Chronic Pain Rehabilit... Murray McAllister Chronic Pain Rehabilit... Murray McAllister

Minnesota Leads Nation in Developing New Payment Model for Pain Rehab Programs

This past summer, Minnesota Governor Mark Dayton signed into law an omnibus health and human services budget bill and in so doing he marked a significant milestone in the recent history of chronic pain management. The bill contained language, introduced by State Representative Deb Kiel and State Senator Jim Abler, authorizing the trial of a new payment arrangement through Medical Assistance, which makes it possible for state recipients of the public health insurance to receive care within an interdisciplinary chronic pain rehabilitation program.

Read More
Chronic Pain Rehabilit... Murray McAllister Chronic Pain Rehabilit... Murray McAllister

When Good Things Become Bad Things

I am nearing the end of a forty-five minute initial evaluation for our interdisciplinary chronic pain rehabilitation clinic and my patient is an amiable woman in her late forties from the suburbs. She drove a minivan to the clinic and attends the evaluation while her three children are at school for the day. Her primary care provider had referred her to us because of her chronic and disabling low back pain, which over the years had become progressively worse and more widespread.

Read More
Opioids Murray McAllister Opioids Murray McAllister

Are Opioids the Most Powerful Pain Reliever for Low Back Pain?

Opioids, or narcotic pain medications, are commonly thought of as powerful pain relievers. Patients frequently request them and healthcare providers often prescribe them for back pain because they think that opioids are the most effective pain reliving treatment. Popular media and others in society also commonly think that without opioids patients will suffer intolerable or “intractable” back pain. The implication is that, again, opioids are the most powerful and effective pain reliever.

But are they the most effective pain relieving treatment for back pain?

Read More
Self-management Murray McAllister Self-management Murray McAllister

Is It Time to Talk About Managing Pain Without Opioids?

Opioids are certainly in the news. The US Surgeon General recently issued a statement on the relationship between their widespread use for chronic pain and the subsequent epidemics of opioid addiction and accidental overdose (US Surgeon General, 2016). The US National Institute for Drug Abuse and Centers for Disease Control have also issued concerns (see here and here, respectively). Mainstream media reports on the problems of opioids appear almost daily.

Read More
Coping Murray McAllister Coping Murray McAllister

On Hearing Patient Stories & Building Community

The Institute for Chronic Pain is an educational and public policy think tank that produces academic quality information on chronic pain. We aim to provide such information in a manner that’s empirically accurate, yet also approachable to patients, their families, non-specialist healthcare providers, third party payers, and public policy analysts. We do so because the field of chronic pain management needs to change.

Read More
Coping Murray McAllister Coping Murray McAllister

Treatment Plan: Do Nothing?

It's cold and flu season again and we all do the best we can to stay well and avoid catching an all-too-contagious virus. We each have our own go-to plans of how to fight it: vitamin C, zinc or elderberry supplements, gargling with salt water, staying warm, rest and binge-watching Netflix shows. My grandmother swore by anise candy that she made from scratch, while my father prefers a hot toddy to remedy a cold. Washing hands is still the number one way to avoid illness -- along with avoiding contact with your face, and keeping your immune system strong.

Read More
Coping Murray McAllister Coping Murray McAllister

How to Get Better When Pain is Chronic

In the last post, we began to introduce a broad definition of coping, as one’s subjective experience, or reaction, to a problem. In this post, let’s expand on this definition and explain how coming to cope better with a problem is a process of coming to experience the problem in a different and better way.

Read More
Coping Murray McAllister Coping Murray McAllister

Can you experience your pain differently?

A major tenet of chronic pain rehabilitation is that the way you experience pain is not the only possible way to experience pain. In other words, the experience of pain differs across individuals and can even differ in the same individual across time. As such, it's possible to have a different experience of pain than the experience that you have today, even if your pain remains on a chronic course.

Read More
Sleep Murray McAllister Sleep Murray McAllister

Relearning to Sleep: How to Cope with Pain Series

Many people with chronic pain have trouble getting regular, restful sleep. To improve sleep, it helps to understand how the 24-hour circadian rhythm works and to grasp other biological rhythms that affect sleep-wake cycles. In other words, what we do during the day impacts our ability to sleep well at night and visa versa.

Read More
Irritable Bowel Syndrome Murray McAllister Irritable Bowel Syndrome Murray McAllister

Irritable Bowel Syndrome: A New ICP Content Page

The Institute for Chronic Pain (ICP) is an educational and public policy think tank that brings together thought leaders from around the world to provide scientifically accurate information about chronic pain and its most effective treatments. We endeavor to provide academic-quality information that is easy to read and as such we serve as a scientifically accurate resource to patients and their families, generalist healthcare providers, third-party payers, and public policy analysts. Our aim is to change the culture of how pain is managed -- to foster a culture in which the field of pain management more readily provides treatments with demonstrated effectiveness.

Read More
Pain Clinic Murray McAllister Pain Clinic Murray McAllister

Does Your Pain Clinic Teach Coping?

As we’ve discussed in an earlier post, not all pain clinics are alike. To be sure, all pain clinics provide therapies aimed at reducing pain. Some, however, don’t stop there. They set out to systematically coach patients to cope better with pain that remains chronic.

Read More
Coping Murray McAllister Coping Murray McAllister

Coping: Ideas that Change Pain

Coping-based healthcare is often misunderstood in society and, as a result, it is commonly neglected by healthcare providers and patients alike. Examples of such care are chronic pain rehabilitation for pain disorders, cardiac rehabilitation for heart disease, psychotherapy for mental health disorders, or diabetic education for diabetes. These therapies are often the last thing that healthcare providers recommend or the last thing people are willing to try, even though they are typically some of the most effective treatments for their respective conditions.

Read More
Philosophy Murray McAllister Philosophy Murray McAllister

“But, I have real pain”: When Ethics Collides with Ontology

No doubt, the words of this title have been uttered countless times by countless people with chronic pain. In my work in chronic pain rehabilitation, someone tends to say it to me most everyday. It often comes when discussing the effectiveness of chronic pain rehabilitation, which focuses on coaching people how to self-manage pain.

Read More
Self-management Murray McAllister Self-management Murray McAllister

Self-Management

Often in discussions of chronic pain and its treatments, self-management gets neglected as a viable option. It gets forgotten about. Or perhaps it just never comes to mind when patients or providers talk about the ways to successfully manage pain. Instead, stakeholders in the field tend to focus on the use of medications or interventional procedures or surgeries.

Read More