A World of Hurt – Toronto 2019

DATE: May 18-19, 2019
Sat 8:15am-5:30pm
Sun 8:00am-4:30pm


A Guide to Classifying Pain

Course Description

This two-day course 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 course 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 live patient demonstrations when available, video and paper case studies will aid application to pain clinicians practice. This course highlights a sub grouping method, 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 course 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 course, the 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.

Course Objectives

Upon completion of the course, participants will be able to apply the principles directly into their clinical practice:

1)  Differentiate subjective and objective clinical characteristics for nociceptive, peripheral neurogenic, central sensitization, affective and motor / autonomic pain mechanisms.

2)  Prescribe neuroscience patient education per yellow flag risk form high domain patterns for fear / escape avoidance behavior, self-efficacy and confidence, emotional stress, and nerve related pain.

3) Understand and make referrals according to 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.

Course Schedule (Approximate)

Day 1

8:00 Registration

8:15 Course Introduction – Musculoskeletal Pain Lessons - [WoH: Forward xi]

8:30 Lecture: Risk Assessment for Musculoskeletal Pain – Introduce Yellow Flag Risk Form -[WoH: pg 258]

9:15 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 Lecture: PNS Patient Education and Active Care Intervention [WoH: pg 77-79,104]

11:15 Lecture: Peripheral Neurogenic Pain Mechanism (PNPM) Subjective & Objective Neurodynamic Evaluation [WoH: pg 102-103, 150-157]

12:00 Lunch (on your own)

1:00 Workshop: Neurodynamic Evaluation Upper and Lower Limb Active Tests [WoH: pg 158-166]

2:30 Lecture: Peripheral Neurogenic Pain Mechanism Intervention [WoH: 104, 135-144]

3:15 Break

3:30 Workshop: PNS Paper Cases Classification Exercise

4:30 Case Study: Video or Live Patient Demonstration: Peripheral Neurogenic Pain Mechanism

5:30 Adjourn

Day 2

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]

9:30 Workshop: Psychometric Testing / Scoring –FABQ [WoH: pg 198-199], PASS [WoH: pg 257], PHQ-9 [WoH: pg 257]
10:00 Break

10:15 Words Workshop: Patient Pain Education using the Yellow Flag Risk Form – Individual to Group Model [WoH: pg ix, Documentation Guidelines and Goal Recommendation]

12:00 Lunch (on your own)

1:00 Lecture: CNS Mechanisms patient education and active care intervention [WoH: pg 236]

2:00 Workshop: CNS Paper Cases Classification Exercise

2:30 Lecture: CNS Sensory and Motor Evaluation Objective Tests Demonstration: CNS Left / Right Discrimination - Spine and Extremity

3:00 Workshop: CNS Sensory and Motor Objective Tests [WoH pg 328-335]

4:00 Summary of Pain Mechanisms – Lamp Analogy

4:15 Questions / Answers

4:30 Adjourn

Who should attend

Physical and Occupational Therapists, Chiropractors, Osteopathic, Naturopathic, Medical Doctors, Psychologists, Physical Therapist Assistants, Occupational Therapy Assistants , Athletic Trainers, Massage Therapists, Personal Trainers and any other practitioners who are involved in treating pain and suffering.

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Your Instructor

Annie O’Connor

Annie O’Connor, MSPT, OCS, Cert. MDT is Chief Clinical Officer at the Shirley Ryan Ability Lab formerly known as the Rehabilitation Institute of Chicago.  Annie has co-authored 2018, Pain Mechanism Classification Chapter, Rehabilitation of The Spine: A Patient Center Approach 3e, Liebenson C (ed). Wolters Kluwer Philadelphia publisher. She has co-authored 2017, Therapeutic Exercise Chapter, Orthopedic Knowledge Update Spine 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.

Annie 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 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), and McKenzie Institute. She continues to treat orthopedic, neurological patients, and canines with pain to achieve the best life possible.

A World of Hurt – Toronto 2019

DATE: May 18-19, 2019
Sat 8:15am-5:30pm
Sun 8:00am-4:30pm