The TRUTH About Pain and Injury.

(A Biopsychosocial Approach)
Bite size Pain

Human pain is not simple! Pain is never just the result of 'something going wrong' with a joint, muscle, tendon, bone or ligament. Nor is it a manifestation of weak, tight, or 'knotted' muscles. It is also not a series of simple signals that run from the body's tissues up nerves registering as pain in the brain. Pain involves the ever changing complex interplay of factors such as our genes, immune responses, nerves, injured and uninjured body tissues, thoughts, beliefs, emotions, and memories. It involves sociological and cultural factors including our environment, family life, and social upbringing. We could think of pain as an emergent perception of our biological, psychological, and sociological state, or put a little more simply, pain is a biopsychosocial experience.If this is all new to you or sounds very complicated and daunting, please don't be intimidated or let it put you off. While it has to be conceded that the nature of human pain is complex, gaining a contemporary understanding of it and using this knowledge in your clinical practice doesn't have to be. What we have done throughout this course is break down the component parts of the biology, psychology, and sociology related to human pain states, so that we can study them and understand them within the context of human pain. This affords us the opportunity of bringing all of these elements together again as part of our clinical reasoning process, knowing that this is grounded in the highest quality scientic evidence available, and that we are providing our patients with the most effective treatment approaches available for their pain and injuries. Although our scientific understanding of pain is far from complete, it is worth taking a moment to celebrate and acknowledge the amazing progress and advances in the treatment of pain that have come around over the last 30-years. In fact its true to say that we have learned more about pain in the last 30-years than we have in the whole history of medicine that preceded this! If I think back to what I was taught about pain in the early 1990's at university the 'pain teachings' of this era are now literally 'dead in the water'. Other than learning about nerve action potentials and a bit of 'pain gate' theory its all gone, confined to the annals of medical history under the category of 'nice idea but wrong'! As I've said elsewhere, scientists and health professionals (including me) working with people with pain back then did the best they could with the knowledge they had at that point in time. Unfortunately, it just wasn't enough to be able to help lots of our patients with pain. What's more, the facts about pain science have turned out to be radically different to the multiples of unsubstantiated theories and 'guesswork' that came before. Historically, it is these flawed and outdated theories about pain and illness that still underpin many of the philosophies and treatment approaches being used and offered to patients all around the world today. Knowing this, it is perhaps not surprising that these treatment approaches when placed under scientific scrutiny have displayed very modest or often poor levels of success when it comes to treating pain. In view of the fact that pain is a bio-psycho-social experience, it is logical and perhaps not surprising to learn that high quality scientific evidence demonstrates that clinical approaches addressing the biological, psychological, and sociological factors involved in each person's individual pain experience are by far the most successful way to treat pain. This is exactly what we discuss in detail throughout 'The Truth About Pain and Injury'. This course covers key topics such as pain biology. How to explain and help patients understand pain biology in the context of their pain. Exercise and rehabilitation approaches including 'SMART' & 'SMARTER' principles. Graded exposure, including activity / exercise pacing, and baseline setting. Psychological interventions such as mindfulness, motivational interviewing, and cognitive behavioural approaches. There is also a helpful review of pain pharmacology including the indications for the use (or not) of pain medications. There are evidence-based discussions about the use of passive therapies in the treatment of pain, including how and when manual therapy can be integrated into an evidence-based biopsychosocial approach. Our passion and aim is to help you understand the complex nature of human pain and to become skilled in its treatment and management, so that at the end of the course you feel informed and confident to treat all patients with pain. Whether this is pain related to sports injuries in elite or professional sports settings, or chronic pain in a pain clinic or pain management programme, and all other pain in between. As I have said many times over the years, "pain is pain is pain". If we understand its biopsychosocial elements and nature, we should be able to help treat anyone with pain irrespective of its cause.TOMORROW CAN BE DIFFERENT!