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Rationale For The “Path Out Of Pain” Program

If pain from an injury does not resolve within 4-6 months, a cycle of chronic pain can become established. Once a chronic pain cycle is established, a purely physical treatment regime rarely resolves the problem. Chronic pain has an impact on the person, their family, and their lifestyle. Unless these issues are addressed, the situation frequently deteriorates, and the pain persists. Research has demonstrated that an integrated or multi-disciplinary approach to management is essential. This may include physical therapy, exercise therapy, psychology, occupational therapy, and a return-to-work rehabilitation program. The following references provide background to the need for, and value of, such an approach:

“The Challenge of Pain” (R. Melzack & P. Wall)
“The Psychology of Pain” (Richard A. Sternbach [Ed.])
“Psychological Control of Pain” (D. Elton et al.)

This program includes relaxation training to release muscular tension, which can be a major source of pain. Good body use is taught, as well as body awareness, so that old patterns of muscular tension and pain can be released. Specific Pain Control techniques are introduced once basic relaxation has been mastered. Attitudes to the injury and pain are explored and attitudes which promote healing of the injury and resolution of related emotional issues are developed. Assistance with return to work is an integral part of the program, whether the worker has commenced a graduated return to work, or is as yet "unable to resume work". Education about chronic pain is provided to help reduce anxiety and fear about the injury and the future. This can be critical to a successful return to work. Group pain management provides motivation, inspiration and support. Without this, many injured workers struggle to recover, and some fail to recover. Finally, exercise and fitness programs are developed to prepare the worker for a successful return to work. For details see McIndoe (1994) and McIndoe and Littlejohn (1995).


  1. McIndoe R 1994 “A behavioural approach to the management of chronic pain: A self-management perspective. Australian Family Physician” 23: 2284-2292.
  2. McIndoe R, Littlejohn G 1995 “Managment of fibromyalgia and regional pain syndromes.” Modern Medicine 38: 56-69.


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