We get asked that a lot.
It is usually then followed by a somewhat despairing recount of their personal pain story. You can tell they have told it many times.
I then find myself writing the same email back to them that I have written many times previously.
How are we different? What do we actually do?
STEPP is a combined physio and psychology program. We take a different approach to the standard pain management programs that are usually hospital based group sessions and focused on managing medications and teaching sufferers to cope with the pain. Our focus is on education that explains the neuroscience behind how chronic pain develops and what continues to drive it.
Research shows that if people understand ‘why’ they hurt and how their danger warning system became so sensitive, they are empowered to make the necessary changes to turn the volume knob back down again. Chronic pain is very complicated. Getting someone to take more medication, or telling them to go out and start exercising is simplistic and really sets them up to fail unless someone stands back and helps them look at the bigger picture and learn how to fly under the radar of a supersensitive nervous system. There are many factors that need to be addressed and managed, and these extend beyond physical and psychological that may seem the obvious ones.
The beauty of our nervous system is that it adapts and changes to what we throw at it. The fancy term for this is neuroplasticity. It adapted (in an attempt to protect you) into the pain mess that you find yourself in now. The truly encouraging thing is that it is capable of adapting its way back out – it all depends on how it is treated. We help clients apply physical and psychological approaches & treatments to desensitise their hypersensitive nervous system. Over time this will reduce pain which then flows onto better movement and more successful physical upgrading. It certainly isn’t a quick fix. Most people spend months and years slowly remodelling their nervous system into a bit of a mess, and it takes a while to straighten it out again. It is a lifestyle change – making good decisions about how you let yourself think and act.
So what does our program actually look like?
Felicity and I see clients initially together so that we can have a thorough understanding of the client and what has contributed to their chronic pain experience. After that there are a number of individual sessions with both of us (physiotherapy and psychology). The number of sessions is really based on individual need, but we require all participants to do the education sessions first as this knowledge underpins the treatment approach.
All psychology sessions are 1 hour and are generally weekly. There is usually around 10-12 in total.
The first 5 physio sessions are specifically for education and are weekly for 1 hour. They then change to standard 30 min sessions and may become more spread out. These are more physio type sessions where we work at physical upgrading, desensitizing strategies and techniques, targeted treatment if required etc. The number depends on need, but an estimate would be 5-8 sessions.
There is a manual for the program, homework and activities to do. Every week. Seriously. You are going to have to do some work. We have no magic wand to wave over you, nor do we have that elusive silver bullet that will make all your problems disappear. Now is the time to take back your life and manage it – not passively hope that someone else is going to fix it for you. You need to commit to lifestyle change, and if you don’t have time to focus on all this, then we would suggest that perhaps now is not the right time for you to start.
Cost is always the next question, and this does depend on your funding source. We can assist you to request insurer approval for Workers’ Comp and Accident claims to cover the full cost. We can work with DVA to cover the full cost. If you are a private client, then there are some rebates available that will assist to cover some of the costs under Medicare (Mental Health Care Plan and Chronic Disease Management) and if you are in a private health fund then you may also be partially covered for some of the costs.
So if you are interested in help with pain management in the Nowra area, give us a call at the STEPP program. We would be more than happy to have a chat with you.