Innervate Intensive Pain Program

Innervate Pain Management offers an intensive group based program

The Agency of Clinical Innovation has developed evidence based guidelines for applying group based pain treatments. Innervate Pain Management has developed  the Intensive Pain Management Program to reflect the ACI guidelines. "One size doesn't fit all" www.aci.health.nsw.gov.au.  Innervate has been running group multidisciplinary intervention programs since July 2005.

Innervate Intensive Pain Management Program (Intensive multidisciplinary group program 96 hours)

The Innervate Pain Program is an intensive (9am-4pm, 3 days per week for 4 weeks, plus 2 follow-up contacts over a 6 month period), multidisciplinary, cognitive behavioural pain management program. Vocational rehabilitation is the priority goal for all participants.

The Innervate Pain Management team is staffed by a Specialist in Pain Medicine, Clinical / Health Psychologists, Physiotherapists, Exercise Physiologists, Breathing Therapist, Occupational Therapist, Counsellor and a Rehabilitation Counsellor. All team members are highly experienced, not only in the management of persistent pain, but also in vocational rehabilitation for chronic pain.

Treatment Objectives - By End of Program  

• Increased functional activity levels e.g. time spent standing or sitting, the amount of weight lifted or carried, the distance driven in a car, the time spent typing or writing, etc.
• Decreased “down time” i.e. time spent resting or recovering from increases in pain
•  Improving the emotional response to pain, with a particular focus on reducing the fear of pain and decreasing levels of frustration and depression
• Reduced use of analgesic medications: cessation of opioid and benzodiazepine use, reduction in all other pain medications, under medical supervision
• Weaning off reliance upon passive treatment modalities: walking sticks, collars and splints, heat packs, TENS machines, “hands on” modalities such as physiotherapy and chiropractic
• Upgrading of medical certification from “has no current work capacity” to “has capacity for some type of employment” – or increase in number of hours at work for those still employed – based on attendance of 21 hours per week at Innervate Pain Program
• Increased confidence in the ability to work despite pain, and readiness to begin actively job seeking or obtaining job seeking skills e.g. job placement program
• Development of firm goals for their personal, physical, social and vocational future that are commensurate with their insurers and rehabilitation providers expectations
• Reduced work adjustment issues and improvement in vocational readiness to make future plans
• Improved understanding regarding the compensable system and their role and responsibilities under this system.

Treatment Objectives - By 6 months post program

Because chronic pain is a long term problem, participants on the Innervate Pain Program are expected to continue applying the strategies and techniques for the long term. By 6 months after the end of the program, we expect to see another set of gains over and above those made by the end of the course. These longer term outcomes include:

• Reduced use of healthcare resources (GP and specialist visits, hospital attendances, passive physiotherapy)
• Upgrading to pre-injury hours and duties for those already in employment
• Reduction in time off work, improved work productivity due to greater physical mobility and better concentration
• Return to work on a sustainable basis for those unemployed because of pain at the outset of the program.

Program Content

In order to achieve life-changing outcomes such as those listed above, the Innervate Pain Program has to be an intensive, multidisciplinary treatment.

A typical day on the program involves:

• 1.5 hours of exercise, including functional, aerobic and strengthening exercises
• 30 minutes of stretching
• 2-3 hours of lectures, talks and learning exercises relevant to the understanding of chronic pain and the application of the coping strategies in daily life
• 30 minutes of applied relaxation training
• 30 minutes for lunch, 15 minutes for morning tea
• 1 hour for individual discussion of progress with each participant, including evaluation of medication reduction plans and the development of future vocational or rehabilitation goals.

Planned Meeting with Employer/Rehabilitation Provider

There is an opportunity for the key stakeholders such as the insurer, rehabilitation provider, RTW coordinator or the employer, to attend an individual meeting at Innervate to meet with their injured worker and a few members of the Innervate team. By week four of the program a great deal of work has occurred at the physical level and of course hopefully more importantly, to their thinking and behaviour which is summarized and discussed. Typically, for most participants these changes include their goals and plans for the future which has been developed with the Innervate rehabilitation counsellor who in turn has liaised with team members, the rehabilitation provider and or insurers during the program to ensure the RTW goals are clear.

Of course specific details will also be given regarding the recommendations for the Certificate of Capacity upgrade and around expectations for further physical goal targets, the comment around restrictions (if applicable) or areas that need to be incorporated regarding their future activities. In addition, further information is offered regarding the participants pain triggers required with recommendations around what work based strategies will need to be incorporated when they are undertaking work. All of these details will be available in their end of program reports and will be endorsed by the medical specialist given the physical gains, medical issues and development of goals are discussed during two case conferences with the pain specialist.

Communication Day

There is a Communication Day in Week 3 of the program, where partners and family members are invited to spend the day with us. This is an opportunity for family members to observe how the program is run, and to ask any questions that they might have about their family member’s pain problem. There is a specific focus on teaching family members how to respond to pain and pain behaviours in the most helpful and adaptive ways. They are encouraged to view their new communication skills as a more appropriate way of interacting in relation to the pain.