Comprehensive Pain Management
(Formally known as Franklin Pain and Wellness and Warwick Pain)

Attleboro, MA(508) 236-8333
Franklin, MA(508) 507-8818
South Kingstown, RI (401) 234-9677
Warwick, RI(401) 352-0007

Franklin, MA • (508) 507-8818
Warwick, RI • (401) 352-0007
South Kingstown, RI • (401) 234-9677

Attleboro Pain Center MA Blog

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Managing the Effects of Chronic Pain in the Workplace

Joseph Coupal - Thursday, March 22, 2018
Comprehensive Pain Management - Attleboro, MA

Pain is the top cause of adult disability in the United States, costing the workforce as much as $334 billion each year in lost productivity costs, according to a 2012 study in the Journal of Pain. While the musculoskeletal “pain points,” such as back pain and carpal tunnel, are well known and their direct costs well-documented, there has been less emphasis on—or awareness of—the secondary or mental health effects of pain: anxiety, depression, unclear thinking and memory loss.

There is also a “compounding effect”—the more pain persists, the more of an impact it can have. It may become a vicious cycle, as discomfort in one area causes problems in another. Employees who are suffering and unable to work miss out not only on the income, but also the sense of meaning, purposefulness and belonging that can be gained from a job. Initial distress may lead to chronic anxiety and even depression.

In fact, the cost of presenteeism to businesses is 10 times higher than that of absenteeism and amounts to as much as 57.5 days lost per employee each year.

Four Pillars of Pain Management

In order to effectively address chronic pain, employers need to take a systematic, evidence-based approach, including pain assessment, education, worksite therapy and training. The “four pillars of pain management” are:

  1. Develop a system of employee-centered integrated pain management practices based on a model of care that offers access to the full spectrum of pain treatment options. Evidence-based pain management is founded on a proactive and holistic approach that is pegged to outcomes, such as absenteeism, presenteeism, morale and worker satisfaction. It is based on preventing, managing and eliminating musculoskeletal discomfort, and continuously analyzing outcome data to see what is or is not working. A holistic approach addresses body, behavior and environment in an employee-centric pain mitigation model. This focuses on stretching, posture, body mechanics, coaching and training. It also incorporates technology that promotes healthy behaviors and creates a more “user-friendly” ergonomic office environment for sitting, standing, pushing, pulling and lifting. Early interventions can pre-empt the need for doctor’s visits or more involved physical therapy, reducing medical and workers compensation claims.
  2. Take steps to eliminate barriers to pain care and improve the quality of care. The two biggest barriers to improving care are access and the stigma that attaches to those who seek it. Providing onsite treatment enables employees to more readily seek out and receive counseling and treatment. This can be augmented by making resources available and by providing each employee with a self-treatment and pain management plan. Organizations can help reduce the perceived stigma by promoting the importance of awareness and early intervention pre- and post-treatment, and making employees aware of the costs to the company when chronic discomfort or pain compromises performance. Since pain does not stop at the executive suite, leadership can also play a key role in this effort by actively championing and participating in the program.
  3. Develop methods and metrics to monitor and improve the prevention and management of pain. Pain exists on a continuum of intensity. People will generally start with no noticeable pain or discomfort at all, then eventually start to notice some mild discomfort from sitting at their desk, standing on the floor for too long, or performing any number of repetitive everyday tasks. While it is difficult to quantify pain, businesses can quantify it in terms of costs with respect to absenteeism, presenteeism and reduced productivity, as well as workers compensation and health care costs. An “evidence-based” pain management approach begins with a workforce assessment, enabling organizations to get a firm handle on the prevalence and associated costs of musculoskeletal pain, and gauge the effectiveness of the solutions in place.
  4. Increase organizational awareness of pain and knowledge of treatment options. The first step in raising workforce awareness around this issue is to educate senior management. Several recent studies indicate that support from supervisors and co-workers had a positive effect on workers with chronic pain based on self-reported health-related quality of life. Their ongoing promotion and reinforcement of that commitment, combined with visible participation, will demonstrate that employee health and wellness is one of the company’s core values.

Total Worker Health

While employers increasingly understand the connections between wellness, safety and absence management, pain mitigation has historically been viewed as a risk management strategy. A pain program based on the four pillars, however, also fits the traditional wellness framework, which shifts the focus from risk to measures of productivity.

For more information on pain management, contact Comprehensive Pain Management in Attleboro, MA.

Source: rmmagazine.com

Common Nerve Block Procedures for Chronic Pain

Joseph Coupal - Thursday, March 08, 2018
Comprehensive Pain Management - Attleboro, MA

What are some of the more common nerve block procedures for the treatment of chronic pain? What are some of the common side effects associated with these nerve blocks?

The vast majority of injections done for the diagnosis or treatment of chronic pain are performed on an outpatient basis. All of them may be performed under fluoroscopic (x-ray) guidance but are sometime performed in the office without x-ray. Below is a brief description of some of the more commonly performed nerve blocks by pain management specialists.

Epidural Steroid injection: Epidural steroid injection is an injection performed in the back or neck in an attempt to place some anti-inflammatory steroid with or without a local anesthetic into the epidural space close to the inflamed area that is causing the pain. These injections are generally done for pain involving the back and leg or the neck and arm/hand. They may be done under x-ray guidance. Epidural steroid injections may be placed in the lumbar (low back), thoracic (mid back), or cervical (neck) regions.

Facet Joint Injection: The facet joints assist with movement of the spine both in the neck and back. Injection into these joints can provide relief of neck and back pain; these injections are always performed under x-ray guidance. You will be on your stomach for this injection if it is done for back pain; however you may either be on your stomach or back if the injection is performed for neck pain, depending on the preference of the physician. A needle is placed in your neck or back and advanced to the level of the joint under x-ray visualization. Contrast dye is used if the needle is put within the joint, and sometimes used if the injection is designed to numb the nerves to the joint. This block is often a diagnostic block and a more long lasting injection may be indicated if you have significant pain relief from this injection.

Lumbar Sympathetic Block: A lumbar sympathetic nerve block is performed for pain in the leg that is thought to be caused by complex regional pain syndrome type I (or CRPS I). These injections are often performed under fluoroscopic (x-ray) guidance. Local anesthetic is placed near to the lumbar sympathetic chain in order to relieve the pain. Your leg will likely become warm immediately following the injection: this is an expected effect and not a complication. The injection is done from the back, in the lower aspect of the back. A needle is placed, often under x-ray guidance, to a spot just to the side and approaching the front part of the spine where the ganglion is located. If it is done under x-ray, a small amount of dye is injected to make sure the needle is in the right spot. After the doctor is satisfied that the contrast dye is in the right place, they will inject numbing medicine then remove the needle.

Stellate Ganglion Block: A stellate ganglion block is an injection that can be performed for the diagnosis of complex regional pain syndrome of the arm or hand or for treatment of pain to that area. It can also be used to help to improve blood flow to the hand or arm in certain conditions that result in poor circulation of the hand.

For more information, contact Comprehensive Pain Management in Attleboro, MA.

Source: asra.com


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