Chronic Pain Rehab

Conveniently located to serve the areas of Los Angeles, Woodland Hills, Agoura Hills, Northridge, Van Nuys, Sherman Oaks, Thousand Oaks, Tarzana, Encino, Chatsworth, Calabasas, Bell Canyon and Westlake Village.

Introducing an alternative way to treat your chronic pain. 

Are you suffering from pain on a daily basis?  Do you find yourself avoiding activities you used to take for granted because of pain?  Is the pain leaving you exhausted, and unable to care for your family or finish tasks?  Are you looking for a way to manage your symptoms other than medications or surgical interventions?

Comprehensive Rheumatology Center is introducing a holistic program designed to increase your quality of life.  We coach you on lifestyle changes scientifically proven to reduce pain, and focus on alternative treatments to decrease your pain and fatigue.

What is Chronic Pain?

Elderly couple discomfort chronic pain

Pain is our body’s normal way to alert us to potential or actual injury to the body.  Most of the time, once the injury heals, the pain stops.  However, in many people, the pain continues long after its original cause is gone or medically well controlled. When pain lasts longer than 3 months, it is called chronic pain.

While we don’t know exactly why chronic pain occurs in some people, it appears that the cause is hypersensitivity of the central nervous system (the brain and the spinal cord). In other words, the central nervous system “turns up the volume” in response to a stimulus that may normally not be painful, or less painful to other people.  At times, a mind-body syndrome develops, where pain anticipated by the mind based on past experience causes actual and real pain in the body, presumably to protect the body from further injury. 

To make matters worse, fear of pain and injury increasingly causes retreat from activities associated with pain, resulting in depressed mood and physical inactivity, which compound pain and fatigue.  In turn these result in poor sleeping and eating habits that further feed the cycle of pain and fatigue. 

Many medical conditions can trigger chronic pain and fatigue.  These include arthritis, back pain, headache, fibromyalgia, Celiac disease, stress injuries, and nerve damage, among others. Other factors tied to chronic pain and fatigue include certain food insensitivities, certain vitamin or hormonal deficiencies, prolonged and severe stress, heightened anxiety, and even a consistent tendency towards negative thought patterns.

How Do We Treat Chronic Pain?

Male chronic pain

People with chronic pain quickly realize that treatments of acute pain are not effective for chronic pain.

To treat chronic pain, we must first rule out continued injury, including musckuloskeletal and neurologic, that cause continued pain. Once that is ruled out, then we need to re-train the brain and the central nervous system to react appropriately to unpleasant stimuli.

Since many factors contribute to persistence of pain, no treatment of chronic pain is complete without addressing all the different factors that may continue to contribute to pain. Our chronic pain program involves a multi-disciplinary, holistic approach to treatment of chronic pain.  Together we:

  • Investigate a full history of the origin and cause of the pain
  • Rule out or treat persistent injury, including musculoskeletal and neurologic injury.
  • Launch a full investigation into all the factors that can contribute to chronic pain, including stress, physical activity, diet, and sleep.
  • Devise an individualized treatment program and tailor it to what would best benefit each individual.
  • Work towards gradual return to healthy activity and rest patterns that promote health and healing.

Specific treatments can include but are not limited to:

  • Anti-Inflammatory diet education and implementation
  • Physical therapy program
  • Sleep consultation and sleep hygiene education
  • Cognitive behavioral techniques to reduce fear of pain
  • Mindful Based Stress Reduction (MBSR) instruction and practice
  • Activities proven to promote self-healing powers of the brain
  • Low impact physical activity regimen to increase strength and flexibility
  • Review of use of vitamins and supplements that can alleviate pain
  • Coordination with other specialists and disciplines as needed

By the end of the program you may find that you no longer need the medications you have used in the past for your pain.  You may also find that you are able to participate in more of the activities that you used to take for granted before chronic pain.

Addressing Objections

We understand that motivation and access are difficult factors while living with chronic pain. As a result, most of the components of the program are conveniently addressed in our office, or remotely via telemedicine.  Referral and coordination for outside resources will be done by our office so that you can focus on feeling better. We will also do all insurance verifications to give you an idea of the out of pocket cost to you, if any.

Frequently Asked Questions

How is this different from what other doctors have suggested that I couldn’t do?

Often doctors prescribe things like exercise, change in diet, sleeping more, or stress reduction, without providing patients with guidance, support, monitoring, or feedback.  For one thing, these are not the kinds of things that can be addressed in a 15 minute session twice a year!  For another, most medical offices do not have staff trained specifically to address these things or devoted to coordination of multiple services.  We do!  We have noticed that our patients have better outcomes when they are supported in these areas.  This time, you will have people who will coach you and will be by your side in your journey.

How can I possibly increase my activity level when it causes me pain and exhaustion?

Short answer: baby steps!  This is not a “no pain no gain” model.  You will need to start small, build gradually, and expect to go a couple of steps back as you move forward.  You will also need to rely on low impact exercises that do not aggravate your existing pain, at least initially.  It is helpful to have assistance and guidance in incorporating activity back into your life.

What do you mean by turning down the volume on response to stimuli?

Think of pain as the beeping of a smoke detector.  Imagine if the smoke detector in your kitchen starts to beep any time you light a candle or there is any kind of smoke, as opposed to only when there is a fire or significant smoke.  The beeping is very real, unrealistic to ignore, and in response to real smoke.  But it is unhelpful and aggravating when the smoke that sets it off is not a danger to us.  We want to recalibrate the smoke detector in your central nervous system to sound the alarm only when smoke means danger. 

How could focus on sleep, activity, and stress management help?

Imagine if the smoke detector in your kitchen (from the prior question) continues to beep even after you have put out the fire.  This may be because the room is still filled with smoke from the first fire, another fire has started somewhere else, or there is something other than smoke that the smoke detector is interpreting as dangerous smoke.  It is not wise to just ignore the painful beeping of the alarm, even if one could tolerate it.  It is important to eliminate these possible sources so the smoke detector stops beeping.  It is also helpful to make changes that would prevent the smoke detector from being triggered again.

Why retraining the brain?  Is this counseling?

Part of your treatment program may involve mindful meditation and cognitive technique. This is not psychological counseling, or psychotherapy, though it has certain elements in common with cognitive behavior therapy.  It is like sending your brain to the gym to build and strengthen specific “mental muscles” or neuropathways in the brain in a very structured way.

If meditation can reduce actual physical pain, why has it not worked for me?

Certain kinds of meditation, particularly mindful meditation, have been scientifically proven to reduce physical pain in patients with cancer, broken backs, fibromyalgia, and many other conditions.  While meditation at home can be very helpful, it may not be enough. A mindful meditation directed by scientific approach will be structured, guided, and will require practice over several weeks.  This too is like learning to flex mental muscles and takes practice.  We will help you get started, provide you with guidance and resources, and monitor your progress as you build gradually. 

Should I take multi-vitamins?

If your body needs or can benefit from multiple vitamins, it is best to take them in a way that maximizes absorption. Some people with chronic pain and fatigue may benefit from intravenous administration of vitamins.

In Summary

This is an exciting journey that involves a multi-disciplinary approach to pain and which requires a serious commitment from you. At the end of the program, most people report a significant improvement in their pain level as well as regaining function.

As you are considering if you are the right candidate for this program, ask yourself:

  1. Is my life centered around pain? Do I alter my activities because I’m worried about pain?
  2. Am I unable to perform little tasks at work or chores I used to do because of pain?
  3. Have I stopped doing things that I enjoy because of pain or fatigue?
  4. Am I concerned about long term effects of pain medications (or surgeries) to treat my pain?
  5. Does it seem that nothing I do alleviates the pain?  Is it getting worse?
  6. Do I feel anxious, irritable, or depressed from pain? Is it affecting my relationships?
  7. Am I unable to do things with or for my family because of pain and fatigue?

If you answered yes to these questions, then ask yourself: 

  1. Am I tired enough from the pain to be ready to commit to treating it from the root?
  2. Am I willing to make small manageable changes to my routine?
  3. Would I benefit from someone guiding and supporting me through these changes?

If you answered yes, then this program is made for you.  Contact today and let’s get started on your journey!

Call Us Now: (818) 598-0000

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