Pain Science Education

Peripheral neuropathy is the result of damage to the nerves located outside of the brain and the spinal cord. People who have this condition typically suffer from persistent long-term pain as well as other symptoms. There is no shortage of conventional treatments for neuropathy, but these do not address the condition at its root. Over the years, integrative approaches have become more popular in treating both diabetic and chemo-induced neuropathy, and there is a strong evidence base to back their use.  Heather Carlyle, PT, DPT, FIPSI, specializes in using integrative and lifestyle medicine in her physical therapy practice. Heather has a passion for helping people improve their quality of life in a natural way. She created Path to Less Nerve Pain , a hybrid online health education program that she developed to treat and reverse neuropathy. In this conversation with Dr. Joe Tatta, Heather discusses the different components of her program. She also talks about the causes of neuropathy, its symptoms, and the various traditional, complementary alternative and integrative medicine approaches that can be used for its treatment.

My guest is Dr. Anabela Silva. She is a Physiotherapist as well as an Adjunct Professor and the Director of the Physiotherapy Program at the University of Aveiro in Portugal. Her research interests include the effectiveness of pain, neuroscience education, exercise, and the exploration of factors associated with the onset of pain and the maintenance of pain in children and adolescents. We'll discuss some of her recent investigations regarding pain and children and adolescents. We'll discuss the specific factors associated with the onset, the persistence of musculoskeletal pain in children and adolescents, and how to assess and identify these factors at an early age. Without further ado, let's begin and let's meet Dr. Silver and learn about pain in children and adolescents.

In my profession of physical therapy, the lack of gay, lesbian, bisexual, transgender, and queer-specific education has given rise to deficiencies in our cultural competence and our humility. When deficiencies exist in a profession’s educational system, as well as its continued education system, it can create a climate of discrimination and disparity. This ultimately leads to decreased access to health and effective healthcare. In the context of chronic pain, which is what we discuss on this show, LGBTQ+ people are more likely to suffer from a long-term chronic pain condition than heterosexuals. To begin this episode, I would like to share with you a couple of reasons why this community or this population of people experience more pain before we meet our expert guests. The first reason is that a larger portion of the LGBTQ+ community lacks access to health insurance or lives in poverty, more so than their heterosexual counterparts. They’re more likely to delay medical care or, at times, just forgo it completely because they can’t afford it or they simply just don’t have access to quality healthcare.

We are discussing the power of peer support and group learning and chronic pain recovery. My expert guest is Dr. Amber Richard Bauer. Amber is a doctor of Physical Therapy focusing on Chronic Pain Recovery and Pain Education. She's also a certified instructor for Empowered Relief and a facilitator for mental health ten-week virtual pain care program. Amber uses elements of Acceptance and Commitment Therapy, Cognitive Behavioral Therapy, Pain Neuroscience, Education, and Mindfulness paired with her knowledge as a Physical Therapist to help clients recover from chronic pain and return to living meaningful lives.   Amber is a lifelong dancer and a believer in the power of the mind-body connection to heal from chronic pain, trauma, as well as illness. In this episode, you will learn about the benefits of group training for people with chronic pain, why it's important for people with pain to get support from other people, dealing with a similar condition, and the role of a licensed health professional in facilitating group care.   At the beginning of this episode, we talk about Amber’s journey, both her educational journey from being a dancer to a physical therapist through psychologically informed care and then back as well as her personal experience in living with and overcoming chronic pain, which we know is vitally important. Without further ado, let's begin and meet Dr. Amber Richard Bauer.   Love the show? Subscribe, rate, review, and share! Here’s How » Join the Healing Pain Podcast Community today: integrativepainscienceinstitute.com Healing Pain Podcast Facebook Healing Pain Podcast Twitter Healing Pain Podcast YouTube Healing Pain Podcast LinkedIn Healing Pain Podcast Instagram

It is great to be here with you again. In each episode, we generally discuss the impact of physical therapy treatments on the management of chronic pain and other chronic diseases. From there, we have explored other overlapping problems and conditions, such as things like opioids, the over-prescribing of opioids or addiction, and the movement to choose physical therapy as an alternative to opioid medication. A clear movement also exists for a physical therapist to play a more pivotal role in treating and managing non-communicable diseases such as diabetes, metabolic syndrome, hypertension, and cardiovascular disease. This should not be too much of a leap because, as physical therapists, we have had a specialty in cardiopulmonary physical therapy for many decades. Something happened during the COVID-19 pandemic which changed our profession as well as changed our personal lives. America’s mental health declined, with anywhere between 28% to 40% of adults struggling with depression during the height of the pandemic. Many of those numbers have stayed consistent. More people have been prescribed antidepressant medications and the mental health care shortage intensified with many providers in clinics having waitlists of 4 months to 1 year, which left many people without essential healthcare or mental health care services. As licensed doctoral trained healthcare professionals, we, physical therapists, whether realize it or not, see people with mental health concerns daily in almost every practice setting. Our profession, like many others, has begun to advocate for ways to improve mental health and mental well-being. We now know that the epidemic of depression requires a supporting role by physical therapists. The reason is that the influence of physical therapy extends way beyond the physical benefit. It improves mental health and promotes mental well-being. Screening and addressing behavioral and mental health concerns are within the scope of physical therapy practice guidelines. The American Physical Therapy Association published these guidelines in 2020 in the House of Delegates’ position statement. This position is generally in line with the best evidence and the growing trend in psychological uniform physical therapy, which incorporates bio-psycho-social treatments for chronic pain and other health conditions. A few decades before the American Physical Therapy Association published these guidelines, there was the International Association for Physical Therapy and Mental Health, which is a sub-chapter of the World Confederation of Physical Therapy, which described the need and scope of physical therapy and mental health, behavioral health, and psychiatry. What we are seeing is the construct of psychologically informed physical therapy is the same, similar to, or compliments mental health physical therapy, which is used to facilitate body awareness, problem-solving skills, cognitive restructuring, and ways to cope, which reinforce self-efficacy and improve quality of life in the face of poor mental health. It would then appear inherent that a physical therapist can use biomedical treatments as well as psychosocial treatments based on their key role in reducing disability and fostering positive human growth. Occasionally, as physical therapists, we sell ourselves short and fail to understand the depth and the breadth of the impact we can have on someone’s quality of life. What I am referring to is the emotional and psychological benefits that can increase the value of care that we provide as individuals and as a profession. Now more than ever, it is important that we understand and explain the breadth of the therapeutic benefits that we provide because studies demonstrate that approximately a quarter of all Americans may have a mental health condition. 25% to 50% of patients in a general outpatient physical therapy clinic have a mental health condition and upwards of 70% of patients with low back pain that report to physical therapy have some level of depression. We are already seeing this in practice. There is a place for us to be primary care and entry point providers into the mental health care system. However, that does not mean that we simply “refer out.” It means that. As professionals, we stay engaged in patient care, and we continue to play a role independently or in the code management of the mild, moderate, and severe depression or other mental health conditions that exist in the populations of patients that we treat. In fact, there is some literature that mild to moderate depression improves over the course of physical therapy, regardless of whether or not a mental health provider is engaged in the plan of care. How can that be or why is that? It is because movement, body awareness, physical activity, exercise, and many other interventions that we use as professionals are a catalyst for positive mental health and improved psychological well-being. When you combine physical activity with cognitive reappraisal, there is generally a greater impact on outcomes and the quality of life of the patients that you care for. Joining us to discuss the role of the physical therapist in treating depression is Dr. Tony Varela. He is a physical therapist who brings many years of experience in musculoskeletal health, including pain management. His professional principles were paved through residency and fellowship, grounded and rich patient experiences, and reinforced by serving those surviving chronic pain, cancer, as well as trauma, and PTSD from war. He believes there is a better version of ourselves ready to push through and he is an Assistant Professor at Arkansas College of Health Education. Tony authored a paper in the February 2022 edition of Physiotherapy Theory and Practice called The Theatre of Depression: A Role for Physical Therapy, which we will discuss in this episode. Without further ado, let’s begin. Let’s meet Tony and discuss the role of physical therapy in the treatment of depression. Love the show? Subscribe, rate, review, and share! Here’s How » Join the Healing Pain Podcast Community today: integrativepainscienceinstitute.com Healing Pain Podcast Facebook Healing Pain Podcast Twitter Healing Pain Podcast YouTube Healing Pain Podcast LinkedIn Healing Pain Podcast Instagram

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It's great to be here with you. Thanks for joining. In this episode, we are discussing a new assessment tool to guide behavior change, which is called The Physical Therapy Healthy Lifestyle Appraisal. It was developed by Dr. MarySue Ingman, who you will meet in a couple of moments. This is the first validated assessment tool for a physical therapy practice, where we can look at nutrition, physical activity, stress, sleep, and tobacco use. What I like and appreciate about this tool is that it's quick, easy, fits well into physical therapist practice, and especially if you are using integrative or lifestyle medicine approaches to treat chronic pain or chronic disease management.   Let me share a little bit about our guest. Dr. MarySue Ingman is an Associate Professor in the Doctor of Physical Therapy Program at St. Catherine University in St. Paul, Minnesota. Her research interests include the role of a physical therapist, health promotion, and clinical practice. She's published studies on motivational interviewing and the role of physical therapists in health promotion and wellness. In this episode, you will learn a lot about counseling, assessment, and the science of behavior change. In fact, this episode is a sneak peek into some work that all of us have been working on for years. Some of you may know that I co-edited a textbook. That textbook is called Integrative and Lifestyle Medicine in Physical Therapy. My co-editor was another physical therapist, who you might know, whose name is Dr. Ginger Garner. In that textbook, we invited about 40 physical therapy professionals, researchers, and educators, to contribute to this book on Integrative and Lifestyle Medicine in Physical Therapy. Chapter 3 in this textbook, which is called Coaching, Counseling, and the Science of Behavior Change, was written by MarySue and her colleague, Dr. Janet Bezner, a Professor in the Department of Physical Therapy at Texas State University. That textbook is on track to come out soon. We are excited because we think that this will be useful for physical therapy educators, as well as clinicians who are using integrative and lifestyle medicine in physical therapy. As I mentioned, Chapter 3 is written by MarySue, where we go into Coaching, Counseling, and the Science of Behavior Change, which we will discuss in this episode. Without further ado, let's begin and learn about the Physical Therapy Healthy Lifestyle Appraisal and meet Dr. MarySue Ingman.   Love the show? Subscribe, rate, review, and share! Here’s How » Join the Healing Pain Podcast Community today: integrativepainscienceinstitute.com Healing Pain Podcast Facebook Healing Pain Podcast Twitter Healing Pain Podcast YouTube Healing Pain Podcast LinkedIn Healing Pain Podcast Instagram

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We have a new topic that we are highlighting on the show. We are discussing resilience and growth after trauma, also known as post-traumatic growth, which is a theory that explains the positive human transformation that can occur after any type of physical trauma, psychological or emotional trauma, spiritual trauma, or even after struggling with a prolonged illness. Joining us to discuss trauma and post-traumatic growth is Dr. Melissa Zeligman. She is an Assistant Professor of Counseling Education at the University of Central Florida. Prior to her Doctorate, she served as a mental health counselor working in the agency, medical, legal, as well as high school settings. Her research focuses on trauma work, including the experience of post-traumatic growth. Positive growth or post-traumatic growth is something that interests me, especially within the context of treating people with chronic pain or other chronic health conditions that we see in physical therapy or other physical medicine or rehabilitation settings. You are going to learn a lot about this topic. Hopefully, you will embrace it as much as I have in both clinical practices and become very interested in the research. If you are interested in learning more about a trauma-informed approach to treating chronic pain, make sure to check out our course at the IntegrativePainScienceInstitute.com called Trauma-Informed Pain Care, where you will learn how to treat trauma from a trauma-informed perspective for people living with chronic pain. Without further ado, let’s begin and learn all about post-traumatic growth. Love the show? Subscribe, rate, review, and share! Here’s How » Join the Healing Pain Podcast Community today: integrativepainscienceinstitute.com Healing Pain Podcast Facebook Healing Pain Podcast Twitter Healing Pain Podcast YouTube Healing Pain Podcast LinkedIn Healing Pain Podcast Instagram  

In this episode, we are discussing the latest evidence which supports the use of a ketogenic diet and its potential impact on pain and central nervous system sensitization. My guest is Dr. Rowena Field. She is a physiotherapist with many years of experience, primarily in chronic pain management. We discussed the results of her recent PhD dissertation, where she investigated the use of a ketogenic diet for the treatment of chronic pain and now incorporates this approach in her physiotherapy practice. We will discuss how a ketogenic diet impacts pain, blood biomarkers, and quality of life for patients with chronic pain and other chronic health conditions. This is sponsored by the Functional Nutrition for Chronic Pain Practitioner Certification. In this training, you will learn how to apply diet and nutrition for multiple chronic pain syndromes, including how to use a ketogenic diet for the treatment of chronic pain. Without further ado, let's begin. Let’s meet Dr. Rowena Field and learn about how a ketogenetic diet impacts chronic pain   Love the show? Subscribe, rate, review, and share! Here’s How » Join the Healing Pain Podcast Community today: integrativepainscienceinstitute.com Healing Pain Podcast Facebook Healing Pain Podcast Twitter Healing Pain Podcast YouTube Healing Pain Podcast LinkedIn Healing Pain Podcast Instagram