Long-term pain can affect the entire life of an individual. Thus, the pain rehabilitation is based on a behavioral medicine perspective with Acceptance and Commitment Therapy as a way to achieve behavioral change. The Pain Rehabilitation Team in Sandviken is part of Region Gävleborg (Gävleborg County Council).
Region Gävleborg's Pain Rehabilitation Team is also part of the Medical Rehabilitation Clinic, located at the local hospital in Sandviken. The team consists of a occupational therapist, a PE teacher, an almoner, a psychologist, a physician, a physiotherapist, a rehabilitation coordinator and a nurse. The aim of the rehabilitation is to improve the patients' life quality and facilitate engagement in family life, work and society.
An individual rehabilitation plan is developed together with the patient and, sometimes, his or her closest relatives. The patient and their closest relatives are important parts of the rehabilitation team.
Information about the program
You need a referral or an individual request of care to be admitted for rehabilitation. The service is financed by Region Gävleborg (Gävle County Council) but you are charged the regular patient fee upon each visit. The Cost Control Policy (Högkostnadsskydd) is applicable.
Before the first contact, a questionnaire will be sent to you, which you then fill out and return to the clinic.
The first contact is usually a doctor visit. The purpose of the visit is to investigate your medical and psychosocial situation, resources and barriers and motivation for rehabilitation, including work.
If you are considered to have use of attending the Pain Rehabilitation Program you will return for an assessment day to a psychologist and a physiotherapist and often to the doctor again. The team conducts an interdisciplinary assessment and maps your resources and limitations in relation to the demands at home and at work. The team members, who have met you at the assessment day, make the decision if you are going to have pain rehabilitation by the team in Sandviken or not. If you are going to have pain rehabilitation, a rehabilitation plan is made and a coordinator is appointed to you. If you, after the assessment, are discharged an answer to the referring doctor is made.
An individual rehabilitation plan is developed together with you and, sometimes, with your closest relatives.
The occupational therapist and the almoner will often meet and assess you before the pain rehabilitation starts. You may also get an individual training program or/and relaxation program to prepare yourself before entering the program. These are examples of preparation activities between assessment and the Pain Rehabilitation Program (PRP). Other thing that may be part of the preparation is registration of your physical activity, work planning and perhaps additional testing or treatment efforts.
The aim of the PRP is to improve the quality of life and increase your acceptance of pain through behavioral changes as well as facilitating engagement in family life, work and society. The main goal for most patients is starting or returning to work/studies or maintaining/expanding working hours.
The pain rehabilitation lasts for 8-12 months from assessment to follow up. The PRP lasts for six weeks, three-four days a week. One of the six weeks is located at home with different homework. Each program has 6-8 patients. If you live far away you can stay at the patient hotel in Sandviken during the PRP.
The PRP includes both theoretical and practical training. No passive treatments such as injections, massage or acupuncture are given during the rehabilitation. The team uses a behavioral treatment model with a holistic biopsychosocial perspective. This treatment model has medical, psychosocial and vocational components. The team makes an individual pain analysis and also determines the consequences of pain for you. You may also have the opportunity to express your core values in life, which form the goals in your individual rehabilitation plan.
At the end of the program you will set new goals to the follow-up.
Four weeks after the PRP one of the contact persons has a follow-up by having a telephone meeting with you. You will also return for 1-2 days of follow-up, approximately 3-4 months after finishing the PRP. The follow-up includes individual meetings, lectures and evaluation of your individual goals.
Twelve month after the program you may fill in a new questionnaire.
If you have individual specific needs you might have an individual rehabilitation. The length and the contents of the rehabilitation can vary. Some group activities can be included.
The Pain Rehabilitation Program (PRP) turns to adults suffering from long-term (i.e. pain experienced for >3 months) non-malignant pain in muscles and joints that has a negative effect on life quality. The pain is usually located in the neck, head, shoulders, back and pelvis. It is also common to have wide spread pain. You might be on sick leave or working, studying or being unemployed.
You may have difficulties managing daily life and/or difficulties in taking part in recreation and society. It is important that you have a positive attitude towards returning to work and have an open mind to behavioral changes.
You may have already received several forms of health care services but without any significant or long lasting effect. Thus, you should be in need of a whole interdisciplinary multimodal team or at least two professionals except a physician.
To participate in our program, you must be able to manage your personal hygiene and daily life and participate in agreed activities during the pain rehabilitation.
You are not allowed to participate in the program if you have an ongoing alcohol or drug abuse. If you have acute physical, cognitive or psychiatric problems, that might affect active participation in the program, you are also excluded.
The Pain Rehabilitation team in Sandviken is part of the National Quality Registry for Pain Rehabilitation (NRS).
306 patients were referred to the Pain Rehabilitation team in 2017. 135 of the referrals were accepted and met a doctor at the Clinic of Rehabilitation Medicine for a first visit. Of these 135 patients, 80 patients continued to the Pain Rehabilitation team for further screening and examination. 33 patients took part in the Pain Rehabilitation program for sex weeks. 80 % were women, the average age was 41 years and they had suffered from pain-related issues approximately for 5 years before entering the program.
In recent years, The Pain Rehabilitation team has had unusually few patients born outside of Europe, both on new visits and in programs, compared with the pain-loss team in the rest of Sweden. In 2017, the number of patients born outside of Europe has risen sharply, and is now approaching the average in Sweden.
In 2017, 50 % of the patients were unable to work at the time of the first visit. After the five week program, 90 % felt well treated by the Pain Rehabilitation team and that the program had been useful for them.
At the end of the Pain Rehabilitation program, the patients estimated that the goals they had set for themselves at the beginning were fulfilled in 80 % of the cases. The most common goal areas were related to physical functioning, daily activities and employment/occupation.
Relatives to about more than half of the patients also participated in the rehabilitation at some point. All patients were discharged from the hospital after completing their rehabilitation.