Modern Pain Science Webinar: A Recap

Thank you to all that were able to attend the webinar “Modern Pain Science”, presented by Upstream on May 18th. The course was presented by Upstream’s Director of Workers’ Comp Quality and Education Chris Scoma and Vice-President of Employer Solutions Brian Murphy. Whether you were you able to attend or not, we thought it would be valuable to provide a recap of the key points that were discussed.

The course first covered the definition of pain and discussed the difference in pain versus nociception. Pain was defined as a distressing experience associated with actual or potential tissue damage with sensory, emotional, cognitive, and social components. The perception of pain is real, whether or not harm has occurred or is occurring and our thoughts and emotions are involved in the formulation of this perception. It is important to understand that pain is more than just a physical response.¹

Pain involves more than just nociception, which is purely the neural encoding of a noxious stimulus, whether it is mechanical, thermal, or chemical in nature. This understanding of pain differs from our old understanding of the pain response, which posited that pain was purely an output based on the intensity of the noxious stimulus. We now understand that pain is the output after the stimuli are put through a variety of filters, and pain only occurs if that analysis is determined to be a priority to our body.

The course then went on to define what role Physical Therapy can have in assisting with patients in dealing with pain. Some of the most commonly understood Physical Therapy interventions can assist patients when dealing with their pain. These include manual therapy, exercise, modalities, trigger point dry needling, and taping techniques.

What is commonly underappreciated is the therapists’ ability to listen and educate patients that are in pain. Most importantly is to take a biopsychosocial approach to patient care versus a biomedical approach. A biomedical approach focuses on a structural or pathoanatomical explanation for pain generation, versus a biopsychosocial approach that recognizes pain is a consequence of the interaction of various social, psychological, and biological factors. ²

A Physical Therapist can employ numerous strategies to address their patient’s pain from a biopsychosocial perspective. These include assuring the patient that pain does not necessarily mean there is tissue damage and to provide the patient with reassurance in their body’s ability to heal itself. The therapist should also maintain consistent messaging and avoid any fear-inducing messaging that feeds in to the patient’s perception of pain and tissue damage. These strategies are particularly important when working with patients in the workers’ compensation system.

It is also important to educate injured workers on the importance of continuing to work in some capacity during their rehabilitation, as numerous studies have cited that continuing to work during an injury facilitates an improved functional outcome and a quicker return to full duty.³

Once again, we hope that those that attended found the course educational while taking away some practical applications. If you were unable to attend we hope you can join us for our next CEU webinar in September. Please watch for more information to come.

To learn more about Upstream Rehabilitation or request information, click here.

1. Amanda C. de Williams, Kenneth D. Craig Updating the definition of pain Pain J. 157 (2016) 2420–2423
2. Beales D, Fried K, Nicholas M, Blyth F, Finniss D, Moseley GL. Management of musculoskeletal pain in a compensable environment: Implementation of helpful and unhelpful models of care in supporting recovery and return to work. Best Pract Res Clin Rheumatol. 2016;30(3):445-467. doi:10.1016/j.berh.2016.08.011
3. Noonan, J., & Wagner, S. L. (2010). A biopsychosocial perspective on the management of work-related musculoskeletal disorders. AAOHN Journal, 58(3), 105-114.