CASE STUDY B
Mary Green
Nurse with chronic pain for 10 years
Mary Green was injured in 1995 whilst working as a nurse. She underwent multiple treatments from various treatment providers, with no significant improvement. After working on restricted duties for 7 years, Mary significantly exacerbated her injury in 2002. She came into the AlphaOne Intensive program in 2005 not having worked since 2003.
At the start of the program, Mary said she could not work at all given her pain. However, she was very motivated to learn new strategies to help her manage her psychological and physical difficulties in relation to her pain. On day one, Mary had high levels of anxiety, fear relating to her pain, and low self-esteem. In her words, she was 'terrified to think that my pain may get worse because I find it so difficult to manage at present'.
Over the course of the one-to-one program, Mary gradually increased her confidence to manage her pain by applying strategies such as pacing and avoiding the boom-bust cycle. The program gradually reinforced Mary's ability to undertake daily activities and physical exercise without increasing pain.
A specific activity program was developed which focused on core and postural strengthening, pelvic stability, and functional movement. Mary made significant improvements which reinforced her efforts to improve her physical tolerances and confidence with being physically active. Mary's self image improved as she started to think of herself as a physically active person. Through the application of pacing techniques, Mary's walking tolerance improved from 24 to 45 minutes, sitting from 4 to 20 minutes, standing from 3 to 20 minutes and driving from 9 to 25 minutes.
Mary found the emotional component of the program very useful . As she was able to better manage her anxiety, her reports of pain decreased. In the past, Mary said that her treating physiotherapists disagreed with the notion that psychological distress and pain were related. The AlphaOne Intensive program however addressed both physical and emotional dimensions and validated her experience that indeed there is a strong link between psychological distress and the experience of pain.
Overall, AlphaOne Intensive enhanced Mary's self-efficacy and belief in her own capacity to manage her emotional state, pain and return to work goals. At completion of the program, she became very proactive, taking her rehabilitation into her own hands. Her WorkCover certificate was upgraded to 12 hours work capacity per week and Mary was referred to a rehabilitation provider for retraining.
On her final visit, Mary stated that 'it was the philosophy of the program and the lifestyle approach that allowed me to see the big picture of where I want to be and get past the physical and emotional barriers'.