Functional restoration is an intensive interdisciplinary group process of education, psychotherapy, and physical reconditioning through exercise and functional activities.  The process results in reformation of neuromuscular, sensory and cognitive patterns that influence the individual patient's thinking, perception and physical response to pain.  An individualized care plan provides each patient with a "tool kit" of methods to manage chronic pain and return to a productive lifestyle. An integrated interdisciplinary treatment model has been shown to be superior to physical therapy and psychotherapy provided separately in terms of functional and emotional gains.

 

The functional restoration program meets five days a week for group-oriented education and individualized exercise.  A typical day involves participation in five one-hour classes / sessions wigth activities including physical conditioning, psycho-educational groups, vocational counseling, medical follow up, and education in nutrition and wellness.  There are approximately 200 hours of physician to patient contact time in an eight-week program.  Abbreviated programs are offered, and are structured on individual needs.

 

Patient functional progress and program participation is reevaluated weekly at our interdisciplinary team conferences.  Case managers and claims adjusters are welcome to attend in person or by teleconference. 

 

For individuals that live too far away to travel daily, we provide coordination with local hotels to offer special package rates and services for our patients.

 

Since 2001, our program has helped improve the quality of life for our graduates, with many returning to normal activities of living, including both family responsibilities and employment.

 

Our goals include:

 

Although the overwhelming majority of on-the-job injuries successfully resolve with appropriate treatment, approximately 10% - 15% of work-related injuries go on to account for a significantly larger proportion of medical costs. We believe that much of these costs are the result of ineffective medical management of complex chronic pain disorders.  Our Functional Restoration Program (FRP) was designed to lead to effective case management and resolution of difficult-to-manage pain cases.

 

Our program can provide a resolution to  the tangle of conflicting opinions, competing diagnoses and inconsistent or interrupted medical treatment management.

 

Before a patient with chronic pain arrives at the Functional Restoration Program (FRP), their situation has often become complicated by  conflicting medical, psychosocial, vocational and legal opinions. To help clarify issues that may have stalled a particular case, we provide a comprehensive multidisciplinary evaluation (MDE) conducted by an experienced pain management physician, clinical psychologist (with testing) and physical therapist. The team discusses each case in conferences with and without the patient, and our comprehensive report from this full-day evaluation will document our consensus regarding the patient's appropriateness for the FRP. In the cases that are determined not to be appropriate for the program, we will provide recommendations for further assessment, treatment, or intervention.

 

Each participant meets weekly during the program with a BAPWC physician who will discuss medical concerns, adjust medications, provide education and coordinate care. Our physicians' philosophy is to optimize medication efficacy based on functional activity, while minimizing side effects.

 

Effective Communication

We believe that the successful resolution of a complex case includes open communication between all involved parties including the patient, adjuster, medical or nurse case manager, attorneys, and referring physicians. Our team meets regularly to evaluate the progress of each patient, and weekly reports are provided to involved parties. In the event of problems with compliance, lack of progress or early discharge, it is our policy to immediately advise the adjuster and case manager.

 

Our multidisciplinary team provides integrated care targeted toward specific functional and psychosocial goals for each patient. Weekly formal team meetings and daily informal team physician-patient interactions help maintain a thoughtful structure to the program and allow flexibility for the individual learning process.

 

Most graduates complete the program having made substantial and measurable improvements in function, strength and emotional well-being. To help support our graduates in maintaining these gains, we have incorporated an after-care program that includes bi-monthly participation in a peer-led alumni support group. We also encourage prompt authorization of independent gym memberships for most patients for a seamless transition from our Functional Restoration Program to the patient's independent exercise program designed specifically to help maintain any physical gains obtained through the program.

 

We are committed to maintaining the most positive and effective atmosphere for learning at the Southern California Pain & Wellness Center. Through our initial multidisciplinary evaluation process, we accept only those patients who appear motivated and who we believe will be successful. In the event that full participation is not being realized, we will identify perceived barriers to full participation and provide the patient with whatever assistance needed overcome these barriers. In the event that this is not achieved, we proceed to early discharge in a non-judgmental manner with full documentation provided to parties along with recommendations for continued medical care.