SignOnSanDiego.com > News > Nation -- 'Boot camps' = treat chronic pain sufferers: biofeedback, therapy, exercise under one = roof

From: Subject: SignOnSanDiego.com > News > Nation -- 'Boot camps' treat chronic pain sufferers: biofeedback, therapy, exercise under one roof Date: Mon, 17 Mar 2008 17:19:26 -0500 MIME-Version: 1.0 Content-Type: multipart/related; type="text/html"; boundary="----=_NextPart_000_01D8_01C88853.0D6735B0" X-MimeOLE: Produced By Microsoft MimeOLE V6.00.2900.3198 This is a multi-part message in MIME format. ------=_NextPart_000_01D8_01C88853.0D6735B0 Content-Type: text/html; charset="iso-8859-1" Content-Transfer-Encoding: quoted-printable Content-Location: http://www.signonsandiego.com/news/nation/20080316-0953-chronicpainbootcamp.html SignOnSanDiego.com > News > Nation -- 'Boot camps' = treat chronic pain sufferers: biofeedback, therapy, exercise under one = roof

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	More=20 National news 'Boot camps'=20 treat chronic pain sufferers: biofeedback, therapy, exercise = under=20 one roof =

=93It affects your relationship=20 with your spouse, your family, your friends, your boss,=94 = she said.=20 =93It's like you're trapped in your body and you can't get = out. It's a=20 feeling of being completely out of control.=94=20

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

=93I ask a patient who has had chronic pain for 10 years = to put the=20 mind blank, don't think about anything,=94 says Dr. Dante = Chialvo, a=20 researcher at 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 up, = but not as=20 a normal brain at rest would, he said. =93There is an = objective=20 biological difference in the brain.=94=20

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

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

The Chicago program, affiliated with Northwestern's = medical=20 school, attacks pain on three fronts =96 biological, = psychological and=20 social. It doesn't claim to cure chronic pain, but instead = gives=20 patients tools to lessen its hold on their lives.=20

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

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

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

Patients know the drill. In the fragmented world of = health care,=20 they bounce from internist to chiropractor to massage = therapist to=20 surgeon =96 with none of the experts sharing information.=20

=93You will try anything and everything to get out of the = pain,=94=20 Parseghian said. =93You discover all of your efforts are = fruitless and=20 you have spent monumental amounts of money.=94=20

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

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

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

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=20 alone cost billions of dollars each year.=20

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

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

Chronic pain patients' medical and pharmacy bills =93show = up on our=20 radar,=94 said Dr. James Cross, Aetna's national medical = policy chief.=20 The patients are =93frustrated and clearly suffering=94 and = =93looking for=20 an answer,=94 he said.=20

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

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

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

=93Anybody out there can put up a sign and say, 'I'm a=20 comprehensive pain rehabilitation program,'=94 Turk said. He = recommended programs affiliated with university medical = centers and=20 the nearly 100 interdisciplinary programs accredited by the=20 Commission on Accreditation of Rehabilitation Facilities.=20

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.=20

=93You didn't say one thing about your pain or the back. = That used=20 to monopolize our conversations,=94 her husband told her.=20

That impressed Parseghian. =93I guess I hadn't realized = just how=20 much my back issue had really manifested itself into our=20 relationship,=94 she said.=20

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

And she was armed with breathing techniques and phrases = to repeat=20 when she suffered a flare-up: =93This has happened before = and I have=20 survived it. I'm going to be OK.=94=20

During her second week home, she reported, =93I took my = first=20 ballet class last week.=94=20

=93I thought that day would never come,=94 she said. = =93Little by=20 little, I'm regaining the control in my life that I thought = the=20 injury had robbed me of.=94=20

On the Net:
Commission on = Accreditation=20 of Rehabilitation Facilities: www.carf.org/
Rehabilitation = Institute of=20 Chicago: www.ric.org/

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