Maria Polymeneas has co-run the Paragon Pain Program with Peter Roberts and the physiotherapists at Roberts Physiotherapy since 2000. Patients with chronic pain (3-6+ months post injury) can benefit from attendance at this program to restore function. A shorter program has also been developed to prevent the development of chronic pain and is available to patients within the first 4-6 weeks of injury when it is obvious the return to work and recovery will be delayed.
This extensive program is based on best practice self-management drawing from many disciplines including the latest research in neuroscience.
The Pain Program includes lectures, facilitated discussions, self-reflection activities, as well as a physical program of stretching, movement-awareness, conditioning exercises, breathing and relaxation. A significant component of the lectures and discussions included explanations and examples of psycho-neurobiological mechanisms of pain, behavioural responses to pain and fear-avoidance behaviour. Education regarding anatomy, acute pain mechanisms, tissue healing and resilience led into an understanding of the concept of “hurt versus harm” and the encouragement of healthy activity levels. Key questions discussed are: “Why am I sore?”, “Is it safe to move?”, and “How can I move?” with practical support in the form of a modified gym program.
The sociology and psychology of chronic pain is also addressed (depression, anxiety, distorted thinking) and the functional problems associated with this (social isolation, fear of return to work, sleep disturbances, intimacy and sexual problems, medication dependency) are discussed. Participants are assisted to develop more adaptive strategies, effective decision making, to recognize their thinking processes and make appropriate changes and to stop themselves becoming institutionalized.
While attendance at the Pain Program allows for a more extensive education and opportunity for implementation, the concepts can also be taught 1:1 quite effectively.
Enhanced knowledge of pain mechanisms is thought to decrease the fear-factor of chronic pain. Perspective is gained on chronic pain as no longer serving a useful function, interpretation and accuracy of pain reception, and its relationship to tissue healing. The goal is that patients are thus empowered with confidence to move previously injured tissues and restore health, normal movement and function. The overall goal is to develop both psychological and physical function and return to work and to life in general.
Patients with chronic pain (3-6+ months post injury) can benefit from attendance at this program to restore function. A shorter program has also been developed to prevent the development of chronic pain and is available to patients within the first 4-6 weeks of injury when it is obvious the return to work will be delayed.