Alyson Lowrey, PT, DPT, OCS is the co-instructor for the H&W course Pain Science for the Chronic Pelvic Pain Population - Remote Course alongside Tara Sullivan, PT, DPT, PRPC, WCS, IF. Alyson treats the pelvic floor patient population through an orthopedic approach, working closely with pelvic floor specialists.
Pain neuroscience education (PNE) is the explanation of the neurophysiological changes in the central nervous system in patients with chronic pain. It includes how the nervous system functions and factors that influence its function such as social, psychological, and environmental factors. Pain neuroscience education aims to increase the patient’s knowledge about pain, decrease the threat of pain, and allow the patient to reconceptualize pain from a biopsychosocial perspective.
As a clinician seeing a patient with chronic and complex pain, it can be very daunting trying to determine how much education you should give the patient. Patients are generally very invested in improving their quality of life and therefore invested in learning how to treat their pain. Using techniques such as motivational interviewing is one way to determine if a patient is receptive to new information about pain and how to deliver that information. Education about pain needs to be varied and tailored to each patient based on their prior knowledge and perceptions, learning styles, their language, and their health literacy.
When a patient has an increased understanding of their pain and how their nervous system works, it can change their perspective about their pain by decreasing the threat value of their pain. PNE is the first step in the process of increasing a patient’s pain thresholds during exercise and functional activity. When patients no longer fear their pain as a sign of tissue damage, they can become empowered to re-educate their nervous system and pain processing centers in their brain. As providers, we are able to do this in several ways. We can do this by helping build new coping strategies and thought processes around their pain and dispelling misconceptions about their pain and physical ailments. We can suggest lifestyle and movement modifications that allow for more functional movement that doesn’t increase their pain activation centers. We can also adjust and modify our treatment plan around the patient's needs for success at each session. Consistently being a voice of encouragement, empowerment, and validation is also a very important component of PNE and our treatment as clinicians for our patients with chronic pain.
This course provides a thorough introduction to pain science concepts including classifications of pain mechanisms, peripheral pain generators, peripheral sensitization and central sensitization in listed chronic pelvic pain conditions; as well as treatment strategies including therapeutic pain neuroscience education, therapeutic alliance, and the current rehab interventions' influence on central sensitization. The rehab professionals who attend will be provided the understanding and tools needed to identify and treat patients with chronic pelvic pain from a pain science perspective. Lecture topics include the history of pain, pain physiology, central and peripheral sensitization, sensitization in chronic pelvic pain conditions, therapeutic alliance, pain science and trauma-informed care, therapeutic pain neuroscience education, the influence of rehab interventions on the CNS, and specific case examples for sensitization in CPP.