Pain 116 - 121

Course overview

Hour 1 *Relate the different neurophysiologic mechanisms to the development of chronic pain states. *Draw the pathways specific to Lamina I versus Lamina V sensory pathways. *Discuss basic science research that supports the main theories of chronic/central pain syndromes. *Apply basic neurorehabilitation techniques to modulate chronic pain circuits. *Develop treatment plans for chronic pin patients consistent with current pain models. Hour 2 *Relate the effects of interoceptive dysfunction to the development of chronic pain. *Draw the pathways specific to Lamina I versus Lamina V sensory pathways. *Discuss how the interoceptive nervous system may relate to Functional Neurologic Symptom Disorder. *Apply knowledge of how interoceptive dysfunction may negatively affect higher cortical functions. *Design and utilize strategies that normalize interoception to improve intractable patient symptoms. Hour 3 *Relate the effects of cold sensory deficit to chronic central pain states. *Map the pathways specific to Lamina I versus Lamina V sensory afferents. *Discuss basic science research that links C-Fiber subpopulations with hyper-excitability of sensory neurons. *Apply techniques to gate pain processing through the Dorsal Insula/Anterior Cingulate pain switch. *Utilize the relationship between cold pathways and pain pathways to gate chronic pain. Hour 4 *Identify the relationship between the ANS and chronic pain. *Explore the cause of sympathetic maintained pain. *Discuss the emerging role of the brain and spinal cord in CRPS. *Apply non-invasive neuromodulation techniques for pain control. *Formulate an effective treatment plan based on current knowledge. Hour 5 *Relate the effects of failure within the DNIC to the development of chronic pain. *Draw the pathways specific to ascending sensory and descending pain modulatory circuits. *Apply knowledge of the DNIC, as it relates to chronic lower back pain. *Discuss basic science research that links the PAG with the phenomena of offset analgesia and conditioned pain modulation. *Formulate and apply treatment plans based on stimulation of the DNIC utilizing spinal cord stimulation, motor cortex activation and heterotopic noxious conditioning stimulation. Hour 6 *Relate the effects of cingulate cortex activation on chronic pain suppression. *Draw and identify regions of the cingulate cortex pertinent to pain and suppression. *Discuss basic science research that links area's 32, 24 and 25 with pain and its relief. *Apply specific techniques to modulate cortical areas 32, 24, and 25 for pain suppression. *Formulate and implement a treatment plan based on the M1-ACC pain model.