Rehabilitation considerations for the client with chronic, nonmalignant pain.

Chronic, nonmalignant pain is a significant stressor for one in five Americans. It robs society of productive work days and families of the stability generated through positive personal interaction, a steady, adequate source of income, and confidence in the ability to handle the future. On a personal level, there is increased stress, which generates increased attention to physical symptoms, a loss of self-esteem, and feelings of helplessness, powerlessness, and hopelessness. These psychological issues can spiral out of control, wreaking havoc not only in the client, but also in family dynamics and roles. Case managers are in an ideal position to help blunt the toll of this pain by active listening and focusing on interventions that help the client take an active role in his or her care and maintain as much independence as possible.