Preoperative Pain Neuroscience Education for Knees and Shoulders

Presented by Adriaan Louw

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Video Runtime: 45 Minutes; Learning Assessment Time: 29 Minutes

Orthopedic surgery rates are increasing. Approximately one in four patients experiences persistent pain and disability after surgery, and postoperative rehabilitation has shown limited efficacy in easing the pain and disability. Recent research has shown that various pain issues surrounding orthopedic surgery—central sensitization, fear avoidance, and catastrophizing—play a significant role in postoperative outcomes. In light of this, a preoperative pain neuroscience education program was built for knee replacements and shoulder surgery. This course will showcase the rationale for the program, including the evolution and development of the program. The course takes participants through the program step-by-step, making it easy for clinical application. This is ideal for clinicians working with patients struggling with knee and shoulder pain in the perioperative period.

Meet your instructor

Adriaan Louw

Adriaan earned his undergraduate degree, master’s degree, and PhD in physiotherapy from Stellenbosch University in Cape Town, South Africa. He is an adjunct faculty member at St. Ambrose University and the University of Nevada, Las Vegas, teaching pain science. Adriaan has taught throughout the US and internationally for 25…

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Chapters & learning objectives

Rationale for Preoperative Pain Neuroscience Education for Knees

1. Rationale for Preoperative Pain Neuroscience Education for Knees

Central sensitization, fear avoidance, and catastrophizing are present in a subgroup of patients with knee osteoarthritis scheduled for knee replacement. These factors all respond favorably to pain neuroscience education and thus warrant the development and testing of a preoperative pain neuroscience education program for knee replacement.

Preoperative Pain Neuroscience Education Program for Knee Replacement

2. Preoperative Pain Neuroscience Education Program for Knee Replacement

Pain neuroscience is best taught to patients via metaphors, examples, and images. This chapter systematically takes students through the various metaphors, examples, and images used in the preoperative pain neuroscience education program for knee replacement.

Tests, Trials, and Results: Preoperative Pain Neuroscience Education Program for Knee Replacement

3. Tests, Trials, and Results: Preoperative Pain Neuroscience Education Program for Knee Replacement

A series of studies tested the preoperative pain neuroscience education program for knee replacement. Results show immediate post-education changes in surgery expectations and sensitivity of the operated knee, while postoperative studies show superior surgical experience for pain neuroscience education-trained patients.

Pain Neuroscience Education for Orthopedic Surgery: What’s Next?

4. Pain Neuroscience Education for Orthopedic Surgery: What’s Next?

Following the success of preoperative pain neuroscience education for lumbar and knee surgery, attention has shifted to other orthopedic surgeries. Early data shows positive effects on shoulder surgery, while attention is also shifting to hip replacement and failed back surgery.