Two years after lower lumbar back surgery, Diana Brayton leaned back in her chair to pick up a pencil on the floor. As she straightened her back, she felt pain ripping down her body.

This pain, becoming chronic, left her virtually immobilized. When she wanted to hold her two-month-old daughter, she needed to lie on the floor. When she drove to Dubuque to visit her family, she stopped midway to lay flat in the back seat. Every day, after she woke up and before she went to bed, she thought about her pain.

Her doctors, family, and friends were telling her what she should do to manage her pain, yet none of their suggestions helped ease it.

"I didn't know what I was going to do," Brayton said. "I pictured myself in a wheelchair and living in a nursing home for the rest of my life."

Brayton had that thought nearly nine years ago, and her life now is far from how she once imagined it. Today, she playfully wrestles with her three children in the backyard, twists and turns down waterslides, and travels to places like Hawaii for family vacations.

With the help of the integrated health care team at UI Back Care, part of the Department of Orthopaedic Surgery, she finally overcame her pain by gaining control and learning techniques to effectively manage it.

Unlike many other chronic back pain clinics, UI Back Care's two-week rehabilitation program emphasizes a holistic approach to therapy. In addition to learning physical therapy techniques to manage back pain, participants learn life-long skills that help them recognize and manage those things that cause stress in their lives.

"Chronic pain affects more than the physical body; it affects the entire person," said Valerie Keffala, PhD, a psychologist who teaches coping skills at UI Back Care. "We use a mind-body approach to help patients manage pain."

"I realized that many things in my life at the time of my relapse were stress factors and that they made my pain worse," Brayton said. "During the program, I learned relaxation techniques, such as deep breathing and focusing. I still use them today."

At UI Back Care, this holistic approach is practiced by a multidisciplinary team, including physical therapists, physicians, a vocational rehabilitation counselor, a medical social worker, and a psychologist.

"But the most integral member of our team is the patient," said Ted Wernimont, a medical social worker at UI Back Care.

"They are the ones who have to manage the pain, and they have to want it for themselves," said Mary Lou Fairchild, one of the team's physical therapists.

The program gives patients the opportunity to actively participate in their own recovery.

During the program, patients share their personal stories of pain with others, work collaboratively on a number of physical and mental training activities, and all stay in the Iowa City area where they can socialize with each other.

Because pain is both invisible and individual, it is often difficult to treat. And back pain-one of the most common health problems in America-is treated the most inconsistently.

"When people with chronic pain first inquire about our rehabilitation program, they usually feel misunderstood, frustrated, and angry. But through the program, they find the support needed for an effective and lasting recovery," Fairchild said.

Just look at Diana Brayton.

For more information, patients and families should call toll-free UI Health Access number, 800-777-8442, and ask for the UI Back Care rehabilitation program. For consultation or referral, physicians should call UI Consult, 800-322-8442.

"When I first went to UI Back Care, one of the counselors told me, 'I understand you hurt.' That was something no one had every told me before."

Diana Brayton

Water aerobics are part of life's normal routine for Diana Brayton after her participation in the UI Back Care rehabilitation program.