CHICAGO - Ballet teacher GayleParseghian thought she might never dance again after a back injurywhile moving heavy furniture left her with unrelenting pain.
However, an intensive, four-week "boot camp" got the55-year-old dancer from Toledo, Ohio, back to the barre. The program atthe Rehabilitation Institute of Chicago taught her to manage thechronic pain that had tormented her for more than a year.
"It affects your relationship with your spouse, your family,your friends, your boss," she said. "It's like you're trapped in yourbody and you can't get out. It's a feeling of being completely out ofcontrol."
New research suggests that chronic pain affects the brain'sability to rest, disrupting a system that normally charges up somebrain regions and powers down others when a person relaxes.
"I ask a patient who has had chronic pain for 10 years to putthe mind blank, don't think about anything," says Dr. Dante Chialvo, aresearcher at Northwestern University's Feinberg School of Medicine whois not involved with the boot camp.
MRI images show the pain sufferer's brain lighting up, but notas a normal brain at rest would, he said. "There is an objectivebiological difference in the brain."
The early findings could explain the sleep disturbances,decision-making problems and mood changes that often accompany chronicpain, he said. They also could explain why the boot camp approachworked for Parseghian.
The Chicago program, affiliated with Northwestern's medicalschool, attacks pain on three fronts -- biological, psychological andsocial. It doesn't claim to cure chronic pain, but instead givespatients tools to lessen its hold on their lives. Patients spend Monday through Friday stretching, exercisingand moving in new ways. They meet with a physician, an occupationaltherapist, a physical therapist, a biofeedback therapist, a clinicalpsychologist and a movement specialist. They might address depression or sleep problems or adjusttheir medications, and they learn from the other patients in theprogram. Getting all of these things under one roof differs from mostapproaches to treating chronic pain, said Dr. Steven Stanos, theprogram's medical director. Patients know the drill. In the fragmented world of healthcare, they bounce from internist to chiropractor to massage therapistto surgeon -- with none of the experts sharing information. "You will try anything and everything to get out of the pain,"Parseghian said. "You discover all of your efforts are fruitless, andyou have spent monumental amounts of money." She tried herbal patches, vitamins, injections, prescriptionnarcotics and a battery-operated device that uses electrical impulsesto block pain. Nothing worked.
Surgery would have been next. She was in a surgeon's waitingroom when she read an article about the boot camp. If acute pain is the body's alarm system, alerting toinjury-causing dangers, then chronic pain is an alarm going haywire,screaming a warning long after the danger has passed. The American Pain Society estimates that millions of Americansare in chronic pain from backaches, jaw pain, headaches andfibromyalgia, a mysterious syndrome marked by muscle pain and fatigue.Sore spines alone cost billions of dollars each year. In 2005, Americans with aching backs and necks spent $20billion on prescription drugs and another $31 billion for outpatientdoctor visits, according to a recent study in the Journal of theAmerican Medical Association. Total spending on spine treatmentsincreased 65 percent from 1997, adjusted for inflation. Risingalongside that was the proportion of people with spine problems whoreported limited function. Such spending with such poor results gets insurance companies'attention. Chronic-pain patients' medical and pharmacy bills "show up onour radar," said Dr. James Cross, Aetna's national medical policychief. The patients are "frustrated and clearly suffering" and "lookingfor an answer," he said.
Although boot camp-style programs cost up to $20,000, Crosssaid that's cost-effective compared to the procedure and pillmerry-go-round. The company cites studies showing that patients whohave completed boot camp programs experience lasting pain reduction andlower stress. Aetna also believes patients completing the programs aremore likely to return to work and less likely to seek other expensivetreatments. Other insurers also cover the programs, but convincing morecompanies will take more evidence, said Dennis Turk, a pain researcherat the University of Washington in Seattle and a believer in theapproach. It's unclear what combination of therapies works best forwhich patients and whether four weeks are needed for everyone, Turksaid. Patients should be cautious, he said, because quality varies. "Anybody out there can put up a sign and say, 'I'm acomprehensive pain-rehabilitation program,'" Turk said. He recommendedprograms affiliated with university medical centers and the nearly 100interdisciplinary programs accredited by the Commission onAccreditation of Rehabilitation Facilities. Two weeks into the boot camp, Parseghian's husband visited herin Chicago for the weekend. They toured an art museum and went shoppingtogether. Later, he phoned her with an observation.
"You didn't say one thing about your pain or the back. Thatused to monopolize our conversations," her husband told her. That impressed Parseghian. "I guess I hadn't realized just howmuch my back issue had really manifested itself into our relationship,"she said. Two weeks later, she headed home with a detailed schedule forher first week back, including plenty of time to relax. She knew thestaff would check with her in another four weeks to see how she wasdoing. She also was armed with breathing techniques and phrases torepeat when she suffered a flare-up: "This has happened before and Ihave survived it. I'm going to be OK." During her second week home, she reported, "I took my firstballet class last week." "I thought that day would never come," she said. "Little bylittle, I'm regaining the control in my life that I thought the injuryhad robbed me of." Originally published by The Associated Press. Source: The CharlestonGazette. Provided by ProQuest Information and Learning. Powered byYellowbrix.
