Managing Chronic Pain with Yoga

The Union Health Pain Management Center (“Pain Clinic”) specializes

in the diagnosis and management of chronic pain. They provide a multi-specialty approach to pain management that considers the whole person. The Pain Clinic team includes physicians, psychologists, physical therapists, occupational and vocational therapists, nutritionists and dieticians. This team works together with patients to create a customized treatment plan that is effective in alleviating their particular type of chronic pain.

Chronic pain can lead to additional problems including missed time at work, family disruption, difficulty with normal activities of daily life, depression, social isolation, low self-esteem, trouble sleeping, tiredness, anxiety, reduced quality of life, and negative changes to the brain1,2. “Chronic pain represents a significant public health issue with tremendous economic, social, and medical costs”1. Chronic pain does not discriminate; it can affect anyone of any age in any socioeconomic class.

As a department of Union Health, the Lugar Center collaborates with other departments in addition to organizations across the state of Indiana to implement new projects. The Pain Clinic asked the Lugar Center for Rural Health to leverage its experience with grant management to be involved with this project. The Lugar Center has experience with beginning new projects, finding funding, and managing grants.

This project was chosen due to the startling prevalence of opioid use in pain clinic patients and the growing opioid epidemic in the United States. The results of this project have the potential to impact how providers approach pain management in all specialties. Although this project used pain clinic providers, any physician that prescribes opioids or manages chronic pain can use this approach of adding mind/body exercise into patients’ care plans.

This project has two sections. The first is a pilot program that was led by the Pain Clinic providers to offer an alternative non-drug approach to pain management. The program is voluntary, and patients can excuse themselves from the program at any time. Patients are fully informed of the program components and continue to have regular medical visits with their Pain Clinic provider during the program. The second section is program evaluation that will analyze the results of the pilot program after the conclusion of the program.

Current patients at the pain clinic are evaluated by their physician and recommended for the program if their physician believes they would benefit from participation in yoga classes for pain management. If the patient agrees to the program requirements, they are formally referred to the Center for Fitness and Performance (CFP) via a standard referral form. The Pain Clinic contacts the CFP to set up an appointment for an initial assessment, which collects patient information.

Once the patient has completed the initial assessment, they can attend the next yoga class. All yoga classes are instructed by a certified yoga instructor. Classes are tailored according to the abilities of the participants. Multiple yoga classes are offered each week for this program in the CFP classroom.

In addition to yoga classes, tai chi is being offered starting in September 2019 for Medicare, pain and pulmonary rehab patients. Classes are held in once per week in the CFP classroom and in the Pulmonary Rehab department.

For more information about the Union Health Pain Management Center or the Center for Fitness and Performance, please visit Union Health’s website at www.MyUnionHealth.org.

1American Academy of Family Physicians. (2018). The AMA and AAFP Urge Removing All Barriers to Treatment for Substance Use Disorder. Retrieved from: https://www.aafp.org/dam/AAFP/documents/advocacy/prevention/risk/BKG-AMA-AAFP-MAT.pdf

2Institute of Medicine. (2011). Relieving pain in America: A blueprint for transforming prevention, care, education, and research. Washington, D.C.: The National Academies Press. doi:10.17226/13172