Current pain and headache reports
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Curr Pain Headache Rep · Apr 2012
ReviewComplex [corrected] regional pain syndrome: what specialized rehabilitation services do patients require?
Complex [corrected] regional pain syndrome (CRPS) is a complex disorder, the optimal treatment of which requires an interdisciplinary approach encompassing medical, interventional, psychological, and rehabilitation services that emphasize the role of physical and occupational therapies. The central focus of treatment is the restoration of function, utilizing a systematic, coordinated, and progressive set of therapeutic strategies. The poorly delineated pathophysiology and variable course of CRPS suggest that individualized strategies are required for optimal management, but also mean that carefully controlled trials of physiotherapy are difficult to conduct. This article presents a brief review of the nature and pathophysiology of CRPS, the medical and psychological approaches that have been found to be effective, and a review of the current trends in rehabilitation.
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Curr Pain Headache Rep · Apr 2012
ReviewFocused review of interdisciplinary pain rehabilitation programs for chronic pain management.
Interdisciplinary pain rehabilitation programs (IPRPs) are based on a functional restoration approach to treating complex chronic pain conditions. With a greater appreciation for a biopsychosocial approach to more effectively manage patients with chronic pain has come the development of more comprehensive treatment programs with less of a biomedical emphasis (i.e., interventional therapy, unimodal physical therapy, and passive modalities) and more of a biopsychosocial one. Interdisciplinary programs involve the use of multiple disciplines such as physical and occupational therapy, pain psychology, medical pain management, vocational rehabilitation, relaxation training, and nursing educations. ⋯ A greater understanding of the unique features and shared values of successful programs will help one better understand how these programs can be more widely used and available. The review will also highlight common psychometric outcomes tools used in assessing patients and monitoring outcomes. Most importantly, the review will help to answer a common question, even among pain physicians: "What goes on in those chronic pain programs?"
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Curr Pain Headache Rep · Apr 2012
ReviewHealth economics of interdisciplinary rehabilitation for chronic pain: does it support or invalidate the outcomes research of these programs?
Interdisciplinary rehabilitation has been shown to be effective for treatment of patients suffering from chronic nonmalignant pain with respect to activity level, pain intensity, function, or days of sick leave. However, effects in clinical outcome do not necessarily imply a superiority of the intervention from an economic point of view. ⋯ Recent publications add interesting information to the current discussion; these studies cover the long-term development of sickness absence post-intervention and the cost effectiveness of workplace interventions, as well as a collaborative intervention in primary care. Much research has been done, and tendencies of effectiveness are visible, but there is still a long way to go to understand the economic implications of interdisciplinary rehabilitation from the perspectives of society, the health insurers, and the patients.