Addison R G
NIDA Res Monogr. 1981 May;36:12-32.
The Center for Pain Studies of the Rehabilitation Institute of Chicago (formerly known as the Low Back and Pain Clinic) has developed a multidisciplinary program for the management of chronic pain. Typically patients present a variety of chronic pain syndromes, most frequently low back pain, which have not responded to previous treatment including surgery, physical therapy, medication, vogue therapies, and other pain management programs. Patient capability to engage in normal daily activities such as standing, walking, sitting, lifting, etc. is often limited; most are unable to work or carry on pre-injury activities. Psychological ramifications of chronic pain appear frequently as a retreat from responsibility by the patient for his own welfare, manifested by distinct behaviour patterns (measurable on the MMPI); however, the ability of the patient to cope with chronic pain is largely a function of his ability to cope with other stresses prior to onset of pain. The patient's physical and psychological status alters his relationships with spouse and children, straining family well-being. Economic factors often occasion additional alteration in personal and family relations. Frequently a spouse not employed outside the home goes to work. Compensation programs and aid from public agencies may provide insufficient support or, conversely, compensation practices may establish perverse incentives toward recovery by providing the patient with net income equal to or greater than normally received.
芝加哥康复研究所疼痛研究中心（前身为腰背痛诊所）制定了一项针对慢性疼痛管理的多学科计划。通常，患者表现出多种慢性疼痛综合征，最常见的是腰背痛，这些疼痛对包括手术、物理治疗、药物治疗、时尚疗法和其他疼痛管理计划在内的先前治疗均无反应。患者进行正常日常活动的能力，如站立、行走、坐下、提举等，往往受到限制；大多数患者无法工作或从事受伤前的活动。慢性疼痛的心理影响经常表现为患者对自身健康的责任退缩，表现为明显的行为模式（可通过明尼苏达多项人格调查表测量）；然而，患者应对慢性疼痛的能力很大程度上取决于他在疼痛发作前应对其他压力的能力。患者的身体和心理状况会改变他与配偶和子女的关系，影响家庭幸福。经济因素常常会导致个人和家庭关系的进一步变化。通常，原本没有外出工作的配偶会去上班。赔偿计划和公共机构的援助可能提供的支持不足，或者相反，赔偿做法可能通过向患者提供等于或高于正常收入的净收入，对康复产生不良激励。
