ARC Physical Therapy+ is committed to being a resource in our communities for pain management. As part of that, many of our therapists have formal training in pain neuroscience education.
What is pain neuroscience education (PNE) and how can it help manage chronic or persistent pain?
Pain neuroscience education is the process of educating patients to help them understand the biological and physiological processes involved in their pain experience.
- Traditional education models have focused only on using biomedical explanations for pain.
- A lack of successful treatment options for chronic pain led to providers working together to further develop PNE programs including extensive research on results. PNE focuses on the bio-psycho-social model of education.
Evidence has shown that neuroscience educational strategies focused on teaching people in pain more about the biological and physiological processes involved in their pain experience, changes patient beliefs regarding their pain, thus reducing the threat of pain.
How do we know we are in pain?
Pain is a multiple system output, activated by an individual’s specific pain neural signature (pain neuromatrix). The neural signature is activated anytime the brain determines that the body tissues are in danger and action is required.
Pain is not produced until the brain decides that the body is in danger.
When tissues are injured or altered in your body, the nerves from that area send danger signals up to your brain via the spinal cord. Your brain then runs the neural signature, or pain neuromatrix, for that body part and then decides what type of output to create.
The neuromatrix is comprised of multiple processing centers in your brain including those used for motor planning, thought processing, emotions, movement & coordination and your senses just to name a few.
When the brain receives a pain signal it puts all the areas of the neuromatrix to use to scrutinize and decide if the situation is dangerous. From there an output or response is determined. Should I run away? No big deal, I’m fine? Panic? This is good as sometimes getting out of the way of an oncoming bus is more urgent than addressing a non-life-threatening injury like a sprained or broken ankle.
What about the impact of chronic pain?
However, research has shown that 1 in 5 people live with chronic or persistent pain due to a nervous system that is heightened or tends to output the “danger signal” when there is no real danger involved.
Every individual has their own pain neuromatrix. Everything that a person has gone through or experienced affects how their brain processes the signal in choosing a response or output.
A person who strains their low back lifting a piece of furniture at home is going to have a much different experience compared to someone like an EMT who strains their low back while assisting a patient with life-threatening injuries in a dangerous environment. Who’s brain is more likely to sense danger the next time they stress their low back? The EMT or the furniture mover?
How can PNE help?
Although 20% of people are likely to experience chronic or persistent pain at some point, pain neuroscience education in the hands of a physical therapist can help.
Simply gaining education on how the nervous system and pain works can help calm a brain and nervous system that has become extra sensitive.
There are many other interventions that can also help with decreasing and managing chronic pain including:
- graded motor imagery
- directed aerobic exercise
- mindfulness
- sleep hygiene
- relaxation
- manual therapy
- and many others
PNE works best when combined with an exercise program.
How can PNE impact workers’ comp and our overall healthcare system?
With this approach, the patient understands what pain is and how it works and has realistic expectations for post-operative pain. Patients are more likely to undergo standard follow-up, rather than seek additional imaging, tests and treatments. Even better, substantial differences are observed in average costs and the level of patient satisfaction.
Get your pain under control.
A physical therapist trained in administering PNE is a brilliant combination when it comes to fighting chronic pain.
To learn more, find the ARC Physical Therapy+ clinic nearest you, or call 844-755-4272.
RESOURCES
J Orthop Sports Phys Ther 2021;51(2):57–59. doi:10.2519/jospt.2021.9804
Moseley, G.L., A pain neuromatrix approach to patients with chronic pain. Man Ther, 2003. 8(3): p. 130-40.
https://pmc.ncbi.nlm.nih.gov/articles/PMC11033461/ More about the actual education of providers
https://www.jospt.org/doi/10.2519/jospt.2021.9804 PNE should be combined with movement
