Chronic Pain
Any pain or discomfort that persist for an extended period of time. It can be the result of previous injury, disease, stress, or can manifest spontaneously.

Types of Chronic Pain
Accuhealth Inc. staff is experienced at treating a variety of chronic pain syndromes. Pain disorders commonly treated by our staff includes:

	Cervical Radiculopathies
	Facial pain
	Fibromyalgia
	Low back pain and Lumbar Radiculopathies
	Failed Back Syndrome
	Headaches
	Myofascial Pain Syndrome
	Nerve Entrapment Syndromes
	Neuralgias and Peripheral Neuropathies
	Phantom Limb Pain
	Reflex Sympathetic Dystrophy
	Pelvic Pain
	Joint Pain

Reasons for Referral to Accuhealth Inc.The patient has not responded to primary or secondary stages of physical medicine treatment in a reasonable period of time (between 4 to 6 months) And/Or The patient exhibits pain behavior that is limiting and/or mental/emotional dysfunction, which is disruptive to their activities of daily living.

Pain Management Program Activities

Chronic Pain Evaluation Process Management
Diagnostic assessment will be initiated prior to the patient's entry into the program. Patients will undergo physical medicine, physical therapy, and psychological evaluation prior to acceptance and entry into the pain management program. Severe pain behavior or pain disability is not considered grounds for non-admission. Patients with significant limitations will have their programs individually designed to accommodate their beginning level of functioning. The goal of the initial evaluation process is to obtain measures of baseline functioning.

Psychology
The mental health counselors have experience in pain management and behavioral medicine techniques. Emphasis is upon attaining a healthy sense of self-regulation. Patients are instructed in related topics such as neuropsychology of pain and psychological strategies that can be employed to lessen the intensity of subjectively perceived pain. Other issues that are commonly addressed include family problems in chroni8c pain, sexual dysfunction and depression. Therapeutic experiences include individual, group and didactic presentations.

Biofeedback Training
Biofeedback training for psycho-physiological therapy is a traditional medical procedure. Biofeedback training represents a bridge between physical medicine and psychology: a kind of behavioral medicine. This training experience will assist the patient in reduction of maladaptive neuromuscular difficulties, which can reduce the severity of suffering as it relates to the pain of experience.

Vocational Assessment
The vocational counselor conducts a vocational assessment to determine the patient's vocational interests as they relate to training or job placement. Interfacing is coordinated with employers and vocational agencies.

Physical Therapy
Patients will be actively involved in physical activities that will increase flexibility, muscle tone, and mobility. Improving physical strength and body mechanics will be emphasized. The primary focus will be on restoration of functioning.

Accupuncture
In keeping with our comprehensive approach to pain management, we are pleased to offer acupuncturist as a part of our treatment team. Accupuncture alters the neurochemistry of the patient's body without medications and their accompanying side effects. It is a conservative way to treat chronic pain conditions when the diagnosis favors a less invasive approach.

Massage, Yoga and other Modalities
Various modalities are utilized to expand the patient's awareness of interdisciplinary opportunity. Most reinforces self-regulation and the basic concept of a "self-help" model is utilized. Participation in a variety of activities is included to eliminate the concept of invalidism within the patient.

Goals and Benefits of the Program

	Decrease intensity of subjective pain
	Increase ability to manage pain
	Improve functioning
	Reduce health care use related to chronic pain
	Regain appropriate focus of daily living
	Appropriate use of medication
	Renew enjoyment in recreation
	Return to productive employment

Examples of Patients that could Benefit

	Diagnostic findings are insufficient to explain the pain or further invasive medical treatment is not an option
	Pain has persisted beyond the expected healing time
	The patient has chronic pain linked to adverse interpersonal relationships which interfere with rehabilitation
	The patient has physical/mental impairment greater than expected on the basis of the diagnosed medical conditions
	The patient is facing significant, permanent loss of functioning that requires vocational and psychological readjustment
	Documented history of inappropriate and excessive use of healthcare services: such as frequent emergency room visits
	Documented history of inappropriate and excessive use of prescription medications or self-medication
	Patient continues to express unrealistic expectations regarding outcome of medical/psychological intervention in relief of their symptoms
	Referral early in treatment in order to prevent later development of an excessively disabled lifestyle role
	Poor post-surgical rehabilitation

Medical / Interventional / Pain Management
Team physicians have the responsibility of providing initial physical examinations. They assist patients by controlling medicines and assessing need for other diagnostic tests. Physicians encourage the patient in the understanding that the patient has the primary role in rehabilitation and pain management. We do provide the anesthesiological management of pain with:

	Peripheral Nerve Blocks
	Epidural Steroid Injections
	Selective Nerve Root Blocks
	Sympathetic Neurolytic Blocks
	Trigger point Injections
	Video Fluoroscopy

Physician Referrals
Referring of patients can be made directly to the Pain Management Office. They will accept insurance, workers' compensation and in some instances, letters of protection from attorneys. We will make necessary follow through verification, authorization, etc. Routine contact with the referring physician will be maintained throughout the patient's program participation. The referring physician will continue in the role of primary physician and the patient will be returned to their direct treatment upon program completion.