Week 3 Teaching People About Pain PNE Flashcards
The neural signature is activated whenever the brain perceives…
a threat
TF: there are bottom up and top down
true
how do we treat bottom up pain
there is pain, so we manip and mob and TENS, and do think we can treat the tissue.
how can we treat the top down approach
train the brain, and teach about pain. We want to wet the brain, sends opioids. education and change the perception of the threat.
what are traditional education models
fear, and we see bad. we show patients things that will cause them fear and make their condition worse. we use biological models.
prevailing biomedical models focus on
tissues and tissue injuries
how do orthopedic based professionals explain pain to patients
with anatomical and pathology-anatomical based models.
what are the problems with these anatomical and biological models
- they increase fear in patients, increases pain, and has no use of decreasing pain and disability
- people want to know about pain, not their anatomy and biology. It doesn’t explain the complexity of the pain.
which is better teaching from a biomedical model, or teaching from a pain science education model
PNE
what does TNE do
explains to patients their pain experience from a biological and physiological perspective of how their NS and brain processes pain, which allows them to move better, exercise better and think about pain different.
TNE/PNE has a positive effect on
pain, disability, catastophization and physical performance.
who administers TNE, and how long does it last
PTs, and can be in an 8 hour session, or even in 30-60 minutes.
what is the difference between TNE in a group setting, or 1 on 1
group; cost effective
1:1 is much better
what are some educational tools for PNE
pictures metaphors hand drawings workbook with readings neurophysiological questionnaires. Visual tools
what are some TNE adjunct treatments
MT soft tissue work manip/mobs spinal stabilization HEP circuit training Aerobic
what is PNE+
PNE with exercises
what are some components of TNE
you teach about neurophysiology. do not talk about anatomy or emotional stuff, think about nocioceptive paths, and neurons with synapses. Also talk about central sensitization and plasticity of the nervous system. talk about the alarm systems and how they become sensitive.
how do we talk about alarm systems to patients when doing TNE
tell them the NS is an alarm system, and that all nerves are connected. one fires, others will too. Also talk about what how easily the alarm is triggered. and that it is extra sensitive.
what is the goal of TNE+ with patients
get the pain down and turn down that alarm system.
what happens after we reconceptulaize pain with TNE
the threat becomes smaller, they can move more. And movement is medicine, so we can begin to treat them.
what do we do with patients after talking about pain
exercise: do pacing and graded exposure, and educate about pain
how often should we do this TNE training
2x/week for 8 visits, talk about pain and do 30-45 minute sessions.
what can TNE do for chronic pain patients
change their beliefs about pain. change their attitudes, give them better cognition and physical performance, improve their outcomes with exercise, decrease the red brain activity and improve function.
does TNE work in acute settings? give an example
yes it does! people with LBP, do 22 minute session on PNE, and now they can get more ROM because their NS is calmed down.
