Initial Multidisciplinary Evaluation
A team assesses pain, function, and mind together.
- 20%: Adults with chronic pain (roughly one in five)
- 3: Assessment domains (medical, physical, psychological)
- 60–90: Typical intake length (minutes, first visit)
- 4–6: Screening tools used (validated questionnaires)
Why evaluation is multidisciplinary
Pain, mood, sleep, and movement all interact.
What gets measured
Pain intensity, function, catastrophizing, mood, sleep.
Setting a baseline
Baseline scores anchor every later comparison.
Medical Management & Interventional Care
Non-opioid medication and targeted procedures start here.
- 3–4: First-line drug classes (non-opioid options)
- Minimized: Opioid use, modern pathways (reserved, not first-line)
- Injections: Common procedures (nerve blocks, ablation)
- 2–6: Response window (weeks to judge effect)
Non-opioid pharmacotherapy
NSAIDs, anticonvulsants, and antidepressants target pain pathways.
Interventional procedures
Nerve blocks and injections reduce localized pain signals.
Medication is a bridge
Medicine enables rehab, it rarely cures alone.
Physical Rehabilitation & Graded Activity
Therapy and graded activity rebuild tolerance safely.
- 8–12: Typical PT sessions (weeks, structured plan)
- Key goal: Fear-avoidance reduction (pacing over avoidance)
- ~20–30%: Functional gain, PT alone (moderate improvement)
- Graded: Activity progression (small measurable steps)
Graded exposure to movement
Activity increases gradually, breaking the pain-avoidance cycle.
Strength and conditioning
Deconditioning is reversed through structured exercise.
Pacing over pushing
Consistent pacing beats occasional overexertion.
Psychological Support & Coping Skills
CBT and coping-skills training ease pain-related distress.
- 8–10: CBT sessions, typical course (weekly sessions)
- Significant: Catastrophizing reduction (with structured CBT)
- ~50%: Comorbid depression/anxiety (in chronic pain patients)
- 5+: Skills taught (coping, relaxation, reframing)
Cognitive behavioral therapy
Reframing pain-related thoughts reduces distress and disability.
Coping-skills training
Relaxation and pacing skills lower perceived pain intensity.
Mind and body are linked
Distress amplifies pain signaling in the nervous system.
Integrated Multimodal Outcome
Combined domains outperform any single treatment alone.
- ~60–80%: Multimodal function gain (vs single-domain care)
- Best outcomes: Programs using 3 domains (per clinical evidence)
- Lower: Relapse reduction (with integrated follow-up)
- Highest: Quality of life gain (when domains combine)
Synergy across domains
Medical, physical, and psychological gains compound together.
Better than any single path
No single treatment matches combined multimodal results.
Sustained long-term function
Integrated care sustains gains well beyond discharge.