Considering Precision and Utility When we Talk About Pain. Comment on Cohen et al

Moseley, G. Lorimer; Pearson, Neil D.; Reezigt, Roland R; Madden, Victoria J.; Hutchinson, Mark R.; Dunbar, Martin; Beetsma, Anneke; Leake, Hayley B.; Moore, Pete W.; Simons, Laura E.; Heathcote, Lauren C.; Ryan, Cormac; Berryman, Carolyn; Mardon, Amelia K.; Wand, Benedict M

doi:10.1016/j.jpain.2022.05.010

Cited by 10 publications

(5 citation statements)

References 25 publications

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“…Long-term follow-up at 6 months demonstrated that knowledge was maintained at 65%, but not at the level immediately after the intervention. Further research on pedological approaches to pain science and long-term retention in entrylevel DPT students can assist faculty and institutions in guiding a strategic implementation of pain sciences in curricula once a baseline is established (Bonatesta et al, 2022;Moseley et al, 2023;Fechner et al, 2024).…”

Section: Discussionmentioning

confidence: 99%

Curricular assessment of pain science education in an entry-level doctor of physical therapy program

Logan,

Baldwin,

Reed

et al. 2024

ijhs

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Aim: Institutions should evaluate the current curricula and level of DPT student’s pain-related knowledge to allow for strategic implementation and modifications. The purpose of this study was to evaluate entry-level DPT) students' knowledge of pain neurophysiology spanning the curriculum to assist in guiding strategic modifications. Methods: This cross-sectional study was conducted using a convenience sample of students from eight different campuses within the same institution. Students completed the Revised Neurophysiology Pain Questionnaire (rNPQ) in the first week of the following courses, spanning three terms within the curriculum. Analysis included descriptive statistics and a comparison of means. Results: A total of 838 students completed the rNPQ. The overall mean score was 71.9% (8.6+1.6). An incremental increase in the rNPQ was noted later in the curriculum. A difference was noted between campuses (p=0.005) when not separated by course. A statistically difference in delivery format (p=0.002) was found, more specifically between T4 and T6 (p<0.001). Conclusion: This data will guide the optimal integration of modern pain science curricular recommendations. Further research in the quantity, quality, and delivery of pain science education can guide future curricular development to include modern pain science concepts.

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Section: Discussionmentioning

confidence: 99%

Curricular assessment of pain science education in an entry-level doctor of physical therapy program

Logan,

Baldwin,

Reed

et al. 2024

ijhs

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“…Contemporary models describe pain is an emergent phenomenon of brain activity rather than an identifiable "thing" (51,(53)(54)(55)(56). Calls to reflect social and phenomenological aspects of pain in scientific definitions (57, 58), consistent with the shared social experience of pain in the Medieval Period, are growing.…”

Section: Discussionmentioning

confidence: 99%

Understanding pain in modern society: insights from attitudes to pain in the Medieval Period

Paley,

Johnson,

Paley

2023

Front. Pain Res.

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Historical records provide knowledge about the way people lived in the past. Our perspective is that historical analyses of the Medieval Period provide insights to inform a fuller understanding of pain in the present era. In this article, we appraise critiques of the writings of people living with pain during the mid (high) to late Medieval Period (c. 1,000–1,500 AD) to gain insights into the nature, attitudes, lived experience, and sense-making of pain. In the Medieval Period, pain was understood in terms of Galen's four humours and the Church's doctrine of pain as a “divine gift”, “punishment for sin” and/or “sacrificial offering”. Many treatments for pain were precursors of those used in modern time and society considered pain to be a “shared experience”. We argue that sharing personal stories of life is a fundamental human attribute to foster social cohesion, and that nowadays sharing personal stories about pain is difficult during biomedically-focussed time-constrained clinical consultations. Exploring pain through a medieval lens demonstrates the importance of sharing stories of living with pain that are flexible in meaning, so that people can connect with a sense of self and their social world. We advocate a role for community-centred approaches to support people in the creation and sharing of their personal pain stories. Contributions from non-biomedical disciplines, such as history and the arts, can inform a fuller understanding of pain and its prevention and management.

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“…Within this context, specifically concerning therapeutic pain education, a debate may arise between the utility and accuracy of language [66]. We find ourselves coexisting with concepts we have had to abandon in recent years despite their seeming usefulness, precisely because of the inherent nocebo effect they carry.…”

Section: Discerning the Ambiguity Between Pain And Nociception: A Cru...mentioning

confidence: 99%

A Manifesto in Defense of Pain Complexity: A Critical Review of Essential Insights in Pain Neuroscience

Párraga,

Castellanos

2023

JCM

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Chronic pain has increasingly become a significant health challenge, not just as a symptomatic manifestation but also as a pathological condition with profound socioeconomic implications. Despite the expansion of medical interventions, the prevalence of chronic pain remains remarkably persistent, prompting a turn towards non-pharmacological treatments, such as therapeutic education, exercise, and cognitive-behavioral therapy. With the advent of cognitive neuroscience, pain is often presented as a primary output derived from the brain, aligning with Engel’s Biopsychosocial Model that views disease not solely from a biological perspective but also considering psychological and social factors. This paradigm shift brings forward potential misconceptions and over-simplifications. The current review delves into the intricacies of nociception and pain perception. It questions long-standing beliefs like the cerebral-centric view of pain, the forgotten role of the peripheral nervous system in pain chronification, misconceptions around central sensitization syndromes, the controversy about the existence of a dedicated pain neuromatrix, the consciousness of the pain experience, and the possible oversight of factors beyond the nervous system. In re-evaluating these aspects, the review emphasizes the critical need for understanding the complexity of pain, urging the scientific and clinical community to move beyond reductionist perspectives and consider the multifaceted nature of this phenomenon.

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Considering Precision and Utility When we Talk About Pain. Comment on Cohen et al

Cited by 10 publications

References 25 publications

Curricular assessment of pain science education in an entry-level doctor of physical therapy program

Curricular assessment of pain science education in an entry-level doctor of physical therapy program

Understanding pain in modern society: insights from attitudes to pain in the Medieval Period

A Manifesto in Defense of Pain Complexity: A Critical Review of Essential Insights in Pain Neuroscience

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