A World of Hurt: A Guide to Classifying Pain Overview

COURSE DESCRIPTION: 

This two-day live interactive webinar introduces information critical to the assessment and treatment of patients with acute, sub-acute and chronic pain. Utilizing pain science research regarding pain mechanisms this webinar teaches pain clinicians how to classify and treat pain as it relates to the peripheral and central nervous system. A Pain Mechanism Classification System (PMCS) will be introduced and then guide selection of patient education and active care interventions for each pain mechanism.  The PMCS demonstrated through video and paper case studies will aid application to pain clinicians’ practice. This webinar highlights a subgrouping framework, PMCS, which addresses pain throughout the continuum from acute, subacute and chronic stages covering chemical, structural, mechanical, cognitive, emotional, social, psychological and cortical mechanisms.  This webinar integrates pain science research into a biopsychosocial approach with practical application for patient education and active care interventions.  Promoting a common language between pain clinicians of all disciplines and patients. Included in this webinar, the brief application of peripheral nervous system neurodynamic evaluation, treatment, and central nervous system sensory and motor evaluation, patient rated outcome measures and psychometric tools outlined by dominant pain mechanism. The PMCS patient education and active care interventions support all patient ages and musculoskeletal to neurological diagnoses suffering from pain.

14.75 CEU's approved by the Ohio PT board and pending with the Ohio OT board.

COURSE INSTRUCTORS:

Annie O’Connor, MSPT, OCS, Cert. MDT is Founder and CEO of a World of Hurt, LLC a dedicated consulting, teaching, telehealth and research company for the application of Pain Mechanism Classification System into MSD clinical practice. In addition, she is Chief Clinical Officer at the Shirley Ryan Ability Lab formerly known as the Rehabilitation Institute of Chicago. Annie has co-authored 2019, Pain Mechanism Classification Chapter, Rehabilitation of The Spine: A Patient Center Approach 3e, Liebenson C (ed). Wolters Kluwer Philadelphia publisher. She has co-authored 2020 and 2017, Therapeutic Exercise Chapter, Orthopedic Knowledge Update Spine 6 & 5, American Academy for Orthopedic Surgeons publisher. This chapter specifically is dedicated to helping Medical Doctors understand pain mechanism classification and the importance in therapeutic exercise selection. She has co-authored 2015 book “A World of Hurt: A Guide to Classifying Pain” and September 2016 Journal Article in JMMT “Validation of a pain mechanism classification system (PMCS) in physical therapy practice”. Both publications offer a research supported “paradigm shift” in managing Musculoskeletal Pain promoting effective and efficient outcomes with significant cost savings.  She is an Orthopedic Clinical Specialist (OCS) of the American Physical Therapy Association and has a Certification in Mechanical Diagnosis and Therapy in the McKenzie Method (Cert. MDT). She teaches nationally and internationally the World of Hurt training courses, a six course training series designed for interdisciplinary application of the PMCS into clinical practice. She lectures nationally and internationally on musculoskeletal pain mechanism classification and intervention, neurodynamic evaluation and treatment, mechanical diagnosis and therapy of spine and extremities, kinetic chain evaluation, functional manual therapy and exercise prescription. She was instrumental in establishing the Pain Mechanism Classification System approach for musculoskeletal pain and neurological spasticity at the Shirley Ryan Ability Lab formerly known as the Rehabilitation Institute of Chicago. She is a member of American Physical Therapy Association in the orthopedic section and canine special interest group, the North American Spine Society (NASS) serving on the Exercise Committee, and McKenzie Institute. She continues to treat orthopedic, neurological patients, and canines with pain to achieve the best life possible through her Chicago based private practice and the Shirley Ryan Ability Lab.

Melissa Watson, MSPT, Cert. MDT is Vice President of the World of Hurt, LLC and assistant instructor for the World of Hurt six training courses. She received her Master’s in Physical Therapy and her Bachelor’s in Exercise Physiology from Ohio University. Melissa practices at the Shirley Ryan Ability Lab formerly known as the Rehabilitation Institute of Chicago Burr Ridge Outpatient Center with 17 years of clinical experience in neurological rehabilitation. Melissa is a Master Clinician and certified clinical instructor with the Shirley Ryan Ability Lab where she mentors other clinicians and students on their professional and clinical development.  She is a recognized mentor in utilizing Pain Mechanism Classification System for Neurological Patients with MSD Pain and Spasticity. She is practicing clinically in the Day Rehabilitation setting with a research interest in musculoskeletal pain and applying both pain classification and MDT principles within the neurological population for spasticity. She is currently leading a Day Rehab Pain Group Committee where she is leads other Day Rehab clinicians on a research supported pain science education group that are focused on pain science education and active care treatment for patients with centrally dominated pain throughout 6 sites of care facilitating a standard for education through inpatient and outpatient clinicians in a large system of care. She certified in Mechanical Diagnosis and Treatment – McKenzie Method. She is an instructor of the Pain Mechanism Classification System outlined in the book “A World of Hurt: A Guide to Classifying Pain” and uses both sub grouping methods exclusively in her neurological clinical practice to guide patient education and exercise prescription to facilitate functional return.

AGENDA

Day 1 (7.75 CEU’s)

8:00am                 Course Introduction – Musculoskeletal Pain Lessons - [WoH: Forward xi]

8:20                 Lecture: Risk Assessment for Musculoskeletal Pain – Referral System

9:00                 Lecture: Pain Mechanism Classification System (PMCS) – Definitions and Research   [WoH: pg 21-23; 28-31]

9:45      Break

10:00               Lecture: Peripheral Nervous System (PNS) Pain Mechanisms Subjective, Objective Characteristics [WoH: pg 102-103]

10:30                Interactive Workshop: PNS Paper Cases Classification Exercise

11:30                Lecture: PNS Patient Education and Active Care Intervention [WoH: pg 77-79,104]

12:00    Lunch 

1:00                  Lecture:  Peripheral Neurogenic Pain Mechanism (PNPM) Subjective & Objective Neurodynamic Evaluation [WoH: pg 102-103, 150-157]

2:00                  Lecture: PNPM Intervention [WoH: 104, 135-144] 

3:00      Break

3:15                  Interactive Workshop: Neurodynamic Evaluation Upper and Lower Limb Active Tests [WoH:pg 158-166]

4:00                  Case Study: Video Demonstration: PNPM

5:00                  Question & Answers

5:15      Adjourn

Day 2 (7.0 CEU’s)

8:00                  Lecture: You don’t get pain without a brain

8:45                 Lecture: Central Nervous System (CNS) Subgroups Subjective and Objective Characteristics [WoH: pg 222-223; 202-203; 260; 327-328]

9:30      Break

9:45                  Interactive Workshop: CNS Paper Cases Classification Exercise

10:30                Words Workshop: Patient Pain Science Education [WoH: pg ix, 39-40, 82-83] introduce the Yellow Flag Risk Form [WoH: pg 258], Documentation Guidelines and Goal Recommendation including Psychometric Testing / Scoring – FABQ [WoH: pg 198-199], PASS [WoH: pg 257], PHQ-9 [WoH: pg 257]

12:00    Lunch

1:00                  Lecture: CNS Mechanisms patient education and active care intervention         [WoH: pg 236; 206-218; 264-265, 269-271,276-277, 281; 335-339, 343]

1:45         Interactive Workshop: Role-playing clinician and patient pain science topics: Explaining CNS mechanisms, Traffic Light Guide to Movement Safe Pain, Pain Journal

2:45     Break   

3:00                  Interactive Demonstration: CNS Motor & Sensory Evaluation Objective Tests Demonstration [WoH pg 328-335]

4:00                  Summary of Pain Mechanisms – Lamp Analogy 

4:15                  Questions / Answers

4:30      Adjourn

ADDITIONAL INFO

A zoom link will be provided for both days to track attendance and award CEU's.  It is strongly recommended to print the electronic PDFs or have a second screen to view the PDFs to allow you to take notes.  

Of note, it is highly recommended but not required that registrants also purchase "A World of Hurt: A Guide to Classifying Pain" book.  The course will reference and teach information directly from the book.  The proceeds for the book do not go to the instructors or the World of HURT, LLC, but rather go to the Mike Hage PT memorial fund out of Shirley Ryan Ability Lab to continue research and education on the Pain Mechanism Classification System.  The publisher provides a one-time discount price of $55.00 to each class participant.  Purchase information will be provided after registration for the course, with the participant being responsible for USPS shipping costs. Shipping will take several weeks.

1. Briefly differentiate subjective and objective clinical characteristics for nociceptive, peripheral neurogenic, central sensitization, affective and motor/autonomic pain mechanisms
2. Prescribe pain science patient education per Yellow Flag Risk Form high domain patterns
3. Understand the need for patient rated outcome measures and psychometric measures for pain
4. Effectively classify dominating pain mechanisms using PMCS
5. Effectively prescribe active neurodynamic exercise for peripheral neurogenic pain mechanism, and Sensorimotor exercise for motor/autonomic pain mechanism

$250 for general registrants.  

Cancellation and Refund Policy: OhioHealth reserves the right to cancel or delay this course due to any unforeseen circumstances.  In the event this meeting would have to be canceled, OhioHealth will refund your registration fee.  If a participant cancels, refund of conference fee minus a 25% administrative charge will be made if written notice of cancellation is received no later than 10/17/2020.  No refunds will be granted after October 22, 2020.