Connect
Author: Rachel S. Wasson, PhD, LP, CYT
Who is the Pain Rehabilitation Center (PRC) for?
The Pain Rehabilitation Center (PRC) is for any person with chronic symptoms that significantly impair their functioning and quality of life.
We see patients with a wide range of symptoms and sensitivities, including but not limited to, chronic pain, fatigue, dizziness, gastrointestinal dysfunction, sensory changes, tremors, spells, muscle spasms, tremors, and clumsiness.
Patients can have a variety of health conditions and medical complexities, including but not limited to, musculoskeletal conditions, neurological conditions, pre- and post-transplant patients, nonepileptic seizures, functional neurological disorder (FND), postural orthostatic tachycardia syndrome (POTS), Ehlers Danlos syndrome (EDS), hypermobility spectrum disorder, migraines, headaches, Irritatable Bowel Syndrome (IBS), and fibromyalgia.
Participants’ ages range from adolescence to older adulthood.
What treatment options are available through the PRC?
The most intensive and effective treatment service we have available is the Comprehensive 3-Week Program, which has been running for 50+ years. This program is an in-person, outpatient treatment that is held Monday – Friday from 8:00 AM to 4:30 PM. The primary goal of treatment is to improve functioning and quality of life. Treatment focuses on lifestyle changes, including behavioral health, chemical health, emotional health, and physical health.
We also offer a Virtual Cognitive Behavioral Therapy for Chronic Symptoms Drop-In Course. This virtual program includes Cognitive Behavioral Therapy (CBT), neuroscience, and some occupational therapy principles. However, this online program does not include close medical supervision, medication management, chemical health, or physical health focus. For patients with significant impairment in functioning and medicial complexity, we strongly recommend the Comprehensive 3-Week Program.
What is Central Sensitization Syndrome (CSS)?
Video explaining CSS: https://www.youtube.com/watch?v=vJNhdnSK3WQ
What health professionals are part of the treatment team?
The PRC is comprised of an interdisciplinary team, including psychologists, nurses, physical therapists, occupational therapists, and advanced practice providers. Pain Medicine, Pharmacy, and Nutrition also work with our patients as necessary. We closely collaborate with our colleagues throughout Mayo Clinic to ensure appropriate plan of care.
Is the PRC a drug rehabilitation or addiction program?
No. Our focus is on improving functioning and quality of life for people with chronic symptoms, which may include reducing or tapering certain types of medications in the Comprehensive 3-Week Program.
Is the program just “mind over matter” or telling patient to “ignore their symptoms”?
No. We know that the symptoms patients with Central Sensitization Syndrome (CSS) are experiencing are very real and disruptive. We are strong advocates that CSS symptoms are not a result of psychological distress, pretending, or exaggerating. Therefore, simply pretending that you are not experiencing symptoms will not elicit any beneficial changes. All recommendations provided in programming are based on the most up to date neuroscience on how the sensory and motor neural pathways operate. We encourage behavioral and lifestyle changes to promote improved functioning and quality of life.
Who is not appropriate for PRC?
We are unable to provide assistance with ADLs, including feeding, administering medication, and toileting. Therefore, patients need to be able to complete these activities independently in order to participate in program.
Patients who recently had surgery will need clearance from their surgical team and post-operative treatment teams in order to participate in program.
PRC is intended for patients that have completed all medical work ups, as PRC will not offer additional diagnostic studies, procedures, or second opinions. Patients must be willing to taper and discontinue opioids as part of the strategies facilitated in the program.
Can I bring my service animal?
We are unable to accommodate service animals in our program due to safety concerns. The only exceptions are seeing eye service dogs.
Can I do the Comprehensive 3-Week Program online or opt out of parts of the program that do not apply to me?
No. The Comprehensive 3-Week Program is an intensive treatment program that is only available in-person and must be completed in it’s entirety. The Online 8-Week CBT for Chronic Symptoms is offered as an alternative.
What medications are typically tapered in the Comprehensive 3-Week Program?
On admission day, patients will meet one-on-one with a team member to review their current medication list. We will develop a plan for medication with patients collaboratively. Medications that are subject to change, include but are not limited to, opioids, benzodiazepines, sleep medications, muscle relaxers, and stimulants. We also ask that patients abstain from alcohol and cannabis related products during the duration of the treatment program.
What do graduates say about this program?
https://www.youtube.com/playlist?list=PLSWR1ylG_6JaW_4FLJGeSLwu1lPSRMATp
Are meals provided during programming?
No. There is an hour lunch break in the daily schedule. Patients are provided a refrigerator that they can use for snacks, beverages, and lunches. There is also a patient cafeteria available.
Is this an in-patient program?
No. The program is an outpatient program. Patients engage in programming from 8:00 AM – 4:30 PM, Monday – Friday. The evenings, lunch hour, and weekends open to patients to do as they wish.
Where do people stay if they are not local?
If people live more than 45 minutes away from Mayo Clinic in Jacksonville, we recommend that patients find short-term lodging near campus. Some patients prefer to spend the entire 3 weeks in short-term lodging, while others prefer to go home on the weekends.
Can I continue working my job or engaging in educational activities while enrolled in the Comprehensive 3-Week Program?
We recommend that patients are primarily focused on engaging in the program during the 3 weeks.
Can letters for FMLA, short-term leave, or disability be provided?
We can provide letters for FMLA and short-term leave for the duration of the 3-week program. We do not provide letters for disability.
I have done physical therapy before. How will this be any different?
Our physical therapy focuses on full-body reconditioning to build a foundation of fitness. We do not overly focus on any one body area. Participants engage in stretching, cardio, and strength-based work. We start off very mild, and gradually build up intensity over time.
The program also includes other aspects, such as behavioral health, chemical health, and emotional health that are not typically included in traditional outpatient PT programs.
Is this program just group psychotherapy?
No. The program is based in Cognitive-Behavioral Therapy and is group-based. However, at no point is it group psychotherapy. All informaiton is provided in a lecture format and is focused on disseminating knowledge and teaching practical skills.
I am concerned that physical therapy is not safe for me to engage in. Will this be safe for me?
On admission into the program, our physical therapy (PT) team does a thorough evaluation of baseline physical functioning and health history. This gives our team to ability to modify PT as necessary to ensure safety. Our PTs work daily with patients with complex health histories and a wide range of functional capacities. They are also knowledgeable in working with patients with hypermobility disorders.
Can my family and friends be with me during any part of the program?
Family and friends are welcome to attend our “Family and Friends Day” that is held every Friday during programming. They may join in-person or virtually. More details on this are available for current patients. Otherwise, patients are engaging in the programming independently during the day.
What are the outcomes?
On average, patients report about a 60% increase in their daily functioning and 40% decrease in their symptoms. Most patients start the program with moderate to severe levels of depression and anxiety, and leave with mild to no depression and anxiety by the end of the program. Of the graduating patients, 87% reported decreased pain and/or symptom interference in completing daily life activities, while 73% reported reduction in pain and/or symptom severity which was maintained 6 months following discharge.
What if I have a symptom flare during the program? Can I call in sick?
We ask that all patients attend all programming days, as active treatment occurs each day. Regardless of symptoms, we encourage patients to come to programming. Once patients arrive, our treatment team will make an assessment and provide a plan for next steps and modifications as needed.
I have spells/episodes/nonepileptic seizures/function symptoms. I am worried about how the treatment team and other patients will respond to my symptoms. What should I expect?
Our treatment team is experienced with managing spells/episodes/nonepileptic seizures/functional symptoms. We calmly and confidently monitor these symptoms as appropriate and ensure that patients are safe.
How often is this program offered? How big are the groups?
The Comprehensive 3-Week Program is offered continuously throughout the year. We utilize a rolling admission style. We do not use a closed-cohort model. Patients are enrolled into program on a regular basis, which gives us flexibility with scheduling.
We have two groups running concurrently, up to 15 people in each group.
CONTACT INFORMATION
Phone: 904-956-1780
Fax: 904-956-1895
Email: flapainrehabcenter@mayo.edu
Address: 4500 San Pablo Road, Jackosnville, FL 32224
Youtube Playlist: https://www.youtube.com/playlist?list=PLSWR1ylG_6JaW_4FLJGeSLwu1lPSRMATp
Mayo Clinic Connect Chronic Pain & Symptoms Rehabilitation Blog: https://connect.mayoclinic.org/blog/chronic-pain-symptoms-rehabilitation/
Like
Helpful
Hug
Connect