Pain Science Education

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 were discussing how to build a Stepped Care Model for the treatment and intervention of chronic pain. The Stepped Care Model for chronic pain originated in the VA health system and has been used in a number of other places. This model prioritizes the role of primary care providers in optimizing pharmacological management as well as the timely and equitable access to patient-centered evidence-based non-pharmacologic approaches. Joining us to discuss this model is Dr. Matthew Bair. His principal research focuses on chronic pain, psychological comorbidity, and developing strategies to improve pain management in the primary care setting. He has a strong background in conducting clinical trials, developing and testing interventions that combine pharmacologic and non-pharmacologic treatments, and his funded work often contrasts pharmacological and behavioral approaches for pain management. He has served on several national Veterans Affairs committees related to improving pain management as well as the Clinical Practice Guideline Committee at the American Pain Society. He serves as an Editorial Board Member for Pain Medicine and the Journal of General Internal Medicine. In this episode, you will learn all about a Stepped Care Model for Chronic Pain, the effectiveness of a Stepped Care Model, and the impact of chronic pain amongst veteran populations. Without further ado, let’s begin and let’s meet Dr. Matthew Bair and learn about a Stepped Care Model for 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

In this episode, we are discussing an important reimbursement issue related to physical therapy, as well as pain care in general. That is value-based healthcare. Value-based healthcare is a healthcare delivery model in which providers, including hospitals, as well as practitioners, are paid based on the patient's health outcome. This model differs from the traditional fee-for-service or a capitated approach in which providers are typically paid based on the amount of services they deliver. Joining me on this episode to discuss the trend of value-based healthcare, specifically in the physical therapy profession, is Dr. Alice Bell.   She earned her Doctorate in Physical Therapy Degree from the University of Montana. Now is on staff as a Senior Payment Specialist in the Public Affairs Unit of the American Physical Therapy Association. Her professional activities include serving as a member of the Centers for Medicare Technical Expert Panel for alternative payment systems, the CPT Editorial Panel, and is an APTA appointee to the NDHI Opioid Crisis Workgroup. She has been involved in bundled payment projects and exploring the alternative practice and payment model efforts focused on early and direct access to physical therapy.   In this episode, you will learn all about value-based healthcare, where value-based care intersects with the biopsychosocial approach to pain. Also, how physical therapists can assess their readiness for participating in an alternative payment model and how physical therapists can play a more central role in addressing pain in the US healthcare system. Without further ado, let's begin and let's learn about values-based healthcare with Dr. Alice Bell. 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 how to use functional nutrition to treat and alleviate chronic musculoskeletal pain. My guest is Aparna Natarajan. She is a Certified Nutrition Specialist with a Master's degree in Nutrition and Functional Medicine. She is a clinician, a researcher, and an educationist who has contributed to the Institute for Functional Medicine's Meal Planning Program as a subject matter expert. She's cultivated an understanding of the mind-body connection and combines both the science, as well as the art of nutrition, Reiki, and emotional freedom technique.   We will discuss the importance of nutrition and overcoming chronic pain, as well as the benefits of an elimination diet for those living with chronic pain. If you enjoy this episode, make sure to stay tuned because I have a perspective paper that is being published in PTJ, the Journal of Physical Therapy, on the topic of nutrition and chronic pain, specifically for the physical therapy professional, though it relates to other professions as well.   That's moving through the peer-review process. For those of you that have published before, as you know, sometimes that can be a bit of a slow process but it will be out, rest assured, hopefully, sometime in early 2022. For now, let's begin and meet Aparna and learn about the importance of nutrition for 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

Welcome back. We're discussing how to beat cancer holistically with Chris Wark. Chris is a cancer survivor, a best-selling author, and a patient advocate. He was diagnosed with Stage 3 colon cancer at the age of 26. After surgery, Chris made the decision to go against his doctor's advice, opted out of chemotherapy, and chose to use nutrition as well as other natural therapies to heal. Chris has become one of the most well-known cancer survivors on the planet and reaches millions of people per year as a blogger, podcaster, speaker, as well as a global health coach. In this episode, we'll discuss how to beat cancer primarily by using nutrition and other lifestyle-based interventions. Without further ado, let's begin and let's meet Chris Wark. 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're talking about pain education and specifically asking the question, "What do patients value learning about pain?" Our expert guest is physiotherapist and pain researcher Hayley Leake. After working clinically for six years, Hayley embarked on a PhD mission at the University of South Australia with Professor Lorimer Moseley's research group. Her research aims to optimize pain education for adolescents and adults living with chronic pain. Pain education is a popular treatment approach for treating persistent pain that involves learning a variety of concepts related to pain and is thought to be an important part of recovery. In this episode, we discussed targeted concepts and themes that seem to be the most important of value to those living with chronic pain when delivering a pain education intervention. Without further ado, let's begin and meet Physiotherapist and Pain Researcher, Hayley Leake. 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

We have an important episode. We're discussing the association between chronic pain and suicide. The information you'll learn in this episode may help you screen for the risk of suicide more effectively. It may help you effectively treat suicide, and by learning and sharing this information, you may save a life. According to the American Foundation for Suicide Prevention, suicide is the tenth leading cause of death in the United States. In 2019, approximately 48,000 Americans died by suicide. In that same year, there were an estimated 1.4 million suicide attempts. Chronic pain is a risk factor for suicide, and research indicates that chronic pain is present in about 10% of those who die by suicide. It's important as licensed healthcare professionals and loved ones of those who live with chronic pain that we learn how to ask the right questions, assess for risk factors, and intervene to help prevent suicide rates. In a few moments, you'll meet Clinical Psychologist, Dr. Joan Rosenberg, who has conducted research in the field of suicide, as well as treated patients in her clinical practice. Before we begin, I wanted to provide you with some information to effectively ask, assess, and intervene in those you feel may be at risk for suicide, especially those who live with chronic pain. First, I'd like to provide you with a shortlist of factors that may increase the risk of suicidal behavior among people living with chronic pain. If you're a healthcare professional, these might surprise you because we see common risk factors almost every day when we treat people with chronic pain. The first one is insomnia. Insomnia is common among people living with pain and also associated with an increased risk of suicide. The next is an over-reliance on passive coping strategies when you recognize or observe that someone is hoping their pain will go away from these passive coping strategies, increasing their risk of suicide. The next is pain catastrophizing, a topic we've talked about in-depth on this show. All of us are well aware of the catastrophizing pain scale, and there are also other scales and self-report measures that identify catastrophizing. It's very important that we include that in our initial paperwork. The next is prescription pain medication access when other factors are present. We're talking mostly about opioids here. It's not just if someone is taking opioids. There have to be several other factors. The factors that you learned about now present. As we're talking about prescription medication, always be on the lookout for what they call the triple threat, which is opioid, anti-anxiety medication, and alcohol use disorders. Those three together, people oftentimes overdose as well as an increased risk factor for suicidality. There are specific pain diagnoses that have been associated with an increased risk, specifically chronic lower back pain. The diagnosis of psychogenic pain, which is medically unexplained pain or medically explained physical symptoms as well as migraine, those three, chronic lower back pain, psychogenic pain, and migraines. Feelings of helplessness or hopelessness, individuals who will feel that they can do nothing to change or impact their pain and believe that positive outcomes are not possible for them may be at an increased risk for suicide, and then finally isolation or perceived burdensomeness. Oftentimes these go together. If you recognize or identify distressed and interpersonal relationships where someone feels like they are a burden to others or express feelings of not belonging, these are associated with an increased risk of suicide. Suicide can look and sound a lot like depression. It's important that we screen for depression. We all know that depression rates are high in those living with pain. There's a simple way that you can screen for depression in your clinical practice, no matter what type of health professional you are. That's with the PHQ-9, Patient Health Questionnaire-9. It's readily available online if you google Patient Health Questionnaire-9. This is a multipurpose instrument for screening, diagnosing, monitoring, and measuring the severity of depression. It includes nine questions. What's great about this is not only does it screen for depression but question number nine is a single screening question on suicide risk. A patient who answers yes to question nine needs further assessment for suicide risk by an individual who is competent to assess this risk that may or may not be you. Hopefully, by the end of this episode, you will realize that screening for suicide is possible. What I also like about the PHQ-9 is it gives you a couple of different cutoff points for mild, moderate, moderately severe, and severe depression. With those cutoff points, it recommends proposed treatment action for each cutoff point. It's Patient Health Questionnaire-9, super simple, nine questions to screen for depression. Question number nine is specifically for suicide risk. With some of that background information, let's bring in our expert guest, Dr. Joan Rosenberg. Dr. Rosenberg is a cutting-edge psychologist known globally as an innovator in the field of mental health. She is a two-time TEDx speaker and serves as a blogger for Psychology Today and has been a featured expert in multiple documentaries on television and radio. As a licensed psychologist, Dr. Rosenberg speaks on how to build emotional strength and resilience, psychotherapy, and suicide prevention. She's a Professor of Psychology at Pepperdine University in Los Angeles, California, as well as maintains an active clinical practice. This episode aims to create a roadmap or a blueprint for assessing and intervening with suicide. Without further ado, let's begin and learn about this important topic and meet Dr. Joan Rosenberg.   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

We explore how overweight and obesity are linked with persistent pain and the importance of physical therapists promoting combined nutrition, exercise, and weight loss programs when treating chronic pain syndrome. Joining us as an expert guest is Anneleen Malfliet. She is an Assistant Professor, Postdoctoral Researcher, and a member of the Pain in Motion international research group. Research in clinical investigations centers on chronic pain with a special interest in spinal pain, central sensitization nutrition, and diet. In this episode, we will explore the broader lifestyle perspective when considering the link between obesity and chronic pain, how a clinician can assess the presence of obesity or be overweight. Finally, how to approach weight reduction and organize a weight management program in clinical practice. There is a lot packed into this episode. You will gain a lot from the information and data that Anneleen has around the impact of obesity on chronic pain. Let's begin and meet Anneleen Malfliet.   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

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're exploring the concept of interoception, and how it impacts both physical and mental well-being. Interoception can be defined as one sense of their internal state of the body. This is a full-body sensory experience that has both a conscious as well as a subconscious or semi-conscious layer to it. As practitioners, we're able to train the sense just as we would train balance or proprioception. Interoception includes the brain's processing of signals relayed up from the body into specific sub-regions of the brain, such as the brainstem, the insula and the somatosensory cortex. This felt a sense of our body, its organs, and all of our physiologic processes allow for specific, as well as subtle or nuanced representation of our emotional and physical state. Interoception is important for maintaining homeostasis in the body. It improves one’s self-awareness or body awareness. It's a critical component of mindfulness training, especially when you're working with body-based conditions, such as reversing chronic pain or releasing trauma. Both have important ties to interoceptive processing. Training interoception, which we can also term as this eighth sense, is often left out of both physical and mental health treatment for chronic pain. Joining us to speak about interoception is Occupational Therapist Kelly Mahler. She an Occupational Therapist, serving school-aged children and adults and is a winner of multiple awards, including the 2020 American Occupational Therapy Association Emerging & Innovative Practice Award. Kelly is a principal investigator in several research projects pertaining to interoception, self-regulation, trauma, and autism. In this episode, we'll further define interoception, how it can be used in clinical practice and how interoception has an influence on chronic pain and other chronic disease conditions. Without further ado, let's learn about this eighth sense of interception and let's meet Dr. Kelly Mahler.   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