This episode will serve both the clinician who treats pain as well as patients who suffer from musculoskeletal pain through education about pain mechanisms and the active care necessary to recover. Orthopedic clinical specialist Annie O'Connor lectures nationally and internationally on the Pain Mechanism Classification System, neurodynamic evaluation and treatment, mechanical diagnosis and therapy of spine and extremities, kinetic chain evaluation, and exercise prescription as represented in the book, A World of Hurt, which she co-authored. Annie provides three amazing tools to explain pain mechanisms. She walks us through what these are, how to use them, and what they mean.
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Healing is not just one method. It varies greatly just as how one person experiences pain differently from another. Piecing out neuroscience together with the science of yoga and mindfulness for the relief of chronic pain is Dr. Sara W. Lazar, PhD. She is an author, associate researcher in the Psychiatry Department at Massachusetts General Hospital, and an assistant professor in Psychology at Harvard Medical School. With her background, Sara leads us deep into the discussion about how mindfulness and yoga changes the structure of the brain - how they help decrease pain catastrophizing and pain interference. She shares some great techniques on meditation that can benefit and alleviate chronic pain and even help slow the aging process. Sara also weighs in on yoga versus mindfulness versus the combination of both.
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Barbara Bald says that pain is never always physical. After being diagnosed with chronic pain, she found that healing is not just about going to various tests and taking different medications. Developing pain has much to do with patient perspective, and to overcome that could eventually also overcome chronic pain. She takes us into her journey that led her to realize the path to a pain-free life. Talking about belief systems and stress, she outlines how these things affect the way we perceive pain and healing. Ultimately, she shows us the importance of opening yourself up, to stop the resistance to pain, and allowing some of the unpleasantness to change for you.
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Dr. Shiroko Sokitch was originally trained in general surgery and worked as an emergency room physician for over ten years when she noticed that many of the patients she was treating were struggling with pain and other chronic health conditions. She decided to attend to acupuncture school and later studied functional medicine. She now owns and operates a successful integrative primary care practice using the best tools from Western, Eastern, and functional medicine. Learn how Dr. Sokitch was able to successfully transition from traditional medicine to functional medicine. She shares her unique practice where she uses different types of therapeutic modalities, her seven keys to healing, and touches on her new book, Healing When It Seems Impossible. This is a great podcast if you're interested in integrative or functional medicine as well as the success of one practitioner and how she was able to integrate so many different types of therapeutic and healing modalities under one roof.
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People tend to think that having no pain is normal when in fact, having a little is. While that is the case, there are still some ways that can help us manage pain. Talking about effective strategies for pain management is Dr. David Cosio. He is a pain psychologist in the Pain Clinic and interdisciplinary pain program at the Jesse Brown VA Medical Center in Chicago. He earned his PhD from Ohio University with a specialization in Health Psychology. Starting with his journey, he shares how he got involved in health psychology and then into pain management. He explains the difference between a health psychologist and a clinical psychologist. Having both backgrounds, he gives a holistic look into pain—taking into consideration the environmental aspects as well. He gives us a peek into his book, Pain Relief: Managing Chronic Pain Through Traditional, Holistic, and Eastern practices, by talking about the concept of a fifth vital sign. He shares as well pain education and the future of chronic pain in the VA.
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The microbiome is an interesting and rapidly growing area of research. There are trillions of microbes inhabiting our bodies, and we have more microbial cells than we do human cells. Dr. John Cryan, PhD, professor and Chair of the Department of Anatomy and Neuroscience at the University of Cork, Ireland, talks about everything involved with the microbiome, from mood to pain to neurotransmitters through our nutrition. His current research includes the neurobiological basis of stress-related disorders including depression, anxiety, pain, and drug dependence. His research group is also focused on understanding the interaction between brain, gut, and microbiome and how it applies to stress and immune related disorders, including irritable bowel syndrome, obesity, and other disorders such as autism. His research into the microbiome has far-reaching public health implications - from how he views his area and sections to how the microbiome influences brain development, chronic pain development, and of course the impact of probiotics on mood. Dr. John Cryan, PhD discusses the influence of the microbiome on pain, mood and stress.
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Is our American diet affecting us? We know that it's affecting our weight, our metabolic syndrome. We know that it's leading to diseases such as diabetes and prediabetes. However, it's also effecting neuropathic pain. Neuropathic pain is pain caused by damage or disease affecting the somatosensory nervous system, a part of the sensory nervous system. No wonder out diet is called SAD or the standard American diet. Almost everything about the western diet or the standard American diet leaves you feeling not well. It’s linked to chronic pain type syndromes, brain fog, anxiety, depression, and many other things. Learn how to retrain your brain and body so you can live the joy-filled and pain-free life you deserve. Dr. Tatta talks about neuropathic pain and shares some tips and strategies that you can use to either treat your neuropathic pain or, if you're a practitioner, what you can do as far as neuropathic pain when it comes to nutrition.
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Whether you are a practitioner or a patient interested in learning more about psychological informed care, you will benefit a lot from Dr. Beverly E. Thorn’s research which focuses on investigating the important components of cognitive behavioral therapy for chronic pain. Beverly is Professor Emerita of psychology at the University of Alabama. She is the recipient of the 2018 Wilbert E Fordyce Clinical Investigator Award from the American Pain Society. She explains why the cognitive model is important in the treatment of chronic pain care, what should be included in cognitive treatment for chronic pain, and how many sessions are required to see meaningful change. She also touches on the importance of motivational enhancement and assertiveness, why treatments designed for those with pain should be simple and accessible, as well as some of the mechanisms, the similarities, and the differences between cognitive behavioral therapy and mindfulness approaches for chronic pain.
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Suffering from chronic pain can be challenging. It makes you feel powerless either because you’re unable to heal your body or can’t find a way get the pain to stop. As a result, you feel victimized by the pain. Helping you overcome the effects of victimization is transpersonal psychologist, Dr. Meg Haworth, PhD. Learn how the emotions affect the illness and how to release them through the mind. Familiarize the simple mind-body medicine tools for resetting yourself when you encounter some triggers. Find out how proper nutrition supports the body to heal itself, accelerating the emotional, mental, and spiritual work. Ultimately, take control of your condition as you begin to feel better and move your health to the next level.
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So many factors can cause and modify pain, not only physical but mental and emotional as well. Taking the psychological aspects of it, Dr. Mark Bishop tackles how expectations and biases influence the outcome for patients who have chronic pain. Dr. Bishop is a physical therapist with 30 years of experience in managing musculoskeletal disorders. Learn how patient expectations are related to rehabilitation outcomes and how provider biases influence those expectations. Likewise, find out the ethical implications of applying expectation into clinical practice Dr. Bishop goes in-depth with the topic.
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Self-compassion is a tool that you can use to improve your well-being, your self-confidence, and your resilience. It’s one that we need to pay a lot more attention to in the world of pain care. What's interesting about self-compassion is that oftentimes it's easy for us to be compassionate towards others, but applying the same kindness to ourselves can be a real challenge. Moral development specialist and co-author of the book called The Mindful Self-Compassion Workbook, Dr. Kristin Neff, conducts research on self-compassion, a central construct in Buddhist psychology and one that had yet to be examined empirically. In addition to her pioneering research into self-compassion, she has developed an eight-week program to teach self-compassion skills. Dr. Neff discusses why self-compassion in pain care is important, not only for those living with chronic pain, but also for the practitioners who treat pain every day in the clinic.
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Tackling about an interesting topic that does not often receive enough attention in the world of chronic pain management, Roshi Joan Halifax talks about the intersection of compassion and empathy in chronic pain care. She is the founder and head teacher of the Upaya Institute and Zen Center, and a pioneer in the field of end-of-life care. Growing up as a sick kid, her journey began by being surrounded with people who are in pain and fighting cancer. This gave her the opportunity to talk with caregivers, doctors, nurses, physical therapists, counselors, and psychotherapists. Expanding her knowledge, she has come to learn about opening the landscape of the best of our human qualities as we serve others. At the heart of this is the value of compassion and empathy—circling around the topic of pathological altruism, Edge States, empathic distress, contemplative practice, and mindfulness.
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Pain goes beyond what we physically feel in our bodies. It reaches back into other aspects—from the mental to emotional. Take a deeper dive and explore the neuroscience of nociception and the perception of a painful stimulus with Dr. Tor Wager, director of the Cognitive and Affective Control Laboratory and Professor of Psychology and Neuroscience at the University of Colorado, Boulder. He talks about the factors that influence pain as well as the facts or myths about pain as a learned experience. Also learn where the experience of pain comes from and the functions it serves while tracing the relationship between emotion and pain. Find out why exposure to pain may be the fastest way to overcome and alleviate it.
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Traveling around Asia and in Tibet for a little bit, meditation expert Sean Fargo became fascinated by the simplicity of the life of Buddhist monks. Sean found a Dallas master who took him under his wing and taught him a lot of mindfulness exercises like mindfulness of walking, mindfulness of standing, and mindfulness of breathing. The combination of simplicity and difficulty and the Dallas master’s way of being was peaceful, radiant, and loving led Sean to think about devoting the rest of his life to cultivating this way of being in the world. Sean shares a brief overview of the four foundations of mindfulness, how to use mindfulness to deal with adversity or unpleasant feelings and experiences, and how to access or crack open the heart space and experience the full spectrum of human emotions which can help with both your pain and suffering.
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Nothing rounds up our understanding better about chronic pain than listening from a patient’s perspective. To have undergone through that pain with all the struggles and medications that come with it, a person could give the best account of dealing and overcoming all of it. Carol Kugler Ellis was diagnosed with fibromyalgia. As she shares her story, she imparts great wisdom and insight about chronic pain. Taking it head on, she clearly and honestly opened up about her pain, where she is currently now, and where she is headed in terms of her health. Her resilience has shown how we can be bigger than our pain, live beyond it, and reclaim our life back.
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Nutrition is often one of the first interventions that I recommend for pain relief, especially if you have pain from an inflammatory disease such as fibromyalgia, CRPS, rheumatoid arthritis, osteoarthritis, or even headaches. Anti-inflammatory nutrition has a sound evidence base to support it, but it's often ignored when it comes to chronic pain care management. When it comes to implementing it into a physical therapy practice, nutrition is very important because most of the patients that are being treated are people who have chronic pain or other types of pain syndromes. Nutrition consultant and chef Leanne Ely discusses the anti-inflammatory nutrition and introduces a particular diet that's showing up on people's plates more and more, the ketogenic diet, which is now being explored in many clinical studies.
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The treatment of chronic pain has been placed under a microscope because of the fallout from the widespread opioid epidemic. As we turn away from using opioids as a treatment for long-term pain, what many of you want to know is what are the alternatives? What are the non-drug alternatives or the non-pharmacological treatment and pain management for conditions so common such as lower back pain? Three experts, Dr. Steven George, Dr. Corey Simon, and Dr. Adam Goode are licensed physical therapists, educators, and researchers studying the conservative treatment of pain at Duke University. They talk about the dangers of long-term opioid use and the non-pharmacologic pain care as an alternative for treatment of pain. Learn about the effects of a home -based telephone-supported physical activity program for veterans with chronic low back pain with Dr. Adam Goode. Dr. Corey Simon shares his research called A Paradigm Shift in Geriatric Low Back Pain Management. Dr. Steven George touches on his research on advancing psychologically informed practice for patients with persistent musculoskeletal pain.
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Pain is a feeling we’re conditioned to heal without fully understanding it first. This leads us to taking the wrong medication that we suffer more from in the end. Pain master David Butler explains not only what pain is but dives deeper into the psychosocial model of pain care. He wrote a book called Explain Pain where he went beyond the traditional way of explaining pain by tapping into the emotional, mental, and physical state of a person. David also provides examples that relate pain to numerous parts of the bodies, providing us the knowledge to take into consideration how we tend to view CBT as opposed to how it should be understood. David sheds light on the importance of education as part of treating your pain by giving scenarios and thorough yet understandable reports on pain science.
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The chronic pain epidemic has opened up many doors as to the way practitioners approach pain and how the multiple systems of our body are intimately connected. It has also made us realize that this metaphor of the mind-body connection is no longer just a metaphor. Nowhere is this more exquisitely expressed than in the connection between our gut and our brain, or what is called the gut-brain axis (GBA). Your brain and gut are connected by an extensive network of neurons and a highway of hormones that are constantly providing feedback as to how hungry you are, whether or not you're experiencing stress, if you've ingested something that's bad like bacteria or a microbe, and if you're experiencing unpleasant sensations such as pain. Research suggests there exists a rich and dynamic relationship between your enteric nervous system, that's the nervous system in your gut often referred to as your second brain, and your central nervous system. This innovative construct offers both practitioners and patients a window into understanding the mind-body connection, as well as further understanding how chronic pain develops and process. Chiropractic physician and certified nutrition specialist, Dr. Jason Piken, discusses food and nutrition as it relates to the gut-brain connection, as well as a few key nutritional supplements.
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According to a report by the American Joint Replacement Registry, there were 860,000 hip and knee replacement surgeries in 2017. That means by the end of 2018, we will be over the 1 million mark in the United States. Thousands of these orthopedic surgeries are performed yearly within the Veterans Affairs. Patients are offered surgery as an option for pain relief and improved function. Chronic post-surgical pain is a common and debilitating problem that occurs in 5% to 85% of patients following surgery, and it is highly correlated with prolonged opioid use. Veterans are particularly at high risk for developing chronic post-surgical pain due to their higher rates of post-traumatic stress disorder, anxiety, and depression. Clinical psychologist and research health scientist Dr. Lilian Dindo talks about how Acceptance and Commitment Therapy (ACT) can be used to prevent chronic post-surgical pain and opioid use in at-risk veterans. Dr. Lindo explains why chronic post-surgical pain develops, who's at-risk for developing it, why veterans have an increased risk, how we can intervene early and prevent this pain, and how a one-day intervention using ACT shows great promise in preventing chronic post-surgical pain.
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Each day, millions of yoga enthusiasts flock to yoga studios for their daily or the weekly practice, celebrating an ancient wellness tradition as well as a form of exercise and therapy that's been validated in many studies by modern pain science. If done under the guidance of a skilled instructor or therapist, it can bring several health benefits that help people cope with conditions including anxiety, depression, chronic pain, high blood pressure, osteoarthritis, and chronic stress, something that all of us are exposed to on a daily basis. If you're a practitioner who treats patients with pain, Shelly Prosko says you can integrate yoga therapy into your pain practice. Shelly is a physiotherapist and professional yoga therapist who is dedicated to bridging the gap between yoga and modern healthcare philosophies. Learn how you can integrate yoga into your physiotherapy treatments to create and sustain optimal health.
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If you're someone who lives with pain and is trying to figure out the best therapies to utilize, you may be interested with Dr. Kathleen Sluka’s mechanism-based approach to pain management. Dr. Sluka is a neuroscientist and physical therapist who studies in neurobiology of chronic pain at the University of Iowa. She says the mechanism-based approach is also equally important if you're a practitioner who’s seeking a new and groundbreaking conceptual framework for evaluating the underlying cause of your patient's pain. Dr. Sluka’s lab has three very important goals - to improve pain management, to discover new therapies for pain management, and to improve the use of currently available treatments for chronic pain. Dr. Sluka discusses the five categories of pain mechanisms as well as the distinction between nociceptive pain, neuropathic pain, and a new term called nociplastic pain.
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