Pain Science in Osteopathic Practice S2423S1

Lecturer: Dr Jorge Esteves, PhD, MA, BSc, DO osteojorge@gmail.com 

Learning outcomes of the course:

The student is able to:

• Display a good understanding of crucial neuroanatomy and neurophysiology related to pain relevant to osteopathic practice.
• Identify and evaluate key pain theories and models, discuss their advantages and disadvantages, and elucidate future directions of osteopathic practice with respect to pain science.
• Understand the multidimensional, complex nature of pain and the patient experience well.
• Apply pain science principles clearly and coherently as part of their patient management.
• Utilize key developments in multidisciplinary pain science as applied to osteopathic practice to enhance clinical reasoning and patient management.
• Have an appreciation for the role of osteopathy in pain modulation and symptom modification.

 Prerequisites and co-requisites

Research methods and skills 5 ECTS credits or equivalent research and development studies. Experience in Osteopathic practice. Sufficient knowledge of neuroanatomy and -physiology.

Course contents

Note some concepts will be covered in more than one session, this reflects the interaction of concepts within the course.

Week 1: Pain Science in Osteopathy – why it matters?

• Complexity and uncertainty in clinical practice
• Osteopathic care: how does it work? What are the mechanisms?
• The future pain clinician: competencies for psychologically informed care

Pre-recorded session in Week 1 – Neuroscience of Pain

• Introduction and pain definitions
• Review of relevant pain-related neuroanatomy and neurophysiology
• Pain theories (Cartesian/dualistic model, Gate-control theory, Pain Neuromatrix, Biopsychosocial model)
• Peripheral sensitisation. Modulation of nociception in the spinal cord.
• Pain sensitivity - altered nociceptive processing typical in musculoskeletal/pain conditions

Week 2: The brain in pain

• The nervous system as a predictive machine
• Pain classification and nociplastic pain
• Descending modulation of nociception
• Psychological aspects of pain

Pre-recorded lesson in Week 2 – Predictive Processing, Free Energy Principle and Active Inference

Week 3: Complex pain conditions

• Pain and allostasis
• Role of the interoceptive/neuro-endocrine immune system
• Functional pain syndromes
• Sensory attenuation in musculoskeletal care: neurobiological mechanisms and clinical implications

Pre-recorded lesson in Week 3 - Enactivism: a comprehensive approach to mind, pain, and person-centred care

Week 4: Osteopathic person-centred care

• Therapeutic alliance and person-centred care
• Strategies for behaviour change: verbal and non-verbal communication, including touch
• Osteopathic care- role in pain modulation and symptom modification

Week 5: Putting it together, clinical reasoning

• Multidimensional models and management
• Beyond the biopsychosocial model: towards a humanistic/person-centred approach to care - enactivism and active inference perspectives
• Models of explaining pain to patients

Prerequisites and co-requisites

Assessment criteria

Satisfactory

• The student can use pain science approaches in osteopathy practice to solve pain management problems and recognize and analyze the benefits of pain science in osteopathy.

Good

• The student can gather, process, produce and evaluate knowledge of pain science; to use concepts of the area of expertise correctly, to solve problems in the field of pain science and osteopathic practice, to develop new viewpoints or solutions for osteopathy practice

Excellent

• The student can create a consistent knowledge base for osteopathy practice by making use of guidelines and scientific sources critically and analytically, using concepts of the area of expertise innovatively to solve demanding problems in the field of pain where new knowledge and competence are created to apply and combine information from different fields; to develop innovative insights or technological solutions into patient use and practice; to communicate about subject convincingly both orally and in writing to patients, audiences within and exterior to the field.

Approved / Failed

• Sufficient performance: has completed basic requirements to pass the course and has attempted to apply and articulate concepts and information verbally and in writing but has not made enough effort overall; the assignments and/or team projects are weak and require further input. The student has demonstrated little effort, interest, and motivation for class activities and course assignments.

Further information

• The language of tuition is English.
• The course is assessed on a 0 (failed) – 5 (excellent) grading scale.

Contact info:

• Jorge Esteves osteojorge@gmail.com