Northwest Occupational Medicine Center

Excellence Since 1972

Pain Management

We offer a comprehensive functional restoration program that addresses the multitude of skills necessary to cope with chronic health and improve your day-to-day functioning without excessive reliance on pain medication.

An effective intensive interdisciplinary functional restoration program requires an extensive array of treatment provided by skilled therapists covering a variety of disciplines. Our program includes physicians, psychologists, biofeedback specialists, physical therapists, occupational therapists and vocational specialists. Our treatment team partners with the patient, referring physicians, other community treatment providers, and family members to offer the most concentrated effort towards helping the patient achieve the maximum level of functioning.

Referral and Assessment Process

The referral process begins with contact between our admissions staff and any of several parties involved in the patient’s care. Such parties might include the attending physician, nurse case manager, vocational rehabilitation counselor, or insurance or MCO representative. Clinic admission’s staff seeks to obtain authorization of the initial evaluation and make arrangements for an initial appointment. At the initial evaluation, the patient is assessed by a physician and psychologist, each of whom conduct a clinical interview and obtain the patient’s history, review available records and diagnostic studies, and complete a detailed examination. An additional assessment with a vocational specialist may also be completed, if requested. Following the initial evaluations, the initial assessment team meets to discuss the findings, make recommendations including appropriateness for treatment in our functional restoration program. NWOMC recommendations for a functional restoration treatment for the past 5 years has averaged approximately 40% annually. The remaining patients may not be appropriate candidates at that time or other treatment approaches may be offered for consideration.

Medical Services

One of the main goals of our functional restoration program is to decrease the individual’s over-reliance upon continuing medical services. Therefore, our physician’s involvement within our interdisciplinary program is primarily consultative in nature. Our physician coordinates care with the patient’s attending physician, addresses emergent medical issues, prescribes injury-related medications, and directs tapering of pain medications, as needed. Upon completion of the program, the staff physician provides recommendations to the patient’s attending physician for follow-up planning.

Physical Therapy

Within our functional restoration program, physical therapy typically consists of stretching, strengthening, and improving cardiovascular function through an individualized exercise program. Each program is designed to address the de-conditioning that often results from chronic pain. In contrast with outpatient physical therapy, the focus within the functional restoration program is on the entire person, in an attempt to increase functional capacities. Addressing individual musculoskeletal deficits that impact functional ability and progress is incorporated as needed into various exercise regimens.

Occupational Therapy

Our occupational therapists work with program patients to identify difficulties in performing daily occupations, and assist patients in developing methods to increase functioning in these areas. Our occupational therapists also provide detailed education to the patient on the topics of body mechanics, pacing, posture, and ergonomics. For example, body mechanics training teaches the individual how to use their bodies to move efficiently and safely during daily occupational tasks. Patients practice actual activities while being coached by occupational therapy staff. As part of the interdisciplinary functional restoration program, occupational therapy offers the individual an opportunity to apply the gains that they have made in other areas, such as increased strength and flexibility, to their daily life activities.

Psychological Services

During interdisciplinary functional restoration program, patients work with our psychologists who specialize in the area of chronic health assessment and treatment. Patients participate in psycho-educational groups addressing such pain related topics as sleep management, family issues, assertive communication, and the way that cognitions affect their ability to cope with pain. Patients also meet individually with our psychologists to address individual needs related to goal setting, stress management and mental health issues that contribute to or are exacerbated by chronic pain. Our psychologists work closely with patients to develop a plan for generalizing and maintaining their new pain coping skills after completion of the interdisciplinary program.

Biofeedback and Relaxation

In biofeedback and relaxation training, patients use a variety of monitoring devices to observe their own muscular tension, surface temperature, heart rate, and other physiological functions. Increased awareness of this information allows individuals to improve their ability to evoke a relaxation response, and in turn reduce the negative effects of chronic pain and muscular tension. Functional biofeedback training allows patients to generalize their relaxation skills to daily and work-related activities. By combining biofeedback monitoring with simulation of daily activities, individuals can alter their posture, pacing, and muscular tension to improve their overall functioning and productivity. Our board certified biofeedback therapists offer a range of treatment modalities to trial a variety of effective methods and strategies.

Vocational Services

Vocational services provided within the context of a functional restorationprogram often involve close coordination of the program’s vocational specialist with the externally assigned vocational rehabilitation counselor. Effective communication between the internal and external vocational providers allows for rapid problem solving if difficulties or challenges arise during treatment.

For pain management services to be truly effective within a return to work context, the presences of a clearly defined vocational goal or direction should be established prior to treatment and agreed upon by all parties. Upon entry into the program treatment efforts are then customized to help the patient achieve there goals, if feasible. Vocational services might include vocational testing to further clarify vocational strengths and limitations, vocational exploring, counseling to address issues of vocational adjustment, or job search skills training. In some instances, GED preparation may also be included to assist in vocational preparation. If a specific return to work site is already identified, then work site visits may also be arranged to address any needed job modifications.

Putting It All Together

It is important to understand that although each of the specific components of the Functional Restoration Program are designed to promote gains in that specific area, the greatest benefit from treatment comes from the synergistic effect that the different therapies have on each other.