16 August 2021: Articles
Pain Neuroscience Education Delivered by a Student Physical Therapist for a Patient with Persistent Musculoskeletal Pain
Unusual or unexpected effect of treatment
Michael O’Connor A , Robert Sillevis A* , Mark R. Erickson ADOI: 10.12659/AJCR.932212
Am J Case Rep 2021; 22:e932212
Table 1. Pain neuroscience education curriculum and treatment data.
| Visit | 1 | 2 | 3 | 4 | 5 | 6 | 7 |
|---|---|---|---|---|---|---|---|
| PNE content | Sensitive nervous system alarm analogy to explain peripheral sensitization, nerve sensor analogy to explain nociceptors, visual aids | Spreading pain alarm system analogy to explain sensitization and spreading pain, calming sensitive nerves and pain as a gauge for activity, visual aids | Brain as the CEO analogy for central processing of pain, wet brain analogy for descending inhibition, visual aids | Measuring cup analogy for psychosocial overload, Snake entering the home analogy for prolonged stress response, visual aids | Inflammatory soup analogy for neurogenic inhibition, Map analogy for pain neuromatrix, visual aids | Movement map analogy for fear avoidance of pain with movement, Smudged map for somatosensory smudging, visual aids | Callus formation for biological adaptability, speeding car analogy for threat perception, phantom limb pain analogy for pain as a brain output, visual aids |
| Manual therapy | Joint manipulation C5–7 right, Upper thoracic T3–T4 supine, HG joint posterior and inferior glide, neural mobilizations left upper extremity with median nerve focus | Joint manipulation C5–7 right, Upper thoracic T3–4 supine, GH joint posterior and inferior, neural mobilizations left upper extremity with median nerve focus | Joint manipulation C5–7 right, Upper thoracic T3–4 supine, GH joint posterior and inferior glide, neural mobilizations left upper extremity with median nerve focus | Joint manipulation C6–7 right, Upper thoracic T2–4 supine, 1 rib seated, GH joint inferior glide, neural mobilizations left upper extremity with median nerve focus | Joint manipulation C6–7 right, Upper thoracic T2–4 supine, 1 rib seated, GH joint inferior glide, neural mobilizations left upper extremity with median nerve focus | Joint manipulation C6–7 right, Upper thoracic T2–4 supine, 1 rib seated, GH joint inferior glide, neural mobilizations left upper extremity with median nerve focus | Joint manipulation upper thoracic T2–4 supine, 1 rib seated, GH joint inferior glide, neural mobilizations left upper extremity with median nerve focus |
| Therapeutic exercise | Core stabilization progression, UE strengthening | Rotator cuff strengthening, UE strengthening | Core stabilization progression, rotator cuff strengthening | Core stabilization progression, static balance interventions | Core stabilization progression, UE strengthening | Core stabilization progression, rotator cuff strengthening, LE strengthening | Core stabilization progression, UE strengthening |
| C – cervical; GH – glenohumeral; LE – lower extremity. | |||||||