Abstract

The treatment of chronic pain conditions is difficult, time consuming, expensive, and, all too often, unsuccessful. An effective alternative is chronic pain rehabilitation or functional restoration (FR). An FR team works together to help patients achieve better outcomes with reduced disability. The basic treatment goals of early and chronic FR rehabilitation programs are functional improvement; improved abilities in performance of activities of daily living (ADL); a return to leisure, sport, and vocational activities; and improved pharmacologic management of pain and related affective distress. Individuals at risk of developing chronic pain conditions may benefit from an FR program because physical and psychological interventions can be used before the disability becomes chronic. FR programs emphasize a multidisciplinary, biopsychosocial approach in which physicians, psychologists, and occupational, physical, and relaxation therapists work in concert. FR treatment includes quantification of physical deficits, psychosocial and socioeconomic assessment, and an emphasis on reconditioning the injured area or body part. The team-centered approach includes simulation of work or activity; disability management using cognitive–behavioral approaches; psychopharmacologic management that focuses on improving analgesia, sleep, and affective distress; and, in appropriate cases, detoxification. FR is a patient-centered, whole-person, team approach that focuses on helping patients achieve individual goals that enable them to improve physical and psychosocial function, decrease pain, lessen disability, and improve quality of life, including return to work.

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