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New Pain Publications
By Steven D. Feinberg, M.D.

In a newly published textbook, Comprehensive Treatment of Chronic Pain by Medical, Interventional, and Integrative Approaches: The AMERICAN ACADEMY OF PAIN MEDICINE Textbook on Patient Management. March 2013 (Springer Science+Business Media) there are two chapters that may be of interest to you. I can provide copies on a limited basis for educational purposes if requested.

Assessing Disability in the Pain Patient (Feinberg, S.D. & Brigham, C.R.)
Key Points
• Assessing disability in the pain patient is often difficult due to both administrative and clinical issues, yet this assessment is essential.
• Clinically, quantifying pain remains problematic as chronic pain is a subjective phenomenon, often associated with confounding behavioral, characterological, personality, and psychological issues.
• Typically, the physician does not define “disability”; rather, the physician defines clinical issues, functional deficits, and, when requested, impairment. Disability is most often an administrative determination.
• The assessment of disability associated with chronic pain is complex, and the evaluator must approach the clinical evaluation with recognition of the many factors associated with the experience of pain and disability.
• The treating physician who has a doctor–patient relationship with the claimant may have a different perspective than the “independent” disability evaluator.
• While an independent medical evaluation has some similarities to a comprehensive medical consultation, there are significant differences.

Interdisciplinary Functional Restoration and Chronic Pain Programs (Feinberg, S.D., Gatchel, R., Stanos, S., Feinberg, R., & Johnston-Montieth, V.) Key Points
• An interdisciplinary functional restoration approach to pain management has been empirically shown to be therapeutically and cost-effective.
• The biopsychosocial model of diagnosis and treatment operates on the idea that illness and disability is the result of, and influences, diverse areas of an individual’s life, including the biological, psychological, social, environmental, and cultural components of their existence.
• It is important to identify those individuals at risk for delayed recovery and transitioning from an acute pain episode to a chronic pain condition.
• Functional restoration programs emphasize a biopsychosocial approach including different disciplines and anticipating an individual’s gradual progression to a normal lifestyle.
• Treatment approaches include medication optimization, normalization of function, education, physical reactivation, cognitive-behavioral therapy, various mind-body techniques to manage chronic pain, and return of new functional activities.

Email me for copies on a limited basis for educational purposes. To purchase the 1104-page hardcover or ebook, click here.

Feinberg Medical Group
825 El Camino Real Palo Alto, CA 94301
Tel 650-223-6400
Fax 650-223-6408

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