Chronic Pain School
As the need to devise safer options for chronic pain treatment in older patients becomes critical, innovations in patient education have assumed more importance. Like diabetes, heart disease, and other chronic medical problems, patient education plays as important a role in outcome as medication management. The cost-effectiveness of group education not only allows for a single provider or team of providers to educate larger numbers of patients at once, but it also can serve as a facilitated forum for patients to share ideas and concerns.
The VA has established chronic pain schools in a large number of its facilities. These schools offer a fixed block of classes that patients and family members can take, which cover many aspects of living with chronic pain. Topics may include the following:
- Alternative therapies for pain such as acupuncture, yoga, and massage
- Nonopioid treatment options for pain
- Opioid treatment options for pain
- Physical therapy, recreational therapy, and occupational therapy adjuncts for pain control
- Pain psychology to teach relaxation techniques, approaches to conflicts that may worsen pain, and education about underlying psychiatric problems that can worsen pain when not properly treated, such as depression, anxiety, and substance abuse
- Information about prosthetics that can be helpful, such as braces, canes, and walkers for patients with gait instability, and helpful appliances to use for reaching and dressing for patients with arthritis and for those who are unable to easily care for themselves without these aids
Pain schools emphasize the importance of improving function as an adjunct to improving pain control and gaining a better sense of well being. They can be geared toward the elderly or mixed-age groups. They are frequently moderated by a nurse educator, pharmacist, or another member of the primary care or pain team who has an interest in patient education. Although primarily found in VA facilities, pain schools can be adapted to any practice setting and serve as a way to decrease medication risks and make the time spent with the physician, advanced registered nurse practitioner, or physician assistant more productive. They also change the dynamic of a “fix me” attitude and ensure the patient and patient’s family understand the importance of being part of the therapeutic solution. Whenever possible, it is important for the family to understand the role they play in improving chronic pain.