What is a Functional Restoration Program?
Functional restoration programs use a biopsychosocial approach to chronic pain. One must understand that there are physiologic, psychologic, and social factors that perpetuate the presentation of pain. This program aims to empower the patient to take control of these factors that could negatively modify pain. The treatment objective is to decrease pain, restore functions, allow patients to return to work, improve strength and conditioning, and limit unnecessary health care utilization (frequent emergency room visits for severe pain). Typically those with chronic pain will have deconditioning syndromes marked by 4- to 6-month periods of very limited activity. They will present with decreased mobility, strength, and endurance, as well as anxiety and depression. Anxiety related to activity may also be present in this population. Candidates for enrollment include those who present with pain focused behaviors; those who do not progress with conventional rehabilitation; those with pain disproportionate to injury; and those with disruption of daily life, social interaction, work participation, and family responsibility. A functional restoration program is an extensive outpatient program lasting several weeks. The program typically includes individual and group sessions. Programs will include rigorous physical therapy to improve strength and flexibility. Physical therapy will help allay fear that activity will worsen or exacerbate pain. Occupational therapy will assist in performing activities of daily living and ergonomic training. Social work will assist participants to reintegrate back into the workforce. Psychiatry or psychology will work on behavioral strategies to cope with pain, including cognitive behavioral therapy and therapy for related anxiety or depression. Physicians may work on detox to minimize medication management. Clinicians will also work with the patients on any associated medical or musculoskeletal complaints that arise. Functional restoration programs have been proven beneficial for low back pain sufferers.