I’m super honored that you're spending this time with me. As many of you know, the month of June is Gay Pride or what is known as LGBT Pride Month across the globe. This is a time of celebration as well as one of increased awareness where the LGBT community promotes their equality, builds community and celebrate sexual diversity and gender variance. If you've been following along with the blog, I interviewed clinical psychologist, Lore Dickey, about transgender healthcare. Now, you'll meet Dr. Chris Condran who is a Doctor of Physical Therapy to discuss LGBT inclusion in the physical therapy curricula and profession. Chris is an Orthopedic Physical Therapist and an instructor in the Transitional Doctorate of Physical Therapy Program at Arcadia University where he teaches health and wellness promotion as well as case analysis.
His educational background includes a Master’s in Exercise Physiology and MBA in business administration, a DPT in physical therapy and he's enrolled in the EdD program at the University of North Carolina. He has personally advocated for curriculum change within physical therapy education and has created training material on the subject of LGBT inclusion in physical therapy practice. His research advocacy interests are centered on providing inclusive clinical environments, transgender health issues, eliminating health disparities in the LGBT population and establishing a curriculum for LGBT cultural competency in the classroom and beyond. He is also a board member of PT Proud, which is the LGBT catalysts committee under the Health and Policy Administration section of the American Physical Therapy Association.
On this episode, he will share some of his unique life experiences related to diversity, equity and inclusion of LGBT individuals in the physical therapy profession. If you're a practitioner or potentially an educator and you're interested in the topic of LGBT inclusion in physical therapy or any other medical practice, Chris and his colleagues had created an LGBTQ Competency Handbook for Physical Therapists. This is a free manual and you can download it which includes information about LGBT inclusion in both the clinic and the classroom. To download this handbook, all you have to do is text 138Download to the number 44-222. If you're on your computer, you can open a new browser and you can type in the URL, www.IntegrativePainScienceInstitute.com/138download. Chris and the other members of PT Proud, would love if you can get your hands on that and put it to good use in both the clinic as well as in education. I want to personally thank Chris as well as my other colleagues at PT Proud for being a catalyst and making some bold moves and taking the step forward with this important topic. Without further ado, let's begin with the amazing Chris Condran.
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It's a pleasure to be spending this time with you. One of the activities that I do each week is I set aside some time to sit down and brainstorm about all the various topics that are related to chronic pain. The reason why I do that is it helps me find interesting and inspiring people to share with you on this show. If you follow this show for probably for a couple of years I've been doing it, you know that I've spoken about popular topics such as pain education, pain psychology, exercise, physical therapy and nutrition. One topic that interests me and quite frankly is the topic that doesn't receive enough attention in the media or receive grant money for research is the topic of health disparities. A health disparity is a difference in the health status of different groups of people.
For example, patients such as racial minorities and women have been identified as not receiving adequate pain care. Another group that faces significant barriers, adequate healthcare are transgender people. Transgender is an umbrella term for a diverse group of people whose gender identity or expression differs from societal expectations of how they should look, act or identify based on the sex they were assigned at birth. There are approximately 1.5 million transgender people living in the United States of America. Although this data is incomplete because many transgender people feel uncomfortable or feel that it's not safe to share their personal information.
From a healthcare perspective, transgender people experience higher rates of suffering and disabling conditions including a wide range of mental health problems and chronic pain conditions including chronic pelvic pain. Unfortunately, when transgender people seek treatment, they often encounter providers who do not understand their unique needs, face challenges with health insurance and are often neglected or perhaps even mistreated within the healthcare system. Here to speak with us about improving transgender healthcare is Dr. lore m. dickey. lore was raised as a female but never truly felt at home with the female identity. Several years after his transition, he returned to school to become a licensed clinical psychologist. He learned early in life that the best way to make a change is to be part of the solution. lore is the author of two books, 22 journal articles and seventeen book chapters.
He's an advocate for the trans community and a prolific and engaging speaker. lore is also providing you with two free resources that you can download on the show. The first is the American Psychological Association Task Force on Guidelines for Psychology Practice with Transgender and Gender Nonconforming People. lore developed these guidelines along with the APA. The second is a complete list of all the books and book chapters which lore has contributed to. lore did receive the 2014 Presidential Citation by the American Psychological Association for his dedication to the LGBT community. He's got great resources. Take a moment now to download them. To download them, all you have to do is text the word, 137DOWNLOAD, to the number 44-222. You can do that right on your smartphone or if you're on a computer, you can open up a new browser and type in the URL www.IntegrativePainScienceInstitute.com/137download. lore is a leader in transgender healthcare. I want to thank him for joining us on this show and all the work that he's doing for the transgender community. Let's begin and let's meet Dr. lore dickey.
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If you're following the latest in pain science or maybe you've attended certain lectures, you know that pain science education is on the tip of everyone's tongue these days. Whether you come from the explain pain camp, that's my personal favorite, or maybe the pain neuroscience education camp, pain biology and intervention, more and more professionals are using to treat chronic pain. There's a good reason for this. We have a growing body of evidence that states that pain education can improve things like pain, pain catastrophizing, fear avoidance, as well as pain interference, so much so that the experts now agree that every practitioner should be greasing their wheels with pain biology education as an intervention to help people cope. Even though pain education has seeped its way into the foundation of your practice, the one thing we still don't know is which patients with chronic pain are more likely to improve their knowledge following pain biology education.
Joining us to discuss pain science education and how to assess the reconceptualization of pain is Joshua W. Pate. He is an Australian physiotherapist and a PhD candidate with a passion for teaching people about pain so they can develop active sales management strategies. His PhD includes investigating a child's concept of pain as well as the validation of the concept of pain inventory. Joshua has also created two TED Ed videos that can be used as part of a targeted pain science education program. Both of those are cool and super high tech. I recommend you check out the one on phantom limb. On this show, Joshua will explain why someone's concepts of pain matters, which patients are more likely to improve their knowledge after a two-hour pain education session, why the neurophysiology of pain questionnaire may not be appropriate to use with children and finally, what language kids use to describe their concept of pain.
If you want to study along with us, Josh has shared two of his key papers that you can download for free. The first is called A Child's Concept of Pain and the second is Pain Neuroscience Education on YouTube: A Systematic Review. For free access to both of these papers, all you have to do is pick up your cell phone and text the word, 136Download, to the number 44-222. I'll send it right to your inbox. If you're on your computer, you can open up a new window and type in the URL, www.IntegrativePainScienceInstitute.com/136Download. Take a moment to download those two free resources that Josh has provided. He's doing some exciting and inventive work in the area of pain science education as well as pediatric pain management, and I can't wait to introduce his work to you. Let's begin and chat with Joshua.
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If you follow this show for some time, you know that one of the aims of this show is to help reconceptualize pain from a biomedical perspective and increase the awareness of a biopsychosocial approach to pain care. Chronic pain has long been recognized as an experience that can threaten your need for safety, both physically and psychologically, but what about feeling safe from a social context? Social context can be a powerful mediator and influence how pain is experienced. The social context of pain is such an important topic that there's even a movement to change the definition of pain from being an unpleasant sensory and an emotional experience to one that emphasizes pain as an experience associated with sensory, emotional, cognitive and social components.
Joining us to talk about the pain in a social context is Dr. Kai Karos. Kai earned a Bachelor's and a Master's in Psychology at Maastricht University in the Netherlands. He then went on to complete a PhD where he investigated the effects of threatening social environments on the experience and communication of pain. Kai is working as a postdoctoral researcher investigating in the social learning of pain-related fear and avoidance. You will learn all about pain as a threat to the social self, including how pain interferes with the basic human needs such as the need for autonomy, the need to belong and the need for justice and fairness. Kai is a highly sought-after speaker regarding the social context of pain and one of a small handful of researchers globally who is investigating this important topic. This is a topic that does not receive enough media attention, so I'm excited to share this with you.
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I’ve been so excited to put this all together for you and to share with you. You will meet an exceptional physical therapist who is helping women with chronic pain and anxiety by combining physical therapy with functional nutrition. Lauren Bahr is a licensed physical therapist. She’s a health coach and she’s a graduate of the Functional Nutrition for Chronic Pain certification program at the Integrative Pain Science Institute. Lauren combines physical therapy together with functional nutrition in the plan of care for her clients with chronic pain and anxiety in her private practice, which is called Simply Balanced Wellness.
What I love about this interview with Lauren is not only is she passionate about the type of practitioner that she’s become, but clear about sharing her entire journey of learning and discovery to arriving at the place she is, where she’s now able to combine traditional physical therapy, pain education, functional nutrition and even some of the coaching skills with helping her clients with pain and anxiety. We all know these are skills that do not appear in a traditional physical therapy curriculum or quite frankly, in any traditional form of medical education. Lauren has spent years learning these techniques as well as honing her skills to be the practitioner she is now. Lauren is even now dipping her toes into Acceptance and Commitment Therapy, a treatment which I think is going to be critical when she’s working with her clients with anxiety, as well as chronic pain in her private practice.
As you go through this, what stands out to me is Lauren’s journey. It’s her journey as a practitioner and she also weaves in her journey as someone who dealt with her own health challenges of chronic pain and chronic fatigue. To help you out, Lauren includes a free download to accompany her interview. This free gift is called the Breakfast Recipe Book. If you are interested in nutrition or if you’re someone who’s currently using nutrition with your clients, you’ll know that breakfast can be a time that’s challenging for our patients and our clients because many of the convenient breakfast foods out there are highly processed, they’re loaded with sugar and they even include trans-fat. If you want a combination of three things that are bound to cause inflammation in the body, which can lead to chronic pain, processed foods, loaded with sugar and loaded with trans fats. Often many of the processed breakfast foods include that. In this Breakfast Recipe Book, you’re going to find a ton of delicious recipes that you can use for yourself or with your family or you can use it for nutrition education when you’re working with your patients.
To download this free gift, all you have to do is text 134Download to the number 44-222 or you can open up a browser on your computer and you will type in www.IntegrativePainScienceInstitute.com/134download and you can grab that free gift which will be delivered right to your inbox. I want to thank Lauren for being a member of the Functional Nutrition for Chronic Pain Certification. If you’re someone who’s looking for an integrative practitioner like Lauren who has a combination of these important skills that can help you with chronic pain, check out the Integrative Pain Science Institute Practitioner directory. You’ll be able to search there on a map to find a practitioner in your area. Let’s welcome Lauren Bahr.
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We're going to talk about primary spine care providers. If you follow this blog for quite some time, you know that spine problems and spine disorders are among the most common, most costly and most disabling problems that we experienced in Western society with regard to chronic pain. For the purpose of this blog, when we talk about spine-related disorders. We're talking about a group of conditions that include back pain, neck pain, all the various types of headaches and migraines, radiculopathy and other types of symptoms that are related directly to the spine. If you want to know an interesting and perhaps shocking statistic, virtually 100% of the population is affected by this group of disorder s at least once in their life, if not twice.
One proposed solution to treating chronic spinal pain in our healthcare system is to train practitioners who can function as primary care providers for the care of the spine itself. There are already physical therapists and chiropractors who function in a primary care role for the spine, although we don't have enough that are trained adequately. Some may lack the clinical skills and the confidence to function in this primary care provider role. At times, these can be big shoes to fill because a primary spine care provider requires a particular skill set that includes the ability to apply the latest evidence-based procedures, adequately educate and motivate patients and prevent and manage disability. The interesting thing is that much of this has already been tested and it's proved to improve patient satisfaction, reduced pain, reduced disability and reduce medical costs.
Joining us on this episode to discuss this important topic is Dr. Marcia Spoto, who is a professor at Nazareth College in Rochester, New York. What's interesting about Marcia that she holds both a degree in physical therapy as well as in chiropractic medicine. She understands the care of the spine from two very important professions that contribute to the health of spine care throughout our nation and perhaps even globally. She has over 35 years of educating and caring for the spine. She also taught classes at the university level with regards to musculoskeletal management, pain management and differential diagnosis. She's maintained an active private practice called STAR Physical Therapy, which is in Fairport New York. She also serves on the American Physical Therapy Association Orthopedic Practice Committee and is a Co-chair of the New York Physical Therapy Association Public Policy Committee. Dr. Spoto does serve as a consultant for BlueCross BlueShield where she's a member of the Spine Care Pathway Program.
If you want more information about this episode and if you want more information to read along and follow along with us, I recommend you download a paper that's free. It's called The Establishment of a Primary Spine Care Practitioner and its Benefit to the Healthcare Reform System in the United States of America. To download this free resource, all you have to do is text 133 Download to the number 44222. You can go to the website at IntegrativePainScienceInstitute.com/132Download and you can download it directly from there. This is an evidence-based paper from a reliable medical journal that talks about the establishment of a primary spine care practitioner. It’s great information. If you are a practitioner who works with spinal care too, check this out and also if you’re someone who's interested to learn more information about care of the spine. Without further ado, let's begin with Dr. Marcia Spoto.
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It’s great to be with you sharing the latest information on pain science and the care of chronic pain. On this episode, our expert guest is Dr. JP Caneiro. JP holds a PhD in Musculoskeletal Physiotherapy. He’s part of an international team of clinicians and researchers that developed a behavioral intervention named Cognitive Functional Therapy. JP holds a research position at Curtin University where he runs a multicenter trial for low back pain as well as lectures in the Master’s of Physiotherapy program. Clinically, JP focuses on the management of complex pain working at Body Logic Physiotherapy in Perth, Australia. He’s also an associate editor for the British Journal of Sports Medicine and for two educational websites. The first one being called BodyInMind.org and the second, Pain-Ed.com.
In addition to the great information that JP will share on this episode, he’s also generously providing you with four free downloads that you have to get your hands on because they’re so good. They’re so important whether you’re a practitioner treating someone in pain, or you’re someone who has had pain and you’re looking for answers on how to alleviate it and return to a more active life. The first handout is called A New Way of Thinking About Pain. This is a good infographic that includes phrases to help people reframe what pain is so they no longer think that they’re being damaged or that they’re being harmed by the pain.
The second is an infographic about the Cognitive Functional Therapy framework. You can look at this and follow along with that framework as JP and I talk about his great work on this episode. The last two are the important studies that JP has been involved in the past few years with regards to chronic low back pain and Cognitive Functional Therapy. The first paper is called Cognitive Functional Therapy. It came from a 2018 Journal of Physical Therapy. The second paper which is published in 2018 Scandinavian Journal of Pain is called The Implicit Association Between Back Posture and Safety of Bending and Lifting in People Without Pain. JP was part of that study, a pivotal study with regards to a lot of the work that we’ve talked about on this episode.
To download these free four gifts that JP has generously provided, all you have to do is text the word, 132Download, to the number 44-222. If you’re on your computer, you can open up a new browser, and you can type in the URL, www.IntegrativePainScienceInstitute.com/132Download. All these handouts will be available for free. If you’ve been following this podcast, some of the work that we’ve been putting out over the last couple of years, you may have noticed that all the content that used to have under DrJoeTatta.com has now been moved to one place. It’s all located on the IntegrativePainScienceInstitute.com website. This is going to be our new home, it’s a place where you can go for all the free podcasts, all the free blogs and all the free gifts and giveaways. Lastly, the practitioner training and continued education courses. I’ve organized it so it’s in all one place for you and it’s easy to access. Let’s meet JP and he’s going to share what he discovered during his PhD studies and how he has been able to translate this important knowledge into clinical practice. JP is a brilliant clinician. He’s easy to talk to. You’ll find that his passion in helping people with their pain really shines through. I know you’re going to enjoy and you’re going to learn a lot on this episode as I did. Sit back and relax, let’s meet JP.
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On this episode, we are discussing the insufficient evidence for invasive procedures and chronic pain in how we can move our sick care system toward an integrative model of pain care. Joining us is Dr. Wayne Jonas. He is a practicing family physician, an expert in integrative health and a widely published scientific investigator. He served as the Director of Alternative Medicine at the National Institutes of Health and was the Director of the World Health Organization's Center for Traditional Medicine. He published a book called How Healing Works and in September of 2018, he published a systematic review and meta-analysis called Are Invasive Procedures Effective for Chronic Pain?
Make sure to download this free gift called a Guide to Nutrition for Chronic Pain. To receive the Guide to Nutrition for Chronic Pain, all you have to do is text the word 131 Download to the number 44222 or if you're on your computer, you can open up a browser and type in the URL www.DrJoeTatta.com/131Download and you'll receive instant access to this free gift. If you are a practitioner interested in learning more about nutrition for chronic pain, make sure to check out the certification program offered through the Integrative Pain Science Institute called Functional Nutrition for Chronic Pain. You can learn more by visiting www.IntegrativePainScienceInstitute.com and then you can click on the courses tab. It's fully accredited for 36 PT CEUs. Let's begin with Dr. Wayne Jonas.
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In this episode, we are talking about the rapidly expanding field of telehealth, which is the use of electronic communication to remotely provide healthcare information services to patients who need physical therapy. Telehealth is gaining more and more attention as providers, patients and payers all seek more effective, and cost-efficient ways to deliver care. Here to speak with us about telehealth and physical therapy is Rob Vining. He has been a physical therapist for many years and has worked across all settings with the focus on outpatient orthopedics. His current mission is to bring telehealth and technology into the practice of physical therapy. He Cofounded the software company, PTLive and created the educational platform Telehealth PT. He hosts the Telehealth 20 Podcast and PT TechTalk. He is also a guest lecturer at physical therapy programs about telehealth in the physical therapy profession.
As a free gift to accompany this episode, Rob is providing you with the telehealth library. This package is valued at over $120 and includes archived Q&A sessions, webinar training, featured in-depth discussions on telehealth, information on marketing, consumer engagement, technology, security, and much more. To download this free telehealth library, all you have to do is text the word 130Download to the number 44222. If you’re on your computer, you can go to the URL www.DrJoeTatta.com/130Download where you can enter your name and your email address. Take a moment to download this free gift and let's begin with Rob.
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I am excited that you're here with me as we discuss the latest in pain care and pain science. We are discussing the topic of pain catastrophizing, which has been identified as a prognostic indicator of poor outcomes for many types of chronic pain syndromes. Interventions to address pain catastrophizing are commonly used by many pain professionals including physical therapists and psychologists but have not been tested in patients who are undergoing total knee arthroplasty or what is known as a total knee joint replacement. To speak with us about whether pain coping skills training can potentially help patients undergoing total knee arthroplasty is Dr. Dan Riddle. He is a Professor of Physical Therapy, Orthopedic Surgery and Rheumatology at Virginia Commonwealth University. His clinical and research interests are in the lower extremity and musculoskeletal disorders with the primary focus on osteoarthritis and joint arthroplasty.
Dr. Riddle studies diagnostic, prognostic and intervention-based research techniques with an emphasis on the role of pain in both the disease and recovery process. He is currently the chair of the Neurological Aging and Musculoskeletal Epidemiology study section for the National Institutes of Health. He has received numerous awards for his work, including an award from the Foundation for Physical Therapy and the National Institute of Arthritis. He will discuss his multi-center three-arm single-blinded randomized controlled trial for pain catastrophizing. In his study, one group received usual care, one group received Cognitive Behavioral Therapy delivered by a physical therapist and one group receive arthritis education delivered by registered nurse. I love this study because of its three-arm design. I think you'll be surprised at the outcome as to which group did better. This study and this podcast is valuable information which can help you make better clinical decisions about your plan of care for patients undergoing total knee arthroplasty.
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Patients have a very unique perspective on what they are going through. Yet health professionals tend to leave them out of the picture. Showing the importance of how health systems should get feedback from what patients want is Zoe Letwin. Zoe has a master’s degree in Professional Education and is currently a second year PhD student in the Health Profession Education field at Western University. Gathering up all her knowledge and insights, she talks about Inter-professional Pain Education and shares her competency-based framework that details the ways practitioners can create a competent person-centered partner in pain care. Zoe builds up from her passion about creating a culture of empathy in pain education and values lifelong learning, taking us into how the complexity of pain should involve everyone together.
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Dr. Chad Cook, PT, PhD, the Program Director of the Doctor of Physical Therapy Program at Duke University, brings to light the value of psychologically-informed care. Getting deep into how it contributes to physical therapy and pain care, he lays down some literature about it - from the studies to the biases in them - showing how psychologically-informed practices are so hot right now and where they should improve. Dr. Cook talks about why pain mechanisms are important for every pain practitioner to understand and why this can benefit not only them as practitioners but those who are in pain or knows someone in pain.
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Do you know that you can use meditation to lessen stress and accomplish more in your life? This is what Emily Fletcher teaches. Emily is the founder of Ziva and the creator of The Ziva Technique, and is regarded as a leading expert in meditation for high performance. She joins us to talk about her meditation, her book called Stress Less, Accomplish More, The Ziva Technique and its benefits, and more. If you're interested in learning more about mindfulness, meditation, and manifesting wonderful things in your life, you will learn a lot from this great podcast.
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A niche in the medical field that is rarely explored is children and pain. This is where Dr. Steven Kamper, PT, found a good place to research as he reviewed its relationship to the parents’ pain. This also leads to his passion to pursue the process of integrating research into practice. Dr. Kamper takes us into a more profound understanding of research as he discusses the importance of evidence-based practice or research into clinical care.
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Women's health is very special as it concerns menstrual cycles, fertility and infertility, menopause, and all issues involving female hormones. Birth control expert Dr. Jolene Brighten, NMD recognizes this uniqueness. She discusses links between hormones, inflammation and chronic pain, balancing your hormones naturally, post birth control syndrome, and why this isn't being discussed more in mainstream medicine. She also shares about the nutritional plan that she uses with her patients to help them balance their hormones naturally and come off the pill.
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As what has been constantly reiterated, chronic pain should not only be addressed from the physical and biomedical model. It is time to shift to what is called the biophysical model where the social ramifications of living with chronic pain should be explored. Social psychologist Dr. Claire Ashton James, PhD is totally on-board with this. Her research investigates the social aspects of health and well-being with a focus on pain management. She explores how culture influences pain as well as the importance of patient-provider communication. Moving towards some issues in the field, Dr. Claire addresses the role of bias in the medical encounter, the impact of patient trust to pain, and the role of group-based pain management programs to health, behavior, and well-being.
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Going to the nutrition side of chronic pain is Dr. Kathleen Holton, PhD and assistant professor at the Department of Health Studies at American University. With her combined background in epidemiology, nutrition, and neuroscience, she provides a great view on the positive and the negative effects of certain foods and food additives when it comes to chronic health. Dr. Holton shares the effects of free glutamate in foods to our diet and health, while giving tips on what to look out for when shopping.
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There's so much controversy in the diet field. Being a naturopathic physician, Dr. Alan Christianson, NMD is definitely on the frontline of this as he tackles the biggest diet myths. Most of the time, people's need to eat healthy and be fit and healthy lead them to succumb to different diet trends. They explore and tend to blow out of proportion some information about food. Dr. Christianson talks about nutrition facts and fiction about things we find in foods that, when taken out of context, can make them sound dangerous. He says it is important to know how to separate fact from fiction so you know exactly what to eat when it comes to pain, chronic disease, and your health.
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Overcoming pain is not limited to the usual remedies we take like medication. It goes far reaching into multiple traditions. Sharing his interest on movement therapy and pain science is Todd Hargrove. He is a Seattle-based Feldenkrais practitioner, Rolfer, and author. Todd shares his own journey from being an attorney to getting into Feldenkrais, explaining what it is all about and the difference between functional integration and awareness through movement. He also shares his constant search for new knowledge about what pain is, what causes it, and what can alleviate it, and explains as well what Rolfing is and where yoga ties into that.
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If you are interested in the intersection between gut health, nutrition, and pain, this will be an episode that you will enjoy. Carrie Falling’s work and research is around central sensitization. Carrie began as a manual therapist and digestive health specialist. Illinois. After eight years of practice, she relocated to New Zealand where she became a physiotherapist working predominantly with individuals suffering from persistent musculoskeletal pain. She then left private practice to begin teaching at the University of Otago in New Zealand. She begins her PhD journey investigating persistent musculoskeletal pain in individuals with inflammatory bowel disease. Carrie talks about central hypersensitivity and her journey into this research.
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