The guidelines provided by the New York State Workers Compensation Board offer fundamental principles for implementing pain management programs for non-acute pain. These directives aim to assist healthcare professionals in establishing effective programs to address ongoing pain within the context of comprehensive care.
Healthcare professionals with expertise in developing pain management programs for non-acute pain can rely on the guidance outlined by the Workers Compensation Board to make well-informed decisions about the most suitable approaches for their patients.
It is crucial to emphasize that these principles are not meant to replace clinical judgment or professional expertise. The development of pain management programs for non-acute pain should involve collaboration between the healthcare provider and the patient, considering individual circumstances and treatment goals.
Goals of Pain Management Programs
- Aim to enhance function while minimizing pain.
- Provide measurable improvement in physical capabilities.
- Facilitate return to work.
- Assist patients in assuming self-management responsibilities.
- Ensure maintenance of functional gains post-discharge with appropriate aftercare planning.
- Reduce medication usage.
- Lower healthcare utilization, shifting focus away from medical procedures.
- Long-term objective: Independent self-management in all forms of functional restoration.
Types of Programs
- Outpatient, Inpatient, and, when necessary, telephonic wellness and functional improvement programs that offer coaching, education, and support.
Duration of Programs / Interventions
- Inpatient or Outpatient Pain Management Programs: Ideally three to eight weeks, with reassessment for potential repeat stays if prior functional gains are observed or declined.
- Cognitive Behavioral Therapy (CBT): Typically 10-16 treatments over 6-8 weeks, with a maximum of 16 treatments.
- Psychological Evaluations: Usually a one-time visit, with up to three hours allocated for psychometric testing if needed.
- Psychological Intervention: Optimal duration ranges from six weeks to three months, with potential for longer supervision if necessary.
Biofeedback
- Biofeedback, a type of behavioral medicine, aids patients in acquiring self-awareness and self-regulation skills to enhance control over their physiology.
- It involves using electronic instruments to monitor specific physiological functions, with feedback provided to patients through visual, auditory, or tactile cues, guided by a biofeedback specialist.
- Treatment is customized to suit the patient’s work-related diagnosis and requirements, with home practice encouraged for skill mastery, often facilitated through home training materials.
- The objective of biofeedback therapy is to transfer acquired skills to the workplace and daily activities.
- Candidates for biofeedback therapy should be motivated to learn and apply biofeedback and self-regulation techniques.
- Biofeedback is not suitable for individuals experiencing acute pain or injury but may be appropriate for non-acute pain when integrated into a functional restoration program.
Treatment Guidelines:
- Time to Produce Effect: Typically requires three to four sessions.
- Frequency: Generally conducted one to two times per week.
- Optimum Duration: Typically involves five to six sessions.
- Maximum Duration: Limited to ten to 12 sessions. Any treatment beyond this should be justified based on necessity, expected outcomes, and the potential to facilitate positive functional improvement
