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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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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