This course is addressing chronic musculoskeletal pain. This is pain that extends beyond normal tissue healing time frames of the inflammatory, proliferative, and remodeling phases that is not related to systemic or rheumatic pathologies which are not amenable to physical therapy intervention. This presentation can benefit physical therapists and physical therapist assistants that are treating chronic musculoskeletal pain, and it demonstrates that the drivers of pain are often times related to multiple factors that are unrelated to the objective debility level (i.e. radiographic OA levels). This presentation will address the benefits and physiology of exercise, manual therapy, and side-effects of immobilization on chronic pain. This presentation will also provide specific exercise guidelines, but will raise awareness on the different classifications of pain according to a journal article by smart et al., and the spectrum of pain that chronic musculoskeletal patients fall under. The different pain classifications include: nociceptive pain, peripheral neuropathic pain, and central sensitization. Additionally, this presentation will expand on the role of pain science education in chronic pain patients and the importance of promoting wellness behaviors.
Target Audience : Physical Therapists and Physical Therapists Assistants.
Instructional Level: Beginner/Intermediate
Course Objectives
After completing this course the learner will have a better understanding of the following:
} 1. The relevant epidemiology and the current evidence on the etiology of chronic musculosketal pain, and the evolution from the gate control theory of pain to a more comprehensive bio-psychosocial model of pain.
} 2. Normal tissue healing.
} 3. Differential diagnoses in order to rule out other pathologies.
} 4. The variations in pain types according to smart et al. nociceptive pain, peripheral neuropathic pain, and central sensitization.
} 5. The role of providing the patients with pain science education to reduce pain, and how increasing self-efficacy can reduce pain and increase function.
} 6. The ability of exercise and load to help the patient achieve their functional potential.
} 7. The role of manual therapy, and the evolution of osteopathic based manual therapy into modern manual therapy which takes into account the contribution of the central nervous system.
Table of Contents
Chronic Musculoskeletal Pain
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