Pain Management for Adults

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Video Runtime: 84 Minutes; Learning Assessment Time: 52 Minutes

Pain is produced by the brain when it perceives that there is danger to the body and that action is required. Pain is very complex and is a multiple system output. It is not uncommon to have an adult in persistent pain without any structural dysfunction. When the central nervous system becomes involved the pain is often disproportionate, moves around the body, and produces abnormal sensations and motor dysfunction. Numerous research studies have shown that the central nervous system undergoes plastic reorganization following injury, and if left untreated this can become maladaptive. This course covers strategies to improve outcomes by addressing peripheral and central changes through the biopsychosocial model of treatment.

Meet your instructor

Susan Stralka

Susan W. Stralka, PT, DPT, MS, is a licensed physical therapist with many years of experience treating both musculoskeletal and neurovascular consequences of injury. She earned her bachelor's degree, master's degree, and Doctorate in Physical Therapy from The University of Tennessee Health Sciences Center in Memphis,…

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Chapters & learning objectives

1. Understanding that Pain is an Output

This chapter will present recent neuroscience updates that pain is very complex and is not an input but an output. The degree of injury does not equal the degree of pain and not all pain is bad. The types of nociceptors and their role in pain will be discussed.

2. Identifying Peripheral and Central Symptoms

Peripheral symptoms following acute injury are straight forward with the ability to identify the tissue injured and in designing a treatment program. Central symptoms also called central sensitization are present when the symptoms persist after the tissue has healed because of multiple brain areas being involved. This chapter will review ways to identify peripheral symptoms from symptoms that involve central nervous system changes.

3. Body Perception Changes with Central Sensitization

The normal representation of the body parts in our brain is found on the homunculus or body map and is termed cortical organization. Following injury and with central sensitization the body map changes and causes body disturbances.

4. Calming the Brain

Evidence reveals that common psychological factors such as anxiety and depression are common following injury. It is necessary to calm the nervous system or the hyper-excitable neural system and this needs to be included as a mainstream treatment approach and not considered as an alternative treatment. The importance of patient self-management will be discussed.

5. A Condition with Central Nervous System Reorganization: Complex Regional Pain Syndrome

Often persistent pain, sensory involvement, and motor dysfunction are not identified immediately. The longer the symptoms persists the more cortical reorganization occurs. In treating these patients a comprehensive program of utilizing the biopsychosocial approach and early intervention must occur.

6. Pain Review for Phantom Limb Sensation, Spinal Cord Injury, Shoulder-hand Syndrome, and Neuropathies

The role of central sensitization in common pain conditions. Ideas for identifying and treating these discussions will be presented.

7. Foundation for Treatment and Summary

Understanding brain changes and identifying symptoms is only one part of adult pain management. The mind and body are so closely related that the therapist treating pain must understand the patient’s biopsychosocial situations and the way the patient likes to learn to have successful outcomes.

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