The Interdisciplinary Treatment Approach for Chronic Pain Management: The Key Components for Success

Part of the Handbooks in Health, Work, and Disability book series (SHHDW)


Interdisciplinary treatment is an empirically-validated approach to managing chronic pain conditions (Gatchel & Okifuji, 2006; Oslund et al., 2009) and is based upon a biopsychosocial conceptualization of the patient’s pain experience. This chapter will describe the basic rationale behind an interdisciplinary approach, the interdisciplinary program framework, and the role that this approach plays when considering disability in the workplace. Indeed, musculoskeletal and neuropathic pain are an all-too-common chief complaint with which patients present to pain treatment facilities (Gatchel & Mayer, 2008). The focus of this chapter will be on the treatment of nonmalignant pain (as opposed to chronic malignant pain). Musculoskeletal pain affects the muscles, ligaments, tendons, bones, and nerves. Low back pain is one form of musculoskeletal pain; up to 80 % of medical costs for back pain can be accounted for by the 5–10 % of acute back pain conditions that develop into chronic pain conditions (Gatchel & Mayer, 2000). Chronic spinal disorders also represent a significant proportion of nearly 1.9 million injuries and illnesses in the US industry, with direct-cost expenses of approximately $418 billion, and indirect costs of about $837 billion (Brady et al., 1997; Melhorn, 2003). Neuropathic pain is another form of chronic nonmalignant pain, and it includes peripheral neuropathy, complex regional pain syndrome (e.g., reflex sympathetic dystrophy), neuralgia, carpal tunnel syndrome, cubital tunnel syndrome, and other neuropathic pain conditions.


Chronic Pain Carpal Tunnel Syndrome Complex Regional Pain Syndrome Reflex Sympathetic Dystrophy Biopsychosocial Model 
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  1. Brady, W., Bass, J., Moser, R., Jr., Anstadt, G. W., Loeppke, R. R., & Leopold, R. (1997). Defining total corporate health and safety costs significance and impact: Review and recommendations. Journal of Occupational and Environmental Medicine, 39(3), 224.CrossRefPubMedGoogle Scholar
  2. Chao, M., Szeto, G. P., Yan, T., Wu, S., Lin, C., & Li, L. (2011). Comparing biofeedback with active exercise and passive treatment for the management of work-related neck and shoulder pain: A randomized controlled trial. Archives of Physical Medicine and Rehabilitation, 92, 849–858.CrossRefGoogle Scholar
  3. Collett, B. J., Cordle, C., & Stewart, C. (2000). Setting up a multidisciplinary clinic. Baillière’s Clinical Obstetrics and Gynaecology, 14, 541–556.PubMedGoogle Scholar
  4. Cunningham, J., Rome, J. D., Kerkvliet, J. L., & Townsend, C. O. (2009). Reduction in medication costs for patients with chronic nonmalignant pain completing a pain rehabilitation program: A prospective analysis of admission, discharge, and 6-month follow-up medication costs. Pain Medicine, 10, 787–796.CrossRefPubMedGoogle Scholar
  5. Dagenais, S., & Haldeman, S. (2011). Evidence-based management of low back pain. St. Louis, MO: Mosby.Google Scholar
  6. Gatchel, R. J., & Mayer, T. G. (2000). Occupational musculoskeletal disorders: Introduction and overview of the problem. In T. G. Mayer, R. J. Gatchel, & P. B. Polatin (Eds.), Occupational musculoskeletal disorders: Function, outcomes and evidence. Philadelphia: Lippincott Williams & Wilkins.Google Scholar
  7. Gatchel, R. J., & Mayer, T. G. (2008). Evidence-based review of the effectiveness of functional restoration for the management of chronic low back pain. The Spine Journal, 8, 65–69.CrossRefPubMedCentralPubMedGoogle Scholar
  8. Gatchel, R. J., McGeary, D. D., McGeary, C. A., & Lippe, B. (2014). Interdisciplinary chronic pain management: Past, present, and future. American Psychologist, 69(2), 83–88.CrossRefGoogle Scholar
  9. Gatchel, R. J., Noe, C. E., Pulliam, C., Robbins, H., Deschner, M., Gajraj, N. M., et al. (2002). A preliminary study of multidimensional pain inventory profile differences in predicting treatment outcome in a heterogeneous cohort of patients with chronic pain. Clinical Journal of Pain, 18(3), 139–143.CrossRefPubMedGoogle Scholar
  10. Gatchel, R. J., & Okifuji, A. (2006). Evidence-based scientific data documenting the treatment and cost-effectiveness of comprehensive pain programs for chronic nonmalignant pain (Peer Reviewed Journal). The Journal of Pain, 7(11), 779–793. doi:
  11. Gatchel, R. J., Peng, Y., Peters, M. L., Fuchs, P. N., & Turk, D. C. (2007). The biopsychosocial approach to chronic pain: Scientific advances and future directions. Psychological Bulletin, 133, 581–624.CrossRefPubMedGoogle Scholar
  12. Gatchel, R. J., & Turk, D. C. (1999). Interdisciplinary treatment of chronic pain patients. In R. J. Gatchel & D. C. Turk (Eds.), Psychosocial factors in pain (pp. 435–444). New York: The Guilford Press.Google Scholar
  13. George, S. I. (2008). What is the effectiveness of a biopsychosocial approach to individual physiotherapy care for chronic low back pain? The Internet Journal of Allied Health Sciences and Practice, 6(1), 1–10.Google Scholar
  14. Harrington, J. T., Dopf, C. A., & Chalgren, C. S. (2001). Implementing guidelines for interdisciplinary care of low back pain: A critical role for pre-appointment management of specialty referrals. The Joint Commission Journal on Quality Improvement, 27(12), 651–663.PubMedGoogle Scholar
  15. Huge, V., Schloderer, U., Steinberger, M., Wuenschmann, B., Schöps, P., Beyer, A., et al. (2006). Impact of a functional restoration program on pain and health related quality of life in patients with chronic low back pain. Pain Medicine, 7(6), 501–508.CrossRefPubMedGoogle Scholar
  16. Jensen, T. S. (2012). Anticonvulsants in neuropathic pain: Rationale and clinical evidence. European Journal of Pain, 6(Suppl. A), 61–68.Google Scholar
  17. Jousett, N., Fanello, S., Bontoux, L., Dubus, V., Billabert, C., Vielle, B., et al. (2004). Effects of functional restoration versus 3 hours per week physical therapy: A randomized controlled study. Spine, 29(5), 487–494.CrossRefGoogle Scholar
  18. Loeser, J. D., Boureay, F., & Brooks, P. (1990). Desirable characteristics for pain treatment facilities. Seattle, WA: International Association for the Study of Pain (IASP).CrossRefGoogle Scholar
  19. Mayer, T. G., & Gatchel, R. J. (1988). Functional restoration for spinal disorders: The sports medicine approach. Philadelphia: Lea & Febiger.Google Scholar
  20. Mayer, T. G., Gatchel, R. J., Polatin, P. B., & Evans, T. H. (1999). Outcomes comparison of treatment for chronic disabling work-related upper-extremity disorders and spinal disorders. Journal of Occupational and Environmental Medicine, 41(9), 761–770.CrossRefPubMedGoogle Scholar
  21. McCracken, L. M., & Turk, D. C. (2002). Behavioral and cognitive-behavioral treatment for chronic pain: Outcome, predictors of outcome, and treatment. Spine, 27(22), 2564–2573.CrossRefPubMedGoogle Scholar
  22. Melhorn, J. M. (2003). Work-related musculoskeletal back pain: The many facets. The Spine Journal, 3(6), 411–416.CrossRefPubMedGoogle Scholar
  23. Noe, C., & Williams, C. F. (2012). The benefits of interdisciplinary pain management. The Journal of Family Practice, 61(4), S12–S16.PubMedGoogle Scholar
  24. Norlund, A., Ropponen, A., & Alexanderson, K. (2009). Multidisciplinary interventions: Review of studies of return to work after rehabilitation for low back pain. Journal of Rehabilitation Medicine, 41(3), 115–121.CrossRefPubMedGoogle Scholar
  25. Oslund, S., Robinson, R. C., Clark, T. C., Garofalo, J. P., Behnk, P., Walker, B., et al. (2009). Long-term effectiveness of a comprehensive pain management program: Strengthening the case for interdisciplinary care. Proceedings (Baylor University Medical Center), 22(3), 211–214.Google Scholar
  26. Poulain, C., Kernéis, S., Rozenberg, S., Fautrel, B., Bourgeois, P., & Foltz, V. (2010). Long-term return to work after a functional restoration program for chronic low-back pain patients: A prospective study. European Spine Journal, 19(7), 1153–1161.CrossRefPubMedCentralPubMedGoogle Scholar
  27. Robbins, H., Gatchel, R. J., Noe, C., Gajraj, N., Polatin, P. B., Deschner, M., et al. (2003). A prospective one-year outcome study of interdisciplinary chronic pain management: Compromising its efficacy by managed care policies. Anesthesia and Analgesia, 97, 156–162.CrossRefPubMedGoogle Scholar
  28. Roche-Leboucher, G., Petit-Lemanac’h, A., Bontoux, L., Dubus-Bausière, V., Parot-Shinkel, E., Fanello, S., et al. (2011). Multidisciplinary intensive functional restoration versus outpatient active physiotherapy in chronic low back pain: A randomized controlled trial. Spine, 36(26), 2235–2242.CrossRefPubMedGoogle Scholar
  29. Sanders, S. H., Harden, R. N., & Vicente, P. J. (2005). Evidence-based clinical practice guidelines for interdisciplinary rehabilitation of chronic nonmalignant pain syndrome patients. Pain Practice, 5(4), 303–315.CrossRefPubMedGoogle Scholar
  30. Stanos, S., & Houle, T. T. (2006). Multidisciplinary and interdisciplinary management of chronic pain. Physical Medicine and Rehabilitation Clinics of North America, 17(2), 435–450.CrossRefPubMedGoogle Scholar
  31. Thurnberg, K. A., & Hallberg, L. R. M. (2002). The need for organizational development in pain clinics: A case study. Disability and Rehabilitation, 24, 755–762.CrossRefGoogle Scholar
  32. Timm, K. E. (1994). A randomized-control study of active and passive treatments for chronic low back pain following L5 laminectomy. The Journal of Orthopaedic and Sports Physical Therapy, 20(6), 276–286.CrossRefPubMedGoogle Scholar
  33. Turk, D. C., & Monarch, E. S. (2002). Biopsychosocial perspective on chronic pain. In D. C. Turk & R. J. Gatchel (Eds.), Psychological approaches to pain management: A practitioner’s handbook (2nd ed.). New York: The Guilford Press.Google Scholar
  34. Turk, D. C., & Swanson, K. (2007). Efficacy and cost-effectiveness treatment of chronic pain: An analysis and evidence-based synthesis. In M. E. Schatman & A. Campbell (Eds.), Chronic pain management: Guidelines for multidisciplinary program development. New York: Informa Healthcare.Google Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  1. 1.Counseling and Psychiatric ServicesSouthern Methodist UniversityDallasUSA
  2. 2.Department of PsychiatryThe George Washington Medical Faculty AssociatesWashington, DCUSA

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