Physicourses Pain

The Neuroscience of pain, the brain, athletes and sports performance by EIM

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 controlssports 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.

Social Determinants of Pain by EIM

Social determinants of health (SDOH) have shown to have a major impact on peoples health, well-being and quality of life. Physical therapy as a profession has acknowledged this and now educational content and sessions aim to teach therapist about SDOH as well as strategies to positively impact these SDOH. What about pain specifically? Pain is an individualized, unique human experience. This experience is what brings someone to physical therapy seeking care. What social determents impact pain specifically? What can be done for it? Do current physical therapy-led interventions lean itself to issues with safety, transportation, education, income, discrimination, violence, literacy and more? Sure, a combination of education, exercise and strategies to calm the nervous system is current best-evidence for pain management, but how do we deliver it when the playing field is not even? This session will delve into various complexities about pain including social support, employment, gender roles, culture and ethnicity, nature versus nurture, socioeconomic factors and more. Apart from recognizing these factors and how they impact a pain experience, this session will take current best-evidence strategies for pain management by physical therapy and showcase strategies to implement these in the face of social determinants of health, or pain.

Pain Science: Hands On or Hands Off by EIM

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.

Examination and Treatment of Cervical Radiculopathy and Neuropathic Arm Pain by EIM

Neuropathic pain is one of the most challenging clinical conditions encountered by physical therapists. Old, mechanical compression models of nerve injury are now superseded by a neuroscience understanding of neuroinflammation, vascular and immune changes, cytokine signaling, demyelination, and ion channel expression. Clinically, advances have been made into the examination of neuropathic pain with advanced sensory testing, neurodynamics, and clinical cluster-recognition. This newfound understanding of nerve pain has shown how movement-based professions such as physical therapy can effectively treat neuropathic pain. Using cervical radiculopathy and arm pain as an example, speakers will update attendees' knowledge of neuropathic pain, including double-crush phenomenon; how to test and screen for it; and how to build a comprehensive treatment plan. Treatment discussed will include manual therapy, exercise, neurodynamics, pain neuroscience education, graded motor imagery, and more.

Chronic Whiplash Associated Disorders and Pain Science by EIM

Chronic pain after a motor vehicle collision (MVC) is very common with an estimated 30% of patients developing persistent pain and disability. New emerging science show that post-traumatic stress disorder (PTSD) symptoms of hyperarousal, re-experiencing the accident, avoidance and numbing is very common in chronic whiplash-associated disorders. The addition of PTSD symptoms, along with well-described comorbid depression and anxiety may indicate why traditional, tissue-only focused physical therapy treatments struggle to produce successful outcomes. Newly designed psychologically informed treatments aiming at fear-avoidance, pain catastrophizing, trauma, depression, anxiety, and PTSD-symptoms have shown some potential benefits alongside physical treatments offered by physical therapists. The use of these psychologically informed treatments, along with movement-based treatments of exercise and manual therapy may hold the key to a more successful outcome. New research shows that patients in MVCs prefer psychologically informed treatments delivered by physical therapists, versus psychologists and overall prefer it over a pharmaceutical approach to their pain. This session will discuss the various factors associated with poor outcomes, screening tools that should be used by clinicians and various treatments to help decrease pain and disability.

The Latest Integrative Research and Approaches in the Successful Treatment of Chronic Pain Conditions

Brian Trzaskos, PT, LMT, CSCS, CMP, MI-C

The National Institute for Health reports that 25.3 million Americans live with chronic pain, while health economists estimate that the cost of chronic pain in the United States is $635 billion annually. Current research is revealing the broad ineffectiveness of pharmaceutical strategies and strongly suggests that successfully treating the multifactorial nature of chronic pain requires an integrative, holistic approach including attention on key emotional, psychological, and behavioral factors. Integrative approaches including Tai Chi, breath-work, graded movement and mindfulness are widely recognized body- mind modalities and research supported, non- pharmacological approaches in treating chronic pain conditions.This course has been designed to outline the scientific and physiologic basis of key body- mind components, instruct simple integrative practices shown to be effective in remediating chronic pain, and review the evidence base for validating these approaches in the treatment of patients dealing with chronic pain conditions.Highlights Consistently improve painful symptoms, even in long standing issues Understand the coupled nature of emotional, psychological, and behavioral factors in dealing with chronic pain Immediately apply novel treatment approaches that organically increase patient referrals

Treating Shoulder Pain

Dr. Darren Smith, PT, DPT

The lifetime prevalence of shoulder pain is approximately67% with data suggesting these numbers continue to increase. Furthermore, data demonstrates a 50% patient recovery rate over 12-18 months with about half of patients experiencing recurrence within a year. This webinar will present how to analyze scapular dysfunction focusing on anatomical considerations to optimize patient outcomes. These include, but are not limited to, the contributions of muscle-length relationships and motor control in shoulder impairments. This course will outline how to analyze scapular impairments and provide corrective exercises. These techniques will be presented in a way that will allow you to immediately incorporate these concepts into your practice.Highlights Immediately improve your client's functional shoulder outcomes using practical treatment techniques Practical assessment and re-assessment strategies to treat common syndromes of the shoulder

Neck Pain

William Oswald, PT, DPT, OCS

The cervical spine presents unique challenges to rehabilitation professionals because of the varied and complex presentation of patients with cervical spine pain. Evaluation and treatment approaches vary amongst clinicians and can be improved by incorporating the current best evidence into clinical practice. This course will provide professionals with the knowledge needed to properly evaluate and treat patients with symptoms commonly found in the cervical spine.Highlights Immediately improve your examination and treatment strategies for the cervical spine Incorporate the current best evidence into the treatment of cervical spine pathologies Effective, evidence-based interventions for a common diagnosis

Cervicogenic Headache: Evaluation and Treatment Strategies

William Oswald, PT, DPT, OCS

The prevalence of cervicogenic headache has been reported to be as high as 20% of the headache population. The diagnosis of cervicogenic headache can be challenging due to the potential overlap with more serious conditions along with the unique quality and behavior of symptoms. When cervicogenic headaches are assessed systematically, it can become much less daunting. In this course we will provide evaluation and treatment strategies to manage this condition safely and effectively.Highlights Improve your examination and treatment for cervicogenic headaches Review and discuss potential causes of cervical and head symptoms Effective, efficient, evidence-based interventions for headaches related to cervical spine pain