Week 3 Teaching People About Pain PNE

Question 1

The neural signature is activated whenever the brain perceives…

Answer 1

a threat

Question 2

TF: there are bottom up and top down

Answer 2

true

Question 3

how do we treat bottom up pain

Answer 3

there is pain, so we manip and mob and TENS, and do think we can treat the tissue.

Question 4

how can we treat the top down approach

Answer 4

train the brain, and teach about pain. We want to wet the brain, sends opioids. education and change the perception of the threat.

Question 5

what are traditional education models

Answer 5

fear, and we see bad. we show patients things that will cause them fear and make their condition worse. we use biological models.

Question 6

prevailing biomedical models focus on

Answer 6

tissues and tissue injuries

Question 7

how do orthopedic based professionals explain pain to patients

Answer 7

with anatomical and pathology-anatomical based models.

Question 8

what are the problems with these anatomical and biological models

Answer 8

1. they increase fear in patients, increases pain, and has no use of decreasing pain and disability
2. people want to know about pain, not their anatomy and biology. It doesn’t explain the complexity of the pain.

Question 9

which is better teaching from a biomedical model, or teaching from a pain science education model

Answer 9

PNE

Question 10

what does TNE do

Answer 10

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.

Question 11

TNE/PNE has a positive effect on

Answer 11

pain, disability, catastophization and physical performance.

Question 12

who administers TNE, and how long does it last

Answer 12

PTs, and can be in an 8 hour session, or even in 30-60 minutes.

Question 13

what is the difference between TNE in a group setting, or 1 on 1

Answer 13

group; cost effective

1:1 is much better

Question 14

what are some educational tools for PNE

Answer 14

pictures
metaphors
hand drawings
workbook with readings 
neurophysiological questionnaires. 
Visual tools

Question 15

what are some TNE adjunct treatments

Answer 15

MT
soft tissue work 
manip/mobs 
spinal stabilization 
HEP 
circuit training 
Aerobic

Question 16

what is PNE+

Answer 16

PNE with exercises

Question 17

what are some components of TNE

Answer 17

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.

Question 18

how do we talk about alarm systems to patients when doing TNE

Answer 18

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.

Question 19

what is the goal of TNE+ with patients

Answer 19

get the pain down and turn down that alarm system.

Question 20

what happens after we reconceptulaize pain with TNE

Answer 20

the threat becomes smaller, they can move more. And movement is medicine, so we can begin to treat them.

Question 21

what do we do with patients after talking about pain

Answer 21

exercise: do pacing and graded exposure, and educate about pain

Question 22

how often should we do this TNE training

Answer 22

2x/week for 8 visits, talk about pain and do 30-45 minute sessions.

Question 23

what can TNE do for chronic pain patients

Answer 23

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.

Question 24

does TNE work in acute settings? give an example

Answer 24

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.

Question 25

why is TNE effective?

Answer 25

redefines pain and changes cognition. This will reduce the threat and folks get less pain, and seek less care.

Question 26

does pain equal damaged tissues?

Answer 26

NO

Question 27

with TNE are we treating or managing pain

Answer 27

treating.

Question 28

is chronic pain usually treated or managed

Answer 28

managed.