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Dr. Joe Tatta | The Healing Pain Podcast

Chronic pain is a debilitating condition that affects one’s ability to live a full and active life and impacts both physical and emotional health. Whether you are living with chronic pain or a physical therapist or other health professional such as an occupational therapist, psychologist, social worker, nurse, or physician seeking information for treating pain, we invite you to join our global community. Welcome to The Healing Pain Podcast with Dr. Joe Tatta, a podcast that promotes the latest evidence and methods for the safe and effective treatment of chronic pain. Featuring top experts, we bring you the latest research from the fields of pain science, physical therapy, physiotherapy, pain psychology, functional nutrition, integrative and functional medicine, as well as discuss innovation and provide expert opinion every week. More and more patients are seeking integrative and comprehensive pain therapies that care for both their body as well as their mind. A biopsychosocial approach to the care of pain has arrived. Many realize that pain medications and surgery alone are not enough to address the root cause of their problems - such as fibromyalgia, chronic low back pain, osteoarthritis, rheumatoid arthritis, autoimmune disease, CRPS, neuropathy, anxiety, depression, and PTSD. Dr. Joe Tatta is a global leader in integrative pain care and an advocate for the safe and effective treatment of chronic pain. He is the Founder of the Integrative Pain Science Institute, a cutting-edge health company reinventing pain care through evidence-based treatment, research, and professional development. For 25 years he has supported people living with pain and helped practitioners deliver more effective pain management. His research and career achievements include scalable practice models centered on lifestyle medicine, health behavior change, and digital therapeutics. He is a Doctor of Physical Therapy, a Board-Certified Nutrition Specialist, and Acceptance and Commitment Therapy trainer. Dr. Tatta is the author of two bestselling books Radical Relief and Heal Your Pain Now and host of The Healing Pain Podcast. Learn more by visiting www.integrativepainscienceinstitute.com. The Healing Pain Podcast is a great resource for patients suffering from chronic pain as well as for professionals seeking additional professional CEU credits and free continuing education on the most up-to-date information for treating pain based on a biopsychosocial model of pain care. The show covers a wide range of topics that will help you learn all about chronic pain management such us how clinicians can treat pain more effectively, learn how exercise and physical activity alleviates pain, the role nutrition plays in reversing and treating chronic pain, how to use mindfulness, cognitive behavioral therapy, and acceptance and commitment therapy to treat many chronic conditions, and so much more! Chronic pain doesn’t have to be an obstacle in the highway of your life that makes you step on the brakes. Arm yourself with the knowledge on how you can better manage or even eliminate it so you can start living your best – and pain-free – life! Join The Healing Pain Podcast community today.
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Dr. Joe Tatta | The Healing Pain Podcast
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Oct 20, 2021

This was a fun episode for me for lots of different reasons. The first reason, I spent a lot of time over past episodes talking about cognitive-behavioral therapies, in essence, if you will, the more top-down approaches for the treatment of chronic pain as well as other health conditions. Being a physical therapist, I work with both the mind as well as the body. I want to turn some attention toward more of the embodied therapies, more of the bottom-up approaches, and how they can have a very positive influence and impact on someone's pain and their overall health.

In this episode, we are going to discuss awareness through movement and how the Feldenkrais Method can be used as a tool for pain management. My guest for this episode is Professor Teresa Miller. She is the Founding DPT Program Director at St. John's University, a graduate of the American Physical Therapy Association Educational Leadership Fellowship, and a Guild Certified Feldenkrais Practitioner.

She is an Associate Professor Emeritus from State University of New York Downstate Medical Center in Brooklyn, New York, where she taught physical therapy for years. Dr. Miller received her PhD in Physical Therapy from Temple University, her MS in School Psychology, a BS in Physical Therapy, and AIS in Physical Therapy Assisting.

In this episode, we discuss what is the Feldenkrais Method, how it is developed, what are the guiding concepts of a Feldenkrais lesson, how Feldenkrais can help those managing chronic pain and how to find a Guild Certified Feldenkrais Practitioner. A little FYI before we begin this episode, Dr. Miller was one of my professors of Physical Therapy at the State University of New York Health Science Center, Brooklyn way back from 1995 to 1997.

I consider her a colleague, a mentor, as well as a friend. It was lots of fun for me to do this episode with her. It takes you back in time a little bit too when I was a student and reviewing some of the work that she did, which is groundbreaking. Feldenkrais was not so popular in 1995 when I went to PT school. She was one of the first people to introduce me to more of the mind-body as well as embodied approaches to treating pain.

I want to thank her for her time and for joining us for this episode. I know you are getting a lot out of it. I especially want to thank her for her leadership and bring some of these mind-body approaches into my personal practice as a PT but also into the profession and providing evidence for it. Without further ado, let's begin and meet my good friend, Teresa Miller.

 

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Oct 13, 2021

Friends, thanks for joining me on this episode. I am speaking with Physical Therapist Zachary Stearns about how to screen for psychological factors when treating patients with chronic pain. Zachary is a physical therapist in Durham, North Carolina. He's board-certified in Orthopedic Physical Therapy and has worked in outpatient clinics, which have a focus on musculoskeletal pain management. He's currently working on a large research study, which is called the AIM-back program. This is a collaborative effort between Duke University and the U.S Department of Veterans Affairs. He's also a PhD student in Health Sciences.

In this episode, we discuss the benefits of screening for psychological factors or what we call “yellow flags” in chronic pain management. What types of screening tools can you use? Self-report measures that you can use in your practice. As physical medicine professionals, should we be screening for suicidality? If we do have a positive screening, how do we approach that? How do we follow through with that? Finally, the barriers to implementing and screening psychological factors in clinical practice. I want to thank Zachary for joining me on this episode.

If you're a clinician, this is a content-rich episode where we go deep into how to screen for psychological factors, which are important. We also touch on the topic of suicidality. We have a little bit of a healthy discussion on, “Should we be screening for suicide and what do we do after we screen for suicide?” Zachary also just finished writing a paper in the Journal of Orthopaedic & Sports Physical Therapy. I did mention that at the beginning of the episode. It's great. It's really useful and it would help you. Without further ado, let's begin and let's meet physical therapist, Zachary Stearns.

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Oct 6, 2021

In this episode, we have two incredible guests. I'm excited to bring two guests with some incredible experience and research behind them to talk about an important topic, which is bringing ACT to a multidisciplinary pain clinic setting. My guests are Physical Therapist Corinne Cooley and Psychologist Heather King. First, I'll tell you about Corinne. She is a Physical Therapist at the Stanford Pain Management Center and a Clinical Residency Faculty Member in the Stanford Orthopaedic Clinical Residency Program in California. She works with pain physicians and pain psychologists to help optimize complex patient care plans, and leads the exercise and movement portion of interdisciplinary outpatient programs.

 

Psychologist, Heather King, is a Clinical Associate Professor in the Department of Anesthesiology and Peri-Operative Pain Medicine. She also serves as the Director of the Pain Psychology Fellowship at Stanford. Her areas of expertise are Cognitive Behavioral Therapy for pain as well as insomnia, and Acceptance and Commitment Therapy. In this episode, we'll discuss an investigation that Corinne and Heather were both involved in.

This study included an outpatient interdisciplinary approach with pain psychology using ACT as well as physical therapy, and compared that to traditional Cognitive Behavioral Therapy. In essence, this was an ACT plus PT intervention compared to a Cognitive Behavioral Therapy intervention alone. They got some interesting data and some results to share. They share how they went about investigating this topic and some of the outcomes as well as the patient population, and how ACT flowed through the psychology as well as the physical therapy part of care.

 

As you know, I'm a little biased toward mindfulness and acceptance-based approaches, to living life to the fullest, especially with chronic pain. That's why I'm so excited to share Corinne and Heather with you. They also use ACT as their primary form of Cognitive Behavioral Therapy in their treatment. Just a reminder, if you want to learn more about ACT for chronic pain, there are two great resources for you. The first is my book, which is called Radical Relief. The second is our course, ACT for Chronic Pain, here at the Integrative Pain Science Institute.

 

Take the time to read about some of the topics we're talking about with regard to chronic pain, both on how ACT can help the psychological aspect as well as the physical aspect of pain. Also, how Heather and Corinne worked together as this tight interdisciplinary team, which is important in the study they created. Hopefully, we can see more of this in healthcare settings. I highly recommend if you're a professional to download the paper. It’s open access. You can read either the paper and follow along with the show or read the paper after. Without further ado, let's begin and meet Physical Therapist Corinne Cooley and Psychologist Heather King.

 

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Sep 29, 2021

In this episode, we're tackling the important but often times not spoken about the impact of trauma and PTSD on the experience of chronic pain. We're going to be sharing a masterclass that was delivered by a physical therapist, Dr. Jeremy Fletcher, on the topic of trauma-informed pain care and why all of us as healthcare professionals should be more sensitive to the needs of people living with trauma and PTSD. Jeremy does share a number of slides. It's got some great data and some beautiful slides to share with everyone.

 

Let me tell you a little bit about Jeremy before we begin this episode. Jeremy is a Physical Therapist and serves as the Director of Community Integration for a company called Veterans Recovery Resources. This is a non-profit mental health organization, which is located in Mobile, Alabama. He is a former Professor of Physical Therapy. He's also presented at state, national, and international conferences on the topic of chronic pain, health behavior trauma, as well as community health. He's a Major in the US Army Reserve and holds several leadership positions for non-profit organizations throughout Alabama. His service in the Afghanistan war earned him a Bronze Star for working in a combat zone. He's also a veteran, a father, a coach, as well as a husband. I know you'll gain a lot from this episode.

 

Jeremy talks about the topic of trauma from a clinician's perspective. He also talks about it from his own perspective, as far as being in a war and suffering from his own PTSD. He's also leading our Trauma-informed Pain Care Course at the Integrative Pain Science Institute. That course is open for registration now. It's a five-week course with a mentor and learning session at the end of the course. You can find out more about the Trauma-Informed Pain Care Course that Jeremy is leading on this episode. You can also go over to the website at IntegrativePainScienceInstitute.com. Scroll over to the Courses tab and scroll down, and you'll find the Trauma-Informed Pain Care Course page.

 

We would love to see you in that course. It is so important that all of us mental health providers oftentimes receive some trauma-informed pain care, but those of us who are physical medicine professionals, PTs, OTs, oftentimes, we need to reinforce that training. This is an incredible course to do that. Without further ado, I welcome you to read this episode of this masterclass. If you have any questions, you can reach out to us at the Institute. Our email is Support@IntegrativePainScienceInstitute.com. Without further ado, let's begin to learn about Trauma-Informed Pain Care with Dr. Jeremy Fletcher.

 

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Sep 22, 2021

The month of September is Pain Awareness Month. In years past, I've done lots of different things for Pain Awareness Month. I've held online summits, which hosted 30 plus experts. I've done courses for professionals and people with pain. In 2021, I was trying to figure out, "What are we not talking about in the chronic pain space that we need to bring more awareness around? What should we be talking about? What can we bring some more disruption around to disrupt our pain care world out there that isn't always as effective for people with chronic pain?"

As I started to reflect on my practice and the patients I've seen over many years I've been treating patients looking at research, I said, "We need to talk more about the link between trauma and chronic pain." This September, I've done a couple of different things to raise awareness around the trauma-pain connection. The first is I've done lots of different posts on my Instagram handle. If you can head on over to Instagram and find me, my handle is easy. It's @DrJoeTatta. You can find me on Instagram. Like and follow me. I have lots of great posts and sliders that are perfect for you if you're a practitioner or someone with chronic pain and you want to learn more about the trauma-pain connection.

The second is I partnered with a physical therapist this September. His name is Dr. Jeremy Fletcher. He is teaching our first Trauma-Informed Pain Care Course. You can find that by going to IntegrativePainScienceInstitute.com. Head on over to the Courses tab and scroll down and you'll find the Trauma-Informed Pain Care course. That's open now and you can register. It's available for CEs as well as CEUs for physical therapists and other licensed health professionals. It's about seven hours long and has lots of great content.

Jeremy is a physical therapy educator. He works for a company called Veterans Recovery Resources, which is a not-for-profit organization, which helps veterans with both their physical well as mental health needs. He is a dad, coach and also a survivor of trauma himself. He is a veteran of the Afghanistan War. He brings lots of professional as well as personal input to this topic. I've learned so much from Jeremy. He and I lectured in 2020 at Combined Sections at the APTA National Conference. I'm going to lecture again in 2021 at the national conference, which is in February. You can meet both of us there if you're around.

Finally, I've reached out and partnered with people like our guest, Dr. Robyn Walser, who is an ACT-trained clinical psychologist. She is one of the world's leading experts in treating trauma and PTSD. She is the Director of TL Psychological and Consultation Services. She is also an Assistant Professor at the University of California, Berkeley and works with the National Center for PTSD. As a licensed clinical psychologist, she maintains international training, consulting as well as therapy practice.

Robyn is well-known as an expert in Acceptance and Commitment Therapy, specifically for the treatment of trauma and PTSD. She has co-authored seven books, including a book on Learning ACT. Robyn's work spans traumatic stress, depression, substance use and chronic pain. She has written research articles, chapters and books on these topics. She has been doing ACT training and workshops since 1998.

Robyn is incredible. I've seen her in action at a couple of national conferences through ACBS. I've also read a couple of her books. They're great. Head on over to Amazon and make sure you check out all of her books. Dive into this episode, read the topics that she and I are talking about around chronic pain and trauma, see if it resonates with you and think to yourself, "How much do I understand about trauma, PTSD, adverse childhood experiences and the social-political contextual aspects of trauma?" All these are important factors when it comes to treating people with chronic pain. Let's begin this episode and meet Dr. Robyn Walser.

 

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Sep 14, 2021

As always, it's an honor and a pleasure to be spending this time with you. Before we begin, there are a couple of thank yous as we move forward. I wanted to thank OPTP Products for hosting me on their webinar, which was on September 16th. I conducted a webinar for them on mindfulness and acceptance-based approaches for the treatment of chronic pain. Also, I talked about some information from my latest book, Radical Relief, which you can find on their website as well. Thank you for all the great people at OPTP. Make sure you check them out on their website, which is OPTP.com.

 

On October 21st, I'll be giving a two-hour session on mindfulness and acceptance-based approaches for the treatment of chronic pain at the New York Physical Therapy Association Annual Conference. I hope to see you there. I also want to thank the NYPTA for inviting me. Finally, you can catch me and our guest in this episode at The 2021 Educational Leadership Conference in Atlanta, Georgia. The Excellence in Physical Therapy Education Conference highlights excellence in physical therapy, as well as innovation. It's a collaborative effort by the APTA Academy of Education and the American Council of Physical Therapy.

 

If you're a PT or PT educator and you're going to be at the 2021 ELC Conference, make sure to visit me and my colleague. We're presenting a session called Mindfulness and Acceptance-based Interventions in Physical Therapy Education. It's time to address the cycle of distress using evidence-based practice. Also, if you're attending the conference, make sure to catch the keynote by our guest, Dr. Nicole Piemonte. It's on Friday, October 22nd at 8:00 AM. She'll be speaking about cultivating the habits of the heart of patient care, including compassion, vulnerability and imagination.

Let me tell you about Dr. Nicole Piemonte before we begin. She is the Assistant Dean for Student Affairs and a faculty member in the Department of Medical Humanities at Creighton University School of Medicine. She earned her PhD in Medical Humanities, where she focused on Philosophy and Medical Ethics. Her teaching and research focus on incorporating the humanities into medical education in order to cultivate future practitioners who are tuned to suffering, vulnerability and social justice.

 

In this episode, we discuss the benefits of confronting suffering and vulnerability, both in healthcare education, as well as its impact on patient outcomes. Once again, I want to thank the New York Physical Therapy Association and the Educational Leadership Conference for inviting me to speak. It's a great honor. I look forward to meeting all of you and without further ado, let's begin. Let's meet Dr. Nicole.

 

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Sep 8, 2021

We have an incredible guest and we're discussing ways to heal and prevent common childhood diseases. Our guest is an ear for parents, a voice for children, a resource for other healthcare professionals, and she's on a mission to help one million children get off meds. They may not need it if they were eating the right food for their health system. My guest is Dr. Sheila Kilbane. She is a board-certified pediatrician. Who's also trained in integrative medicine. She practices medicine in Charlotte, North Carolina, and consults with physicians around the globe using her holistic strategies to help parents resolve eight chronic recurring health conditions. Dr. Kilbane, welcome to the show.

 

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Sep 1, 2021

By now, you know that I'm a big fan of mindfulness and acceptance-based approaches for the treatment of chronic pain and I'm pretty sure I'm not the only one. If you look at studies, an increasing number of Americans are using some type of integrative or contemplative practice on a daily or a weekly basis to improve upon their physical health, as well as their mental health.

 

One of the reasons why I love mindfulness and acceptance-based approach so much is because, as practitioners, we're faced with an increasingly complex, more chronic, and more disease professional landscape. The other reason is I believe we've arrived at a place where we can no longer separate the brain from the body or the mind from the body, however you'd like to look at it.

Consider for a moment that there's a well-known, backed by evidence and science, strong positive association between living in a state of stress, which then turns into emotional distress and then finally, on to mental illness. There's a bi-directional relationship between mental illness and physical illness that's inseparable.

 

Currently, 1 in 5 Americans lives with a mental illness, that's about 52 million people and there have been surveys of physical therapists working in the general orthopedic practice where 75% report treating comorbid mental health problems on a daily or weekly basis. Mindfulness and acceptance-based interventions are a family of methods that emphasize a present moment awareness, nonjudgmental stance, and employ values-based living.

The techniques and exercises embedded in these methods teach you how to cope with stressful thoughts, stressful emotions, and even painful physical sensations. The goal is not to clear the mind or to prevent difficult emotions or thoughts from occurring. We don't have a great way to do that. It's about learning how to relate differently to all your experiences, even the distressing ones as part of our human experience.

 

These methods are useful in clinical practice, especially if you're aiming for health promotion, improving physical function, injury prevention, pain management, modulating the immune system, alleviating noncommunicable disease, and even improving sports performance. Mindfulness is much more than meditation. These are thoroughly investigated, science-backed, and proven methods of health behavior change.

 

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Aug 25, 2021

Thanks for joining us. My guest is Mathew Embry. Mathew has a great story of overcoming adversity and a chronic condition. Mathew was diagnosed with a debilitating form of progressive MS where he was offered no cure and few if any solutions. He and his father, who is a PhD trained researcher, set out on a quest to find answers. They dove into the peer-reviewed medical literature and discovered natural ways to halt and reverse the progression of multiple sclerosis.

His entire journey can be found in the Amazon documentary called Living Proof, where Mathew shares his story of halting the progression of MS. The documentary also explores the relationship between MS charities and the pharmaceutical industry, their lack of transparency with regard to medical funding, as well as their power, influence, and sometimes their ability to avoid opportunities to raise awareness around lifestyle-based treatments such as nutrition and exercise therapy for the treatment of MS. We discussed this story and how potential conflicts of interest affect those in need of chronic disease treatment. Without further ado, let's begin and meet Mathew Embry.

 

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Aug 18, 2021

In this episode, we are discussing the impact of the health insurance industry on the effective treatment of chronic pain. This is a topic I have been wanting to create some content around for some time. When I look back at the evolution of the show, the episodes typically fall into two buckets. I'm either talking about effective treatments, trying to build, spread awareness around conservative effective treatments for chronic pain or I'm talking about the latest, or some new research that I feel is innovative.

In those two buckets, I'm also always looking for where are the problems and the barriers for us as professionals and for people living with pain to access effective pain care. When I look at the problems, there's one big problem that is like a big flashing red light, the elephant in the room. That's the health insurance industry.

I asked myself, "How has this changed throughout my career?" As a physical therapist, I started practicing or treating patients in 1997. In 1997, I can't think of too many barriers for me treating a patient. When do I say that I'm talking about how much it costs a patient to access conservative pain care and then is that treatment covered? Those are the two big issues, "How much does it cost? Is it covered?" I can tell you back in 1997, I don't remember any patient having a deductible. If there was a copay or something moderate, it's maybe $5 or $10.

I'm not saying as citizens, professionals and people living with pain that we shouldn't be fiscally concerned about the delivery of healthcare because that's important, especially in the United States of America. However, I can tell you in 2021, the average American contributes to their health insurance. Meaning there's typically an employee portion each month as an employee that contributes to your monthly premium. There's also an annual deductible and then there are copays on top of all of that.

As people in the United States of America, this may be the most important for those of us who live in the United States but I know this impacts all of us around the world, we are paying a lot of money into our health insurance. We have to ask the question, "What are we getting back? What is the benefit that we are receiving?" The average deductible in New York City, the place where I live, is somewhere between $5,000 and $10,000 for a family plan. I have seen family plan deductibles upwards of $20,000. It's clear that premiums have increased.

The second thing for us to consider is copays. When I first started in 1997, copays were maybe $5 or $10. It's not uncommon now. I have seen copays that equal the cost of the PT visits. Copays that run anywhere between $40, $50, $60 and $70 upwards to $100 to receive physical therapy care. We are paying more.

However, at the same time, I have also seen visits decrease. In the United States of America, this varies depending on the diagnosis and where people live, the average length of stay for a PT session is about twelve visits. Consider you have to treat someone who has fibromyalgia and you only have two visits per week for six weeks for a total of twelve visits before the insurance company terminates care.

Effectively, what large insurance companies have done is have contracted or hired third-party medical management companies, which come in. It's what they call they manage health insurance claims, which I would like to call what it is the aggressively deny claims for conservative care. This includes things like physical therapy, occupational therapy, speech, mental health services, as well as addiction treatment.

Not only do they manage that care but oftentimes, insurance companies will not approve a patient seeing multiple providers. For example, insurance companies often regulate if a patient is seeing both a physical therapist and chiropractor or a PT and OT. Any combination of those, they don't like when patients are using their insurance to the fullest extent.

Let's carry that over into what is identified as the gold standard for the treatment of chronic pain, which is multidisciplinary or interdisciplinary care. That's when the patient can access multiple providers. In the United States of America, we have one interdisciplinary chronic pain clinic for every million people that focus on chronic pain management.

Why do we have that? Insurance companies have identified this as expensive care. It's too expensive to pay multiple providers, at the same time, they have severely cut back on those programs probably since the early '80s somewhere. That's when that trend started. That has come back somewhat but we haven't seen a revitalization of interdisciplinary chronic pain treatment programs in the United States of America specifically because insurance companies won't pay for the care.

Lastly, I don't want to just focus on private health insurance companies in the United States. We have things like Medicare and Medicaid, which are government-sponsored plans. Those two have been cut every year it seems. Some emails go out by organizations, such as the American Physical Therapy Association. It's called Stop The Cut. That's where the Medicare fee schedule is reduced.

Each year or every couple of years, the national government tries to reduce payments to outpatient physical therapy services. When payments are reduced, it often has an impact on the number of visits that we can see patients for and the quality of care that we can provide in an outpatient setting. The question is, "How does the health insurance industry perpetuate the chronic pain crisis?"

Joining me is Dr. Michael Schatman. He is a clinical psychologist who spent many years working in multidisciplinary chronic pain management. He is on the teaching faculty of the Department of Public Health and Community Medicine at the Tufts University School of Medicine in Massachusetts and serves as Director of Research and Network Development for Boston PainCare. He has authored more than 100 journal articles and book chapters on chronic pain management and lectures regularly at the international level. He is also the Editor-in-Chief of the Journal of Pain Research.

In this episode, we are going to talk about the health insurance industry and how it impacts the treatment of chronic pain. This is an important episode. Make sure you share this with your friends, families and colleagues all over social media so we can raise awareness on this topic. Let's begin and meet Dr. Michael Schatman.

 

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Aug 11, 2021

We're talking about analgesic medications and how they can have both a positive and a negative impact on how your muscles function. Analgesic medications are simply medicines that are used to alleviate pain. You may have seen them marketed as painkillers or pain relievers. Technically the term analgesic refers to any medication that provides pain relief without putting you to sleep or causing you to lose consciousness. There are many different types of medications that have pain, relieving properties. Some people tend to lump these all together, but they're different groups or types of medications.

 

Some common names you might have heard of are non-steroidal anti-inflammatory medications, such as NSAIDs. These include things like Aleve and Advil. Another group is narcotic opioids, like oxycodone and morphine, and then another common group or non-opioid analgesics typically falls into that category are things like acetaminophen or Tylenol. In many cases, the effect of treatment of chronic pain may include one or more of the analgesic medications I previously mentioned.

 

However, the use of analgesic medications can be potentially challenging for physical therapists because they're faced with a paradox. On the one hand, an analgesic medication may alleviate pain, which you may think makes it easier for people to move and function. Yet, on the other hand, these medications may negatively impact the physiology of your muscles, nervous system and other parts of your body. Here to talk to us about analgesic medication is Dr. Bahar Shahidi.

 

Bahar is a physical therapist and a researcher investigating how analgesics impact muscle physiology, pain as well as physical function. She is an assistant professor in the Department of Orthopedic Surgery at the University of California at San Diego. Her academic background includes a Bachelor's in Chemistry, a Doctorate Degree in Physical Therapy and a PhD in Neurophysiology. Her research focuses on muscle physiology changes in the presence of chronic spinal pain.

 

In this episode, we discuss how analgesic medications impact clinical outcomes in people with chronic low back pain, exercise responsiveness, how to time the use of analgesic medication relative to physical therapy treatment, and balance medication use and exercise for optimizing patient outcomes. Let's begin and meet Dr. Bahar Shahidi and learn about how analgesics impact muscle physiology.

 

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Jul 28, 2021

In this episode, we're discussing how to bridge the gap that exists between a person and pain, their ability to move beyond suffering and back to life through applying both modern pain science principles, and the ancient wisdom of yoga. Yoga is a practice that is more than 5,000 years old, and the field of pain science is probably more than 40 years old. However, when brought together, both of these methods and techniques offer each other enormous resources and wisdom for the treatment of pain and many other chronic health conditions. Joining me to discuss the combination of pain neuroscience with yoga for effective pain care are physical therapists Niamh Moloney and Marnie Hartman. Niamh is a physiotherapist, pain researcher, and yoga teacher. Marnie is a physical therapist, a certified strength and conditioning specialist, and a registered yoga teacher.

Both have a special interest in pain neuroscience and how to use yoga for effective pain care. In this episode, we discuss how to apply modern pain or science to yoga and yoga therapy, the similarities between yoga and a modern pain science approach, how to optimize both the mind and the body for effective pain relief, and whether or not mindful movement is more effective than general physical activity for pain management. Together, Niamh and Marnie wrote a great book called Pain Science-Yoga-Life, you can find that on Handspring Publishing, make sure to check that out. Without further ado, let's begin this episode and learn about pain neuroscience and yoga for effective pain care.

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Jul 14, 2021

On this episode, we're discussing patient adherence to treatment as a foundational aspect of pain management. The evidence-base and research in this era tell us that high levels of adherence to things like physical activity or perhaps an exercise program are highly correlated with positive health outcomes, but what about when a patient does not adhere to the agreed upon treatment plan? Do we know how to increase patient adherence? Do we know how to promote the maintenance of pain self-management behaviors? Joining me to discuss adherence to and the maintenance of self-management behaviors in people with musculoskeletal pain is Dr. Anne Soderlund. Anne is a Professor of Physiotherapy in Sweden with a special interest in behavioral medicine.

 

Her research area is on prevention, treatment and evaluation of health problems from a behavioral medicine perspective embedded within a physiotherapy framework. This includes a strong focus on an individual's behavior, behavior change, and the ability for functioning in everyday life at different ages. On this episode, we discuss the important topic of helping patients adhere to exercise programs and other self-management techniques for the treatment of chronic pain. As a leader in this area, it has some great research with regard to physiotherapy and behavior change. She's definitely someone's work I recommend that you follow. Without further ado, let's begin and let's meet Dr. Anne Soderlund. 

 

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Jun 30, 2021

We're discussing how to use mindfulness and acceptance-based approaches to overcome chronic pain. My guest is Vidyamala Burch. She is a mindfulness and compassion teacher with years of helping people with pain, illness or stress live fuller and more meaningful lives. At the early age of seventeen, she sustained a spinal injury that required multiple surgeries and left her with chronic low back pain and partial paraplegia. After experiencing a period of hopelessness as well as helplessness, she discovered mindfulness as a way to ease the mental torment associated with physical pain.

 

She's the author of two books, teaches and trains on the topics of mindfulness as well as compassion. Vidyamala was also awarded an honorary membership from The British Pain Society for outstanding contributions to the field of pain management. In this episode, we discuss how Vidyamala has used mindfulness to overcome chronic pain and how she teaches people with chronic pain to live fuller lives through mindfulness meditation. Without further ado, let's begin. Let's learn about mindfulness and acceptance-based approaches to chronic pain.

 

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Jun 16, 2021

The words pain science and pain education are used so frequently nowadays in professional circles that we rarely take the time to explain the difference between the two or reflect on what clinical practice was like before these advancements came into our life. What was it like for people living with pain without this knowledge? Pain science is a part of a larger field of neuroscience, which investigates nociception and the lived experience of pain. It is most often taught in University Physical Therapy programs but over the years, it's begun to show up in the training of many licensed healthcare professionals. Pain education is one component of an overall cognitive-behavioral intervention, which teaches people how to effectively self-manage chronic pain. It focuses on the components of each individual's pain experience and how it affects their daily lives. Research shows that when people have a better understanding of how pain works in the body, it can ease fear, anxiety and create hope.

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Jun 9, 2021

Joining me is one of our faculty members, Dr. Carey Rothschild. She’s going to talk to you all about the importance of pain science and pain education in practice, whether you are a physical medicine or mental health professional. Let me first introduce Carey to all of you. Dr. Carey Rothschild is an Assistant Professor in the Doctor of Physical Therapy Program at the University of Central Florida. In addition to earning her DPT, she's Board-Certified in Orthopedic Physical Therapy and Sports Physical Therapy. She earned a Certificate of Achievement in Pelvic Physical Therapy. Her research related to running and the female athlete has been published in the Strength & Conditioning Journal, the Journal of Strength and Conditioning Research, Sports Health and the Journal of Women’s Health Physical Therapy.

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Jun 2, 2021

It's a pleasure to be spending this time with you. In this episode, we're talking about the latest in pain science and pain education with our expert guest Dr. Carey Rothschild. Carey is an Assistant Professor in the Department of Physical Therapy at the University of Central Florida. In addition to earning her DPT degree, she is also board certified in Orthopedic Physical Therapy and in Sports Physical Therapy and earned a certificate of achievement in Pelvic Physical Therapy. Her research related to running and the female athlete has been published in The Strength & Conditioning Journal, The Journal of Strength and Conditioning Research, Sports Health and the Journal of Women's Health Physical Therapy.

In 2019, Carey received the award for Excellence in Academic Teaching from the Florida Physical Therapy Association. A big part of that was for her innovation in developing and teaching one of the nation's first pain mechanisms and treatment and rehabilitation courses for both physical therapists as well as other healthcare professionals. In this episode, we'll discuss the foundational and important aspects of pain science, pain education and the steps Dr. Rothschild took to create a course on pain science education at the university level. Also, how she has expanded the delivery of pain education not only for physical therapy students but also for other healthcare professionals such as social workers.

Before we begin, I wanted to let you know that Dr. Rothschild has joined the Integrative Pain Science Institute as a faculty and educator. As part of her joining, she has two offerings that I want to share with you. The first one is a free masterclass on pain science education. If you like what you read, stick around or if you're on our mailing list, be on the lookout for an email with regard to a pain science education masterclass. It's a 40-minute masterclass where Dr. Rothschild reviews a case study on a 45-year-old female with chronic pelvic and lower back pain.

This is appropriate for both physical medicine professionals as well as mental health professionals. Keep an eye out for a unique course offering that Carey’s delivering through the Integrated Pain Science Institute. It is called Pain Education for the Health Care Professional. This is a six-week, seven-hour CEU activity where you learn the latest in pain science, as well as pain education and how to effectively assess and treat the multi-dimensional nature of pain.

That's a six-week course. It's worth seven CEs/CEUs. It's called Pain Education for the Healthcare Professional. Make sure you're on the mailing list too. Go over to IntegrativePainScienceInstitute.com and hop on our mailing list. You can opt-in anywhere to receive our emails and you'll receive updates both on the pain science education masterclass, as well as the Pain Education for the Healthcare Professional CEU course and activity. Without further ado, let's begin and let's meet Dr. Carey Rothschild.

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May 26, 2021

We are joined by Dr. Ellen Zambo Anderson, who is an Associate Professor in the Doctor of Physical Therapy Program at Rutgers University. In addition to earning a PhD in Health Sciences, she's an Assistant Director of the Rutgers Community Participatory Physical Therapy Clinic and serves as the Special Olympics Global Advisor for Young Athletes. Dr. Anderson is the co-author of the textbook, Complementary Therapies for Physical Therapy and the Co-owner of YogiAnatomy, a company that provides continuing education on the topics related to complementary approaches for managing well-being, health and function. In this episode, we examine professional burnout in the physical therapy profession and provide suggestions for individuals and institutions to address and decrease burnout. It's an important topic for all of us in the profession of physical therapy and other health professions as well. Make sure to share this episode with your friends and colleagues. Let's get ready and meet Dr. Ellen Zambo Anderson.

 

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May 19, 2021

Thanks for joining me for this special episode of the show masterclass where we're discussing the impact of motivational interviewing on chronic pain. In this episode, I'm joined by Dr. Rose Pignataro, who is a doctor of physical therapy and an expert on how to use motivational interviewing specifically in physical therapy, chronic pain and non-communicable disease. In this masterclass, Rose will discuss what motivational interviewing is, how motivational interviewing can be used alongside other treatments such as exercise, pain neuroscience education, CBT or ACT, and how to bill and code for this intervention in clinical practice.

Finally, she'll go through a case study of a woman with diabetic peripheral neuropathy who is ambivalent to start and exercise or change her nutrition patterns. Make sure you hang on for that case study toward the end of this episode. Dr. Pignataro has joined the Integrative Pain Science Institute as a faculty and educator. You can check out her latest course, which is Motivational Interviewing for Chronic Pain. You can find it on the website at IntegrativePainScienceInstitute.com. Scroll over to courses. Go through our course list and you'll find it there. Without further ado, enjoy this masterclass with Dr. Rose Pignataro.

 

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May 5, 2021

In this episode, you'll get to meet my friend and colleague, David Hanscom, MD. He is an orthopedic surgeon whose practice at one time focused on patients with failed back surgeries. He eventually quit his spine surgery practice to pursue his passion and present his insights into solving chronic pain, which evolved from his own battle and struggles with it. Dr. Hanscom has written two books on the topic of chronic pain and now guides patients more clearly through the complexities of solving chronic pain. In this episode, we explore the connection between anxiety, PTSD and chronic pain. It's a great episode to share with someone who is struggling with chronic pain but healthcare practitioners, specifically orthopedic surgeons and primary care physicians. Let's get ready and let's meet David Hanscom, MD.

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Apr 29, 2021

In this episode, we're going to do something different. Instead of me interviewing someone, I'm going to share a simple yet powerful technique that will help you whether you're someone living with pain or a practitioner who treats people. This exercise is called Dropping an Anchor. It's typically one of the very first techniques that I teach patients who suffer from pain or pain catastrophizing, having problems with difficult emotions, emotion dysregulation, anxiety or any challenge that's coming up in the therapy room. Before we begin, we probably should revisit the term pain catastrophizing and review and identify what that means. Pain catastrophizing is the tendency to magnify the threat value of pain, feel helpless in a context of pain or the inability to inhibit pain-related thoughts in anticipation of a painful encounter. The last part, the inability to inhibit pain-related thoughts in anticipation of a painful encounter, is what I would like you to think about as we go into this episode.

Think about someone who has chronic pain. Each time they come into your clinic, each time they come into the therapy room with you, they are in some way in anticipation that there may be some pain during that session. We're going to talk about pain. I may be moving or moving your arm. You may be experiencing pain. It's a lot of pain-related thoughts that are happening in anticipation of a treatment session. That's why we're going to go through this Dropping an Anchor exercise. If you've taken my ACT for Chronic Pain Course or my Mindfulness-Based Pain Relief Certification, you'll be able to identify that this type of exercise fits squarely in the psychological process of contacting the present moment. You'll also be able to identify some degree of cognitive defusion. Cognitive defusion is the idea of distancing or separating from thoughts. You'll definitely see aspects of both of those during this exercise.

There are lots of different ways you can drop an anchor. You can drop an anchor by focusing on your breath, by stretching, focusing on the rise and fall of the diaphragm, looking around the room and fixating on a point or listening to sounds in the room. You're going to hear all of those flavors now because I'm going to share a session that I had with a client that I worked with virtually. This whole encounter here that I'm going to share with you with my client, Barbara, I have her permission to share this. At the end of that exercise, I gave Barbara a while to debrief so we can talk through what she noticed and experienced during the activity.

Probably the most common mistake I see both therapists, as well as patients, make with this type of exercise is they attempt to use it as a control or a distraction technique. Control and distraction techniques are very opposite of what happens in mindfulness and acceptance-based approaches to pain. Mindfulness and acceptance-based approaches involve helping you turn toward what's in the present moment with an openness and a curiosity and not necessarily to distract, eliminate, control or avoid what's present.

I invite you to participate and play patient. If you're at home, find a comfortable chair to sit in. Any chair will do. You can do this as an eyes-open or eyes-closed exercise. It doesn't matter. I personally enjoy eyes-closed exercises like most people do with regard to cognitive and mindfulness exercises like this. If you're seated, all you have to do is place your palms down on your lap, relax your arms at your sides and gently begin to close your eyes. Let's get ready. I invite you to drop an anchor with us. Let's get started.

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