Chronic Musculoskeletal Pain

Friday, September 7th - Saturday, September 8th, 2012

9:00AM - 5:00PM

9:00AM- 5:00PM

INSTRUCTORS

Virgil T. Wittmer, PhD	Mark D. Bishop, PT, PhD	Steven Z. George, PT, PhD

LOCATION

Brooks Rehabilitation Hospital 
3599 University Blvd. South 
Room: Assembly 1 & 2
Jacksonville, FL 32216

COURSE DESCRIPTION

Pain is a common complaint for almost all patients with musculoskeletal disorders. The practicing clinician can grow frustrated with pain complaints because they are often troubling to the patient and reports of pain can be elusive and inconsistent. The overall goal of this evidence-based education session is to provide the practicing clinician with a “transformed understanding” (Institute of Medicine, 2011) of pain. We will do this by providing an update on current models and data that help to mold a better understanding of pain perception. Course content emphasize musculoskeletal pain from selected studies reported in the pain and rehabilitation literature.

The first session (Friday AM) will start with a brief review of key findings and recommendations from a 2011 Institute of Medicine report detailing the adverse impact pain has on Americans. This will be followed by an update on the neurobiology of pain perception, including a review of classic and updated models and a contrasting of normal and diseased states. Then a historical perspective of pain will be provided, synthesizing the neurobiology and providing orientation to the current thinking of pain processing, including strengths and limitations of various models of pain perception. The morning session will conclude with data from manual therapy studies completed at the University of Florida highlighting application of current pain perception models.

In the second session (Friday PM) measurement of pain will be discussed including assessment of different domains as well as procedures for measuring the output of the pain processing system. The measurement portion will include demonstration for scoring of pain questionnaires and lab for use of standardized stimuli. Variability of pain perception and its potential to explain individual differences will also be reviewed in this afternoon session. Topics covered will include the influence of age, sex, ethnicity, genetics, and psychology on pain reports. The second session will conclude with a question and answer session, including audience polling.

The third session (Saturday AM) will begin with a review of the epidemiology of musculoskeletal pain conditions to set the stage for the focus on clinical management models. Given that the 2011 Institute of Medicine report has highlighted pain as a public health problem, clinical management models will be introduced in the context of primary, secondary, and tertiary prevention. Potential treatment strategies specific to each prevention category will be discussed, as well as the evidence for these treatments. The third session will conclude with a question and answer session, including audience polling. 

COURSE OBJECTIVES
At the end of this course attendees will be able to…

1. Identify the frequency and impact of musculoskeletal pain complaints. 
2. Discuss pathways of pain transmission from the periphery to the central nervous system. 
3. Define the term “central sensitization”. 
4. Discuss potential sources of variability for pain perception.
5. Identify recommended methods to assess pain perception in clinical settings. 
6. Describe factors that are predictive of poor outcomes for musculoskeletal pain conditions. 
7. Discuss models for the development of chronic pain conditions that have been recently highlighted in the literature. 
8. Describe different conceptual management options for the practicing clinician.

INTENDED FOR:

Manual therapy fellows (Brooks/UNF), Orthopaedic or Sports residents (Brooks/UNF or UF), Clinicians or their students that commonly encounter musculoskeletal pain conditions including (but not limited to) MD, PT, PTA, OT, OTA, ATC.

*CEUs applied for Physical Therapy and Occupational Therapy. 

REGISTRATION FEE: