At CMPS, we take a comprehensive multidisciplinary approach to pain. This is been shown by the scientific research literature to be the most efficacious and beneficial means of providing long-term improvement in pain coping and functional improvement for daily life activities. Our multidisciplinary team includes:
- Your Pain Management Physician (not a CMPS staff member)
- Stress Specialist (neurofeedback, biofeedback, hypnosis)
- Addiction Specialist (as needed)
Active intercommunication amongst team members is a crucial component rather than having a variety of different external practitioners engaging in their own individual therapies without reference to what the other one is doing.
We provide this comprehensive pain program for individuals referred by pain physicians, neurologists, primary care physicians, workers compensation, and individuals involved in civil litigation.
We provide a unique set of treatment options unavailable anywhere else in the area which may include any of the following:
- psychiatric medication for pain
- stress management
- family therapy
- deep breathing
- progressive deep muscle relaxation
- addiction counseling
- Suboxone treatment
Pain means an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage.
- Somatic Pain: Result of activation of nociceptors (sensory receptors) sensitive to noxious stimuli in cutaneous or deep tissues. Experienced locally and described as constant, aching and gnawing. The most common type in cancer patients.
- Visceral Pain: Mediated by nociceptors. Described as deep, aching and colicky. Is poorly localized and often is referred to cutaneous sites, which may be tender. In cancer patients, results from stretching of viscera by tumor growth.
Chronic Pain Classification
- Nociceptive pain: Visceral or somatic. Usually derived from stimulation of pain receptors. May arise from tissue inflammation, mechanical deformation, ongoing injury, or destruction. Responds well to common analgesic medications and nondrug strategies.
- Neuropathic Pain: Involves the peripheral or central nervous system. Does not respond as predictably as nociceptive pain to conventional analgesics. May respond to adjuvant analgesic drugs.
- Mixed or undetermined pathophysiology: Mixed or unknown mechanisms.
- Psychologically based pain syndromes
However, suffering and the extent of disability have psychological components which may be very separate from the tissue injury itself or the neurological transmission of pain to the brain. Based on the World Health Organization’s (1980) International Classification of Impairments, Disabilities and Handicaps (McGrath, et al), pain, impairment, disability, and handicap are defined on four different levels or “planes”:
Plane 1: represents the disease or disorder that causes pain.
Plane 2: represents the ‘impairment’and is the pain itself.
Plane 3: represents ‘disability’ due to pain and is manifested as restricted activities or abilities.
Plane 4: represents ‘handicap’ due to pain, such as the failure to meet social or educational demands
At CMPS, our multidisciplinary pain program addresses how one perceives the pain, how will cope with the pain, how much pain affects emotional distress, how much emotional distress and six pain, and how one allows pain to interfere in the activities of their daily life (social, family, occupational, etc.).
Guide to Pain Management in Low-Resource Settings.
People who have painful conditions or injuries are often additionally affected by emotional distress, depression, and anxiety. Chronic pain involves more than the subjective experience of the intensity of pain. The last 30 years, a biopsychosocial model for understanding chronic pain has evolved. According to this model, chronic pain is a syndrome with consequences such as physical and psychosocial impairment. This model contains variables such as central processes on the biological dimension as well as on psychological dimensions, including somatic, cognitive, and affective dimensions.
The cognitive dimension contains how the patient thinks about and attempts to come to grips with the pain experienced. For example, thoughts like “the pain is unbearable” or “the pain will never end” can have an effect on the affective dimension and intensify reactions like anxiety.
Suffering from chronic pain has social consequences, for example, on activities of daily living, family environment, and cultural factors, or it may be affected by previous treatment experiences. Illnesses can be viewed as the effect of the complex interaction of biological, psychological, and social factors.
Emotional and cognitive aspects like anxiety or helplessness and coping with chronic pain can significantly strengthen the pain perception and intensity. Increased pain perception can include emotional components such as despair, sadness, anger, or fear, but it can also be a reaction to impairment due to pain. Correlated with these processes, the cognitive component is the belief that it is not possible to have any relief of pain after unsuccessful treatment. Believing this can, for example, increase feelings of helplessness. The loss of belief in the functionality of one’s own body is experienced as a psychological threat. Very often, the result is a restriction of one’s whole perspective on life through the focus on pain. The consequence is that the person concerned very often retires from physical and social activities. Family conflicts arise because of the feeling of being misunderstood. Self-esteem is affected by the subsequent inability to work. The main focus becomes on consulting doctors to obtain a cure. Increasing consumption of medication is accompanied by fear and apprehension of side effects.
Inactivity because of the impairment by the pain can intensify depressive reactions such as passivity, agitation, lack of sleep, with decreased self-esteem. In a vicious circle, chronic pain can lead to depressive reactions, which influence the perception of and reactions to the pain. Biological processes such as muscle tension can cause pain but can also be caused by increased depression. Depression can lead to more physical passivity, and in consequence, the lessened activity leads to an increase of pain because of degeneration of muscles. All roads, in this scenario, lead to chronic pain.