We at PRIDE know that you want the best for your patients. Please browse around this site to make sure we are the right choice for you, then contact us to make a referral.
Download the 
Referral Form and Fax to 214.351.6453.
PRIDE uses a multidisciplinary and interdisciplinary team approach to achieve Functional Restoration that is:
PRIDE patients come to us with a variety of payment methods including:
The referral team works with out-of-area patients, providing them with travel, hotel, logistical information and support to help make their visit to PRIDE as simple as possible.
Functional Restoration Program
Please do not include personal identifying information such as your birth date, or personal medical information in any emails you send to us. No one can diagnose your condition from email or other written communications, and communication via our website cannot replace the relationship you have with a physician or another healthcare practitioner.
Functional Restoration is designed for individuals with chronic pain who are limited from performing many activities of daily living (ADL) or work functions.
PRIDE’s program uses an interdisciplinary treatment approach, in which experts from a variety of clinical disciplines work together as a team. All treatment is overseen and directed by medical doctors. PRIDE’s staff of physicians includes board-certified specialists in orthopedics, physical medicine & rehabilitation, psychiatry, and pain management. PRIDE’s clinical treatment team includes nurses, nurse practitioners, psychologists, counselors, physical and occupational therapists, exercise technicians and case managers.
All clinicians and physicians are on-site and available to every patient.
Through a combination of physical treatments (stretching, strengthening, and real-life physical activities), skills training (in specific stress and pain management techniques) , education (both individually and class-room setting), personal support (including individual counseling, problem solving, and post-treatment planning), PRIDE’s functional restoration program helps patients overcome barriers to wellness, to regain daily functioning, and to resume a happier and more productive lifestyle.
All patients referred to the PRIDE functional restoration program undergo a thorough physical and psychosocial assessment by the interdisciplinary treatment team. Physical function is measured and quantified by licensed physical and occupational therapists, with tests of range-of-motion, strength and ability to perform activities of daily living (ADLs) like lifting, bending, reaching, climbing and squatting. Psychosocial functioning is quantified with a mental health assessment, by licensed mental health professionals, with the aid of validated patient-reported questionnaires.
Especially unique to PRIDE is the quantitative physical testing procedures which identify “weak links,” or specific areas of musculoskeletal immobility and weakness. Our state-of-the art Biodex assessment equipment is usually seen only at major sports medicine facilities, geared toward testing and training elite athletes. Biodex machines measure Isokinetic (which means measuring at a constant speed through a joint’s available motion) strength and lifting capacity of affected joints and body regions. This technology provides PRIDE with the safest and fastest way to identify, document, and treat physical impairments that are contributing to pain and functional limitations.
Using the testing results, and clinical input from the entire treatment team, individual goals are aligned with each patient, and an individualized treatment program is developed. Each patient and their treatment team then work together to meet treatment goals and achieve successful outcomes.
The testing and computer-assisted training sets realistic individualized training levels that are neither too high nor too low, helping each patient achieve the greatest possible physical progress. Goal achievement and overall outcomes are documented upon completion of treatment.
PRIDE patients also have an opportunity to participate in a Long-Term Care Plan (LTCP) with their managing physicians, to ensure continuity of care through quarterly visits, ongoing medication management, and opportunities for consultation with PRIDE clinicians to address pain flare-ups.
Our FCE uses validated and standardized measurements to compare an individual’s results (individualized by age, gender, height and weight) with a large normative database (what is considered normal for the majority of the population).
PRIDE’s FCE helps the physical and occupational therapists establish treatment goals and progress each patient safely and effectively through physical treatment to reach maximum physical performance.
Test results are provided to referring physicians, staff physicians, case managers, and participants.
PRIDE’s physical therapists (PTs) use the FCE results to create individualized exercise programs for each patient. A significant emphasis is placed on regaining flexibility through one-on-one therapist instruction and yoga-based stretch classes. Advanced exercise equipment is used for targeted muscle strengthening, with a specific focus on the injured or affected body parts.
PTs provide close supervision during all phases of treatment, to help patients reach their fitness and functional goals, and to ensure that their conditioning program is both safe and effective. They also provide educational instruction on specific pain control strategies for managing pain flare-ups.
PRIDE PTs help patients gradually improve:
Prior to the completion of the program, a thorough instruction in an individualized Home or Gym Fitness Maintenance Program is provided.
Occupational Therapy (OT) at PRIDE focuses on whole-body physical conditioning, with simulated functional tasks, designed to prepare patients with physical disabilities to successfully return to important activities of daily living, including work duties.
Using FCE results, OTs create individualized and unique therapeutic activities, to help patients regain physical conditioning and function, and successfully return to the activities that are important to them. Progression of each patient’s conditioning program is closely monitored for safety and patient ability.
PRIDE’s OTs have many areas of expertise, including hand therapies, orthotics, assistive devices, and pain control modalities.
At PRIDE, we use a biopsychosocial approach to treatment, which views chronic pain and disability as a complex interaction among physical, psychological, and social factors. So, the most effective treatment of chronic pain includes both medical and psychological interventions. At PRIDE, we understand that chronic pain can disrupt many areas of your life. It can alter your personality, disrupt your sleep, impact your interpersonal relationships, and interfere with your ability to perform activities of daily living, including work duties. Many people with chronic pain develop negative emotions, including anxiety, anger, sadness, hopelessness, and depression.
Emotional distress directly influences pain by increasing muscle tension, increasing your brain’s perception of pain, and altering levels of neurotransmitters associated with pain. It may also have the indirect effect of causing you to limit or avoid activities, leading to physical deconditioning and loss of function, which may ultimately result in increased pain and disability. PRIDE counselors will help you get out of this cycle of emotional distress, tension, and pain and to better understand the relationship between emotions, behaviors, and physical symptoms. They will teach you effective cognitive and behavioral symptom management skills that will help you feel better, manage your pain better, and function better in your life.
The mental health professionals at PRIDE have over 60 years of experience treating patients with chronic pain and disability.
Patients are welcome to call our offices during normal business hours and speak to our Intake Coordinator to discuss your case and learn how PRIDE can help you. To participate in this rehabilitation program we must get a referral from your provider. Once we receive a referral, we will call you to get scheduled as soon as possible.
Please feel free to call our intake coordinator at 214-389-6686
Thank you for choosing PRIDE (Productive Rehabilitation in Dallas for Ergonomics) for your physical rehabilitation needs. We look forward to meeting you SOON.
Your day starts with a total body stretch class, where an exercise technician will guide you through a relaxing sequence of stretches to prepare you for your day ahead. You can stretch to your comfort and ability level. Be sure to wear appropriate clothing and shoes that will allow you to stretch and exercise comfortably.
Your morning includes personalized workouts with your Physical Therapist (PT), Occupational Therapist (OT), and Exercise Technicians in both the PT and OT gyms.
At mid day, lunch will be provided during an educational class taught by our staff, followed by a Bodyworks class that focuses on keeping you active in fun and challenging ways.
You will participate in an early afternoon educational or exercise training class.
Finally, you will wrap up your day in the PT and OT gyms.
You will have the opportunity throughout your day to meet with your Psychology, Biofeedback, and Rehabilitation Counselors as needed.
As your program nears completion, we will work with you on a post-program fitness maintenance plan.
As a service to our patients, we handle all pre-authorization requirements for workers’ compensation cases, and we will contact managed care insurance providers to determine best coverage. However, we recommend that patients always check with their insurance provider to determine their coverage and benefits.
In most cases, health insurance will cover treatment. Scroll down for a summary of insurances we accept and make sure you talk to our Referral Coordinator if you need help clarifying your insurance coverage.
…if you have any questions, our staff is here to help
PRIDE will process the invoices to the appropriate payor (workers comp, insurance company or other based on set procedure codes). The payer will process the information and make payments based upon agreed fee amounts and schedules. An Explanation of Benefits (EOB) is generated and sent to the patient and to PRIDE.
If you have any questions at any time, our staff is here to help make the billing and insurance process as “pain free” as possible.
If your insurance company is not listed please call us to find out whether you are eligible for coverage. We are happy to assist!
Workers’ Compensation
Coventry
Texas Mutual
Corvel
CareWorks
IMO
Department of Labor
Group Health
We are contracted with most major Group Health Plans. Please call our Referral Coordinator for verification of benefits
is to empower and assist patients to return to work, improve their quality of life, decrease dependence on medication and health providers, and avoid recurrent injuries by increasing physical capacity to the highest level possible through Functional Restoration.
PRIDE (Productive Rehabilitation Institute of Dallas for Ergonomics) was established in 1983 as an alternative to the typical chronic pain management programs available at that time. While these programs were effective in helping patients cope with chronic pain, they did not provide measurable improvement in function, medication management or help with returning patients to productivity. The PRIDE program was established to provide a sports medicine method for treating people with chronic musculoskeletal pain.
…helping injured workers getting back to life and work!
PRIDE’s novel approach to chronic pain, known as Functional Restoration, is a medically directed, interdisciplinary treatment, that emphasizes measurement, mobilization, and re-activation and supported by education, counseling and stress management. It was the first comprehensive Functional Restoration program in the world and has received many awards throughout its years of service (See Awards and Accreditation)
PRIDE’s in-house staff of physicians includes board-certified specialists in orthopedics, physical medicine, rehabilitation, psychiatry, and pain management. PRIDE’s clinical treatment team includes nurses, nurse practitioners, psychologists, counselors, physical and occupational therapists, exercise techs and case managers. Since 1983, PRIDE has been helping injured workers getting back to life and work!
Physicians • Nurse Practitioners • Occupational Therapists • Physical Therapists • Exercise Technicians • Rehabilitation Counselors• Nursing Staff • Biofeedback
Every member of the PRIDE team is committed to providing the best quality of care to help ensure positive outcomes for all patients. The PRIDE team produces success stories every day. Click here to view some recent success stories.
Tom Mayer, M.D. is Board certified in Orthopedic Surgery and is currently a Clinical Professor in the Department of Orthopedic Surgery at The University of Texas Southwestern Medical Center. Dr. Mayer is known in the medical community for his extensive research on chronic musculoskeletal conditions and rehabilitation. He is the former President of the North American Spine Society (1999) and the founding editor of The Spine Journal. He has co-authored many books and scientific articles and is on the Editorial Review Board of multiple journals. His innovations include the concept of Functional Restoration, new techniques in measurement of physical and psychological function (especially for spinal disorders), and the development of techniques for evaluation of permanent impairment. He continues to develop and serve on Review Boards for evidence based treatment guidelines, particularly on coordination of services for sub-acute and chronic musculoskeletal disorders.
As licensed independent practitioners, nurse practitioners practice autonomously and in collaboration with other health care professionals to assess, diagnose, treat and manage the patient’s health problems/needs. As partners in health with patients, Nurse Practitioners take on roles of health provider, mentor, educator, clinical researcher, and administrator.
Margareta Shea, RN, FNPMaile Shea received her Masters of Science in Nursing from Georgetown University and graduated Summa Cum Laude. She is Board certified as a family nurse practitioner with prescription authority in Texas. Before coming to PRIDE in 2003, Maile worked in multiple areas of expertise including orthopedics, oncology, pediatric hematology, bone marrow transplant, family practice and urgent care. She is pleased to work in a multi-disciplinary setting at PRIDE and have the opportunity to partner in care with patients in all phases of rehabilitation and pain management. Away from the office, she enjoys yoga, reading and outdoor fitness.
Janice Imming-Rogers, MS, RN, CS
The RC department provides case management, vocational assistance, and mental health counseling. Case managers help patients overcome barriers to successful treatment, plan for the future, and communicate with insurance carriers, rehabilitation nurses, employers, attorneys, and vocational rehab counselors, to resolve case issues and maximize successful treatment outcomes. Mental health professionals, who specialize in the treatment of chronic pain, are available to provide support, teach effective coping strategies for managing pain and emotional stress, and educate patients about the relationship between their thoughts, mood, behaviors, and pain experience. Specific techniques to help patients cope with chronic pain include supportive counseling, individual and class room education, and skill building in areas such as relaxation, stress management, problem solving, goal setting, sleep strategies, and assertiveness.
Information provided to PRIDE through voluntary online membership applications, meeting or seminar registrations, publication orders or subscriptions may include name, affiliations, business phone or e-mail addresses. This information is for internal use only to provide a requested product or service to the user.
PRIDE uses cookies to remember user preferences, deliver faster service and personalize the site to the degree chosen by users. A cookie is a small piece of information sent by a Web server to store on a Web browser so it can later be read back from that browser. Cookies cannot be used to get data from your hard drive, get your e-mail address or steal sensitive information. You have the option of setting your browser to reject cookies. However, doing this will alter performance of this site.
| Lumbar | 55% | Hip/Knee | 18% |
|---|---|---|---|
| Cervical/Thoracic | 27% | Ankle/Foot | 7% |
| Shoulder/Elbow | 24% | Other | 19% |
| Wrist/Hand | 11% | *Many of our patients are treated for multiple areas of injury | |
| <30 | 7% |
|---|---|
| 30-45 | 32% |
| 46-60 | 50% |
| >60 | 11% |
| Male | 60% |
|---|---|
| Female | 40% |
Relation to Mission Statement and Core Values: This policy will promote the values outlined in the mission statement by promoting basic human rights, dignity, health and safety for all persons served without regard to race, color, creed, religion, national origin, age, sex or disability.
Relation to Business Operations: This policy will promote the ongoing daily business operations by enhancing the adherence to regulatory laws, financial stability, marketing efforts, and research and hiring practices.
PRIDE Department Heads are active ethical committee members.
Pursuit of the PRIDE mission of patient care, research, and publication requires a shared commitment to the core values of PRIDE as well as a commitment to the ethical conduct of all activities. In that spirit, the Standards of Ethical Conduct are a statement of our belief in ethical, legal and professional behavior in all of our dealings with PRIDE.
The Standards of Ethical Conduct apply to all members of the PRIDE community, including all personnel, staff, students, volunteers, contractors, agents and others associated with PRIDE.
Members of the PRIDE community are expected to conduct themselves ethically, honestly and with integrity in all dealings. This means principles of fairness, good faith and respect consistent with laws, regulations and PRIDE policies govern our conduct with others both inside and outside the community. Each situation needs to be examined in accordance with the Standards of Ethical Conduct. No unlawful practice or a practice at odds with these standards can be justified on the basis of customary practice, expediency, or achieving a “higher” purpose.
Members of the PRIDE community are expected to exercise responsibility appropriate to their position and delegated authorities. They are responsible to each other, the PRIDE and the PRIDE’s stakeholders both for their actions and their decisions not to act. Each individual is expected to conduct the business of the PRIDE in accordance with the Core Values and the Standards of Ethical Conduct, exercising sound judgment and serving the best interests of the institution and the community.
PRIDE is committed to the principle of treating each community member with respect and dignity. PRIDE prohibits discrimination and harassment and provides equal opportunities for all community members and applicants regardless of race, color, national origin, religion, sex, gender identity, pregnancy, physical or mental disability, medical condition (cancer-related or genetic characteristics), ancestry, marital status, age, sexual orientation, citizenship, or status as a covered veteran. PRIDE is committed to creating a safe and drug free workplace. Following is a list of the principal policies and reference materials available in support of this standard:
PRIDE’s is committed to the ethical and compassionate treatment of patients and have established policies and statements of patient rights in support of this principle.
Health care facilities are subject to many of the same laws and regulations as other enterprises, as well as those particular to health entities. There are also additional requirements unique to health education. Members of the PRIDE community are expected to become familiar with the laws and regulations bearing on their areas of responsibility. Many but not all legal requirements are embodied in PRIDE policies. Failure to comply can have serious adverse consequences both for individuals and for PRIDE, in terms of reputation, finances and the health and safety of the community. PRIDE business is to be conducted in conformance with legal requirements, including contractual commitments undertaken by individuals authorized to bind the company to such commitments.
The laws of Texas govern the interpretation of legal requirements.
PRIDE policies and procedures are designed to inform our everyday responsibilities, to set minimum standards and to give PRIDE community members notice of expectations. Members of the PRIDE community are expected to transact all PRIDE business in conformance with policies and procedures and accordingly have an obligation to become familiar with those that bear on their areas of responsibility. Each member is expected to seek clarification on a policy or other PRIDE directive he or she finds to be unclear, outdated or at odds with PRIDE objectives. It is not acceptable to ignore or disobey policies if one is not in agreement with them, or to avoid compliance by deliberately seeking loopholes.
In some cases, PRIDE employees are also governed by ethical codes or standards of their professions or disciplines – some examples are physicians, physical therapists, occupational therapists, psychologists, nurses, rehabilitation counselors and counseling staff. It is expected that those employees will comply with applicable professional standards in addition to laws and regulations.
Employee members of the PRIDE community are expected to devote primary professional allegiance to PRIDE and to the mission of patient care, research and public service. Outside employment must not interfere with PRIDE duties. Outside professional activities, personal financial interests, or acceptance of benefits from third parties can create actual or perceived conflicts between the PRIDE’s mission and an individual’s private interests. Gifts, money and/or gratuities are considered benefits and will not be accepted. PRIDE community members who have certain professional or financial interests are expected to disclose them in compliance with applicable conflict of interest/conflict of commitment policies. In all matters, community members are expected to take appropriate steps, including consultation if issues are unclear, to avoid both conflicts of interest and the appearance of such conflicts.
All members of the PRIDE community engaged in research are expected to conduct their research with integrity and intellectual honesty at all times and with appropriate regard for human subjects. To protect the rights of human subjects, all research involving human subjects is to be reviewed by research review boards. PRIDE prohibits research misconduct. Members of the PRIDE community engaged in research are not to: fabricate data or results; change or knowingly omit data or results to misrepresent results in the research record; or intentionally misappropriate the ideas, writings, research, or findings of others. All those engaged in research are expected to pursue the advancement of knowledge while meeting the highest standards of honesty, accuracy, and objectivity. They are also expected to demonstrate accountability for sponsors’ funds and to comply with specific terms and conditions of contracts and grants.
PRIDE is the custodian of many types of information, including that which is confidential, proprietary and private. Individuals who have access to such information are expected to be familiar and to comply with applicable laws, PRIDE policies, directives and agreements pertaining to access, use, protection and disclosure of such information. Computer security and privacy are also subject to law and PRIDE policy.
Information on the PRIDE’s principles of privacy or on specific privacy laws may be obtained from the respective HIPPA information and PRIDE Administrative and Procedure Manual.
The public right to information access and the individual’s right to privacy are both governed by state and federal law, as well as by PRIDE policies and procedures. The legal provisions and the policies are based upon the principle that access to information concerning the conduct of the people’s business is a fundamental and necessary right of every person, as is the right of individuals to privacy.
Internal controls are the processes employed to help ensure that the PRIDE’s business is carried out in accordance with these Standards, PRIDE policies and procedures, applicable laws and regulations and sound business practices. They help to promote efficient operations, accurate financial reporting, protection of assets and responsible fiscal management. All members of the PRIDE community are responsible for internal controls. Each business unit or department head is specifically responsible for ensuring that internal controls are established, properly documented, and maintained for activities within their jurisdiction. Any individual entrusted with funds is responsible for ensuring that adequate internal controls exist over the use and accountability of such funds.
PRIDE resources may only be used for activities on behalf of the PRIDE. They may not be used for private gain or personal purposes except in limited circumstances permitted by existing policy where incidental personal use does not conflict with and is reasonable in relation to PRIDE duties (e.g. telephones). Members of the PRIDE community are expected to treat PRIDE property with care and to adhere to laws, policies and procedures for the acquisition, use, maintenance, record keeping and disposal of PRIDE property. For purposes of applying this policy, PRIDE resources is defined to include but not be limited to the following, whether owned by or under the management of the company. Cash, and other assets whether tangible or intangible; real or personal property;
All PRIDE accounting and financial records, tax reports, expense reports, time sheets and effort reports, and other documents including those submitted to government agencies must be accurate,
PRIDE FUNCTIONAL RESTORATION & PAIN MANAGEMENT
clear and complete. All financial reports will make full, fair, accurate, timely and understandable disclosures as required under generally accepted accounting principles.
All PRIDE staff are to use honesty and integrity at all times when discussing PRIDE personnel, products, servicing and pricing. All personnel will maintain the highest professional standards by influencing business decisions based purely on the quality of services provided. Any promotional products used will be of minimal value and will have the approval of the Board of Directors of PRIDE. At no time is any cash rebate acceptable for any service provided. PRIDE is governed by HB34.
Members of the PRIDE community are strongly encouraged to report all known or suspected improper activities under the provisions of the Policy on Reporting and Investigating Allegations of Suspected Improper Governmental Activities (Whistleblower Policy). Managers and persons in supervisory roles are required to report allegations presented to them and to report suspected abuses that come to their attention in the ordinary course of performing their supervisory duties. Reporting parties, including managers and supervisors, will be protected from retaliation for making such a report, under the Policy for Protection of Whistleblowers from Retaliation and Guidelines for Reviewing Retaliation Complaints. See the Staff Grievance Procedure outlined in the Employee Handbook.
Rev: January 2016
PRIDE IS GROWING!
We will be opening a new location in September 2022!
New location will be at
1101 S. Capital of Texas Hwy., Bldg J, Ste. 100, Austin, TX 78746
Call us today with any questions!
By following this link to the PRIDE Research Foundation web page, you can see a list of articles, search by topic, read article summaries on some of the key reports and request copies of articles.
PRIDE is a current recipient of CARF Accreditation for its Outpatient Rehabilitation Program (Adults). This accreditation has been consistently awarded to PRIDE since 1996. CARF is a private, non-profit organization working to advance quality rehabilitation services. CARF accreditation indicates a service provider’s commitment to “continually improving services, encouraging feedback and serving the community”
In 2008, PRIDE was one of six recipients of the Clinical Centers of Excellence in Pain Management Awards and the only one in Texas. The American Pain Society is a national chapter of the International Association for the Study of Pain (IASP). IASP is the largest multidisciplinary international association for pain with more than 6500 individual members from over 100 countries. This award recognizes the nation’s outstanding pain care centers.
PRIDE was awarded the NASS Research Grant on Functional Restoration outcomes in 1994. NASS is a non-profit medical society focused on improving spine treatments through research, education and promotion. Since 1989, NASS has distributed annual research grants and fellowships for basic and applied clinical science studies.
In 1985, shortly after PRIDE opened, it was awarded the Volvo Award in Clinical Sciences for their results, established in a research paper: “Objective Assessment of Spine Function Following Industrial Injury: A Prospective Study with Comparison Group and One-year Follow-Up.” The Volvo Award in Clinical Sciences in a special honor awarded by the International Society for the Study of the Lumbar Spine (ISSLS). ISSLS is a non-profit organization created in 1974 to bring together individuals who have contributed to research and clinical studies and have an interest in lumbar spine health.
PRIDE is a proud supporter of the 10 x 25 Initiative to help reduce spinal disability 10% by year 2025. Click to learn more.
“PRIDE helped me build my strength in my whole body. I needed this help desperately.”
-M. M.
PRIDE is conveniently located at the Northwest corner of Inwood and Maple minutes from Interstate 35, and the Dallas Tollway.
Take I-35 South; exit Inwood Rd.
Left on Inwood Rd.
Left on Maple Ave.
Take I-35 North; exit Inwood Rd.
Right on Inwood Rd.
Left on Maple Ave.
Take I-30 to I-35 North
Exit Inwood Rd.
Right on Inwood Rd.
Left on Maple Ave.
Take I-30 to I-35 North
Exit Inwood Rd.
Left on Inwood Rd.
Right on Maple Ave.
Self-report questionnaires are often used for initial patient assessment and for measuring treatment effects and responsiveness. Three unique clinical questionnaires, the Central Sensitization Inventory (CSI), the Fear-Avoidance Components Scale (FACS), and the Pain Disability Questionnaire (PDQ) have been developed and validated at PRIDE. All patients who enter the PRIDE functional restoration program complete a comprehensive self-report test battery, including these three measures, at admission, and all those who finish the program complete an identical battery at discharge.
Download Symptom Severity Calculator
Download CSI
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The Central Sensitization Inventory (CSI) was developed to assess the overlapping health-related symptom dimensions of CS/CSSs. Part A has 25 items scored from 0 to 4. Total scores range from 0-100. Part B (which is not scored) asks if one has previously been diagnosed with one or more specific disorders, including seven separate CSSs and three CSS-related disorders. The CSI has now been translated, and psychometrically validated, in a number of different languages.
The CSI was initially introduced in 2012. In its initial psychometric evaluation, the CSI was found to have a high degree of test-retest reliability and internal consistency (Pearson’s r = .82; Cronbach’s alpha= .88). Subsequent validation studies revealed that CSI scores were highly correlated with the presence of one or more CSSs in patients referred to a psychiatric chronic pain management clinic. Additional analyses determined that a cut-off score of 40 out of 100 on the CSI produced good sensitivity (81%) in correctly identifying a group of CSS patients, and acceptable specificity (75%) in correctly identifying a group of non-patient comparison subjects. More recently, severity levels have been proposed, in order to provide more useful information to clinicians and researchers in assessing a patient’s CS/CSS-related symptoms and documenting meaningful clinical changes in response to treatment. The following severity ranges have been recommended: Subclinical = 0 to 29; Mild = 30 to 39; Moderate = 40 to 49; Severe = 50 to 59; and Extreme = 60 to 100.
Supporting References:
User’s Manual:
Neblett R. (2018). The Central Sensitization Inventory: A User’s Manual. Journal of Applied Biobehavioral Research. 23(2):e12123. https://doi.org/10.1111/jabr.12123
Systematic Review:
Scerbo T, Colasurdo J, Dunn S, Unger J, Nijs J, Cook C. (2018). Measurement Properties of the Central Sensitization Inventory: A Systematic Review. Pain Practice. Apr;18(4):544-554.
Multi-Country Factor Analysis:
Cuesta-Vargas AI, Neblett R, Chiarotto A, Kregel J, Nijs J, van Wilgen CP, Pitance L, Knezevic A, Gatchel RJ, Mayer TG, Viti C, Roldan-Jiménez C, Testa M, Caumo W, Jeremic-Knezevic M, Luciano JV. (2018). Dimensionality and Reliability of the Central Sensitization Inventory (CSI) in a Pooled Multi-Country Sample. Journal of Pain. Mar;19(3):317-329.
English version (CSI-En):
Mexican/Central American Spanish CSI:
Developed at PRIDE (2012)
European Spanish (CSI-Sp):
Developed by Antonio I Cuesta-Vargas, PhD, and colleagues, Cátedra de Fisioterapia, Departamento de Fisioterapia, Universidad de Malaga, Andalucia Tech, Instituto Investigacion de Biomédica de Malaga (IBIMA) Grupo de Clinimetria (F-14). Av/ Arquitecto Peñalosa s/n (Teatinos Campus Expansion) 29009 Malaga (Spain)
Cuesta-Vargas AI, Roldan-Jimenez C, Neblett R, Gatchel RJ. (2016) Cross-cultural adaptation and validity of the Spanish central sensitization inventory. Springerplus, Oct;5(1):1837.
French (CSI-Fr):
Developed by Laurent Pitance, PhD, and colleagues, Clinical research institute (IREC), Université Catholique de Louvain, Oral and maxillo-facial Surgery Department and Cliniques Universitaires Saint-Luc, Brussels.
Pitance, L., Piraux, E., Lannoy, B., Meeus, M., Berquin, A., Eeckhout, C., … & Roussel, N. (2016). Cross cultural adaptation, reliability and validity of the French version of the central sensitization inventory. Manual Therapy, 25, e83-e84.
Dutch (CSI-D):
Developed by Professor Cornelis Paul van Wilgen, PT, PhD. Vrije Universiteit Brussel · Faculty of Physical Education and Physiotherapy; Jeroen Kregel, PhD Ghent University, Gent · Department of Rehabilitation Sciences and Physiotherapy; Professor Jo Nijs, PT, MT, PhD Vrije Universiteit Brussel, Brussels · Physiotherapy, Human Physiology & Anatomy (KIMA); and colleagues.
Kregel J, Vuijk PJ, Descheemaeker F, Keizer, D., van der Noord, R., Nijs, J., … & van Wilgen, P. (2016).The Dutch Central Sensitization Inventory (CSI): Factor Analysis, Discriminative Power and Test-Retest Reliability. Clin J Pain, Jul;32(7):624-30.
Gujarati (CSI-G):
Developed by Dr. Dibyendunarayan Bid, PT, and colleagues, The Sarvajanik College of Physiotherapy, Rampura, Surat.
Bid Dibyendunarayan D, Soni Neela C, Rathod Priyanshu V, Thangamani Ramalingam A. (2016). Content Validity and Test-Retest Reliability of the Gujarati Version of the Central Sensitization Inventory. NJIRM, 7(5):18-24.
Brazilian Portuguese (CSI-BP):
Developed by Wolnei Caumo M.D. PhD, and colleagues, Post-graduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil; Pain and Palliative Care Service at Hospital de Clínicas de Porto Alegre (HCPA), Laboratory of Pain and Neuromodulation at UFRGS,Porto Alegre, Brazil; and Surgery Department, School of Medicine, UFRGS, Porto Alegre, Brazil.
Caumo W, Ruehlman LS, Karoly P, et al. (2017). Cross-Cultural Adaptation and Validation of the Central Sensitization Inventory for a Brazilian Population and its relationship with the function of descending pain modulatory system and with the serum BDNF. J Pain Res, Sep;10:2109-2122.
Serbian (CSI-Serb):
Developed by Aleksandar Knezevic, MD, PhD, and colleagues, Faculty of Medicine, University of Novi Sad, Serbia and Medical Rehabilitation Clinic, Clinical Centre of Vojvodina, Novi Sad, Serbia.
Knezevic A, Neblett R, Jeremic-Knezevic M, et al. (2018). Cross cultural adaptation and psychometric validation of the Serbian version of the central sensitization inventory (CSI). Pain Practice: The Official Journal of World Institute of Pain, Apr;18(4):463-472.
Knezevic, A, Neblett, R, Colovic, P, et al. (2020). Convergent and discriminant validity of the Serbian version of the Central Sensitization Inventory. Pain Practice: The Official Journal of World Institute of Pain, Sep;20(7):724-736
Japanese (CSI-J):
Developed by Tomohiko Nishigami, PT, PhD, and colleagues, The Sansom Institute for Health Research, The University of South Australia, School of Health Sciences, City East Campus, Adelaide, SA.
Tanaka K, Nishigami T, Mibu A, Manfuku M, Yono S, Shinohara Y, Tanabe A, Ono R. (2017).Validation of the Japanese version of the Central Sensitization Inventory in patients with musculoskeletal disorders. PLoS One, Dec 7;12(12).
Italian (CSI-I):
Developed by Alessandro Chiarotto, MSc, and colleagues, Department of Epidemiology and Biostatistics, VU Medical Center, Amsterdam; The Netherlands and Department of Health Sciences, Faculty of Earth and Life Sciences, Vrije Universiteit, Amsterdam, The Netherlands; and Amsterdam Public Health, Amsterdam, The Netherlands.
Chiarotto A, Viti C, Sulli A, Cutolo M, Testa M, Piscitelli D. (2018). Cross-cultural adaptation and validity of the Italian version of the Central Sensitization Inventory. Musculoskeletal Science and Practice, 37, 20-28.
Polish (CSI-Pol):
Developed by Beata Tarnacka, MD, PhD, and colleagues, Department of Rehabilitation at the Medical University of Warsaw, Poland.
Turczyn, P, Kosińska, B, Janikowska-Hołoweńko, D, Malec-Milewska, M., Marszalec, N, Maleszka, P, & Tarnacka, B. (2019). Translation and cross-cultural adaptation of the Polish Central Sensitization Inventory. Reumatologia, 57(3), 129-34.
Greek (CSI-Gr):
Developed by Prof Eleni Kapreli PT, MSc, PhD, Paraskevi Bilika, PT, MSc student, Post-graduate Program in Advanced Physiotherapy, Clinical Exercise Physiology and Rehabilitation Laboratory, Physiotherapy Department, Technological Education Institute of Sterea Ellada, Lamia, Greece; Dr Georgios Georgoudis PT, MSc, PhD, Musculoskeletal & Chest Physiotherapy Laboratory, Physiotherapy Department, University of West Attika, Athens, Greece; Randy Neblett MA, LPC, BCB, PRIDE (Productive Rehabilitation Institute of Dallas for Ergonomics) Research Foundation, USA.
Bilika, P, Neblett, R, Georgoudis, G, Dimitriadis, Z, Fandridis, E, Strimpakos, N, & Kapreli, E. (2020). Cross‐cultural adaptation and psychometric properties of the Greek version of the Central Sensitization Inventory. Pain Practice: The Official Journal of World Institute of Pain, Feb;20(2):188-196. DOI: 10.1111/papr.12843
German (CSI-Ge):
Klute M, Laekeman M, Kuss K, Petzke F, Dieterich A, Leha A, Neblett R, Ehrhardt S, Ulma J, Schäfer A (2021). Cross-cultural adaptation and validation of the German Central Sensitization Inventory (CSI-GE). BMC Musculoskeletal Disorders Aug 18; 22(1):708. https://doi.org/10.1186/s12891-021-04481-5
Laekeman M, Ehrhardt S, Kuss K, Petzke F, Dieterich A, Neblett R, Schäfer A (2019) Expert and Patient perspectives on the cross-cultural translation and adaptation of the Central Sensitization Inventory into German. ePoster EFIC Congress Valencia, September. Morressier. https://doi.org/10.26226/MORRESSIER.5D4434D306F5C40FC448474D
Turkish (CSI-Turk):
Developed by Prof Dr Murat Birtane and colleagues, Trakya University Medical Faculty Physical Medicine and Rehabilitation Department, Edirne Turkey.
Düzce Keleş E, Birtane M, Ekuklu G, Kılınçer C, Çalıyurt O, & Taştekin N. (2022). Validity and reliability of the Turkish version of the central sensitization inventory. Arch Rheumatol 37(4):518-526. doi:10.46497/ArchRheumatol.2022.8665
Nepali (CSI-NP):
Developed by Saurab Sharma and colleagues Department of Physiotherapy, Kathmandu University School of Medical Sciences (KUSMS), Dhulikhel Hospital, Kavre, Nepal.
Sharma, S., Jha, J., Pathak, A., & Neblett, R. (2020). Translation, cross-cultural adaptation, and measurement properties of the Nepali version of the central sensitization inventory (CSI). BMC neurology, 20(1), 1-10.
Swedish (CSI-Swe):
Developed by Irina Midenfjord, MS & Magnus Simrén, MD PhD, and colleagues, Dept of Internal Medicine & Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Midenfjord, I., Grinsvall, C., Koj, P., Carnerup, I., Törnblom, H., & Simrén, M. (2021). Central sensitization and severity of gastrointestinal symptoms in irritable bowel syndrome, chronic pain syndromes, and inflammatory bowel disease. Neurogastroenterology & Motility, e14156. https://doi.org/10.1111/nmo.14156
Finnish (CSI-Fin):
Developed by Jani Mikkonen D.C.,DACNB, Ph.D. candidate of Institute of Clinical Medicine, University of Eastern Finland; Hannu Luomajoki, Ph.D., Professor of Physiotherapy, Department of Health, Zürich University of Applied Sciences, Winterthur, Switzerland; Olavi Airaksinen M.D., Ph.D., Professor of Physical and Rehabilitation Medicine (PRM), University of Eastern Finland; Ville Leinonen M.D., Ph.D., Professor of Neurosurgery, University of Eastern Finland.
Mikkonen J, Luomajoki H, Airaksinen O, Neblett R, Selander T, & Leinonen V. (2021). Cross-cultural adaptation and validation of the Finnish version of the central sensitization inventory and its relationship with dizziness and postural control. BMC Neurology, 21(1), 1-15. https://doi.org/10.1186/s12883-021-02151-6
Danish (CSI-Dan):
Developed by Professor Søren O’Neill, D.C., Ph.D, M. Rehab.; Henrik Hein Lauridsen, D.C., MSc., Ph.D.; Johanne Brinch Filtenborg, MSc.; Casper Glissmann Nim, MSc.; Liam Holm, BSc.; Spinecenter of Southern Denmark, Lillebaelt Hospital, Middelfart, Denmark; University of Southern Denmark, Odense, Denmark.
(Psychometric validation is currently in progress)
Korean (CSI-Kor):
Developed by Man Soo Kim, MD, PhD, and colleagues , Department of Orthopaedic Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea
Kim, M. S., Koh, I. J., Kim, C. K., Choi, K. Y., Kim, C. Y., & In, Y. (2020). Cross-cultural adaptation and validation of the Korean version of the Central Sensitization Inventory in patients undergoing total knee arthroplasty for knee osteoarthritis. Plos one, 15(12), e0242912.
Russian (CSI-R):
Developed by Oleg Esin, MD, PhD, and colleagues, Kazan (Volga region) Federal University, Russia, Tatarstan Republic, Kazan.
Esin OR, Gorobets EA, Khairullin IKh, Esin RG, Gamirova RG, Shamsutdinova RF, Fedorenko AI, Faskhutdinova AT, Khakimova AR. Central Sensitization Inventory — a Russian version. S.S. Korsakov Journal of Neurology and Psychiatry = Zhurnal Nevrologii i Psikhiatrii im. S.S. Korsakova. 2020;120(6):51–56. (In Russ.). https://doi.org/10.17116/jnevro202012006151
Persian (CSI-Per):
Developed by Karim Noorollahzadeh, Ph.D candidate of Physical therapy, Department of Physical therapy, Tarbiat Modares University, Tehran, Iran; Sedighe Kahrizi, Associated profosser of Physical therapy, Department of Physical therapy, Tarbiat Modares University, Tehran, Iran; and Mohammad Gholami-Fesharaki, Assistance Professor of Biostatistics, Department of Biostatistics, Faculty of Medicine, Tarbiat Modares University, Tehran, Iran.
Noorollahzadeh K, Kahrizi S, Fesharaki MG, Majid Heidarian M, Neblett R, Behzadipour S (2020). Cross-cultural adaptation and psychometric validation of the Persian version of the central sensitization inventory. MSK Science and Practice, 51, 102314. DOI: 10.1016/j.msksp.2020.102314
Arabic (CSI-Ar):
Developed by Mohammad A. Madi, PT. PhD and colleagues, Department of Physical therapy and Occupational Therapy, The Hashemite University, Zarqa, Jordan
Madi, M., Hamzeh, H., Abujaber, S., & Altubasi, I. (2021). Cross cultural adaptation, validity, and reliability of Central Sensitization Inventory in Arabic language. Disability and Rehabilitation, 1-9. https://doi.org/10.1080/09638288.2021.2006322
Hungarian (CSI-Hun):
Developed by Szilvia Ambrus, DMD, and colleagues, Semmelweis University, Hungary and University Hospitals Leuven, Belgium.
(Psychometric validation is currently in progress)
Thai (CSI-Thai)
Developed by Taweewat Wiangkham, PhD, MRes AHR, BS PT (hons), Cert. ICH GCP and colleagues, Department of Physical Therapy, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok, 65000, Thailand.
(Psychometric evaluation is currently in progress)
Simplified Mandarin for China (CSI-China):
Developed by Bingqian Zhu, PhD, RN and colleagues, School of Nursing, Shanghai Jiao Tong University, Shanghai, China.
(Psychometric validation is currently in progress)
Traditional Mandarin for Taiwan and Hong Kong (CSI-Taiwan):
Developed by Poyu Chen and colleagues, Depart of Occupational Therapy, Chang Gung University, Gueishan District, Taoyuan, Taiwan.
(Psychometric validation is currently in progress)
Marathi (CSI-Mar):
Developed by Dr. Ashwini Kale, MPTh, Associate Professor, MGM’s Institute Of Physiotherapy Aurangabad, Maharashtra, INDIA
(Psychometric validation is currently in progress)
Kannada (CSI-Kan):
Developed by Nidhi S. and colleagues at Srinivas University, Mangalore, India
(Psychometric validation is currently in progress)
Czech (CSI-Czech):
Developed by Tomas Kavka and colleagues, Motol University Hospital and Second Medical Faculty at Charles University, Prague, Czech Republic
(Psychometric validation is currently in progress)
Tamil (CSI-Tamil):
Developed by A.Thangamani Ramalingam and colleagues, Sarvajanik college of physiotherapy, Rampura, chadda-ole, Surat, India
(Psychometric validation is currently in progress)
Indonesian (CSI-Ind):
Developed by Dr. Magdalena Surjaningsih Halim, Saraswati E., Ribka R., Reyhania A. & Rifdah A., Atma Jaya Catholic University of Indonesia, Jakarta
(Psychometric validation is currently in progress)
Ukrainian (CSI-Ukr):
Developed by M. Stanislavchuk, Prof., D.M.S. and V. Bombela, MD., Chair of Internal Medicine #1, National Pirogov Memorial Medical University, Vinnytsya, Ukraine.
Stanislavchuk M, Bombela V, Shkarivskyy Y. Translation, Cross-Cultural Adaptation and Validation of the Central Sensitization Inventory for Patients with Rheumatoid Arthritis. Lviv clinical bulletin 2022, 1(37)-2(38): 21-27.
Pain-related avoidance of activities, due to fear of increased pain or (re)injury, is a common problem for people with painful medical conditions. Fear-avoidance (FA) can lead to decreased functioning and to disability from activities of daily living. Though other self-report measures of FA are available, they have been criticized for not adequately evaluating all important components of FA. The Fear-Avoidance Components Scale (FACS), originally introduced in 2015, is a new measure of FA that attempts to improve on these earlier instruments by comprehensively evaluating important cognitive, behavioral, and affective components of FA in patients with painful medical conditions.
The FACS has 20 items, scored on a 6-point Likert scale, for a total score range of 0 to 100. Total scores indicate one of the following severity levels: Subclinical (0-20); Mild (21-40); Moderate (41-60); Severe (61-80); and Extreme (81-100). In its initial published validation study, the FACS demonstrated strong test-retest reliability (Pearson r between .9 and .94) and internal consistency (Cronbach’s alpha between .89 and .92). The FACS severity levels corresponded well with score distributions from different subject populations with painful medical conditions. Subjects with the highest level of functioning, and presumably the lowest disability and FA, scored in the lower FACS severity levels. Subjects with the lowest levels of functioning, and presumably the highest disability and FA, scored in the higher FACS severity levels. In addition, strong associations were found among FACS scores and other FA-related psychosocial patient-reported outcome variables and objective lifting performance variables in a chronic musculoskeletal pain disorder population admitted to an interdisciplinary functional restoration program.
Supporting References:
English version (FACS-En):
Neblett R, Mayer TG, Hartzell MM, Williams MJ, Gatchel RJ. The fear-avoidance components scale (FACS): Development and psychometric evaluation of a new measure of pain-related fear avoidance. Pain Practice: The Official Journal Of World Institute Of Pain. 2016 Apr; 16 (4):435-50.
Neblett R, Mayer TG, Williams M, Asih S, Cuesta-Vargas AI, Hartzell MM, Gatchel RJ. (2017). The fear-avoidance components scale (FACS): Responsiveness and functional restoration treatment outcomes in a chronic musculoskeletal pain disorder (CMPD) population. Clinical Journal of Pain. Dec;33(12):1088–1099.
European Spanish (FACS-Sp):
Developed by Antonio I Cuesta-Vargas, PhD, and colleagues, Cátedra de Fisioterapia, Departamento de Fisioterapia, Universidad de Malaga, Andalucia Tech, Instituto Investigacion de Biomédica de Malaga (IBIMA) Grupo de Clinimetria (F-14). Av/ Arquitecto Peñalosa s/n (Teatinos Campus Expansion) 29009 Malaga (Spain)
Cuesta-Vargas, AI, Roldan-Jimenez C, Neblett R, Gatchel RJ. (2020). Cross-cultural adaptation and validity of the Spanish Fear Avoidance Components Scale and clinical implications in primary care. BMC Family Practice, 21(44), 1-9. https://doi.org/10.1186/s12875-020-01116-x
Serbian (FACS-Serb):
Developed by Aleksandar Knezevic, MD, PhD, and colleagues, Faculty of Medicine, University of Novi Sad, Serbia and Medical Rehabilitation Clinic, Clinical Centre of Vojvodina, Novi Sad, Serbia.
Knezevic A, Neblett R, Gatchel RJ, Jeremic-Knezevic M, Bugarski-Ignjatovic V, Tomasevic-Todorovic S, Boskovic K, Cuesta-Vargas A (2018). Psychometric validation of the Serbian version of the Fear Avoidance Component Scale (FACS). PLOS ONE 13(9): e0204311. https://doi.org/10.1371/journal.pone.0204311
Dutch (FACS-Du):
Developed by Liesbet De Baets and colleagues, REVAL Rehabilitation Research, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium.
De Baets L, Matheve T, Mingels S, Bruijnes A, Van Goethem A, Huybrechts X, Neblett R, Timmermansa A, Janssens L. (2020). The Development and Measurement Properties of the Dutch Version of the Fear-Avoidance Component Scale in Persons with Low Back and Shoulder Pain. Submitted for publication.
Gujarati (FACS-G):
Developed by Dr. Dibyendunarayan Bid, PT, and colleagues, The Sarvajanik College of Physiotherapy, Rampura, Surat
Bid Dibyendunarayan D, Neblett R, Thangamani Ramalingam A, Patel Charmy J, Patel Karishma N, Patel Rinkal L, Narola Shama J, Sailor Vyoma V. (2020). Cross-Cultural Adaptation, Reliability, and Validity of the Gujarati Fear-Avoidance Components Scale. Physiotherapy – The Journal of Indian Association of Physiotherapists, 14(2) 98.
Brazilian Portuguese (FACS-BP):
Developed by Adriano Pezolato, PT, MSc, PHD student, and colleagues – Postgraduate Program in Rehabilitation and Functional Performance – Faculty of Medicine – University of Sao Paulo – at Lab Move Pain – Laboratory of Research on Movement and Pain – Ribeirao Preto
(Psychometric evaluation is currently in progress)
Persian (FACS-Per):
Developed by Afshin Aghazadeh, Sohani, Soheil Mansour and Mohamad Parnianpour, Iran University of Medical Sciences, Tehran, Iran
(Psychometric evaluation is currently in progress)
Turkish (FACS-Turk):
Kadir Turan PhD student, Zübeyir Sarı, PT, PhD, and colleagues, Marmara University, Department of Physical Therapy and Rehabilitation, Istanbul, Turkey
(Psychometric evaluation is currently in progress)
French (FACS-Fr):
Developed by Manuel Trinidad-Fernández, PT, MSc, PHD student, and colleagues – RERE Rehabilitation Research group, Faculty of Physical Education and Physiotherapy, University of Brussels (VUB), Brussels, Belgium.
(Psychometric evaluation is currently in progress)
Simplified Mandarin for China (FACS-China):
Developed by Zhongyi Tu (Mars) PT, MSc. Yanzhao Zhang, OT, MSc.; Xiaoxuan Xia, PT, MSc.; and Zhaohui Yang, MD. Department of Rehabilitation, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. Mars – Rehabilitation department, Wuhan Union hospital
(Psychometric evaluation is currently in progress)
The PDQ is a self-report questionnaire designed to measure functional disability in patients with pain disorders involving the neuromuscluloskeletal system. The PDQ has demonstrated excellent psychometric properties, including test-retest reliability coefficients ranging from 0.94 to 0.98 and a Cronbach’s alpha coefficient of 0.96. In fact, the PDQ has been shown to have better psychometric properties than other similar self-report disability questionnaires that have been reported in the literature. In addition, higher PDQ scores, both before and after functional restoration treatment, have been shown to be predictive of poorer socioeconomic outcomes one-year after treatment discharge, including poorer rates of work return and retention.
The PDQ uses a visual analog scale, scored from 0 to 10, for each of the 15 items. Add the items to determine a Total Functional Disability score, which ranges from 0 to 150. Five functional disability severity levels have been recommended to aid clinical interpretation: Mild = 1 – 40; Moderate = 41 -70; Severe = 71 – 100; Very Severe = 101 – 130; and Extreme = 131 – 150. Two subscale scores can also be determined. The score total from items 1, 2, 3, 4, 5, 6, 7, 12, 13 indicate a Functional Status Component (FSC), and the score total from items 8, 9, 10, 11, 14, and 15 indicate a Psychosocial Component (PC).
Supporting References:
Knezevic A, Colovic P, Jeremic‐Knezevic M, Demesi-Drljan C, Simic-Panic D, and Neblett R. (2021) Assessing the Functional Status of Patients with Chronic Pain—Cross Cultural Adaptation and Psychometric Properties of the Serbian Version of the Pain Disability Questionnaire. International Journal of Environmental Research and Public Health, 18, 6911. https://doi.org/10.3390/ijerph18136911
Biofeedback is a training tool in which processes in your body, such as muscle tension, are measured and displayed to you on a computer screen. Biofeedback training can help you to become more aware of, and to have more control over these bodily processes. Relaxation training is a related technique that teaches you skills for entering a state of deep mental and physical relaxation, which is associated with healing and pain reduction. Biofeedback and relaxation training are provided by licensed mental health professionals who specialize in behavioral methods for controlling stress, tension, pain, anxiety, and other symptoms. Biofeedback and relaxation training are used in conjunction with stress management education and supportive counseling to teach you ‘self-regulation’ skills for controlling the physical and emotional symptoms that are involved in chronic pain. Following each training session, you will be asked to practice these techniques as homework. You will also be provided with educational handouts and online resources, including a variety of guided relaxation exercises to practice at home.
Almost all PRIDE patients who practice these techniques report success with stress reduction and pain control.
Biofeedback services are provided by licensed mental health professionals who specialize in behavioral methods for controlling stress, tension, pain, anxiety, and other symptoms. Biofeedback is a training tool in which processes in your body (such as muscle tension) are measured and displayed to you on a computer screen. Biofeedback training helps patients become more aware of, and have more control over, these bodily processes. Biofeedback is used in conjunction with guided relaxation training, paced breathing, stress management education, and supportive counseling. Two forms of biofeedback are used most often at PRIDE.
Heart rate variability (HRV) is a measure of heart rate (HR) patterns, which provide information about the function of the autonomic nervous system. The goal of HRV biofeedback training is to create a large wave pattern in the heart (increased HR during inhale and decreased HR during exhale) by maintaining a slow, steady breathing pace (typically around 6 breaths per minute). Use of this technique is associated with autonomic nervous system relaxation, improved general health parameters, and improved symptoms of specific disorders (including high blood pressure, asthma, irritable bowel syndrome, depression, anxiety, post-traumatic stress disorder, chronic pain, and others). PRIDE patients who learn and practice this skill typically report success with increased relaxation, reduce stress/anxiety/pain, and improved sleep.
Surface electromyography (SEMG) is a measure of muscle activity. It allows patients to learn increased awareness and control over specific muscles or muscle groups. SEMG is measured with surface electrodes, placed on the skin over the target muscle(s). This modality can be used to identify muscles that are too tense, and train them to relax, or to identify muscles that are inhibited during use, and train them to recruit more effectively. Specific assessment and training protocols have been developed at PRIDE for specific muscle groups and pain patterns. Many of these protocols have been published in peer-reviewed journals. See the following articles to learn more.
At PRIDE, we treat all chronic pain conditions that create limitations to daily functioning.
In addition, we offer psychological assessment, counseling, and Cognitive Behavioral Treatment (CBT) for chronic pain and injury-related stress and mental health problems, including:
People experiencing chronic pain frequently use medications to reduce discomfort. The use of medications in treating chronic pain can be a helpful tool if managed well. However, long-term use of certain medications, including opioids, does little to solve the problem, and over time, these medications can lose their effectiveness. Even worse, long-term use of opioids and related medications, can result in negative side effects, including chronic constipation, changes in mood, dependence, addiction, and sometimes increased pain (called opioid-induced hyperalgesia).
At PRIDE, our physicians develop individualized medication plans for each patient. PRIDE physicians and staff help patients reduce their dependence on medications through effective rehabilitation and pain management skills training. Patients who complete the treatment program will leave with the medications and pain management tools needed to continue managing their pain effectively, so they can participate in the family, social, and work activities that are important to them.
PRIDE physicians are experts in the most effective and safe medications for managing chronic pain.
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