Thursday Thoughts: What Are Your Thoughts on Therapeutic Neuroscience Education? | Modern Manual Therapy Blog

Thursday Thoughts: What Are Your Thoughts on Therapeutic Neuroscience Education?


This Thursday Thought was inspired by my colleague Dr. Harrison Vaughn's post on Pain Science Education on his blog, In Touch PT.

He likens using Pain Science Education on chronic pain patients to going for three pointers. What do you think? I have been using forms of Explain Pain, since taking one of Butler's first courses 14-15 years ago! The research behind it is fascinating, and it has certainly changed the way I look at chronic pain patients, and interact with patients in general.

My words are softer, my interactions much more positive, and my thoughts about chronic pain patients do not immediately jump to malingerer (although there are still those out there!).

Like Harrison, and I have been at this a lot longer, it has not changed my outcomes with these patients for the most part. There are a few cases here and there where I have absolutely educated them on the realism of their pain processes, and thus improved their function and quality of life dramatically.... but... they still have moderate to severe pain.

You regular readers know of course I am all for this as a movement, and it should be taught in every curriculum. I just think realistically, clinicians should expect the changes will be subtle at first, and the slow in coming, should the patients stay with you in the long run. It's those who have stayed with me for years that had the most positive and significant changes, realizing that it is a long hard road.

I often find it very difficult to be a lone shining light of positive interaction when every other clinician these patients encounter speak of degeneration, EMGs, general scans (or worse yet, no results) like they're going out of style. My question to you readers is this: Has using Therapeutic Neuroscience Education changed your outcomes dramatically? Do you use it at all?

Keeping it Eclectic...

4 comments:

  1. Thanks for the shout-out Dr. E! I'll begin this discussion.


    Just like we spoke yesterday and what you mentioned above, there are limitations to JUST this approach, just like any single approach. I have learned a great deal in how to explain pain that leads to dysfunction/disability for individuals, but it just doesn't have the meat to make a change (typically). I am not saying we throw it out, as we do need to mingle it in with non-threatening movements, manual therapy to get the process going, and education to change lifestyle or behaviors that exacerbate symptoms.


    Having the neuroscience information has allowed me to understand pain...which does allow me to translate it to patients with more authority and confidence. That little bit in itself can make a difference in how a patient perceives our knowledge and overall brand.


    Harrison

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  2. Max and Harrison, agreed. Any traditional manual therapy and exercise based approach fits in nicely with the modern pain science route. You just change the conceptual framework of how you view everything from the interactions to why the treatments work.

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  3. I use it regularly and for the short time that I have been in practice (1 year) I have found it helpful. However, as you pointed out, it often takes time for big changes to occur. When people are paying with their own money they often want a quick fix. Pain science education is not a quick fix so sadly I do lose a few of these clients. I think as I get better at explaining and discussing the topic more of these clients will stick with it for the long haul. As discussed below and I think more and more people would agree but a good multi-model approach is best! Great thought, thanks for sharing

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  4. David, yes the more patients and types you see, the more experience you will get in terms of using stories, metaphors or other methods to get the point across.

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