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Taking a Comprehensive, Holistic Approach to Pain Management

Ankur Dave, MD, Keith Schmidt, MD and Konstantinos Kostas, PhD

It is now clear that chronic pain is not just an extension of acute pain, but a very complex phenomenon that can negatively impact all aspects of a patient’s life. Indeed, research has revealed that chronic pain causes changes in default mode networks of the brain responsible for depression, anxiety, sleep and decision-making.1,2 For this reason, the Comprehensive Pain Management team at the AMITA Health Neurosciences Institute believes that chronic pain must be managed like other chronic diseases. That’s why we deliver pain management that is tailored to each patient’s needs and goals, while also taking into consideration all the other aspects of life that are affected by pain. Patients are initially evaluated using a set of outcome-based questionnaires on physical and psychological wellbeing, followed by a comprehensive clinical exam. Treatment of chronic pain at the AMITA Health Neurosciences Institute reflects the various physical and emotional changes that patients experience as a result of their pain; treatment plans might include not only medications and interventional pain procedures but also health psychology, physical therapy and lifestyle modification. The goal of treatment is not only pain prevention and pain management, but also empowering the patient to take back control of their wellbeing.

The Comprehensive Pain Management team at the AMITA Health Neurosciences Institute works with primary care providers and surgeons to support patients with a variety of complex pain conditions, including spine-based pathologies such as herniated discs, arthritis and spine surgical pain. They establish an ongoing dialogue with referring physicians, sharing the initial treatment plan and providing a mechanism to support ongoing care for patients once they are on a safe and stable treatment plan. The Comprehensive Pain Management team also runs a surgery evaluation clinic for chronic pain patients who are being considered for elective surgery, optimizing the patient’s treatment regimen and weaning them off opioids prior to surgery.

Patients with chronic pain might also benefit from a consultation with the Health Psychology team at AMITA Health Neurosciences Institute.

Health Psychology applies the relationships among behavioral, social, cognitive and biological components of health and disease to the promotion and maintenance of health; the prevention, treatment and rehabilitation of illness; and the improvement of the overall patient experience.

All patients and their family members have access to the Health Psychology team at the AMITA Health Neurosciences Institute, which provides emotional support, treatment and education at every stage of the illness continuum. The team can help patients and families adjust to a new diagnosis, manage treatment side effects, reduce emotional distress and support ongoing emotional recovery. Research has shown that working with a Health Psychologist can empower patients to make informed choices and communicate more effectively with their healthcare providers.3-5

Patients with acute or chronic pain face the specific challenges of accepting pain on a daily basis and coming to terms with a number of issues related to their long-term quality of life and wellbeing. The Health Psychology team accepts patient referrals from inside or outside AMITA Health, and patients receive care in either an inpatient or outpatient setting. Chronic pain is an isolating and unique experience, and every patient copes with his or her pain differently. The Health Psychology team takes an individual patient approach, whereby patients undergo a psychological evaluation that is designed to identify varying degrees of emotional distress. During the consultation, the Health Psychologist will talk with patients about difference aspects of their experience, with the goal of identifying the impact that their condition may be having on their lives. At the end of the evaluation, a treatment plan is devised that takes into account the patient’s need for emotional support, behavior modification and/or ongoing education.

Ankur Dave, MD

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Konstantinos Kostas, PhD

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Keith Schmidt, MD

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  1. Hemington KS, Wu Q, Kucyi A, Inman RD, Davis KD. Abnormal cross-network functional connectivity in chronic pain and its association with clinical symptoms. Brain Struct Funct. 2016;221(8):4203-4219.

  2. Baliki MN, Geha PY, Apkarian AV, Chialvo DR. Beyond feeling: chronic pain hurts the brain, disrupting the default-mode network dynamics. J Neurosci. 2008;28(6):1398-403

  3. Chen J, Mullins CD, Novak P, Thomas SB. Personalized strategies to activate and empower patients in health care and reduce health disparities. Health Educ Behav. 2016. 43(1):25-34.

  4. Roditi D, Robinson ME. The role of psychological interventions in the management of patients with chronic pain. Psychol Res Behav Manag. 2011;4:41-49.

  5. Friedman, R, Sobel, D, Myers, P, Caudill, M, Benson, H. Behavioral medicine, clinical health psychology and cost offset. Health Psychol. 1995:14(6):509-518.


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