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Center's Multidisciplinary Approach Gives Hope to Chronic Pain Sufferers
A worker injures his back on the job and is immediately prescribed pharmaceuticals by his physician to mitigate the pain. The employee returns to work thinking that the problem has been resolved. However, the painkillers are simply masking the symptoms, and the injury continues to fester because the true source of the condition was never fully addressed. Before you know it, the worker is on his way to becoming an opioid-addicted chronic pain patient, which can potentially lead to a long-term disability that can result in hundreds of thousands of dollars in claim costs over his lifetime.
Dr. Fernando Branco, medical director of Rosomoff Comprehensive Pain Center at Miami Jewish Health Systems in Miami, said this isn't how the story must play out. While chronic pain can extend medical treatment, reduce or eliminate the ability of the worker to return to work and vastly increase the total cost of the workers' comp injury if treated unsuccessfully, he said there are approaches that can radically alter this outcome. "Something has changed dramatically over the past 10 to 15 years," he said. "Whereas narcotics used to be one method to treat pain, they have now become the solution. They may decrease pain in the short-term, but if the person is not getting the appropriate treatment, he will become a chronic pain patient."
"It can go from a simple problem to a very dramatic claim in a short time," he said. "With workers' comp patients, the more drugs they take, the more expensive the claim becomes. And if you start them on that path, you'll always have to increase the dosage." Pain-free and RTW. At the Rosomoff Comprehensive Pain Center, Branco and his staff take an aggressive approach to treating chronic pain and provide patients with the opportunity to return home free from pain and no longer reliant on painkillers. For more than 35 years, the center has been treating all types of chronic conditions -- including back and neck pain, repetitive and cumulative trauma disorders and complex regional pain syndromes -- by using a multidisciplinary strategy that focuses on healing the injury itself and halting the progression of disability and pain. Physicians use a combination of holistic treatment methods such as behavior modification therapy, cryotherapy, stretching, and neuromuscular massage, among others, and the results of the treatment are staggering -- nearly 91 percent of patients leave painkiller-free and mostly pain-free. "We are very focused on function," Branco said. "Historically, patient suffering from pain were sent to bed because the belief was that with rest, the person would get better. Today we know that this will actually worsen the individual's condition, but unfortunately many are still doing that today. Our approach is to start with aggressive therapy right away." When an individual is admitted into the program, a team of experts begin with a thorough review of the person's medical records, which can sometimes span 25 years or more. The patient is then assigned a case manager and is brought down to the Florida facility for a multidisciplinary evaluation, which includes a physical and psychological exam, occupational therapy, muscular dysfunction evaluation and electrodiagnostic studies, and other components. The team then sits down with the patient and charts a plan for recovery. This is followed by an eight-hour-a-day, six-day-a-week therapy "boot camp" at the pain center. "Some patients stay as long as eight weeks," Branco said. "What determines that in the end is the amount of narcotics they are on. If you go too fast, you can have too many withdrawal symptoms. We want to make sure they leave here off narcotics." Once the patient has achieved his functional goals and is equipped with exercise and rehabilitation tools to continue the program at home, the center stays in regular communication with the person's local case manager, who also visits the patient to ensure he is making the transition back to normal life. The center also works with the individual's physician to make sure narcotics are no longer part of the treatment equation. If the person has a job, the center will collaborate with his employer to develop a return-to-work plan. Studies have shown that if a patient spends more than six months without work, he will never go back," Branco said. "However, a vast majority of people in our program can return work ready. Many of the individuals we see have been out of work for five to 10 years, but we have found that 69 percent of them can return to the workplace after completing the program." Read more at the WorkersComp Forum homepage. September 7, 2010 Copyright 2010© LRP Publications |
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