My Experience with Pain Science and Sharing It With My Team
I recently attended a course on pain science led by Lorimer Moseley, which deepened my understanding of how to approach persistent pain using a biopsychosocial model. While I’ve long known that pain is not solely a direct result of tissue damage, this course expanded my perspective by delving into how immune and hormonal responses can contribute to the pain experience even when no actual tissue damage is present. What I gained was a new way to organize and present this complex information, making it more accessible and practical for both my clients and my team.
Understanding Pain Differently
The course emphasized the role of the brain in constructing pain experiences based on sensory inputs, beliefs, and past experiences. For me, this was not new, but I found the course presented a more structured way to incorporate the role of immune and hormonal responses in educating clients. Chronic pain often involves a disconnect between what the brain expects and the actual sensory input, which can sustain the sensation of pain, or cause a release in hormone or immune response. This course provided me with new tools to organize and communicate these concepts in a more cohesive manner.
The Fit-for-Purpose Model
A particularly valuable aspect of the course was learning about the Fit-for-Purpose Model for chronic nonspecific low back pain (CNSLBP). Developed to address the limitations of traditional approaches, this model integrates cognitive, behavioral, and neuroimmune factors to change the perception from a “fragile, damaged” back to one that is resilient and adaptable. It was created to challenge deep-seated beliefs about back fragility and promote a shift towards seeing the back as strong and capable. The Fit-for-Purpose Model is supported by research published in the field, which emphasizes a multimodal approach that includes education, graded movement, and sensory-motor training.
Bringing the Lessons to My Team
After the course, I was keen to share these new ways of organizing pain science information with my team at Embodied Physiotherapy and Pilates. We began incorporating these principles to improve how we help clients manage chronic pain, focusing on three main areas:
- Pain Education: Reinforcing that pain does not always correlate with tissue damage, while also addressing the role of immune and hormonal responses. We started using stories and analogies to help clients reframe their understanding of pain.
- Sensory and Motor Precision Training: Implementing exercises aimed at enhancing sensory acuity and refining the brain’s representation of the body. This included having clients identify the location or nature of touch, which helped them feel more in control of their symptoms.
- Graded Movement and Loading: Encouraging gradual movement to rebuild confidence and physical resilience. Our movement coaching now emphasizes that it is safe and beneficial to load the back.
We had an in-service, began to brainstorm ideas of how to get this knowledge to clients, both in our 1:1 sessions and in our group sessions Moving with Chronic Pain. We had a great time, and it has spawned more discussion among our staff since. I really loved how we could practice being creative in how to delineate knowledge, and practice curiosity around learning.
Shifting Internal Models
The course highlighted the importance of helping clients change their internal models of pain, including beliefs shaped by past experiences and societal norms. By integrating education, sensory training, and graded exercise, we aim to gradually shift these beliefs, empowering clients to view their bodies as strong and capable.
Looking Ahead
The insights gained from this course have helped me reframe how I approach pain management, and it’s been exciting to see my team and clients respond positively and I found this course has really opened up some interesting conversations with clients with a lot of depth. At Embodied Physiotherapy and Pilates, we remain committed to evidence-based practices, and the principles from this course have added valuable tools to our repertoire. We continue to refine our approach, aiming to help clients move with less pain and more confidence.
Big take home for folks looking for more information is that the resources found here are lovely and a great place to get started: https://www.painrevolution.org/
You can check out our Moving with Chronic Pain Class as well.
References:
- Wand, B. M., Cashin, A. G., McAuley, J. H., Bagg, M. K., Orange, G. M., & Moseley, G. L. (2023). The Fit-for-Purpose Model: Conceptualizing and managing chronic nonspecific low back pain as an information problem. Physical Therapy, 103(2), pzac151. https://doi.org/10.1093/ptj/pzac151