“I couldn’t get up for 10 minutes,” Maria remembers. She was at the end of her 12-hour shift. May be muscle sprain, she first thought. Just 4 days later, this sprain had turned into debilitating back pain.
Maria is a nurse working in a pediatric intensive care unit. It is true that nurses do some serious heavy lifting, literally in the hospital setting, where they must deal with intense mental and physical demands over grueling 12-hour shifts. Back pain is a common occurrence, over 50% of nurses report chronic back pain. Not many people know that nurses are three times more likely to suffer a back pain than a construction worker, truck driver or a manual laborer.
Diagnosed with degenerative disc, Maria began regular physical therapy treatments that allowed her to function for some time, though she remained in constant discomfort. Unlike her own intensive schedule, her therapist’s clinic hours were 9 am to 5 pm and it was really cumbersome for her to take out two hours during workday. Also, she had not yet met her deductible and was paying for care all by herself. Eventually, she stopped going to the physical therapist.
This was the first time Maria had experienced any back pain in her life. Little did she know that she would be plagued with back pain for the next three years.
“Driving in a car became very painful, I wasn’t sleeping very well at night, and trying to get any work done was really difficult. I was in so much pain and my painkillers just weren’t strong enough. I got very depressed, helpless and hopeless,”, Maria recalled tearfully.
Unlike acute pain, where the predominant emotion is anxiety, for people with chronic pain, it is depression. Chronic pain not only causes loss of function, it also cause a loss of oneself. Pain medicine and opioids don’t take away the pain. They just mitigate it, with a number of side effects and problems. Some people choose to go through increasingly invasive procedures to control pain, such as steroid injections. Some others resort to surgery, such as spinal decompression or disc replacement for intractable back pain. Unfortunately these invasive procedures and surgeries are unnecessary and inappropriate in most cases and don’t fix the problem. Over 50% of patients are back in the system within 12 months of treatment.
Maria did not want to go down the surgical path and she started researching about other non-invasive options, and came to know about multidisciplinary pain clinic. There were only two in her town, the nearest was about 25 miles from her home. She did her math and quickly realized that she could not afford an expensive multidisciplinary pain clinic coupled with taking 4 to 6 weeks out of their life and family.
Maria is not alone. According to CDC, 50 million Americans – just over 20 percent of the adult population – have chronic pain. About 20 million of them have “high-impact chronic pain” — pain severe enough that it frequently limits life or work activities. Most of them do not have access to high-quality multidisciplinary pain options, nor do they have enormous funds to pay for the whole care.
A digital therapeutics program for chronic back pain was introduced by her employer after 2 years of Maria’s first onset of pain. Since it was a virtual program, she could follow it at your her own time. She spoke to the coach right after signing up, who let her know that when it comes to pain management, she has to take charge and become an active part of her own care and unlike traditional models, this program’s emphasis is on self-management.
“I finally figured out that this is my pain,'” Maria said “‘and I’m going to have to own it if I want to get better.'”
Maria and her coach worked together on the goals first. Getting pain under control was first objective. Next on the list was improved function and quality of life, so she can get back to things she likes.
Maria particularly liked the composition of the digital pain management program. It was structured, yet flexible to meet her needs. Like most people with chronic pain, she had developed a fear for exercise. Her coach identified a modest exercise program that she could do safely. The exercises were given to her on a bi-weekly basis. Unlike the stick figures that she received during her in-person physical therapy, these exercise were prescribed right in the app. She could do it anytime of the day. She was able to provide her feedback after each exercise and knew that her therapist is going to review it.
The program connected her to the behavioral coach as well. The behavioral coach informed her that she has to learn to relax and taught her about deep breathing, visualization, and other relaxation techniques to help her better manage the pain she was living with. In addition, she was given byte-size education materials to view. The structured and timely education delivered via short videos was easy to go through, informative and in turn helped her in reducing fear, anxiety and pain related distress.
Now in her third month of the program, she feels like she is in control of her pain and health. She has chosen to focus on her abilities—not her disabilities. She believes that she can live a normal life in spite of chronic pain. It has been an extraordinary journey for her. What seemed impossible just a few months ago appears within reach.
Sprite Health’s corporate musculoskeletal program provides a single point of access for all MSK conditions, across the entire MSK continuum. Our virtual physical therapy services provide a more affordable and convenient way to prevent and treat pain. Chronic pain management provides an evidence-based, PT-led digital program for chronic joint and back pain that includes personalized exercise therapy, behavioral health support, education & guidance.