Category Archives: Pain

Pain Pathways and Treatment Options

In our last blog post (link to post), we focused on chronic pain and suggested that New Jersey’s workers’ comp claim system did a poor job of helping injured workers who are chronic pain sufferers to recover.

But there are two kinds of pain injured workers face: Chronic and Acute. The first step in pain management is knowing which is afflicting the patient. Seems simple? It’s not. Make a mistake here, and you can harm the patient.

WCPN Psychologists first perform a comprehensive evaluation to determine the level and type of pain. Then, working in active a steady communication with the patient’s physical health provider, they begin a targeted treatment plan to help restore the patient to high functionality.
But what’s in that “comprehensive evaluation?” How do they assess the current mental well-being of the patient, so the best treatment plan can emerge?

Well, first of all, there’s no black box. No Wizard behind the curtain.

Together, we and our patient begin the assessment journey. First, we need a good history. This includes an individual and family medical history, as well as the patient’s educational history. The fancy name for this is a “Biopsychosocial Assessment (BA).” Here are some of the things that go into conducting the BA:

  1. We need to identify and gauge the role of pre-existing conditions.
  2. We discover the patient’s levels of anxiety and depression.
  3. We consider the patient’s personality factors that might be affecting his or her perception of pain in daily life.
  4. We review prescription medication use or abuse.
  5. By listening closely, we cull out the patient’s pain history.
  6. We identify specific functional behaviors the patient’s pain is affecting.
  7. Through all of this we introduce appropriate coping skills and the concept of medication reduction. Here, the patient begins to learn about the Mind-Body relationship, after which, as part of treatment, we can begin Awareness Training.

Through a good Biopsychosocial Assessment and follow-on treatment, our constant goal is helping our injured worker patient walk down Recovery Road and return to work as soon as health allows. WCPN Psychologists aim for Recovery: Sooner, Faster, Smarter.

Chronic Pain: No Sunday Stroll In The Park

Pain is part of the human condition. We all know that. However, some people know it more than others. They’ve drawn the short end of the pain stick. For them, pain is chronic, a constant uninvited guest at the table.
At Workers Compensation Psychological Network, New Jersey’s only network of trained and certified workers’ comp psychology clinicians, we often see patients who are afflicted with chronic pain. For these patients, chronic pain can lead to depressive reactions that subsequently influence their subjective experience of pain levels and what they consider to be “tolerable” functional capabilities. These injured workers are lost in a maze.

Some were sufferers even before their workers’ comp injury, which worsened the condition. Others developed chronic pain following the injury. Regardless, many of these patients have difficulty returning to work. A clinician’s role should not be to suggest to these patients that their pain is not real, because it is. Rather, working closely with the patient’s physician and claim adjuster, clinicians should provide common sensible, compassionate treatment so patients can move down Recovery Road with a steady return to work trajectory.

The current system for treating injured workers with mental health issues, especially chronic pain, is not properly focused on a speedy return to work. It is overly fragmented and often appears to employers, claim adjusters and injured workers to be a treatment black hole. Indeed, there is an urgent need for a more systemic and integrated approach in which there is a constant focus on returning to work in some appropriate capacity. We call this recovery that is sooner, faster and smarter.

New Jersey’s injured workers and the men and women who employ them deserve nothing less.