Pain Rehabilitation

Pre-exam: Self-Administered

Friday, September 24, 2021

10:30 AM – 12:00 PM ET

Presenter(s)

Areerat Suputtitada, Professor

Professor in Rehabilitation Medicine
Chair of Neurorehabilitation Research Unit, Chulalongkorn University
Bangkok, Thailand

Presentation Slides Handouts
Thiru M. Annaswamy, MD, MA

Staff Physician and Professor
VA North Texas Health Care System and UT Southwestern Medical Center
Dallas, Texas
Ariana Vora, MD

Assistant Professor
Harvard Medical School Dept of PM&R
Wellesley, Massachusetts
Megan O. Doyle, MS, OTR/L, FPS, Cert-APHPT

I am a full time inpatient rehab occupational therapist and Fellow in Pain Sciences.
St. Luke's Health System
Boise, Idaho
Bridget S. Chin, MD, MA

Assistant Professor, Michigan State University College of Human Medicine
Instructor, Harvard Medical School/Spaulding Rehabilitation Hospital
Grand Rapids, Michigan
James E. Eubanks, Jr., MD, DC, MS

Academic Chief Resident
University of Pittsburgh Medical Center (UPMC)
Pittsburgh, Pennsylvania
Nicole Sasson, MD

Chief, Physical Medicine and Rehabilitation; Clinical Professor NYU Grossman School of Medicine
Dept of Veterans Affairs and NYU Grossman School of Medicine-Rusk Rehabilitation
NY, New York
Jason M. Beneciuk, PT, DPT, PhD, MPH

Research Assistant Professor
University of Florida; Brooks Rehabilitation
Gainesville, Florida
Denise D. Lester, Assistant Professor Anesthesiology and PMR

Anesthesiologist Pain Management
Central Virginia VA Health Services Center
midlothian, Virginia

Chronic Spinal pain conditions are always challenging to be treated. After a clinical evaluation, a best-informed diagnosis is needed before treatment.

Given the complex nature of chronic pain – both physiologically and psychologically – chronic pain-management strategies often require a multidisciplinary approach. To summarize the successes and shortcomings of current medical and rehabilitation models in addressing chronic pain, our teaching course will explore biopsychosocial and integrative approaches to chronic spinal pain management. We will discuss the concept of suffering in the context of chronic spinal pain management, and summarize the prevalence of chronic spinal pain both nationally and globally and describe physical and psychosocial contributors to pain.

Peripheral sensitization and central sensitization are always considerations that need to be considered along with treatment of the "original" sources of pain. Diagnostic ultrasound is a cost-effective option that may be used for diagnosis and further guided treating with novel therapeutic approaches including prolotherapy, platelet rich plasma, anesthetic, corticosteroid or even sterile water only as for improve range of joints motion, regenerative of joints, tendons muscles and nerves. Acupuncture, dry and wet needling, Extracorporeal shockwave therapy (ESWT) and High-power laser therapy (HPLT) play roles of peripheral desensitization and regeneration of damaged tissues. The novel effect of ESWT is diminishing the calcification and HPLT is decreasing the swollen tissue within short period of treatment time. Transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (TDCS) are selected for central desensitization for pain modulation and novel effects for psychotherapy in chronic pain which mostly develop depression or emotional disturbance or even cognitive dysfunction.

Learning Objectives:

• Outline the clinical approach to evaluating patients with chronic spinal pain
• Define the basic approaches to treatment of chronic spinal pain
• Describe the novel treatments to chronic spinal pain
• Describe the emerging concepts of chronic spinal pain management
• Outline the evidence basis behind the novel approaches and emerging concepts to treat chronic spinal pain