Welcome to the Compass Center for Functional Restoration

Compass Center for Functional Restoration is unique to the Sacramento Valley. We offer an intensive program designed to empower people with chronic pain to transform themselves and take charge of their lives. Please review the information provided below and the links to the right and feel free to contact us with any additional questions.

Understanding Functional Restoration: What it is and how we work:

Acute Pain appears unexpectedly, usually from an injury. It will generally last up to six months and can be treated effectively with medicines, therapies or surgeries. Eventually it will go away.

Chronic Pain lasts beyond 6 months and can be ongoing despite medicines, therapies or surgeries.

Because chronic pain most likely will always be present, you must remember there is no such thing as pain elimination. Many patients ask “Why can’t there be a medicine or a surgery to fix this pain?” Typically, pain is considered an alarm system in the brain. After six months of sensing the alarm, changes occur in the brain and the nerves that make the alarm appear more “the normal state” than abnormal. The nerves adapt and feel pain more efficiently.

Consider this analogy…
A professional pitcher on a baseball team can throw a ball 100 miles per hour. But, when he first started he could only throw it at less than half that speed. Only with hours, days, months, and even years of practice did he learn to coordinate his nervous system to optimize both the nerve signals and muscles to throw the ball really fast! His nervous system adapted because he concentrated on making it happen.

Chronic pain patients often become
“professionals” at feeling pain.
Constantly thinking about chronic pain as a source of suffering with no relief leads to a life of hopelessness and despair. Effective chronic pain treatment is the difference between someone who is suffering from chronic pain and someone who is managing chronic pain.

Chronic pain is a difficult condition to treat.
Traditional medicine looks to find a “cure” to pain by finding the correct therapy, medicine, surgery, etc. Chronic pain, by definition, will not go away. It will most likely not be cured. Although this is a true statement, there is still treatment.

A diagnosis of chronic pain is more than just a problem with part of your body such as “my back hurts” or “my neck stings” or “my arm aches”. It is a condition that impacts the entire life of a human being. It affects the motivation to go out and be with people, the ability to think and remember what you just read two minutes ago, the ability to believe that you can still work or be productive, the ability to simply clean the house or cook a meal. In short, it is a diagnosis that impacts the entire life of a person, and his or her family and friends.

Coping strategies are the key to change. A coping strategy can be maladaptive, such as avoiding all activity because of the fear of pain, or adaptive, such as pacing oneself through an activity to manage pain. Eliminating approaches that are negative and replacing them with techniques that are positive is an effective way to manage pain. These techniques must incorporate appropriate use of medications, commitment to proper therapeutic routines, and awareness of how the pain is controlling your thinking and your life.

At Compass Center for Functional Restoration, we treat the whole person, not just the medical condition of pain. Our experience has shown that a diagnosis of chronic pain does not mean your life no longer has meaning. Patients often report that the pain has created a situation where they “feel lost”, or are “just not the same person” anymore. It can seem like a complete loss of control of your life but it does not have to be. You can find ways to create a meaningful life.

When we treat the whole person - the psychological, emotional, and physical person – we find the pain experience changes. It becomes less distressing, and has less impact on the ability to perform everyday activities. Some patients even report a reduction in the amount of pain. Our main goal in treating chronic pain is to teach lifestyle changes through a comprehensive restructuring of beliefs, behaviors and daily practices.

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Program Goals

The main program goals are quite simple. There are 3 main goals:

1. For participants to learn that small steps forward, when accumulated, lead to significant change.
2. For participants to experience some change through implementing small daily steps while in the program.
3. For participants to learn that they are the ones who must do the daily work and make the changes. No one else can do it – not the doctors, nurses, physical therapists, psychologists, attorneys or insurance companies. Professionals can provide the tools and teach the skills, but the participant must implement the training.

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Program Principles

1. This is a course in lifestyle change. If you apply what is taught you will transform yourself. This change will show up in at least four areas of your life:
   1. Physical
   2. Mental
   3. Emotional
   4. Behavioral
2. You will learn how to make these changes in spite of your pain.
3. Your pain is real. Your pain is not “all in your head”.
4. Your pain is chronic. This means that you have had it more than 6 months and will be dealing with it in some way for the rest of your life.
5. You may be dealing with depression, anxiety, or anger. These can be treated, but you will have to put forth effort.
6. This course is voluntary. No one will force you to attend, but if you make the decision to do so, we expect you to participate fully on a daily basis.
7. We do not want to take away hope that medical science might one day find a cure for your pain. However, you cannot afford to wait for this cure and must learn the skills needed for effective daily coping until this time arrives.

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Getting the most out of the Program

1. Commit to the treatment process – be involved in all aspects of it.
2. Attend consistently.
3. Respectfully voice opinions, thoughts and feelings honestly and openly whether positive or negative.
4. Complete homework assignments.
5. Experiment with new ways of doing things.
6. Make efforts every day to improve yourself – understand skills are developed with practice.
7. Take medications as prescribed, and discuss medication only with your doctor.
8. Implement your Flare Up plan and Relapse Prevention Plan immediately.
9. Don’t use pain medications to treat difficult moods. Find out what is bothering you and learn to deal with the issue.

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Program Process

• After referral a patient attends a multidisciplinary evaluation (Physician, Psychologist, and Physical Therapist). You will meet separately with each professional for about one hour.
• The Multidisciplinary team discusses the results to determine treatment options.
• The patient is scheduled to meet with the team to discuss evaluation results and treatment recommendations.
• If the treatment team feels that the patient is appropriate for Functional Restoration, and the patient agrees, request for authorization begins.
• The program is 6 weeks in duration, M-F from 9:00 am – 4:00 pm.
• Patient progress is reevaluated weekly at an interdisciplinary meeting.
• An aftercare program is provided free of charge for an unlimited time in a group setting.

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Frequently Asked Questions

“How can I attend; I live too far away?”

Accommodations (assistance with finding local hotel/motels) can be arranged for long distance commutes.

“I have pain all the time. How can I possibly be expected to attend all day?”

Almost all of our patients ask this question. We are experienced with the patterns of chronic pain and de-conditioning. There are several rest breaks during the day, and the activities are structured to accommodate those who need to build endurance.

“I want to reduce my medications, but what about withdrawal?”

Tapering of medications is an individualized process based upon the amount of medication and each person’s physiological response. It generally occurs before the start of the program. Our medical treatment staff advocates a very gradual reduction of only those medications that are inappropriate for each condition and proceeds gradually to minimize withdrawal symptoms. Concurrently during this process it is suggested that each patient attend psychological counseling to begin to institute healthy coping responses to pain and prepare for participation in the Functional Restoration Program.

“How is it billed?”

Billing can be discussed by contacting our Director of Operations, Conni Thompson.

 

“My insurance always delays things. What if they deny the program?”

ACOEM guidelines recognizes Functional Restoration as the “treatment of choice” for chronic pain conditions. Our staff is experienced at working in concert with all parties (patients, case managers, adjusters, primary physicians, attorneys) to bring the patients the best care available for chronic pain conditions in the most expedient manner. We pride ourselves on our ongoing contact with all parties to communicate appropriateness of care.

 

 

“What about meals while attending?”

There is a refrigerator and microwave available on site. There is also a supermarket locally as well as several restaurants. We encourage healthy eating and incorporate nutritional education as part of the program.

“Can I have some more details on what the program involves on a daily basis?”

The list of activities below may have some weekly variation but is generally the schedule followed each week. Many items are repeated but each week new skill areas are reviewed and over the six weeks a variety of new physical and mental coping tools are learned and practiced.

8:30 - 9:00 am	Each participant is processing daily goals and/or participating in individual psychological counseling.
9:00 am - 9:20 am	The treatment team meets with the group and reviews each participant’s post-program, physical and memory mastery goal for the day.
9:30 am - 10:00 am	Each day there is a guided exercise period where the participants walk or bike for up to 40 minutes and practice skills such as posture, proper body mechanics and increasing endurance. Participants are accompanied by various treatment team members so they can be observed and further instructed.
10:00 am - 11:00 am	The psychologist works with the group reviewing daily improvement factors and various other pain coping techniques. Each participant that enters the program is required to select three different improvement factors from an extensive list of about 25 items. Examples include improving patience, improving socialization, improving problem solving, etc.  The selection of factors is done with the psychologist to help ensure an appropriate selection of factors. Daily each participant is required to notice small changes in each of the behaviors and report back to the group and psychologist. This process also allows the psychologist to determine each persons' ability to change behaviors and how best to assist each participant.
11:00 am - 12 noon	The participants are involved in learning biofeedback and the development of an individualized exercise program. Several types of biofeedback skills are taught and exercise programs are tailored to each person’s particular needs. There is also a physician meeting once per week during this time to review progress, discuss progress towards post program goals, and review medical patient issues.
12 noon - 12:30 pm	Lunch for patients. During this time, the multidisciplinary team frequently meets to discuss barriers toward progress and adjust treatment planning as necessary. Adjusters, case managers, or concerned professional parties are encouraged to participate.
12:30 pm - 1:00 pm	The participants are completing activates related to their post program goal (for most participants this involves taking steps toward a return to some type of employment).  Sample activities can include resume development, contacting prospective employers, etc.
1:00 pm - 2:00 pm	This is an educational hour. There is a different topic for each day of the week. Educational topics include nutrition, psychological coping, Permanent and Stationary status, etc.
2:00 pm - 2:30 pm	Each day there is a demonstration of Functional /ADL training. This includes proper body mechanics for a variety of daily activities. This can include learning how to cope with chronic pain while cooking, cleaning, bathing, dressing, participating in community events, etc.
2:30 pm- 3:00 pm	The participants are taught various relaxation techniques and flare-up protocols.
3:00 pm	Each week the participants participate in Tai Chi thee days per week and/or practice flare-up protocols, biofeedback techniques, or additional post program goal work.
3:45 pm – 4:00 pm	Each day there is another check-in with the team to review the daily process for the goals set earlier in the day.

“What about childcare?”

There is no childcare available. Patients will have to make arrangements independently.

“Every time I exercise it hurts!  Is the Physical Therapy just like all the rest?”

No. Most patients have had experience with Outpatient Physical Therapy and it has not been successful. That is because the style of therapy generally has a different goal – to return you to exactly the level of performance you were achieving prior to the injury. At the Compass Functional Restoration Center, we understand that the pain limits pushing progress at a fast pace. Each Physical Therapy treatment program is custom tailored to your pace and has 2 goals in mind:

1. Develop a flare-up routine – to manage and/or decrease either the frequency or the duration of those “really bad times”
2. Develop a routine that works on your physical challenges but at a pace and comfort level that will not increase your pain.

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Section Quick Links

• Understanding
  Functional Restoration
• Program Goals
• Program Principles
• Getting the most
  out of the Program
• Program Process
• Frequently Asked Questions
• Directions to the
  Compass Center

Compass Center for Functional Restoration

2901 K Street, Suite 402
Sacramento, CA 95816

Phone (916) 444-9446
Fax (916) 444-9447