Body Imagery, Central Pain and Complex Pain

Course Description

Not all pain has a mechanical behavior. Unfortunately, many common traditional intervention strategies are largely dependent upon a “mechanical related” pain mechanism.

“Pain mechanisms” are a subgroup since they represent a “process that is driving the disorder / pain”. Pain mechanisms are generally divided into: nociplastic, neuropathic and nociceptive.

It is our opinion that nociplastic is inadequate in fully explaining the diverse range of clinical presentations we see. There are problems in terminology use, diagnosis, and effective rehabilitation.

On this course we discuss these issues and attempt to solve these problems:

  • Nociplastic pain is considered to have “sub-mechanism categories” to help describe various presentations (e.g., central sensitization)
  • Body Imagery Pain is introduced as a sub-mechanism of Nociplastic pain. It represents a non mechanical pain state that explains many of the atypical pain presentations that are not currently explained by existing pain mechanisms.
  • Functional causation is considered to facilitate better treatment targeting

Why do people have complex, bizarre pain, whole limb pain or paraesthesia? Get all their symptoms on one side of their bodies? Feel swelling when there isn’t any? Have one sided fatigue, heaviness or other bizarre musculoskeletal-like complaints? We’ll show you why and be able to explain it to them!

The brain needs to know what is happening in the body. It gets this information from sensory feedback and forming complex maps. When this information is deficient the brain will change its behavior to get this information. When it is absent, significantly inaccurate or cannot be processed, musculoskeletal symptoms can result.  It is now clear that our virtual brain and body imagery are involved in pain states. In some cases they can be a primary cause of the pain state!

We will cover the clinical characteristics of nociplastic pain, central sensitization and body imagery pain based upon subjective history characteristics, questionnaires and simple laboratory strategies.

You will leave with a clear understanding of how to diagnose various types of non mechanical pain, along with the appropriate subjective history, physical examination and questionnaires to use. You will be able to develop a rehabilitation program for clients with altered body image and nociplastic pain and have appropriate progressions and problem solving strategies.

This course is suitable for musculoskeletal, neurological, pediatric, vestibular and pelvic health physiotherapists.

It can be tailored to meet the needs of specific groups.

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