What about the patient whose pain becomes chronic and disabling

Other factors contributing to the pain must be identified. There has been a large movement toward treating "benign" or "nonmalignant pain" problems with opioid medications and various injections, disc dissolution techniques, device insertion (spinal stimulators, intrathecal drug delivery systems), and surgery. However, these are unlikely to treat the entire problem. In addition, these treatments are invasive, associated with high complication rates, and unlikely to resolve disabling pain or restore functional ability. When the etiology of the pain is not clearly defined and there are multiple inorganic signs, treatment is directed at the functional loss and disability. This type of patient is best served by an interdisciplinary team (not multidisciplinary) approach, such as a functional restoration program. This approach uses cognitive-behavioral methods together with physical methods and is guided by a biopsychosocial approach to the patient's pain and disability. Acceptance of pain and restoring function is paramount to success with this type of program.

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