I read with interest the dialogue “That sinking feeling. A patient-doctor dialogue about rescuing patients from fibromyalgia culture” in the November issue of Canadian Family Physician.1
In 2005, discouraged by the lack of improvement in the lives of my patients suffering from chronic non-cancer pain, I spearheaded a multidisciplinary team that included physicians, pain specialists, a nurse, physiotherapists, an occupational therapist, a psychologist, an exercise physiologist, and fitness trainers from the Kingston Family YMCA.
We developed a 12-week exercise and education program, Y-PEP, based on the chronic pain self-management program by Dr Sandra LeFort at Memorial University of Newfoundland in St John’s.2 Y-PEP sessions include concepts, such as pacing, problem solving, and setting goals, and gently graded exercises, such as tai chi, yoga, and pool therapy.
This low-cost community-based program is now in its third year. We found that our registrants were as disabled at the outset as ill chronic renal failure patients! Those who completed the program had reductions in their depression scores, which correlated with reductions in the degree to which their pain interfered with their lives and increases in their functioning.
As well, qualitative interviews revealed themes of hope, social support, and coping skills that were associated with decreased depression, a shift to an internal locus of control, and increased assertiveness when communicating about pain. Participants indicated that these factors assisted with their pain management and enhanced their participation in meaningful occupations.3
After Y-PEP participation, 2 of my own chronic pain patients returned to work after many years of complete disability.4 If you are interested in bringing Y-PEP to your own community, please contact me by e-mail at rdubin{at}kingston.net.
- Copyright© the College of Family Physicians of Canada