Neuroscience of Pain: Education, Application, and Beyond

Messiah University will host a one-day event exploring a multidisciplinary approach to pain treatment open to medical professionals and students. Eligible participants are able to earn 7.75 pre-approved contact hours for the state of Pennsylvania (2 hours Direct Access Evaluative).

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Morning session
Pain Neuroscience Education: Teaching People about Pain

Pain is complex and new paradigms of pain, i.e., neuromatrix, nerve sensitivity, endocrine and immune responses to pain and neuroplasticity has opened various exciting non-pharmacological options in the treatment of pain. One such approach is altering what patients think and believe about their pain. It is well established that patients often have faulty beliefs regarding pain, which in turn may increase fear, catastrophization, pain and disability. The paradox is that patients are interested in pain; especially how pain works. Growing evidence supports that teaching patients more about the neurophysiology and biology of pain allows for decreased pain, increased movement and function, various decreased psychometric measurements, and higher compliance with therapy. This lecture, based on the latest neuroscience view of pain, aims to help healthcare providers update their knowledge of pain. Furthermore, the lecture will expose healthcare providers to a newly designed pain neuroscience education language used in various research projects and clinical practice with the aim to help patients achieve success. This session is a must for all healthcare providers dealing with people….in pain.

Objectives
Upon completion of this presentation, attendees will be able to:

• Analyze how common faulty cognitions impact pain and disability in people with pain
• Justify the need to carefully reanalyze the use of biomedical information to educate patients about pain
• Recognize the evidence supporting pain neuroscience education for people in pain
• Integrate the latest neuroscience of pain into clinical reasoning in people with persistent pain
• Verify how neuroscience education uses metaphors, examples, and pictures in an easy-to-understand format for people in pain
• Explain to a patient how the body’s alarm system, the nervous system, becomes increasingly sensitive; how it impacts function and how therapy can help.
• Apply concepts, treatments, and examples from the presentation into immediate clinical application

Morning schedule
8-8:30: The Pain and Opioid Epidemic
8:30-9:45: The Neuroscience of Pain
9:45 -10: Break
10-10:30: Evolution of and evidence for PNE
10:30-11:30: Teaching patients about pain: A clinical application
11:30-12: PNE+ - combining PNE with movement, exercise, manual therapy, etc.
12-1: Lunch

Early afternoon session
Pain Science: Hands-on or Hands-off?

With the increasing interest in pain neuroscience education (PNE) there has developed a potential clinical crossroad. PNE is a cognitive intervention, purposefully shifted away from the biomedical and anatomical model. In fact, current PNE research deliberately avoids biomedical education as means to “undo” traditional pain models. With this purposeful shift, many clinicians are left with the question: Is pain science hands-on or hands-off? This session will delve into the cohabitation of PNE and various physical treatments such as mobilization, manipulation, soft tissue treatments, dry needling and exercise. This session will showcase how PNE and physical treatments, especially manual therapy, can and should co-exist. Advances in the understanding of functional and structural changes in the brain shows manual treatments should cohabit with PNE as means to remap cortical maps, alter nociceptive input into the central nervous system, facilitating descending inhibitory mechanisms, etc. Furthermore, emerging PNE research has shown that a combination of physical treatment and PNE is superior to PNE-only approaches and furthermore, PNE can in essence decrease sensitization, thus providing a window of opportunity to introduce physical treatments. This session will additionally showcase the emerging models for choosing PNE and/or manual therapy in patients presenting to physical therapy.

Objectives
Upon completion of this educational session the participants will be able to:

• Recognize the potential crossroads of pain science being hands-on or hands-off
• Develop a working knowledge of how pain science and hands-on treatments can cohabitate
• Use various screening tools pertaining to psychosocial risk factors, pain mechanisms and sensitization to make a clinical judgement on the use of manual therapy and pain neuroscience education
• Conceptualize manual therapy in terms of neuroplasticity, sensory discrimination and graded exposure
• Immediately apply the information from the educational session into clinical practice

Early afternoon schedule
1-1:30: Traditional orthopedic model and pain
1:30-2: Pendulum shift: It’s all about the brain!
2-2:30: Pain Science AND manual therapy, not OR manual therapy
2:30-3: The brain has a body – taking it to the clinic
3-3:15: Break

Afternoon session
The neuroscience of pain, the brain, athletes and sports performance

Pain is common in athletes. Most therapeutic interventions focus on structural tissue-based issues in terms of tests and treatment. Pain, however, is far more complex. It is now well understood that the brain is extremely busy during a pain experience – the same brain that controls…sports performance. This lecture will update attendees on the latest neuroscience of pain, with an emphasis on structural and functional changes in the brain during a pain experience. Then, taking the knowledge of brain activation during a pain experience into consideration, various aspects of sports performance will be analyzed based on compelling new research: The brain activation between a novice and professional athlete is vastly different and how does pain impact this? Can the brain multitask? A brain processing pain puts increase demand on the energy supply of the brain; motor learning is strengthened during sleep; modulating vision enhances sports performance; what is optimal arousal for the brain? This session is a MUST for anyone interested in the advances in sports performance and the brain. This session will also provide attendees evidence-based strategies to influence the brain in immediate take-home tests and treatments including laterality training, sensory discrimination, neuroscience education, graded motor imagery, mirror therapy, etc.

Objectives
Upon completion of this educational session the participants will be able to:

• Understand how the brain processes pain
• Understand how an athlete dealing with pain, ultimately utilizes areas of the brain associated with sports performance, thus impacting their recovery
• Identify bio-psycho-social factors associated with the development of pain in athletes
• Develop strategies, based on the neuromatrix, graded motor imagery and pain neuroscience, on how to optimally treat athletes in pain
• Apply the information from the educational session into clinical practice

Afternoon schedule
3:15-3:45: The neuroscience of pain
3:45-4:15: Pain and athletes
4:15-5: Pain, sports-performance and the brain|
5-5:15: Summary, review and questions