Physical limitations are not required for chronic pain rehabilitation success

A high performance, active duty fitness requirement group rehabilitated equally to a low performance needs civilian group, both suffering from disabling chronic pain. The purpose of this prospective study was to determine whether higher physical performance requirements adversely affected outcome in a chronic pain rehabilitation program. Twenty-three active duty, chronic pain patients were treated along with 22 civilian chronic pain sufferers in a behavior modification, including positive, verbal reinforcement for performance, stress management and family counseling, physical reconditioning, including stretching, strengthening and aerobic conditioning in a slowly progressive fashion to required needs, and narcotic and muscle relaxant detoxification program at a major military medical center. Eighteen patients in each group, representing, respectively, 78 and 82% of the military and civilian participants, successfully completed the inpatient program. Success was defined by (1) elimination of all narcotics and minor tranquilizers, (2) elimination of all physical restrictions that precluded any desired work or play, which required much higher levels for the active duty patients that included: (3) elimination of all physical profile restrictions and (4) objectively passing annual aerobics field test requirements before the program's end. Review of military disability separation records, averaging 24 mo posttreatment, showed that no formerly successful active duty patients had later been discharged because of physical impairments. Of individuals responding to mail questionnaires at an average of 19 mo postprogram, 12 of 14 (86%) initially successful military patients reported continued unrestricted maintenance of physical abilities, whereas 10 of 14 (71%) of the initially successful civilians reported no restrictions in desired activities.(ABSTRACT TRUNCATED AT 250 WORDS)