From Chronicity…… to Performance
Mark Sexton
Chartered Physiotherapist
The Plan
Learning Plan
Early Identification
Early Management
Prevention
Treatment
Rehabilitation
Outcomes
Case Studies
Movement
Nociception
Tissue
Pathology
Central Sensitisation
Neurogenic Pain
Peripheral
Neuropathic Pain
PsychoEmotional
So...
Plasticity
Lorimer Moseley
Central Sensitisation
• Trauma
• Emotional Response, Fear
• Initial Injury severity
• Flaring of old scars
• Maladaptive
–...
Central Sensitisation
• Pain
– Severity, Hypersensitivity
– Latency
– Allodynia
– Pattern – Unpredictable Agg/Easing facto...
CRPS
• Pain Severity, Hypersensitivity
• Swelling
• Skin Shine, Sweat
All Movement has
Effect…
…and
Vice-Versa
Langevin HM and Sherman KJ,
Pathophysiological Model for cLBP
Integrating
Connective Tissue
and
Nervous System Mechanisms
...
Connective
Tissue
Plasticity
Pathogenic
Mechanism
Langevin 2006
Neural
Tissue
Plasticity
Connective
Tissue
Plasticity
Pathogenic
Mechanism
Langevin 2006
Neural Tissue
Plasticity
Connective
Tissue
Plasticity
Pathogenic
Mechanism
Langevin 2006
Connective
Tissue
Plasticity
Pathogenic
Mechanism
Langevin 2006
Pathogenic
Mechanism
Langevin 2006
Pathogenic
Mechanism
Langevin 2006
Pathogenic
Mechanism
Langevin 2006
Pathogenic
Mechanism
Langevin 2006
Movement
Posture
Exercise
Treatment
Tissue
Pathology
Dysfunction
Direct Tissue
Mechanical Stimulus
Cognitive/Behavioural
M...
Movement
Nociception
Tissue
Pathology
Central Sensitisation
Neurogenic Pain
Peripheral
Neuropathic Pain
PsychoEmotional
So...
Learning Plan
Early Identification
Early Management
Prevention
Treatment
Rehabilitation
Outcomes
Case Studies
Chronicity…… to Performance
Mark Sexton
Chartered Physiotherapist
Thank You!
References
• Smart KM, Blake C, Staines A, et al. Self-reported pain
severity, quality of life, disability, anxiety and de...
Web
Prevention and Management of Chronic Pain
Prevention and Management of Chronic Pain
Prevention and Management of Chronic Pain
Prevention and Management of Chronic Pain
Prevention and Management of Chronic Pain
Prevention and Management of Chronic Pain
Prevention and Management of Chronic Pain
Prevention and Management of Chronic Pain
Prevention and Management of Chronic Pain
Prevention and Management of Chronic Pain
Prevention and Management of Chronic Pain
Prevention and Management of Chronic Pain
Prevention and Management of Chronic Pain
Prevention and Management of Chronic Pain
Prevention and Management of Chronic Pain
Prevention and Management of Chronic Pain
Prevention and Management of Chronic Pain
Prevention and Management of Chronic Pain
Prevention and Management of Chronic Pain
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Prevention and Management of Chronic Pain

The Prevention and Managment of Chronic Pain. Slides for my 2012 lecture for the ICGP spring meeting. Early identification of indications of neural sensitivity/adaptation key to appropriate early management and prevention.
Published on: Mar 4, 2016
Published in: Health & Medicine      
Source: www.slideshare.net


Transcripts - Prevention and Management of Chronic Pain

  • 1. From Chronicity…… to Performance Mark Sexton Chartered Physiotherapist
  • 2. The Plan
  • 3. Learning Plan Early Identification Early Management Prevention Treatment Rehabilitation Outcomes Case Studies
  • 4. Movement Nociception Tissue Pathology Central Sensitisation Neurogenic Pain Peripheral Neuropathic Pain PsychoEmotional Social
  • 5. Plasticity
  • 6. Lorimer Moseley
  • 7. Central Sensitisation • Trauma • Emotional Response, Fear • Initial Injury severity • Flaring of old scars • Maladaptive – Psychological – Emotional – Movement
  • 8. Central Sensitisation • Pain – Severity, Hypersensitivity – Latency – Allodynia – Pattern – Unpredictable Agg/Easing factors – Palpation non-differential – Neural involvement
  • 9. CRPS • Pain Severity, Hypersensitivity • Swelling • Skin Shine, Sweat
  • 10. All Movement has Effect… …and Vice-Versa
  • 11. Langevin HM and Sherman KJ, Pathophysiological Model for cLBP Integrating Connective Tissue and Nervous System Mechanisms Med. Hyp. 2006
  • 12. Connective Tissue Plasticity Pathogenic Mechanism Langevin 2006 Neural Tissue Plasticity
  • 13. Connective Tissue Plasticity Pathogenic Mechanism Langevin 2006 Neural Tissue Plasticity
  • 14. Connective Tissue Plasticity Pathogenic Mechanism Langevin 2006
  • 15. Connective Tissue Plasticity Pathogenic Mechanism Langevin 2006
  • 16. Pathogenic Mechanism Langevin 2006
  • 17. Pathogenic Mechanism Langevin 2006
  • 18. Pathogenic Mechanism Langevin 2006
  • 19. Pathogenic Mechanism Langevin 2006
  • 20. Movement Posture Exercise Treatment Tissue Pathology Dysfunction Direct Tissue Mechanical Stimulus Cognitive/Behavioural Movement Treatment Placebo Psychosocial Genetic Pathogenic Mechanism – Therapeutic interventions Langevin 2006
  • 21. Movement Nociception Tissue Pathology Central Sensitisation Neurogenic Pain Peripheral Neuropathic Pain PsychoEmotional Social
  • 22. Learning Plan Early Identification Early Management Prevention Treatment Rehabilitation Outcomes Case Studies
  • 23. Chronicity…… to Performance Mark Sexton Chartered Physiotherapist Thank You!
  • 24. References • Smart KM, Blake C, Staines A, et al. Self-reported pain severity, quality of life, disability, anxiety and depression in patients classified with nociceptive, peripheral neuropathic and central sensitisation pain. The discriminant validity of mechanism-based classification of low back (+-leg) pain. Manual Therapy 2012: 17; 119-125. • Nijs J, Van Boudewijn H, Oostendrop RAB. Recognition of central sensitization in patients with musculoskeltal pain: application of pain neurophysiology in manual therapy practice. Manual Therapy 2010: 15; 135-141. • Nijs J, Van Houdenhove B. From acute musculoskeletal pain to chronic widespread pain and fibromyalgia: application of pain neurophysiology in manual therapy practice. Manual Therapy 2009:14; 3-12.
  • 25. Web

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