Rehabilitation Approaches to Pain and Applications in Outpatient Practice

Chapter 12 introduces a broad range of considerations, alternatives, and coordination of nonpharmacologic pain management. Rehabilitation approaches to pain include somatic, biopsychosocial, and changes in neurochemical pathways in response to exercise, psychological interventions, and other therapeutic aspects. Rehabilitation occurs after injury, trauma, disease, or dysfunction leads to pain and the need for functional restoration. Prehabilitation is now being used in anticipation of planned procedures to reduce the impact of decreased activity in the operative setting and to increase the likelihood of successful return to function. Complementary and alternative therapies are often incorporated into rehabilitative pain management plans. In the process of providing clinical care for patients with persistent or disabling pain-associated conditions, questions of impairment, disability, and pending legal action may arise, and these are discussed. Applications in outpatient pain care address the coordination of pharmacologic and nonpharmacologic approaches and the challenges of planning and organizing effective evidence-based pain self-management plans in the outpatient setting.