Chronic Pain: A Major Public Health Issue
Nearly 100 million Americans are suffering from severe or chronic pain today, which is more than those affected by heart disease, cancer and diabetes. Pain continues to be the number one presenting symptom in healthcare at a great cost to society in terms of lost productivity. The consequences of untreated pain include impaired function, sleep deprivation, diminished quality of life and increased isolation.
Spending more money on the problem does not seem to be useful, as between 1997 and 2005, healthcare costs associated with treating low back pain increased 65% to $86 billion per year, but during the same time, patients reported increased disability due to neck and back pain, including an increase in depression and physical limitations.
Chronic low back and neck pain are major public health issues, leading to significant patient disability, social and financial burden and high healthcare costs and utilization. A 2011 study by Gaskin and Richard found that the total financial cost of pain to society, which combines healthcare cost estimates and the value of lost productivity (based on days of work missed, hours of work lost and reduction wages), ranges from $560 and $635 billion. This is more than the cost of heart disease and cancer combined and nearly 4 times the value for diabetes.
Treatment Options for Chronic Pain
These issues have led to new treatment options aimed at treating the multi-factorial facets of chronic pain, including socioeconomic, psychosocial and economic factors. Functional restoration programs have been well documented in the literature as providing superior potential outcomes over conventional treatment alone.
More recently, the impact of personal goal achievement on patient self-reported outcomes and satisfaction have been studied. Hazard et al found functional achievement to have the greatest impact on patient satisfaction, more so than pain goal achievement. Their conclusion was that a functional goal achievement has great potential as a tool for patient-centered treatment decision making and outcomes measurement for people with chronic disabling back and her neck pain.
While there are successful programs in existence today, many are underutilized, poorly understood and not generally patient-centered. There are significant barriers to their use, including geographic distance, affordability, referring physician discomfort and knowledge gaps. Even more importantly, they are characterized by a perceived and readily acknowledged paternalistic approach to care.
What is a Functional Restoration Program?
There are now goal oriented, patient-centered functional restoration outpatient programs available for patients suffering from chronic low back and neck pain that are not responding as desired to their current medical treatments.
These comprehensive programs address each of the multi-factorial aspects of chronic pain and also address the patient’s individual goals. Through participation in a functional restoration program, a multidisciplinary team of specialists aims to provide patients with improved quality of life and functional status and decreased utilization of healthcare resources, medications and cost.