An orofacial pain dentist or physicianwill evaluate and review your current symptoms and medical history, examine area of the face, teeth, jaw, head and neck, and order any diagnostic testing if necessary. Typically this will include radiographs, imaging studies, and questionnaires. Also, the dentist will provide a self-care program to begin to reduce any strain to the area and encourage healing. A treatment plan will be developed to provide pain relief. If necessary, it will sent to your insurer for prior authorization, and a summary letter will go out to your referring doctor.

Identifying an upper-body painful disorder may be complex. Currently, Minnesota health care providers listen carefull to the patients description of symptoms, assess the patients detailed medical and dental history, and examine the head, neck, face, and jaw for starters. Imaging studies may also be recommended.

We urge you to consult your doctor or pain specialist to rule out other known causes of pain. Facial pain is often a symptom of many possible conditions, such as a TMJ disorder, sinus or ear infections, various. various types of headaches (example: tension headaches), and facial neuralgias (nerve-related facial pain). Ruling out these problems first helps in identifying pain disorders.

The pain specialists at the Minnesota Head and Neck Pain Clinic (MHNPC) provide interdisciplinary transformative care for patients of all ages with an acute to chronic TMJ disorder, facial, head and neck pain conditions.

Chronic pain is the top reason to seek care, the #1 cause of disability and addiction, and the primary driver of healthcare utilization, costing more than cancer, heart disease, and diabetes. Studies have shown that more than half of the persons seeking care for pain conditions at 1 month after it begins still have pain 5 years later despite treatment.

Although treatments such as physical therapy, medications, injections, and splint can provide relief of pain conditions, there is much research that shows that patient engagement in self-management such as cognitive-behavioral therapy (CBT), therapeutic exercise, and mindfulness-based stress reduction can activate and empower patients to reduce risk factors to heal pain conditions long-term. The integration of preventive self-management training of patients with treatment using a team with technology is a smart model of healthcare transformative care that can help the health care system recover from its devastating escalation of addiction and disability due to pain in recent years. Transformative care is the basis for the care of patients with pain conditions provided by the integrative pain specialists of the Minnesota Head and Neck Pain Clinic.

MHNPC is a model for establishing pain clinics nationally using an interdisciplinary team of pain specialists in Medicine, Dentistry, Nursing, Health Psychology, Physical Therapy, and Health Coaching. The interdisciplinary team is best able to provide successful care for complex by integrating self-management training with evidence-based treatment to help transform patients from pain and illness to health and well-being. Our clinic is recognized by the American Pain Society designates as a Center of Excellence in pain management and for our Orofacial Pain Specialty expertise. Self-management focuses on reducing risk factors and enhancing protective actions using brief structured psychophysiological counseling, cognitive-behavioral therapy, and online training. This is combined with short-term use of medical management, physical medicine procedures, injections, and jaw splints that are tailored to the individual needs of the patient. The specially trained telehealth coach follows up with patients by phone to support the patient in implementing self-management and achieving their goals.

Pain occurs in cycles with the symptoms caused by diagnoses, which are caused by injury & strain and then made worse by stress. Long-term success can be achieved when we both treat the condition and train you to reduce these causes of pain. The cause of pain conditions is complex. Our goal is to avoid a pain disorder if possible. Pain cycles involve all realms of your life and are not static and independent but rather are dynamic, evolving, and interrelated processes that involve a set of risk and protective factors that can shift the balance between health and illness. The factors may be diverse and include the body (e.g., muscle, joint, or nerve conditions, posture, weak tight muscles, lifestyle (habits, repetitive strain, posture, lifestyle, eating, sleep), emotions (depression, fear, anxiety, anger, guilt), society (conflict, relationships, abuse, isolation, social support, secondary gain), mind (attitudes, resilience, expectation, understanding), spirit (purpose, hopes dreams, self-compassion, beliefs), and the environment (risky surrounding, disorganized, unclean, noise, pollution). We consider it a best practice to avoid opioid prescription use or minimize it as much as possible.

Causes: Stress that turns volume up on pain Lifestyle: sleep, diet, sitting, chemicals Emotions: depression, anxiety, anger, shame Social life: conflicts, isolation, work/home stress Environment: safety, toxicity, side effects Mind: loss of control, pessimistic, unable to cope Spirit: low energy, loss of hope, self esteem

The MHNPC pain programs and others like it around the country are also consistent with the Institute of Medicines core principles of providing patient-centered care by helping health professionals focus on health care instead of sick care.1-4 When transformative care with robust patient-centered self-management strategies is implemented with all pain conditions, chronic pain, addiction, and care escalation can be prevented. Thus, health care leaders including the Institute of Medicine, the National Pain Strategy, the Institute for Health Care Improvement, and the Institute for Clinical System Integration have recommended integrating care strategies that engage, educate and empower people in preventing chronic pain and addiction.1-5 The MHNPC also addresses the Institute for Health Care Improvements triple aim to improve the patients experience of care, enhance the health of the patient, and control the cost of health care. However, there are many barriers for health professionals to implement transformative care with self-management training. The lack of reimbursement, time burden, and inadequate training skills coupled with the lack of care coordination, fragmented care, poor communication, and conflicting treatments each interfere with patient-centered transformative approaches in clinical practice.

The MHNPC also has a long tradition of providing a cost-effective solution to chronic pain. The clinicians understand and implement many cost containment strategies in our treatment plans. To achieve cost savings, the clinic developed treatment plans that focus on self-care, self-efficacy, and long-term self-management of their pain while addressing both the physical and mental health needs of the patient. The clinic focuses on musculoskeletal health including the range of motion, strength, and conditioning to help patients return to normal functioning. The clinic also provides pain patients with a pain home to minimize overutilization of care. All of their pain care needs can either be provided by the team of pain specialists or arranged and coordinated including care with primary care physician, on-call and emergency visits, and phone and e-visits for healthcare support. The clinic uses specific criteria for imaging, surgery, and pharmaceuticals as indicated and encourages the use of evidence-based medications when possible. The clinics focus on long-term care helps prevent chronic pain and its consequences of addiction, disability, and long-term health care costs by empowering patients to self-manage their pain.

5. Lawson K, Whitebird R, Vazquez-Benitez, G, Grossman E, Fricton JR, PACTA Transformative Self-management Program for Chronic Pain Utilizing On-line Education and Tele-Health Coaching. 2018 International Congress on Integrative Medicine & Health (Abst)