Pain Research – Someone’s Got To Do It.

It’s abundantly clear to me after this weekend, that the folks at the Neuro Orthopoedic Institute (NOI) group in Australia have been busy doing exactly that.

My writing relies heavily on the hard research work of people like these and I am so happy not to have to be the one to produce it.  I have the utmost regard for the kind of mind it takes to do that sort of work.  I, on the other hand, much prefer bringing the information to real people for whom it has practical application in a way that makes sense to them individually.

This past weekend, I was able to attend part of the NOI group‘s EP3 West Coast version of the US edition on Friday at the Washington State Convention Center. Those in attendance were primarily physical therapists, some with doctoral PT training, a few medical doctors, a few adjunct providers – one other chiropractor, a couple of osteopaths, nurses and a some psychologists.

Axons and Dendrites and TLR-4 Cells Oh My!

What I love about this particular body of pain research presented by the NOI group, is the neuro-biology of it. While sitting in the conference and happily soaking up the neurological terminology familiar to me, I wondered how well the basic physical therapy education covers neurology in the US.  Chiropractors get extensive exposure to neurology with increasing detail through the progression of the 5000+ hours of doctoral level curriculum.  It appears that Australian physiotherapy schooling also includes a fair amount of neuro-physiology training.  As I looked about the room at the blank stares, I wondered if perhaps the American PT curriculum isn’t quite as rigorous in this area until perhaps the elective doctoral level? Something for the NOI instructors to perhaps become aware of.

The minds behind this approach to understanding pain via this group out of Australia, is headed up by the two Australian educators who created the book behind the tour. One is a clinical and research physiotherapist and professor of clinical neurosciences at the University of South Australia . The other calls himself a “freelance educator” and sports the suffix EdD, also a physiotherapist who holds a graduate degree in “advanced manipulative therapy” which I believe is the Australian preference over chiropractic although it seems there is significant overlap. As with many different regions in the world there are political reasons that one profession is regarded more highly or accepted more widely.

This weekend they were joined by a local talent, editor-in-chief of the Journal of Pain and University of Washington professor in the Department of Rehabilitation Medicine.

Guess What? “Sh*t” Happens and That Same “Sh*t” Matters When it Comes to Pain.

What tickles me about the NOI group research – at least as presented by the neuro-literate educator of the group – is that it is finally providing scientific evidence of things that we all as humans at some level already know.  Life experiences affect our relationships with pain.

Happy or sad, the things that happen to us as we navigate life, impact us in ways that can cement in time, our cellular reality. Our neuro-physiological responses to pain are significantly dependent upon the molecular patterns set up by a wide array of events and can set us up to experience recurrences of pain more easily or keep us from being able to find our way out of pain.

I was pleased to see that the substance of their work corroborates what many of us who work extensively with patients in pain have always known, and that is the practical reality that pain is often independent of tissue damage. Long after a legitimate tissue disrupting trigger has passed, pain can linger. Pain can also return in the absence of proportional local tissue damage and this is where things get quite fascinating.

The entire premise of my book series about everyday pain is that helping patients grasp the reasons behind their pain and helping them see that they are not irreparably damaged, massively speeds recovery from pain and keeps relapses to a minimum.

Teaching the Teachers

The most lovely thing about these three clinical research masterminds is that they have uncovered and provided the science and research behind the validation needed to implement this pain education. The NOI group seems to be working to educate more clinical educators which is truly going to the source to effect change and I applaud that.

It’s extremely important to refine the professional messaging behind how we greet pain in the practice setting and it will go a long way to changing our pain culture. But what I want to do and am focusing on with my publishing project  these next few years but also farther into the future, is to bring much more of this directly to the patients – the everyday person.

Pay to Play – Healthcare as Usual?

I learned that it was primarily a few local larger medical institutions that brought this conference to their employees by virtue of allotted benefit dollars that provide them with reimbursement for continuing education. The cost of the conference was unfortunately prohibitive to anyone not affiliated with an organization with deep pockets.

The financially prohibitive nature of these conferences (geared specifically to the mainstream medical institutions) presents a discriminatory challenge to equally qualified and information-hungry solo (or small practice) practitioners from a wide variety of relevant specialties. Nevertheless I must applaud the forward-thinking by these health care organizations and hospital groups for embracing the reality and changing attitudes towards the psycho-biology of pain.

It is a changing world and there is hope.

Image Credits:

computer generated TLR4 protein c/o Wikimedia Commons 

statue tripping

writing on the blackboard

pickpocket