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pain neurophysiology education

L C Alvaro-Gonzalez
INTRODUCTION: Migraine is a very common disorder with a raising incidence. The theory of evolution allow us to explain the emergence of the disorder, due to the advantages that the overreactivity to stimulus provided to ancestral groups of Homo sapiens, and a greater presence of the disorder in modern societies, based in the interactions with external factors. Herein we analyze these points. DEVELOPMENT: Design of organisms and their responses to environmental factors emerge to improve survival...
October 1, 2016: Revista de Neurologia
Seth Peterson, Cheri Hodges
BACKGROUND: Lumbar lateral shift (LLS) is a common clinical observation but has rarely been described in a patient with a history of lumbar surgery. The purpose of the current case report was to describe the use of the McKenzie Method of Mechanical Diagnosis and Therapy (MDT) in the multi-modal treatment of a patient with an LLS and a history of multiple surgical procedures in the lumbar spine, including interspinous process device (IPD) implantation. CASE DESCRIPTION: A 72-year-old female with chronic low back pain (LBP) and a surgical history in the lumbar spine was referred to physical therapy for radiating leg pain and presented with a right LLS...
September 2016: Journal of Manual & Manipulative Therapy
Emilio J Puentedura, Timothy Flynn
Teaching people with chronic low back pain (CLBP) about the neurobiology and neurophysiology of their pain is referred to as pain neuroscience education (PNE). There is growing evidence that when PNE is provided to patients with chronic musculoskeletal pain, it can result in decreased pain, pain catastrophization, disability, and improved physical performance. Because the aim of PNE is to shift the patient's focus from the tissues in the low back as the source of their pain to the brain's interpretation of inputs, many clinicians could mistakenly believe that PNE should be a "hands-off," education-only approach...
July 2016: Physiotherapy Theory and Practice
Adriaan Louw, Kory Zimney, Christine O'Hotto, Sandra Hilton
Teaching people about the neurobiology and neurophysiology of their pain experience has a therapeutic effect and has been referred to as pain neuroscience education (PNE). Various high-quality randomized controlled trials and systematic reviews have shown increasing efficacy of PNE decreasing pain, disability, pain catastrophization, movement restrictions, and healthcare utilization. Research studies, however, by virtue of their design, are very controlled environments and, therefore, in contrast to the ever-increasing evidence for PNE, little is known about the clinical application of this emerging therapy...
July 2016: Physiotherapy Theory and Practice
Amarins J Wijma, C Paul van Wilgen, Mira Meeus, Jo Nijs
Pain neuroscience education (PNE) is increasingly used as part of a physical therapy treatment in patients with chronic pain. A thorough clinical biopsychosocial assessment is recommended prior to PNE to allow proper explanation of the neurophysiology of pain and the biopsychosocial interactions in an interactive and patient-centered manner. However, without clear guidelines, clinicians are left wondering how a biopsychosocial assessment should be administered. Therefore, we provided a practical guide, based on scientific research and clinical experience, for the biopsychosocial assessment of patients with chronic pain in physiotherapy practice...
July 2016: Physiotherapy Theory and Practice
W Choi, M Lim, J S Kim, C K Chung
BACKGROUND: Habituation refers to the brain's inhibitory mechanism against sensory overload and its brain correlate has been investigated in the form of a well-defined event-related potential, N100 (N1). Fibromyalgia is an extensively described chronic pain syndrome with concurrent manifestations of reduced tolerance and enhanced sensation of painful and non-painful stimulation, suggesting an association with central amplification of all sensory domains. Among diverse sensory modalities, we utilized repetitive auditory stimulation to explore the anomalous sensory information processing in fibromyalgia as evidenced by N1 habituation...
May 10, 2016: European Journal of Pain: EJP
Claire Fletcher, Lynley Bradnam, Christopher Barr
Chronic pain is prevalent in the western world; however fear of pain often has a greater impact than the degree of initial injury. The aim of this study was to explore the relationship between knowledge of the neurophysiology of pain and fear avoidance in individuals diagnosed with chronic pain. Twenty-nine people with chronic musculoskeletal pain were recruited and completed questionnaires to determine their understanding of pain neurophysiology and the degree of their fear avoidance beliefs. There was an inverse relationship between knowledge of pain neurophysiology and the level of fear avoidance...
May 2016: Physiotherapy Theory and Practice
Rick King, Victoria Robinson, Cormac G Ryan, Denis J Martin
OBJECTIVE: Pain neurophysiology education (PNE), a method of pain education, purports to work by helping patients reconceptualise their pain, shifting from a tissue injury model towards a biopsychosocial understanding related to neural sensitivity. Better understanding of pain reconceptualisation following PNE is needed to improve the delivery of this educational approach to enhance its effectiveness. This study aimed to investigate the extent and nature of reconceptualisation following PNE...
August 2016: Patient Education and Counseling
Hopin Lee, James H McAuley, Markus Hübscher, Steven J Kamper, Adrian C Traeger, G Lorimer Moseley
Evidence from randomized controlled studies shows that reconceptualizing pain improves patients' knowledge of pain biology, reduces catastrophizing thoughts, and improves pain and function. However, causal relationships between these variables remain untested. It is hypothesized that reductions in catastrophizing could mediate the relationship between improvements in pain knowledge and improvements in pain and function. To test this causal mechanism, we conducted longitudinal mediation analyses on a cohort of 799 patients who were exposed to a pain education intervention...
April 2016: Pain
Victoria Robinson, Richard King, Cormac G Ryan, Denis J Martin
Pain neurophysiology education (PNE) is a distinct form of patient education in pain management. The aims of this study were to explore the experience of PNE for people with chronic pain and to gain insight into their understanding of their pain after PNE. This was a qualitative study, based on Interpretive Phenomenology Analysis, using individual semi-structured interviews to collect data. We recruited a purposive sample of 10 adults with chronic musculoskeletal pain (men and women; mean age 48 years; with a mean pain duration of 9 years) who had recently completed PNE delivered as a single 2-h group session...
April 2016: Manual Therapy
Cristina Adillón, Èrik Lozano, Isabel Salvat
BACKGROUND: A key tool for use in approaching chronic pain treatment is educating patients to reconceptualize pain. Thus, health professionals are fundamental to the transmission of pain information to patients. Because their understanding of pain is acquired during the educational process, the aim of this study was to compare the knowledge about pain neurophysiology in first and final-year students from three different health science programs at a single University to determine their gain in knowledge using a well-known questionnaire designed to evaluate the understanding of pain...
2015: BMC Research Notes
Jordan Miller, Joy C MacDermid, David M Walton, Julie Richardson
BACKGROUND: Previous research suggests that self-management programs for people with chronic pain improve knowledge and self-efficacy but result in negligible effects on function. This study will investigate the effectiveness self-management support with pain science education and exercise on improving function for people with chronic pain in comparison to a wait-list control. A secondary objective is to determine which variables help to predict response to the intervention. METHODS/DESIGN: This study will be an unblinded, randomized controlled trial with 110 participants comparing a 6-week program that includes self-management support, pain science education and exercise to a wait-list control...
October 14, 2015: Trials
Louise J Geneen, Denis J Martin, Nicola Adams, Clare Clarke, Martin Dunbar, Derek Jones, Paul McNamee, Pat Schofield, Blair H Smith
BACKGROUND: Chronic pain can contribute to disability, depression, anxiety, sleep disturbances, poor quality of life and increased health care costs, with close to 20 % of the adult population in Europe reporting chronic pain. To empower the person to self-manage, it is advocated that education and training about the nature of pain and its effects and how to live with pain is provided. The objective of this review is to determine the level of evidence for education to facilitate knowledge about chronic pain, delivered as a stand-alone intervention for adults, to reduce pain and disability...
October 1, 2015: Systematic Reviews
Máté Magyar, Boglárka Hajnal, Tamás Gyüre, Csaba Ertsey
Medication-overuse headache affects 1 to 2 percent of the population. Any kind of painkiller, if taken regularly at least 10 days per month can cause medication-overuse headache, and therefore the possibility of this headache has to be raised whenever a patient with a preexistent headache notices a significant increase in headache frequency during a period of frequent painkiller consumption. Medication-overuse headache is most prevalent in females between 40 and 50 years of age. Its main risk factors are smokig, obesity, depression, and anxiety...
July 26, 2015: Orvosi Hetilap
René Pelletier, Johanne Higgins, Daniel Bourbonnais
Present interventions utilized in musculoskeletal rehabilitation are guided, in large part, by a biomedical model where peripheral structural injury is believed to be the sole driver of the disorder. There are, however, neurophysiological changes across different areas of the peripheral and central nervous systems, including peripheral receptors, dorsal horn of the spinal cord, brain stem, sensorimotor cortical areas, and the mesolimbic and prefrontal areas associated with chronic musculoskeletal disorders, including chronic low back pain, osteoarthritis, and tendon injuries...
November 2015: Physical Therapy
Philipp Wälti, Jan Kool, Hannu Luomajoki
BACKGROUND: Non-specific chronic low back pain (NSCLBP) is a major health problem. Identification of subgroups and appropriate treatment regimen was proposed as a key priority by the Cochrane Back Review Group. We developed a multimodal treatment (MMT) for patients with moderate to severe disability and medium risk of poor outcome. MMT includes a) neurophysiological education on the perception of pain to decrease self-limitation due to catastrophizing believes about the nature of NSCLBP, b) sensory training of the lower trunk because these patients predominantly show poor sensory acuity of the trunk, and c) motor training to regain definite movement control of the trunk...
2015: BMC Musculoskeletal Disorders
Ian Gilron, Ralf Baron, Troels Jensen
Neuropathic pain is caused by disease or injury of the nervous system and includes various chronic conditions that, together, affect up to 8% of the population. A substantial body of neuropathic pain research points to several important contributory mechanisms including aberrant ectopic activity in nociceptive nerves, peripheral and central sensitization, impaired inhibitory modulation, and pathological activation of microglia. Clinical evaluation of neuropathic pain requires a thorough history and physical examination to identify characteristic signs and symptoms...
April 2015: Mayo Clinic Proceedings
Diogo Pires, Eduardo Brazete Cruz, Carmen Caeiro
OBJECTIVE: The aim of this study was to compare the effectiveness of a combination of aquatic exercise and pain neurophysiology education with aquatic exercise alone in chronic low back pain patients. DESIGN: Single-blind randomized controlled trial. SETTING: Outpatient clinic. SUBJECTS: Sixty-two chronic low back pain patients were randomly allocated to receive aquatic exercise and pain neurophysiology education (n = 30) or aquatic exercise alone (n = 32)...
June 2015: Clinical Rehabilitation
Steven R Passmore, Bernadette Murphy, Timothy D Lee
Somatosensory evoked potentionals (SEPs) can be used to elucidate differences in cortical activity associated with a spinal manipulation (SM) intervention. The purpose of this narrative review is to overview the origin and application of SEPs, a neurophysiological technique to investigate neuroplasticity. Summaries of: 1) parameters for SEP generation and waveform recording; 2) SEP peak nomenclature, interpretation and generators; 3) peaks pertaining to tactile information processing (relevant to both chiropractic and other manual therapies); 4) utilization and application of SEPs; 5) SEPs concurrent with an experimental task and at baseline/control/pretest; 6) SEPs pain studies; and 7) SEPs design (pre/post) and neural reorganization/neuroplasticity; and 8) SEPs and future chiropractic research are all reviewed...
June 2014: Journal of the Canadian Chiropractic Association
Adriaan Louw, Ina Diener, Merrill R Landers, Emilio J Puentedura
STUDY DESIGN: Multicenter, randomized, controlled trial on preoperative pain neuroscience education (NE) for lumbar radiculopathy. OBJECTIVE: To determine if the addition of NE to usual preoperative education would result in superior outcomes with regard to pain, function, surgical experience, and health care utilization postsurgery. SUMMARY OF BACKGROUND DATA: One in 4 patients after lumbar surgery (LS) for radiculopathy experience persistent pain and disability, which is nonresponsive to perioperative treatments...
August 15, 2014: Spine
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