Chronic Pain is not a disease; it is a symptom. Each patient’s perception of pain occurs in the context of their life situation, affecting work, interpersonal and social functioning, as well as their ability or willingness to remain active; inactivity in turn can aggravate pain. Successful management of pain is dependent on appreciating the dynamics of each patient’s case and proactively managing factors that might delay return to work or restoration of function. Functional improvement should be the immediate focus.
The Medical Treatment Utilization Schedule states that there is a place for interdisciplinary programs at a stage of treatment prior to the development of permanent disability, no later than 3-6 months after a disabling injury. Patients that should be considered candidate for early intervention include those that are not responding to traditional treatments in the expected time frame, those that exhibit pain complaints disproportionate to the expected diagnosis, those with a prior history of delayed recovery, those expressing concerns about the employer, and those that have loss time from work exceeding 4 weeks.
A simplified and rapid recovery is enhanced when intervening early; the most effective way to manage chronic pain is to avoid the development of chronic pain.