She was born with spina bifida and has undergone seven back and three hip surgeries since 1953.

For the past six years, pain has been the constant companion of Gloria T. Morris, a 65-year-old Woodbine resident.


Chronic pain. For those who suffer, like Morris, long-term pain can limit options, destroy careers or cause depression.

"They say these are your golden years," she said, "but I thought there would be no gold in these years for me."


The impact can be so severe that people experiencing long-term pain can completely withdraw from society, abuse drugs or alcohol, even attempt suicide.

Millions suffer from chronic pain. Many never find complete relief or a way to cope.

To help them, Carroll County Med-Service Inc., with Carroll County General Hospital, has opened the Carroll County Center for Pain Management and Rehabilitative Medicine.

Dr. Antonio Y. Medina, a Westminster orthopedic surgeon who will treat patients there, said many patients suffering from long-term pain have not been helped by more traditional measures, such as physical therapy, bed rest or pain medication.

"We would see patients who were not getting better, and there would be nowhere for them to go," Medina said.

The center has given Morris a place to go -- and hope.

She started preliminary treatment twice a week there in December, when the center opened its doors on a limited schedule to patients. Next week, she will begin a daily treatment program,

"I was very pessimistic," Morris said. "But, oh, am I ever optimistic now."


Dr. Gerald D. Schuster, the center's medical director and administrator, has been treating patients with chronic pain for 18 years.

"Pain has become their life," he said. "All other functioning has stopped.

"They could go on indefinitely,being led around by their pain," he added. "We want to change it around and put them back in control."

The center, in the Hunter Professional Building on Washington Road in Westminster, will conduct an open house on Thursday.

The center will use what doctors call a "multidisciplinary approach," meaning patients' emotional and psychological problems will be treated, as well as their physical ones.

Schuster said national studies have shown that pain treatments focusing on a single method have a success rate of about 35 percent in returning patients to a normal level of activity. But a multidisciplinary approach is successful 85 percent of the time, he said.


The program developed for the center is intensive, involving physical therapy, relaxation techniques, education about pain and its causes, psychological counseling, biofeedback, hypnosis and ongoing support group meetings.

Like Gloria, patients who suffer from chronic pain will attend the program eight hours a day, five days a week, for four weeks. Manywill attend follow-up sessions.

A "work-hardening" program will help patients gradually work up to performing duties, such as lifting weight or bending over, needed to return to work.

"It's much more involved than going to a physical therapist," said Dale P. Middleton,a vice president at Carroll County General who helped get the project off the ground.

The first group of patients will start the program next month; six suffer from chronic pain.

Middleton said the center probably will treat about 150 patients annually.


Patients are screened by a physician to determine the best therapy, then sorted into three groups -- those with acute pain, sub-acute pain and chronic pain.

Acute pain is caused by tissue damage from an injury or illness, Schuster said. If pain continues for six weeks, it is referredto as sub-acute pain. And if the pain lingers for six months or more, it is called chronic pain and has devastating physical and psychological consequences for most people, he said.

Victims of chronic pain often must stop working, reduce their workload or change the type of work they do. Almost all experience some depression, which affectstheir family and social life, he said.

Many eventually become shut-ins, trapped by their pain, unwilling to challenge it, fearing thatwill only bring more pain, he said. Many patients cannot sleep and become hypersensitive to environmental changes, such as temperature. About 25 percent such as temperature. About 25 percent eventually become addicted to drugs or alcohol to lessen the pain, he said.

Almost 90 percent of chronic pain sufferers eventually are divorced or separated, Schuster said. Many become impoverished because they have been unable to work for years and have exhausted financial resources on treatment.

Treatment at the Pain Management Center will cost about$7,500 for 20 days, a figure Schuster said he considers reasonable considering today's high cost of health care.


Most insurance companies and workmen's compensation programs cover such treatment for patients suffering from chronic pain, although many health maintenance organizations have been reluctant to pick up the tab, he said.

Getting insurance companies to pay for long-term pain-management treatmenthas been a battle, he said.

Insurance companies' reluctance stemmed, at least in part, from the fact that for years treating pain was not recognized as a sub-specialty by other physicians. Pain treatmentwas not recognized by the American Medical Association until 1986, although many doctors have been involved in pain management and treatment for 20 years.

Schuster said modern pain-management programs' high success rate in returning people to work or at least a functionallifestyle has led medical insurers and other medical professionals to begin to see a value in such programs.

Most of the patients seeking treatment at such centers suffer from pain in the lower back.

Schuster, who also serves as medical director at a similar pain center in Bowie, Prince George's County, said about 75 percent of his patients suffer from lower-back pain and another 15 percent suffer from neck or upper-back pain. About 9 percent suffer ongoing pain from an injury to a limb, and about 1 percent experience chronic pain from some form of cancer.


He said the breakdown varies from clinic to clinic, with some dealing primarily with cancer patients.

Medina saidthat, as an orthopedic surgeon, he sees a lot of patients with back and neck ailments, which explains why many patients referred to the clinic have such ailments.

But the center is equipped to treat patients with a wide range of problems, including headaches and shoulder,abdominal and arthritic pain.

Medina anticipates the center will become a regional facility serving Carroll, Frederick and Baltimore counties, as well as southern Pennsylvania. Other pain-management clinics in the area include the Bowie center run by Schuster and the Jacob and Hilda Blaustein Pain Treatment Center at the Johns Hopkins Hospital in Baltimore.