FAQ
Q: The Rosomoff Comprehensive Rehabilitation Center (RCRC) looks just like any other pain center. How are you different?
A: Pain centers look and sound alike on paper and the treatment may seem or sound the same. All football teams have coaches and the same number of players - yet they don't all win the Super Bowl. It depends on how they work together for the final goal that makes the difference. Here as well, your treatment outcome depends on how all of us (including you) work together for the final goal which is to return to a quality filled, fully functional lifestyle.
Q:I have been to many doctors, and given different diagnoses. I don't know whom to trust. How can I trust and believe the diagnoses I get here?
A:We can offer you our medical opinion based on your evaluation and years of our experience and a very high level of success. This program is very logical and should make sense to you. You should be able to see things which apply to you throughout this program. Ask questions. Evaluate us to make certain it makes sense to you. Read the former Patient Letter Book offering unsolicited "success" stories to help encourage you. This book is available in the therapy areas and on the inpatient unit. We are an academic service and, therefore, are in the forefront of knowledge and new techniques. Professionals from the world over visit our center to learn the techniques we use here. Many of you are sent here because of the conflict in medical opinions and are hopeful that we can settle the issues and move you forward with the appropriate treatment.
Q:I just had x-rays taken. Why more?
A: If you just had x-rays taken the only reason for more is that the ones you have may be inadequate or incomplete. We will repeat studies of your x-rays that are older than six months if it is relevant to the question now being considered. Most often the additional x-rays are to give us further information that was not sought in the original studies you had.
Q:My goal is to be pain free. Is this your goal?
A: TThere are three major goals: (1) Enable you to return to full function and normal activity. (2) Reduce or eliminate pain (3) Enable you to solve or control your own pain if and when pain occurs. We believe that freedom from pain will not occur unless you are fully functional, living a normal life, and using the tools you learn here to manage your pain.
Q: Will I be pain free by the end of the treatment program?
A: That is not possible for every one in such a short period of time. The majority of patients will become fully functional and comfortable and able to resume normal activities. Also, continuing to practice the home program and the techniques taught here will ensure you of no "new" injuries. We know that if function can be restored, pain will come under control and will either disappear or become tolerable. Myofascial syndromes are a chronic problem. They are controlled, not cured – but this should not prevent you from becoming highly functional.
Q:Why does everyone in the program seem to have the same diagnosis?
A:Many of the patients will have similar diagnoses. You should not find that unusual. If someone had a headache and went to a headache clinic, most of the patients would have the same primary diagnosis, headache, even though there are many types of headaches. The majority of our patients have myofascial pain syndrome but this syndrome varies in its nature and the area of the body that is affected. Every individual is unique and will be treated as an individual.
Q:I believe that Myofascial Pain Syndrome means that you think the pain is all in my head and there is nothing wrong with me. Isn't that what you are really trying to say?
A:We have never had a patient whose pain was in their head. We believe your pain is very real. However, pain affects behavior & behavior influences the way pain is felt. Myofascial Pain Syndrome causes significant debilitating pain! The muscular system is very complex and responsible for all movement in your body. It is a physical diagnosis based on physical findings. Muscle pain is quite real. It is the same as the "Charlie horse" that you have all experienced but you have it for a long time. Unfortunately, myofascial problems do not show on x-rays and laboratory tests. It takes a physician who understands, who will actually examine you and feel the muscle disturbance with his fingers to make the appropriate diagnosis.
Q: Will I have any say about my own treatment?
A: This is your treatment for your problems. Please ask questions and express concerns as they arise. Your treatment plan is designed to meet your needs as you progress. We do listen and consider your concerns, questions and feedback. We may not always agree with your beliefs and we ask that you trust our vast experience in working with these kinds of problems to know what is best for you.
Q: The insurance company is paying my bill, therefore, does the insurance company at times, dictate my treatment?
A: The RCPC is dedicated to providing quality care. We are NOT agents of the insurance company and will not compromise our principles. Insurance companies understand that we will be objective and give facts, not say just what any party wants to hear. The system does dictate that we must report our findings to them. We are your advocates and are here to help you and do so without any other purpose.
Q: While I’m an inpatient, why can't I leave. I feel like a prisoner?
A: The reason for not allowing inpatients to leave the hospital at liberty is because the patient is in the middle of treatment and may be in a delicately balanced circumstance. Furthermore, when the individual is not in a controlled environment there remains the opportunity for injury. You may carry out activities which you should not be performing and affect adversely your injury. Moreover while you are in the hospital, it is our responsibility to manage you for 24 hours a day. We are responsible as long as you are in inpatient status. We cannot accept the liability that would be imposed if you are out of the hospital. This is a normal operating procedure for any hospital admission.
Q: My pain and body are different than others. Why do you treat us all the same?
A: The purpose of the evaluation is to identify your unique problems. Patients who are treated at RCRC have similar problems, and thus it may appear that you are all given the same care. This is not so. With your input we will tailor the program to meet your needs. We will treat you as an individual and address your specific problems.
Q:I think physical therapy is the most important part of the treatment program. Why do I have to have these other therapies?
A: Most of the patients have had extensive physical therapy prior to coming here. Yet they are still in pain and not fully functional. We feel that you are a total person and we must address all of your problems. This cannot be done by physical therapy alone. Initially, you might see the most changes in yourself from physical therapy. However, all parts of the program are necessary to rehabilitate you and insure that you have all the tools you need to live a quality life on your terms. It is rather like a jigsaw puzzle, even one missing piece mars the entire picture! All members of the team contribute equally to your rehabilitation.
Q:If the pain is in one part of my body (neck, shoulder, back, head) why do you treat my whole body? and my mind?
A:Chronic pain affects the whole person and very often all aspects of the person's life (work, relationships, finances, self-concept, etc.) That is one reason we have experts in many different specialties to treat and fully rehabilitate the whole person and address all of your problems.
Q:Why doesn't the Center believe in narcotic pain medications?
A:We believe that in the long run narcotics only make chronic pain worse. One reason is that narcotics interfere with your body's production of endorphins, which are pain fighting chemicals that you produce naturally. The program is designed to maximize your production of endorphins through increasing your activity, as it is known that exercise will increase endorphin levels 2 to 3 fold. We will do our best to provide you with pain relief by other treatments and at the same time rid you of narcotic pain medication and its potential bad effects. We may need to prescribe other forms of medication to control anxiety and depression, and this will be necessary for your overall health. This may be temporary although it may be necessary to continue beyond the time of treatment here. Or it may be a long term program which will need to be carried out by your local treating physicians. There are some forms of pain which require pain medication of a non-narcotic type and this will be used if appropriate.
Q: How will you help me tolerate my pain if you take me off narcotics?
A:We will try to help you with your pain with modalities, exercises, TENS, etc. If these methods fail to control your pain, you will be offered non narcotic medications to control your pain along with stretching, massage, ice, shiatsu, relaxation.
Q: If I experience an increase in pain during treatment, am I being injured?
A:We expect you to experience pain during treatment. To have pain relief, shortened muscles must be stretched to normal length. Stretching may be painful. Our therapists are trained to eliminate the risk of injury to our patients while stretching. Pain does not equal injury or disability. Also, you have been inactive for quite a while. If you went to a gym, you would hurt after exercise until you were conditioned. You will learn to recognize the difference between pain and injury. Our physicians all work here full time and will examine you any time you are concerned. We know you must tolerate this pain in order to have a successful outcome. We will do as much as possible to make it bearable. You have probably been in pain a long time so a few more weeks of pain is worth it to get the results you want. Initially massage may be painful, but eventually it relieves pain and is essential to becoming pain comfortable or pain free.
Q:I know how much pain I can take, and how far I can push my body. I know my body better than you do. Why don't you listen to me?
A:Have you ever said that you could not do something and then later learned that you could? Pain is our business. If you knew how to get out of it you would have by now. What you have tried so far has not worked or you wouldn't be here. It's time to try something new. We know from experience if we do not work beyond the point you feel pain your outcome will not be successful. Our team is trained to work you as hard as you need to go to get better. Most people cannot do it themselves because they stop when they have pain. We push you beyond because we know you will get better...even though it hurts! Although most people know their bodies well, the amount of treatment that can be tolerated is something which you cannot fully determine. You must trust our professional judgment to know what your capacity actually is. It may be well beyond the level that you believe. Read the patient letter book to see what former patients said. We have treated over 30,000 patients and know how far to go.
Q: The research shows that the body slows down and thinks it's starving when calories are restricted too much. I haven't weighed what you think I should in 20+ years. Why should I starve here on a reduced calorie diet?
A:When an individual has been injured their ability to adapt becomes diminished, and particularly with back pain, weight is a contributing issue. An excess of 1 lb. is equivalent to 10 lbs. of force applied to the spinal structures. As such, and in order to facilitate rehabilitation, it is best to return to the original distribution for which the patient's body was designed. It matters little that the individual may not have weighed that much in the past 20 years. It has to do with a system that is no longer able to work in a manner that it was doing so before. Obesity can lead to major health problems including chronic pain.
Q:What you do for me in Job Simulation cannot recreate my job; it's not the real world. Why do I have to do it?
A:Job simulation is used to assess and treat patients of working age. It is used to identify potential problems while performing job-related tasks that may produce pain. It enables the team to create a treatment plan to rehabilitate you to perform the tasks of the job. It is not intended to recreate every aspect of your job. It can also give you the confidence to handle the tasks and do the job safely.
Q: Following treatment I want to feel like I used to. Will I?
A:We hope and strive for you to feel better and more physically fit. Some patients take longer to heal than others. You may have difficult times or flare-ups even after leaving here. Hopefully, applying the techniques you learn here will help. You should be able to live an active and fairly comfortable life even if some pain remains. In our experience most of our patients go on to lead very active and full lives after discharge. Some do so immediately and others take a little longer.
Q:Will all my problems (at home, with workman's compensation, financial, etc.) be solved by the end of the program?
A:We are here to help you help yourself. We will discuss your problems and you will learn tools to aid you in beginning the process of addressing and dealing with your problems. This is the beginning of a process, not a final solution.
Q:If I make progress, shouldn't I be pain free when I leave?
A: One third of our patients leave pain free. As the program progresses, some pain relief should be achieved. The final control or relief of pain comes in most cases during the follow up period after discharge. You may experience flare ups which you will be taught to resolve.
Q: Pain is disabling to me! How can I return to work or live a fully functional, quality life if I still have some pain when I am discharged?
A:Pain is disabling when you have not been rehabilitated. When you are discharged you should be quite fit and comfortable. During your stay we will treat those problems causing the pain. You will learn to push or work through the pain, in order to be rehabilitated. You will be taught techniques to decrease any pain you might have. These may decrease pain, but perhaps not eliminate it totally as the process takes longer than the time you will be here. You will learn techniques which- will help you prevent pain increase, and enable you to lead a functional quality life at work and play. Your home program will help you continue to make progress after you leave. Many people have pain from time to time yet they work and are productive. Your treatment program is designed to bring your pain under control or provide relief as circumstances allow.
Q:Can I do the home program whenever I want and still maintain the gains that I have made?
A: The scheduling of your home program is subject to some flexibility. However, it is suggested that the home program be performed regularly, twice daily as directed by your therapist for optimum benefit. You can always contact your therapist to discuss changes. The more conditioned you become the less chance for reinjury or increase in pain. The program is hard work. The maintenance program is worth the effort so you do not lose what you worked so hard to gain. It is also advisable to stretch anytime you feel pain increasing during regular activities.
Q: When I feel better will I still have to do my home program?
A: The home program is not a therapeutic program. It is a maintenance program. If you do not do it you may lose the gains you made and may get worse. Furthermore, if you have a flare up, the exercises alone will not return you to your previous state if you have allowed yourself to get out of shape. You will then need an active program again to return you to your previous state of fitness.
Q: If you say I am rehabilitated then why can't I play football, water/snow ski or jog?
A: If you are rehabilitated, it is unusual for us to say that you cannot go on to physical activities or recreational sports of an exertional nature. However, we may have to point out to you that you may put yourself at risk if you are participating in activities that inherently have risks associated with them. Furthermore, there are some activities that we know to be good exercise but poor for body mechanics or have the possibility of producing trauma. Jogging is a good example. Brisk walking can give the same effect as far as exercise effort whereas jogging is traumatic to the back, hips, knees, ankles and feet. We will rarely tell anyone to not do a sport he/she wishes to participate in. We may indicate the form of risk involved and that it is not as desirable as an alternative.
Q: Isn't it your responsibility to get me better?
A: Our Pain Team is committed to doing everything possible to help you. However, you are the most important member of our team. Without your effort, we cannot help you. You need to take responsibility for your recovery and play a very active role in your rehabilitation. Sometimes you will have to endure more pain to get good results. Ask questions until you are satisfied. Relief or control will never be achieved unless you, the patient, are actively involved, working hard and using what we teach you.
Q: If the Rosomoff Comprehensive Rehabilitation Center does not believe the pain is in my head why have I been assigned a psychologist?
A: We know that when people have been in pain a while it affects their emotions and how they cope with life's problems. Therefore, psychologists are very important members of our team. One is assigned to each patient to help the patient deal with the "fall out" from chronic pain such as anxiety, depression, lack of concentration, fear, anger, marital problems, loss of confidence, self-esteem, etc. They also help you get through our program by teaching you to "stretch your mind" with pain reduction and stress management techniques.
