A= // News=0A= lookups[1] =3D = "http://www.forbes.com/markets/company_news.jhtml?ticker=3D" + userInput;=0A= // Events Lookup=0A= lookups[2] =3D = "http://www.forbes.com/finance/eventcalendar/OneCompanyEvents.jhtml?symbo= l=3D" + userInput;=0A= // Advance Chart=0A= lookups[3] =3D = "http://www.forbes.com/finance/mktguideapps/compinfo/AdvancedChart.jhtml?= symbol=3D" + userInput;=0A= // Executives=0A= lookups[4] =3D = "http://www.forbes.com/peopletracker/results.jhtml?startRow=3D0&name=3D&t= icker=3D" + userInput;=0A= // Symbol Lookup=0A= lookups[5] =3D = "http://finapps.forbes.com/finapps/jsp/finance/compinfo/SymbolLookupFormS= ubmit.do?companyName=3D" + userInput + "&type=3DE&countryCode=3DUS" ;=0A= =0A= if( (userInput.length =3D=3D 5) && ( (userInput.charAt(4) =3D=3D = "X") || (userInput.charAt(4) =3D=3D "x") ) ) {=0A= lookups[0] =3D = "http://www.forbes.com/funds/Tearsheet.jhtml?tkr=3D" + = userInput.toUpperCase();=0A= } =0A= else { =0A= if(userInput.indexOf("&")!=3D-1 || userInput.indexOf("%26")!=3D-1){=0A= lookups[0] =3D = "http://finapps.forbes.com/finapps/jsp/finance/compinfo/SymbolLookupFormS= ubmit.do?companyName=3D" + userInput + "&type=3DE&countryCode=3DUS" ;=0A= }else=0A= lookups[0] =3D = "http://finapps.forbes.com/finapps/jsp/finance/compinfo/CIAtAGlance.jsp?t= kr=3D" + userInput;=0A= =0A= }=0A= =0A= =0A= // Get the selected option=0A= var selection =3D document[thisForm].options.selectedIndex;=0A= =0A= // Do the lookup=0A= window.location =3D lookups[selection];=0A= =0A= // Form should not submit since we are taking care of everything = in the javascript=0A= return false;=0A= =0A= }=0A= }=0A= =0A= function checkKeywordLength()=0A= {=0A= var keywordInput =3D escape(document.keywordLookup.passName.value);=0A= if (keywordInput=3D=3Dnull || keywordInput.length < 2) {=0A= var msg =3D "Please enter at least two characters and try your = search again.";=0A= alert (msg);=0A= return false;=0A= }=0A= =0A= return true;=0A= }=0A= =0A= =0A= function canBePremium(aString){=0A= if(aString.indexOf('magazine') > -1)=0A= return true;=0A= else =0A= return false;=0A= }=0A= =0A= function premiumInfo(aForm){=0A= var aSelect =3D aForm.pub;=0A= var str =3D aSelect.options[aSelect.selectedIndex].value;=0A= var cbp =3D canBePremium(str);=0A= =0A= if(!cbp){=0A= //alert("selected pub is "+str+"cannot be premium");=0A= aForm.premium.checked =3D true;=0A= }=0A= }=0A= =0A= function clearInputField(aField){=0A= =0A= if(aField.value =3D=3D "mm/dd/yyyy")=0A= aField.value =3D "";=0A= }=0A= =0A= function checkTextForWebSearch(){=0A= = if(document.advancedsearch.contentType.options[document.advancedsearch.co= ntentType.selectedIndex].value =3D=3D "web" &&=0A= document.advancedsearch.MT.value =3D=3D ''){=0A= =0A= alert("'With the following text' field cannot be empty for web = search!");=0A= document.advancedsearch.MT.focus();=0A= document.advancedsearch.MT.select();=0A= return false;=0A= }=0A= =0A= return true;=0A= }=0A= =0A= function checkDates(aForm){=0A= =0A= //var webOK =3D checkTextForWebSearch();=0A= //if(!webOK)=0A= // return false;=0A= =0A= premiumInfo(aForm);=0A= =0A= if((aForm.author.value !=3D "" || aForm.tickers.value !=3D "" || = aForm.contentType.value !=3D "all" || aForm.pub.value !=3D = "forbes.com,magazine,fyi,best" || aForm.storyType.value !=3D "all") && = aForm.MT.value=3D=3D"") {=0A= aForm.MT.value =3D "*";=0A= }=0A= =0A= if(aForm.pubDateStart.value !=3D "mm/dd/yyyy" && = aForm.pubDateStart.value !=3D "") {=0A= =0A= if( (aForm.pubDateEnd.value !=3D "mm/dd/yyyy" && = aForm.pubDateEnd.value !=3D "") && aForm.MT.value =3D=3D "") {=0A= =0A= aForm.MT.value =3D "*";=0A= }=0A= } =0A= =0A= =0A= =0A= if(aForm.MT.value=3D=3D""){=0A= aForm.MT.select();=0A= aForm.MT.focus();=0A= return false;=0A= }=0A= =0A= var startDate =3D aForm.pubDateStart.value;=0A= var endDate =3D aForm.pubDateEnd.value;=0A= =0A= if(isValidDate(startDate) && isValidDate(endDate))=0A= return true;=0A= else=0A= return false; =0A= }=0A= =0A= function isValidDate(dateStr) {=0A= // MM/DD/YY MM/DD/YYYY MM-DD-YY MM-DD-YYYY //=0A= if(dateStr =3D=3D "" || dateStr =3D=3D "mm/dd/yyyy")=0A= return true;=0A= =0A= var datePat =3D /^(\d{1,2})(\/)(\d{1,2})\2(\d{4})$/; // requires 4 = digit year, for MM/DD/YYYY=0A= =0A= var matchArray =3D dateStr.match(datePat); // is the format ok?=0A= =0A= if (matchArray =3D=3D null) {=0A= alert(dateStr + " Date is not in a valid format.")=0A= return false;=0A= }=0A= =0A= month =3D matchArray[1]; // parse date into variables=0A= day =3D matchArray[3]; =0A= year =3D matchArray[4];=0A= if (month < 1 || month > 12) { // check month range=0A= alert("Month must be between 1 and 12.");=0A= return false;=0A= }=0A= =0A= if (day < 1 || day > 31) {=0A= alert("Day must be between 1 and 31.");=0A= return false;=0A= }=0A= =0A= if (year < 1900 || year > 2010) {=0A= alert("Year must be between 1900 and 2010");=0A= return false;=0A= }=0A= =0A= if ((month=3D=3D4 || month=3D=3D6 || month=3D=3D9 || month=3D=3D11) = && day=3D=3D31) {=0A= alert("Month "+month+" doesn't have 31 days!")=0A= return false;=0A= }=0A= =0A= if (month =3D=3D 2) { // check for february 29th=0A= var isleap =3D (year % 4 =3D=3D 0 && (year % 100 !=3D 0 || year = % 400 =3D=3D 0));=0A= if (day>29 || (day=3D=3D29 && !isleap)) {=0A= alert("February " + year + " doesn't have " + day + " = days!");=0A= return false;=0A= }=0A= =0A= }=0A= =0A= return true;=0A= }=0A= =0A= =0A= // SEARCH FDC TAB=0A= document.write('
');=0A= document.write('
');=0A= document.write('
Search:
');=0A= document.write('
');=0A= document.write('
Forbes.com
');=0A= document.write('');=0A= document.write('');=0A= document.write('');=0A= document.write('');=0A= document.write(' ');=0A= document.write('
');=0A= =0A= document.write('');=0A= document.write('');=0A= document.write('');=0A= document.write('');=0A= document.write('');=0A= document.write('
');=0A= //document.write('')= ;=0A= document.write('
');=0A= =0A= =0A= =0A= =0A= // SEARCH STOCKS & FUNDS TAB=0A= document.write('
');=0A= document.write('
');=0A= document.write('
Search:
');=0A= document.write('
');=0A= document.write('');=0A= document.write('
Quotes
');=0A= document.write('');=0A= document.write('');=0A= document.write('');=0A= document.write(' ');=0A= document.write('
');=0A= document.write('');=0A= document.write('');=0A= document.write('');=0A= document.write('');=0A= document.write('');=0A= document.write('');=0A= document.write('
');=0A= document.write('
');=0A= =0A= // SEARCH VIDEO TAB=0A= document.write('
');=0A= document.write('
');=0A= document.write('
Search:
');=0A= document.write('
');=0A= document.write('');=0A= document.write('');=0A= document.write('
Video
');=0A= document.write('');=0A= document.write('');=0A= document.write(' ');=0A= document.write('
');=0A= document.write('');=0A= document.write('');=0A= document.write('');=0A= document.write('');=0A= document.write('');=0A= document.write('
');=0A= document.write('');=0A= document.write('
');=0A= =0A= // SEARCH WEB TAB=0A= document.write('
');=0A= document.write('
');=0A= document.write('
Search:
');=0A= document.write('
');=0A= document.write('');=0A= document.write('');=0A= document.write('');=0A= document.write('
Web
');=0A= document.write('');=0A= document.write(' ');=0A= document.write('
');=0A= =0A= document.write('');=0A= document.write('');=0A= document.write('');=0A= document.write('');=0A= document.write('');=0A= document.write('
');=0A= document.write('');=0A= document.write('
');=0A= =0A= // SEARCH BLOG TAB=0A= document.write('
');=0A= document.write('
');=0A= document.write('
Search:
');=0A= document.write('
');=0A= document.write('');=0A= document.write('');=0A= document.write('');=0A= document.write('');=0A= document.write('
Blogs
');=0A= document.write(' ');=0A= document.write('
');=0A= document.write('');=0A= document.write('');=0A= document.write('');=0A= document.write('');=0A= document.write('');=0A= document.write('
');=0A= document.write('');=0A= document.write('
');=0A= =0A= =0A= =0A= // ADVANCED SEARCH TAB=0A= document.write('
');=0A= document.write('
');=0A= document.write('
Search:
');=0A= document.write('
');=0A= document.write('');=0A= document.write('');=0A= document.write('');=0A= document.write('');=0A= document.write('');=0A= document.write('
Advanced
');=0A= document.write('
');=0A= document.write('');=0A= document.write('');=0A= document.write('
');=0A= document.write('
');=0A= document.write('
Fill in one or more search = fields below:
');=0A= document.write('

');=0A= document.write('
');=0A= document.write('
');=0A= document.write('
With the following text:
');=0A= document.write('
From this source:
');=0A= document.write('
Where author is:
');=0A= document.write('
About these = companies
(comma seperated = tickers):
');=0A= document.write('
Published = between:
');=0A= document.write('
Content type is:
');=0A= document.write('
Story type is:
');=0A= document.write('
');=0A= document.write('
');=0A= document.write(' ');=0A= document.write(' ');=0A= document.write(' ');=0A= document.write(' ');=0A= =0A= document.write('
');=0A= document.write('
');=0A= document.write(' ');=0A= document.write('
');=0A= document.write('
');=0A= document.write('
');=0A= document.write('
 and 
');=0A= document.write('
');=0A= document.write(' ');=0A= document.write('
');=0A= document.write('
');=0A= document.write('