This 8-week online interactive course is designed for any clinician treating patients with pain. Patients with persistent pain often represent our most frustrating and challenging times in the clinic and across the health care system. As this population grows so grows our prescription opioid epidemic and our need for effective conservative and non-pharmacological approaches to helping this population. The primary objective of this course is to create a strong foundation in a neurophysiological approach to treating the painful patient.
Each unit of this course will cover key concepts in understanding and treating persistent pain. We will cover, in-depth, the physiologic basis of the experience of pain from nociception to cortical processing. Special attention will be paid to concepts of neuroplasticity, both adaptive and mal-adaptive, at all levels of the nervous system. In depth discussions of context, expectations, and language will lead into subjective and objective evaluation techniques for this population. We will discuss how to create individually designed, psychologically informed treatments that emphasize adaptive neuroplastic changes and return to function. Specific treatment modalities such as therapeutic neuroscience education, laterality training, discrimination training, desensitization, mirror boxes, graded motor imagery, graded exposure, and pacing will be discusses as well as concepts around meditation, breathing, stress reduction/coping strategies, and sleep hygiene. Lastly we will cover special topics such as fibromyalgia and CRPS. There will periodic live online discussions to discuss specific patients, questions from the readings, and bring clinical context to the material.
At the end of this course participants will have a deep understanding of the individual experience of pain, how pain becomes maladaptive, and a true understanding of the patient with persistent pain. Participants will be able to structure evaluations around the patient presentation and design evidenced based psychologically informed intervention to move patients towards independence and improved quality of life.
- 8 weeks long - 2 hours/week commitment
- Lifetime access to course & online community
- Conference calls every 2 weeks
Week 0 (Course Start Date)
- Course Orientation
Week 1: Understanding Pain
- Adaptive Pain Physiology
- Pain Modulation
Week 2: Understanding Plasticity
- Beliefs and Expectations
Week 3: Evaluation
- Subjective Exam
- Objective Exam: A Pain Dominance Approach
Week 4: Peripheral Neuropathic Pain
- Treatment Of Peripheral Neuropathic Pain
Week 5: Central Sensitization Dominant Pain
- Treatment Of Central Sensitization
Week 6: Interventions For Central Sensitization
- Manual Therapy and Persistent Pain
- Interventions For Neuroplastic Change
Week 7: Sleep, Stress, And Pain
- Sleep and Pain
- Stress and Pain
Week 8: Pulling It All Together
- Case Integration
- Participants will have a deep understanding of the physiology of pain and to distinguish between adaptive and maladaptive pain physiology.
- Participants will understand the impacts of both patient and provider beliefs and expectations on outcomes and physiology.
- Participants will be able to identify the key characteristics of nociceptive dominant pain, peripheral neuropathic dominant pain, and centrally dominant pain.
- Participants will be able to design and perform a subjective and objective exam unique to the patient with respect to their pain dominance classification.
- Participants will be able to know when and how to perform neurodynamic testing
- Participants will be able to know when and how to perform objective measures specific to central sensitization dominance (i.e pain pressure threshold, 2 point discrimination, etc).
- Participants will be able to design a treatment plan and progression for patients of peripheral neuropathic dominance.
- Participants will be able to design a treatment and progression for patients of central sensitization dominance.
- Participants will understand the contributions of chronic stress and sleep dysfunction to the experience of pain.
- Participants will be able to design and implement plans to reduce maladaptive stress and improve sleep hygiene.