Dr. Wesley Gilliam: Why Mayo employs a holistic approach to pain management


Wesley Gilliam, PhD, director of Rochester, Minn.-based Mayo Clinic's Pain Rehabilitation Center, spoke with Kaiser Health News about the center's holistic approach to pain management.

The center hosts a three-week program for more than 300 patients annually to address a host of problems, such as lower back pain.

While a great portion of patients entering the program are on opioids, Mayo requires all participants to cease opioid use during the program. While this may dissuade some patients from participating, Dr. Gilliam said 80 percent of the patients opt to stay till completion.

Here's what you should know about the program:

1. Almost every patient enrolled in the program tried numerous other primary and secondary pain treatments, with little to no success.

2. Rather than employing only a medical approach, Mayo experts utilize a biopsychosocial approach. This approach allows clinicians to address the many factors contributing to pain, including biological, psychological and social.

3. The program readjusts patients expectations. Dr. Gilliam told KHN, "People need to accept that they have pain and focus on their quality of life. Some approaches reinforce in patients that the only way you can function is if you reduce your pain, as measured on a pain scale from zero to 10."

At Mayo, providers do not focus on eradicating all pain, but rather work to help patients get back to their important daily activities such as work and hobbies.

4. The program teaches patients meditation and relaxation exercise for those suffering from chronic pain.

5. Some payers may be hesitant to cover the program, often requiring patients to try more conservative treatment options. However, Mayo can write letters to insurers on behalf of patients they deem good candidates for the program.

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