Pain Science Take Homes
San Diego Pain Summit Take Homes
On Feb 14th I had the pleasure of flying out to San Diego California to attend the annual San Diego Pain Summit. It being my 35th birthday on Saturday the 15th, I decided to extend the trip by one day to see the famous San Diego zoo. Pain science and primates, perhaps some of my all time favourite wonders! If you make it to the end of this post some primate fun will be found. To keep it short, I have focused on key take home messages from the 2 day conference. I must say that although we grow most in challenge and conflict, there is something so invigorating about being in a room of like minded people. That indeed, was what the San Diego Pain summit offered. I was energized by many thought leaders who dare to practice humility in their clinical practice, dare to admit what they don’t know, dare to ask why and better yet dare to ask how can we make it better.
Pain Summit Take Home Messages:
1) On Patient-Centered Care:
- Listening and validating
- Forming an alliance
- Identifying and providing support networks
- Defining values, goals and expectations
- Shared decision making and planning
- Sharing clinical evidence and best practices
2) On Medicine Being Part Science Part Clinical Judgment
“We owe it to our patients and to ourselves to be a generation of skeptical, inquisitive and reflective physical therapists that are always seeking to be less wrong” Dr. Nicolas Ferrara, DPT. “Medicine is a science of uncertainty and an art of probability” Sir William Osler. Therefor, it’s imperative to always be learning, seeking to stay up to date with the research and use best practices as they evolve.
3) on Evidence Based Care
“Nothing could be more humanistic than using evidence to find the best possible approach to care” Jules Rothstein, PT, PhD. In cancer care, I am very passionate about this, as there is a lot of alternative therapies out there. Whether this is to ‘alkalize’ the body, take various supplements, heal your cancer through meditation or swim in arctic cold water, we ought to distinguish between young, anecdotal and good science. In my every day conversations with patients I strive to be patient-centered but evidence based, being transparent about what we know and what we are on the verge of learning more about. Tools that work are different than young science, or anecdotal (a story one person has shared). This delegate dance means understanding what is important to the patient’s value systems but using careful language to offer what I understand to be evidence based care; not just a trial and error treatment or anecdotal evidence.
4) on Pain As Protection Not Detection
“80-95% of patients with low back pain have no pathological or anatomical cause for their pain” ref. Hence there is growing evidence that therapeutic alliance, patient beliefs and expectations [...] pain catastrophizing and self-efficacy are more predictive of clinical outcomes than changes to the target therapy (i.e. changes in muscle, posture, joint position) ref. This is important to consider because next to diabetes and ischemic heart disease back pain remain the 3rd top Global Health burden, and 3rd condition for personal health care spending in the United States ref.
5) On Parent-Child Narratives and How Children Remember Pain
“REFRAME THE PAIN” (Be positive, realistic and be brave). How you talk to your children about pain matters moving forward in life.
More about this initiative, lead by researcher: Dr. Melanie Noel.
6) On Primates and How Amazing They Are
After a few days of intellectualism, one must simply relax a little, and so I did. Here is a photograph of a gorilla paying close attention to Dr. Forster, a primatologist's phone. Closely after the monkey broke into great laughter. What is it that they were watching so attentively? A facebook page for gorillas, what a moment to remember…
As always, thank you for your interest in science and rehab.
Kindly,
The Cancer Physio
