Pain is a normal part of life. We all experience it from time to time and in varying degrees. Pain is necessary for survival. What is important to understand is the difference between acute pain and chronic or persistent pain. The purpose, causes and management of the two are vastly different – and treating chronic pain as if it were acute can be futile or even worsen the problem.

The crux of the STEPP program is education. There are no silver bullets or magic fixes – but there is solid evidence to show that understanding ‘why’ we hurt will also help treat your pain. You will learn the current knowledge on how the brain processes pain, and how this knowledge can help to desensitizing hypersensitive pain connections. When the pain response doesn’t turn on so easily, you can start to set functional goals and your activity can be slowly increased. Knowledge of how to manage chronic pain and associated symptoms (eg anxiety) will also assist you to re-engage with life and reduce the suffering associated with your pain.

 

The STEPP program will give you tools to manage and understand your pain, and change the impact that ongoing pain is having on your life. Skills that will help you to stand back and see the bigger picture, and know what course of action to take. Skills that encourage you to think in a way that explores all the factors contributing to your pain, not just a simple cause and effect. Skills that encourage you to seek an active re-engagement in life, rather than a fruitless search for passive answers. Lifestyle changes that help you move towards metabolic wellness. This requires deeper learning and effort on your part. There will be activities for you to do during sessions as well as homework to be done. No one else can do this for you. The value you get will be largely dependent upon your commitment and perseverance.

What is involved?

The STEPP program is a multi-disciplinary program that includes both psychology and physiotherapy 1-hr sessions.

Initial Assessment

All clients are initially seen by the psychologist and physiotherapist at the same time. This is a required part of the STEPP program which allows comprehensive assessment of an individual and their unique situation. It allows thorough case formulation and planning. You are then have a separate physiotherapy and psychology assessment. This is required to establish your current functional status and history, develop baseline measures and highlight the direction for management.  The extent of this assessment is dependent upon whether a 3rd party (such as an insurer) requires specific reporting.

Program:

STEPP is a program that  can be tailored to meet the needs of the individual client. It consists of both physiotherapy sessions and psychology sessions that complement each other. Not all sessions will apply to all clients. Some may depend on whether the program is being funded by and insurer and return to work strategies need to be included.

The standard physiotherapy program is 6 education sessions that develop an understanding of the physiology of chronic pain:

  • All pain is real, however the physiology that drives this experience is different between acute and chronic pain.
  • Being able to make sense of our pain and knowing why we hurt helps recovery.
  • Pain is a protective response that can become learned and maladaptive over time. With chronic pain, that protective response is often no longer associated with the initial tissue damage.
  • Our nervous system adapts to become more sensitive with chronic pain. By understanding how this has occurred, we can challenge the nervous system to become less sensitive. This results in less pain perception.

Once you have a handle on the neuroscience underpinning the pain you currently have, the program moves on to techniques to help desensitize your nervous system, and start to upgrade the physical activity that you can do. This is likely to include graded motor imaging, pacing and developing an appropriate physical upgrading program. It also has a strong focus on lifestyle factors such as sleep and nutrition that are specifically designed to reduce nervous system sensitivity.

The psychology program deals with both the effect of the mind on our pain and the effect of pain on our mind. Our psychology plays an important role in how our nervous system functions, and that is because the brain is the headquarters for both mental and physical health. When we hurt emotionally, we hurt physically too, and the opposite is also true. We use proven psychological interventions to help you reduce and recover from the emotional components of chronic pain which helps the nervous system to calm and realise safety. When our nervous system feels safe again, then it has less need to over-protect which is most often what is driving persistent pain. However, this is an individual recipe and each person has their own unique experience of pain. What we do know though, is these things are contributing to your chronic pain experience. If you want to change your pain, you have to modify all the input variables.

TeleHealth:

There has been a growing demand for services for people who do not live locally and/or have difficulty accessing the program in person. This service is available and we are happy to discuss this with you – see our Telehealth page.

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Click here for a referral to STEPP:

Private Clients:

PHYSIOTHERAPY: If you are a private paying client, some of your sessions may be partially funded through Medicare. If your GP agrees that the program is an appropriate part of Chronic Disease Management (CDM) (item 10960) then they can refer for physiotherapy. This will partially fund 5 physiotherapy sessions (per calendar year) as part of the GP Management plan. If you have already used these sessions for a different allied health practitioner (eg Exercise physiology or dietician) then you are not eligible for further Medicare sessions. Your GP will need to do a specific referral form (CDAH-I 0510) and specify 5 sessions for the physiotherapy. (Indigenous clients can access a further 5 partially funded sessions but need a second referral for 5 follow-up allied health services for item 81335).

If you are not eligible for CDM, your private health fund may cover physiotherapy services.

PSYCHOLOGY: You can access 10 partially funded psychology sessions (per calendar year) under the Mental Health Care Plan – you will need your GP to fill out the appropriate MHCP referral.

Workers’ Compensation:

Prior approval from the insurer is required to attend the program. Your GP is able to include STEPP on the management section of the Certificate of Capacity. Please contact us with this certificate and the details of your insurance claim and we can request approval from the insurer.

Department of Veterans Affairs:

Referrals to psychology and physiotherapy are required. Please forward these to admin@stepp.com.au

Please give us a call and leave a message at 0478 045 617 or preferably send us an email at admin@stepp.com.au and we will get back to you with further details regarding referrals, cost and current waiting lists.