We have developed a comprehensive, interdisciplinary approach to treating pain. A large part of our treatment plan is the Functional Restoration Program (FRP). The FRP is an intensive group process of education, psychology, and physical reconditioning through exercise and functional activities. Through this approach, all the pieces come to place. Patients with chronic pain regain control of their lives.

Our physicians and nurse practitioners also use conventional methods in treating people who don’t qualify for the FRP. However, no individual is treated without the education and strategies practiced in the FRP. Each person plays a key role in his/her own treatment plan. Thus the same philosophy in the FRP is carried throughout the practice, treat the pain, teach the person.

• CARF accredited BAPWC’s FRP
• Cognitive Behavioral Therapy (CBT)
• Continuity of care
• Goal oriented
• Structured, comprehensive programs
• Measurable functional gains
• Outcome focused
• Physical reconditioning
• Tailored to the individual
• Return to work services
• Weekly medical follow-up reports

• Mindfulness-Based Stress Reduction • Nutritional Education • Expressive Arts for Health • Physical Therapy for Chronic Pain • Medication Transition Program

We have developed a comprehensive, interdisciplinary approach to treating pain. A large part of our treatment plan is the Functional Restoration Program (FRP). The FRP is an intensive group process of education, psychology, and physical reconditioning through exercise and functional activities. Through this approach, all the pieces come to place. Patients with chronic pain regain control of their lives.

Our physicians and nurse practitioners also use conventional methods in treating people who don’t qualify for the FRP. However, no individual is treated without the education and strategies practiced in the FRP. Each person plays a key role in his/her own treatment plan. Thus the same philosophy in the FRP is carried throughout the practice, treat the pain, teach the person.

• Medical Treatment Utilization Schedule Endorsed
• Outcome focused
• Highly structured, goal oriented
• Tailored to the individual
• Commission on Accreditation of Rehabilitation
- Facilities (CARF) approved

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Step 1: Physician and patient consultation.

Step 2: Patient meets with EACH multi disciplinary team member.

Step 3: Accessment of multidisciplinary team. Proper pathway is recommended.

Step 4: Accessment outcome will be one of two pathways. Medication Transition or patient enters straight into FRP program.

Step 5: Patient takes part in FRP program’s educational classes and disciplines.

Step 6: After patient completes program, he/she graduates and gets back to a functioning life.

The Bay Area Pain & Wellness Center is committed to the comprehensive and integrated treatment of complex pain problems. Our evaluation process involves a consultation with one of our pain specialists as well as a consultation with a psychologist and physical therapist. Our goal is to treat the whole person.

This pathway involves a program of education, rehabilitation, behavioral management and medication management.

Your treatment will be under the leadership and supervision of your pain specialist. He or she will work closely with all of your providers in an interdisciplinary approach.

The process of functional restoration is applied by our interdisciplinary team to patients experiencing a full range of medical conditions from acute injuries to chronic syndromes. Our practitioners provide problem solving effective functional restoration evaluations and treatment using state of the art California MTUS and ACOEM guideline evidenced based medicine treatment.

We have developed several different clinical pathways to assess and treat most of the patients we see in our practice.

This process allows us to better understand each and every one of you as individuals and treat you as a whole person.

During your initial consultation with your pain specialist, he or she will likely guide you into one of our specific clinical treatment pathways based on your needs.

This is a new and unusual concept in pain management that we hope will make your experience at the Bay Area Pain & Wellness Center the best possible.

The outpatient, Medication Transition Program is for someone who feels stuck on large doses of narcotics, or someone who is not seeing the kind of results or quality of life they deserve.

Our program provides a medically supervised team to detoxify patients dependent on opioid (narcotic) or other medications and is designed to restore control back to the patient.

No drugs have been proven to reverse, cure or “heal” chronic pain. Our outcomes show that patients who limit or eliminate their use of opioids are much more likely to regain control of their lives. Specific recommendations are made to address medication transition as part of a comprehensive plan.

At the Bay Area Pain and Wellness Center (BAPWC) we understand treating chronic pain is a complex and ongoing process for our patients and for this we proactively strive for the best treatment solutions.

A common form of treatment for chronic pain is prescription medications, specifically opioid therapy. Over the past 10 years, the California Workers Compensation Institute (CWCI) reports opioid usage has increased 380%.

Along with the CWCI, the American Pain Society support Pain Medication Monitoring. With their support, we have integrated a Pain Medication Monitoring program here at BAPWC.

Chronic pain is an unpleasant sensory or emotional experience that persists beyond the anticipated time of healing. Its impact reaches the individual and society as a whole.

Chronic pain is an unpleasant sensory or emotional experience that persists beyond the anticipated time of healing. Its impact reaches the individual and society as a whole.

There is no cure for chronic pain, but with the proper treatment, a person can reach higher functional levels and reduce medication intake. It’s estimated that just 25% of people who suffer from pain receive proper treatment.

Our practitioners are specialized in treating pain for: Spine, Chronic Myofascial, Visceral or Pelvic Pain Syndrome, Complex Regional Pain Syndrome (CRPS) and Repetitive Strain Injury (RSI), Geriatric Pain, and Cancer Pain.

MTUS Chronic Pain Medical Guidelines (effective July 2009)

There is now a preponderance of evidence supporting the use of comprehensive interdisciplinary programs, like functional restoration programs, for the treatment of chronic pain.

Evidence Based Medicine supports the use of such programs over more traditional medical alternatives. For injured workers in California who continue to struggle with chronic pain, the MTUS Chronic Pain Medical Treatment Guidelines endorse this approach, as well, making it standard of care in this treatment setting (Effective July 18, 2009).

Page 7 of the MTUS Guidelines notes clearly that “for patients with more complex or refractory problems, a comprehensive multidisciplinary approach to pain management that is individualized, functionally oriented (not pain oriented), and goal-specific has been found to be the most effective treatment approach.”… “Functional restoration can be considered if there is a delay in return to work or a prolonged period of inactivity…”

The MTUS further goes on to state that “Independent self-management is the long-term goal of all forms of functional restoration.” In the interest of helping the patient regain the locus of control, our Functional Restoration Program places a strong emphasis on helping patients overcome medication dependencies. In some cases our physicians employ special treatments to facilitate this progression, thereby augmenting the patient’s experience toward a more positive outcome.

Behavioral health specialists provide care in treating depression, anxiety, anger or other troubling mood states.

The area in your brain where you perceive pain is closely connected to the emotional centers of the brain, at least partially explaining why most people with pain have isturbance in their mood. Our behavioral specialists will teach you tools to better manage depression, anxiety, anger and other troubling feelings that keep you from living more fully.

Adjusting to changes in life due to pain: Chronic pain tends to bring about significant changes in your life, such as limiting your activity level or ability to fulfill life roles, such as mom, breadwinner or spouse, or maintaining the responsibilities you had before the pain. Our behavioral specialists help people to find meaning and fulfillment in their lives despite the pain

Using power of the mind to better manage pain: Ever notice that the pain you feel with a stubbed toe is different when it happens in front of a room full of strangers than when you are home alone after a particularly bad day? This has to do with things like attitude towards the pain, your belief in your ability to manage the pain, your ability to distract from the pain and what you are telling yourself when you have pain. Behavioral specialists help people build confidence in themselves and to promote independence and lessen anxiety about the pain and the future.

Teaching stress management and relaxation techniques: Most people in pain tend to live in a state of chronic stress. Inevitably, your body is exhausted from living in pain and your mind is taxed from living with worry. Behavioral specialists help you to relax your mind and body by teaching you how to manage the stressors in your life that may maintain or intensify your pain. Specific stress management methods include relaxation techniques such as abdominal breathing, progressive muscle releasing, and guided imagery, which have been proven to be effective for people in chronic pain.

The Expressive Arts for Health program offers a variety of services that include ongoing art therapy support groups and visual journaling workshops. In addition, this FRP program spearheads events designed to foster a social community for our patients. In collaboration with Local Art Schools. We now provide classes for those who wish to develop their artistic ability in a studio setting.

(Reserved for FRP graduates)

The Expressive Arts for Health Class:

These classes offer a variety of expressive art services that include art therapy support groups, visual journalizing workshops and an open art studio. In addition, the classes spearhead art-involved events designed to foster a social community.

Class schedule and fee information,
Contact Christine Hirabayashi at (408) 357-7656

For more information about our Expressive Arts for Health Classes, please click here.

One of the most unique aspects of BAPWC is our art therapy component. This nonverbal process is highly effective in helping our participants find a path out of despair and hopelessness. It attempts to bridge gaps in communication and give insight into past and present experiences. What is unveiled creates a new dimension of therapy, often presenting increased insight and self-expression when words are not enough.

Enjoy this display of art through the expressions of our FRP participants’ gallery.

• Functional Restoration Program
• Medication Detoxification Program
• Personal Training
• Introduction to Wellness
• Wellness-Advanced Practice
• Flare up management Lectures
• Healthy Bodies Class
• Individual Physical Therapy

In any traditional setting, physical therapy is directed towards rehabilitation of acute related injuries, or prevention of recreational/sport/work related injuries. Its role in the management of chronic pain is unique and often makes one wonder “What does PT have to do with pain?” Well, the answer is “Quite a bit!” A physical therapist specializing in chronic pain management can assist an individual in many aspects of rehabilitation. This ranges from global strengthening and developing a safe exercise program, to specific flare up management skills and application of specific cognitive strategies to shift an individual’s relationship with their pain. These factors make physical therapy an essential ancillary service in the successful management of chronic pain.

is designed to help people learn how to deal effectively with physical and emotional stresses. Through learning relaxation and awareness practices, participants are taught to use their inner resources to relieve stress and manage pain more effectively.

Results after the program:

Majority of participants who complete the program report:
• Decreased physical & psychological symptoms
• Increased ability to cope with stressful situations
• Improved self-esteem
• Greater energy
• Improved pain levels or coping with chronic pain
• More skillful communication

This lecture teaches the difference between an acute and chronic stress response. You will also learn stress management techniques such as breathing and mindfulness meditation. And we will also help you answer the now infamous question; why don’t zebras get ulcers?

Movement
The human body was designed for movement, not stagnation. One of the most significant contributors to chronic pain is also one of the biggest health problems in our modern society: inactivity.

Inactivity
A surefire way to make chronic pain worse is to avoid moving what already hurts. Inactivity can also set the stage for the development of a frightening number of new problems, ranging from muscle pain to fatal heart attacks.

Immobility
Not only does our modern sitstyle practically force us to be physically immobile much of the day, many of us are literally afraid to move, even when we have the opportunity. This phenomenon occurs when people who already hurt feel they can’t possibly exercise because it will hurt even more.

Fear
Fear of movement is one of the biggest obstacles to winning the battle against pain. Just as the fear of reinjury can cause athletes to void returning to certain activities after an injury, it appears to have a similar effect on a large proportion of patients with chronic pain.

To view participants of the FRP Program, click here.

Food, diets, and eating get more attention in popular culture today than any topic imaginable. Bookstores and magazine racks are crowded with publications hawking magical” foods that can make us look and feel better. Proper nutrition is one of the most important building blocks of good health. If your nutritional habits are not rock solid, you cannot be 100 percent healthy.

The foods we eat directly impact the weight we place on our joints and spines, the strength of our muscles, the amount of inflammation in our bodies, and the health of the blood that travels through the vital organs like our hearts, brains, and livers. Food should never be an afterthought! Instead it should be an ongoing opportunity to cleanse your systems of harmful toxins and inflammation, while taking in plenty of the right nutrients.

Don’t eat more calories a day than you burn in a day. You can use the Mayo Clinic’s Calorie Calculator to get a rough idea of the number of calories you need to burn daily. It’s on their Web site at www.mayoclinic.com

These simple steps create an anti-inflammatory diet:

• Eliminate the white menace: sugar and foods made ofreal flour that is quickly converted into sugar. Read labels and watch out for high fructose corn syrup.

• Avoid excessive salt. Premade meals and fast foods are usually pretty salty, so if you avoid them, your salt intake will automatically subside.

• Throw out processed foods. This will help you stay away from Tran’s fats, high fructose corn syrup, and other sources of empty calories.

• Reduce your dependence on caffeine for optimum mental and physical performance.
• Drink clean water.

• Never skip breakfast, and eat about six small meals per day.
• Have some protein with each meal.

• Make foods rich in omega-3 fatty acids in place of foods high in saturated fats.

Work is one of the major activities of life. The loss one experiences from a major or chronic injury/ illness can be devastating. Not only does this sense of loss come from the physical loss of function, it is also accompanied by social loss (i.e.: loss of lifestyle, social isolation), mental loss (i.e.: depression, anxiety, loss of self esteem) and financial loss (i.e.: lost wages, loss of livelihood). That is why a multiphasic approach is so essential to the healing and recovery process.

Work affects every one of these areas from lifestyle, livelihood and social connections to self-esteem and financial independence. That is why, we offer Return to Work services. Through our Functional Restoration Program, patients often have a renewed belief that they can return to work for the first time in a long time. Once patients come to this realization, they often feel at a loss as to how to accomplish this. Some need to consider new careers for the first time in their lives. We provide return to work services to help guide patients through this process while they are in the Functional Restoration Program.

We believe that moving forward to returning to work can be an essential part of having a more functional and fulfilling life. We are pleased to assist with this process.

Services are customized to the individual patient which may include: Assistance with returning to work at the patient’s place of employment through consideration of ergonomic adjustments/tools, assistive devices, or suggestions for restructuring job tasks or modified duties. We can facilitate these discussions if all interested parties are willing.

If return to work at the patient’s place of employment is not possible or practical, we can assist the patient with job searches for similar employment elsewhere or considerations for a new career. These services may include:

Skill evaluations, Interest testing, Career searches, Goal setting, Resume building, Interview skills, Enhancement tools, Job search resources, Identifying job opportunities and Identifying potential training

Acupuncture is best known for pain control but can be used to treat a wide variety of health conditions. The treatment involves the stimulation of various acupoints on the body. There are hundreds of these points on the body and each acupoint has a unique effect. The points used during a treatment are selected by the acupuncturist based on the patient’s symptoms and overall health condition. The goal of acupuncture treatment is to relieve symptoms, prevent their recurrence and to help improve the patient’s overall health condition.

• Asthma
• Carpal Tunnel
• Dysmenorrheal
• Fibromyalgia
• Headache
• Low Back Pain
• Myofascial Pain
• Nausea & Vomiting
• Osteoarthritis
• Postoperative Pain
• Tennis Elbow

Combining physical rehabilitation, drug detoxification and education in healthy alternatives with medications for pain control, patients can gain control of their pain, and return to a meaningful and fulfilling lifestyle.

Patients referred for Early Intervention are seen for consultation by a board certified pain medicine physician, physical therapist, and psychologist. Together, with the patient, payer and other concerned parties, a goal directed, individualized treatment plan is established. Transitioning off of opioids can be accomplished either before or during the rehabilitation process. Patients are given extensive education about alternatives to managing pain with fewer or no medicines. Treatment length is variable, but can last between one to six weeks. During treatment, patient progress is monitored daily, with on site physicians available to help where needed. Weekly progress reports are generated.

When treatment goals are met, treatment stops. If patients fail to progress as expected, treatment goals are adjusted or treatment is discontinued. In this way we feel confident that the patient’s experience during treatment remains individualized and directed towards a successful outcome for all parties.

In healthcare, how often do we say, “I wish I could have prevented that from happening.” Here we have a clear choice and alternative to offer patients who might be better treated outside of the typical doctor’s office. Patients do have an alternative to chronic narcotics, endless prescriptions for physical therapy, or repetitive injections or surgeries. By providing high quality, focused, integrated health care early, we can positively change the outcome for many people. The key is Early Intervention.

The goal of the Healthy Living Pathway is to help Functional Restoration Program (FRP) graduates maintain their significant functional improvements gained in the FRP, avoid psychological regression, prevent recidivism, and help them transition back to the real world. We have found over the years that, even though most graduates are declared P&S upon completion of the FRP, often times many months or more go by before their cases are finally closed. This seems to create a sort of purgatory for the individual where they are obliged to sit and wait for things to wrap up. The stress they feel during this time over a lack of control of their future, coupled with a loss of structure, seems to contribute to a redirection of their focus away from managing their health effectively and toward more dysfunctional thoughts and actions. Maintaining a sense of connection and support in our facility should help the individual maintain appropriate perspective and positive forward thinkings and maintain physical gains necessary to return to work and life activities at the necessary times.

Likewise, we have found that graduates fortunate enough to have jobs waiting for them upon completion of the FRP experience a much greater sense of accomplishment and satisfaction with their life circumstances, and seem to require less support from our team to move forward in a positive direction.

We recommend Healthy Living Pathway participation include weekly visits for the first two months, and then twice monthly visits thereafter, for a period of up to six months. The visits include two hours of contact time spent in a combination of small groups, one on one, and in the gym, focusing on:

1. Movement Education
2. Functional Activities
3. Maintenance gym program
4. Integration of learned tools
5. Flare-up management
6. Activities of Daily of Living
7. Review of vocational activities
8. Resolving reintegration back into society
9. Focusing on personal goals
10. Cognitive behavioral therapy

This group is facilitated by Shaylin Ebert, MFT-I. If you have any questions about this group, please feel free to call the office at (408) 357-7675. The meetings are for family members of patients in the Functional Restoration Program ages 13 and up.

While we do not formally provide vocational rehabilitation, we do provide structured time for vocational planning and guidance. These services may include:

• Vocational aptitude and interest testing
• Education for the workers' compensation system
• Review of available vocational benefits.

We focus on developing both the patient?s desire and ability to return to work. This includes preparation of an individualized aftercare plan that links the patient with resources for a managed transition back to employment.