Since her diagnosis in 2000, every doctor told her Parkinson's disease was progressive and her health status would never improve. Reluctantly settling for a bleak future, Diane's condition deteriorated toward a state of excruciating pain that required both wheelchair and service-dog assistance.
In 2011, she participated in a pilot program offered by her insurer, Blue Cross Blue Shield of Michigan, based on a neuro-psycho-physical system that "empowered her to take charge of her future." Three months later, Diane reported her stiffness "gone," balance "restored," gait "normal," blood pressure "dropped," speech "less hesitation," sleep "normalizing" and pain "nearly gone."
Today, Diane remembers her decade of misery and "can't believe [she] is living a normal life," with "frequent clinical appointments reduced to annual exams." The "new program" was developed, in 1986, by Dr. Ramon Nunez, who realized then, what the Centers for Disease Control now reports: up to 90 percent of all conditions for which medical attention is sought are stress related.
While stress takes on many aliases, symptoms cause the body to take on a fight-or-flight response, which sends all systems into overload and eventually ends in disease. Dr. Nunez worked with pioneers in biofeedback, stress management and mind-body therapies to weave Eastern medicine with modern science to determine the confluence of "active ingredients."
He distilled volumes of proven techniques and best practices into simple, concise means of allowing the brain and body to work together. The result is Somatic Functional Therapy (SFT), a game-changing means by which employers can get a meaningful handle on employee healthcare costs and outcomes.
Retraining Brain to Heal Body
Somatic Functional Therapy is an educational-therapeutic system that modifies neural pathways by re-educating the brain response to stress. It's not "integrative medicine." It's hard science - blending anatomy, physiology, kinesiology and psychology - that coalesces what Western medicine has yet to fully include in its understanding of disease pathology.
SFT's goal is to improve individual health and functionality, but also to deliver benefits to the community at-large by paving the way for cost-effective population health programs in the workplace. While the genesis of Somatic Functional Therapy was founded and honed on the tens of thousands of patients Dr. Nunez has treated across several decades, the system's protocols have been tested through 10 years of clinical research trials on thousands more participants.
Somatic Functional Therapy has been clinically proven in both individual and group treatment settings to resolve chronic pain and improve stress-related illnesses including hypertension, diabetes, depression, anxiety and sleep disorders, among others. Either hands-on or in clinical group settings, Somatic Functional Therapy provides patients with the educational tools and techniques to immediately improve pain, stiffness and mobility and, over time, resolve stress-related conditions to enhance overall well-being and functionality.
Because the SFT system directly addresses the effects of stress on the body, this drug-free approach may be applicable to 90 percent of conditions for which people seek healthcare. Results are often immediate with continued and sustained improvement based on the individual's awareness and participation. Dr. Joseph Sliwkowski, former medical director at Subaru and Wabash National, was recently trained in SFT protocols and relays an experience using the system in an urgent-care setting.
"A 45-year-old male presented with severe ear pain, which he thought was due to an ear infection, said Dr. Sliwkowski." Upon examination, no ear infection was found; instead, he exhibited limited range of motion with an inability to turn his head to the left. He explained that he had been in a helicopter crash five years prior, resulting in chronic neck pain.
Further examination revealed that his neck muscles were severely contracted (a stress-related effect of the crash), which were pinching a nerve, ultimately causing the pain in his ear. Through four SFT treatments and home self-care assignments, the patient learned to recognize when the muscles of his neck were unnecessarily contracting and how to relax them. He regained total range of motion in his neck.
Further, he had complete resolution of both acute ear and chronic neck pain. "The cost of his treatment through both conventional medicine and complementary therapies had added up through the years. Between Botox injections in his neck, multiple rounds of physical therapy, chiropractic and massage, the final bill approached $30,000 and yielded no improvement.
Compared to just $400 for four visits to a physician who taught him the SFT self-care method that completely resolved the pain and dysfunction within two weeks, the cost effectiveness and value of SFT are obviously worth a closer look.
Cost of Stress-Related Pain, Illness
Approximately 100 million Americans live in chronic or recurrent pain, which the Institute of Medicine (IOM) estimates is greater than the total affected by heart disease, cancer and diabetes combined. "While the 100 million represents about 40 percent of the adult population, only about 20-25 percent are substantially impaired by chronic pain and a smaller number - about 10-15 percent - have substantial work disability because of chronic pain," said Michael Von Korff, senior investigator at the Group Health Research.
"There are certainly 100 million people who experience back pain and arthritis." And it's exacting a terrible financial toll, costing up to $635 billion annually with nearly an even split between medical treatment and lost productivity. IOM researchers also note that people in moderate pain work on average 291 hours less each year and rack up $4,500 more in annual medical costs.
"Given the burden of pain in terms of human lives, dollars and social consequences, actions to relieve pain should be undertaken as a national priority," the report concludes. Chronic pain has taken a terrible toll not only on individuals suffering from chronic pain, but also on the nation's healthcare system.
The massive amount of investment in research, advertising and delivery of drugs -- nearly $30 billion a year in each activity -- has obscured less expensive and more sustainable treatments; particularly, those that patients can do themselves. These points were articulated in the preface of a Samueli Institute report by Col. Chester Buckenmeier III, who heads the Army Regional Anesthesia & Pain Management Initiative at Walter Reed Army Medical Center, and retired Lt. Gen. Eric Schoomaker, the U.S. Army surgeon general.
Paul Hemp, former senior editor of The Harvard Business Review, notes that "researchers say that presenteeism - the problem involving workers on the job, but, because of illness or other medical conditions, not fully functioning - can cut individual productivity by one-third or more.
In fact, presenteeism appears to be a much costlier problem than absenteeism, a productivity-reducing counterpart. And, unlike absenteeism, presenteeism isn't always apparent: it's easy to tell when someone doesn't show up for work, but often difficult to determine when - or how much - illness or what medical condition is hindering performance.
In addition to chronic pain, CDS reports more than half - 117 million -- of adult Americans suffer from one or more chronic illnesses. A 2014 Milken Institute study estimates that the top five chronic health conditions -- heart disease, cancer, diabetes, hypertension and stroke -- cost the United States more than $1.5 trillion a year or more than $12,800 per person with chronic illness, $276 billion for treatment and another $1.23 trillion in lost productivity. Job stress, alone, costs business more than $300 billion a year, according to the American Psychological Association.
Physiology of Stress
Countless studies indicate stress is a major factor in human disease and contributes to most everything from depression to cardiovascular disease to cancer. There's no escaping the mind-body connection. Everyday events like getting cut off in traffic or watching a horror flick can trigger the fight-or-flight reaction -- or the stress response.
While this response is necessary for human survival, when stress is prolonged, the result can be a fight-or-flight response that continues past its usefulness with residual negative impact. According to Dr. Nunez, stress is a precursor to pain that can be expressed in a number of ways: emotional, spiritual, psychological, biochemical, hormonal, systemic and personal or a combination thereof.
Its physical expression includes both conscious and unconscious contraction of muscles, which should return to a relaxed state once the stressor has passed. It's when the muscles don't (i.e., the stress response continues) that pain and illness develop. Habitually contracted muscles become stiff, painful, burn excessive energy and cause undue fatigue.
No one purposefully holds their muscles in constant, unnecessary contraction. The phenomenon is automatic and the resulting pattern, immediately or in a matter of years, can lead to pain and disease. Furthermore, while the effects of stress can manifest as physical illness with time, it's not a hardware (physical) issue per se - it's a software issue and must be resolved in the brain.
The objective behind the SFT system isn't to exercise the body, it's to train the brain to rewire neural pathways, sense pathological effects of the stress response (e.g. muscles that are in habitual contraction) and respond appropriately to return to a neutral, relaxed state.
The limitation of many therapies, such as physical therapy, chiropractic and massage, is that while they may help people feel better for a short time, unless the software issue is addressed, the muscles will tighten again by reflex. But, through education, patients can be taught how to end those patterns and return muscles to a neutral state.
Body of Evidence
More than a decade of clinical research involving 2,400 participants with nearly 13,400 chronic pain conditions (averaging 5 per person) definitively shows that SFT helps employers achieve improved health outcomes and cost savings. For example, more than half of Chrysler employees with chronic back pain resolved their conditions by the end of a multi-week group program compared to zero from the control group.
More than 80 percent of the study's participants experienced significant pain improvement. In addition, Chrysler reported that this, and subsequent SFT-based group programs for pain and stress, contributed to a significant return on investment for its wellness efforts. Chronic pain resolution and improvement were also demonstrated in clinical trials of group programs with employees at Dow Chemical, Henry Ford Health System and with members of Blue Cross Blue Shield of Michigan.
These results were maintained at 16-month follow ups. Improvements also were reported in 50 percent of other stress-related conditions including high blood pressure, gastrointestinal distress, diabetes, high cholesterol and allergies. But, perhaps, even more telling is that 14 percent of those studied stopped taking pain medication and 53 percent took fewer pain medications by the end of the program.
This compelling approach presents an opportunity to reduce patient reliance on opioids for pain management at a time when more than 200 million narcotic prescriptions are written each year. While opioids help manage pain, it's important to note that they do not resolve pain, are ineffective for chronic pain and potentially lethal, even when properly prescribed and administered.
Muscling Out Traditional Treatments
When compared with conventional medicine, one randomized controlled clinical trial involving SFT revealed startling results in terms of outcomes for chronic low back pain sufferers. Participants were divided into three groups that each received individual, hands-on treatment: One was treated with physical therapy; and another with a comprehensive complementary and integrative medicine program featuring treatment by licensed practitioners in acupuncture, chiropractic, neuromuscular therapy, and hypnotherapy; with a third featuring two novice massage therapists who were trained in SFT protocols.
The third group not only had the fewest number of contact hours - but showed the most improvement as many as 25 percent of patients in this group resolved their back pain, whereas only 5 percent in the physical therapy group and 16 percent of those who received the comprehensive integrative medicine approach were able to accomplish the same goal. In terms of cost, the Health Alliance Plan HMO estimated that just one round of physical therapy cost on average $1,500 per person, while the SFT system approach was considerably less.
SFT as Game Changer
By learning how to identify and act on destructive patterns within their bodies, individuals who are in constant pain and stressful states have the power to resolve their illnesses and live healthier, happier and more functional lives. Once they make that transition, then it stands to reason they will be far more productive and engaged at work.
While this therapeutic method can address a multitude of conditions, the focus is on treating individuals first and foremost through education, which represents a lifelong investment in people. Learning the SFT system is also prudent for those yet to be stricken with injury or disease - playing an integral role in prevention and wellness.
Such programs will help burnish investment in people by enabling employees to achieve and sustain better living without pain. Healthier employees will be more satisfied with their own lives, as well as happier and more productive at work - and more inclined to stay with their employer.
In short, it's about focusing on functionality and vitality in the workplace with a system of care that's worth the investment.
Special Note
Importantly, according to the Institute of Medicine's "Best Care at Lower Cost" report, an additional $750 billion is wasted each year on unnecessary services, services inefficiently delivered, prices that are too high, excess administrative costs, missed prevention opportunities and by failing to eliminate fraud leading to little improvement in consumer health, work-life functionality or well-being.
For employers, the invisible costs of presenteeism coupled with wasteful healthcare spending in America present a frightening and motivating prospect. These costs also represent a substantial argument for advancing healthcare system innovation and supporting patient-empowered self-care protocols to help employees make informed choices that engages consumers in better managing these lifestyle risks and common chronic conditions.
About the Author
Les C. Meyer, MBA, is a principal of HPI Advisors, LLC; chairman, Informed Opinion Leadership Action Group; Senior Fellow, Jefferson School of Population Health; member, Institute of Medicine Roundtable on Population Health; member, Health Enhancement Research Organization Employer-Community Collaboration Committee; participant, Clinton Foundation Health Matters Initiative; member, Robert Wood Johnson Foundation Leadership Network; advisor, Center for Healthcare Leadership, Concordia College; and board member, Professional Patient Advocacy Institute. Les.Meyer@HealthAndPerformance.info
Resources
"The True Cost of Poor Health," Mayo Health Solutions; Mayo Foundation for Medical Research and Education; 2008; Accessed Jan. 7, 2015.
"The Cost of Pain to Business and Society Due to Ineffective Pain Care"; American Academy of Pain Medicine; http://www.painmed.org/patientcenter/cost- of-pain-to-businesses/; Accessed Jan. 7, 2015.
"Best Care at Lower Cost: The Path to Continuously Learning Healthcare in America"; Institute of Medicine of the National Academies; Sept. 6, 2012; http://www.iom.edu/Reports/2012/Best-Care-at-Lower-Cost-The-Path-to-Continuously-Learning-Health-Care-in-America.aspx; Accessed Jan. 7, 2015.
