Journal of Pain & Relief
Open Access

Abstract

Overview: Reliance upon the biomedical model and fractured specialty-based care have contributed to a dysfunctional management paradigm for spine-related pain disorders (SRDs), low back and neck pain. In this dynamic, interactive 90 minute workshop, a blend of didactic and practical instruction will teach attendees how to incorporate biopsychosocial assessment questionnaires and learn focused, evidence-based physical examination procedures. Those attending will learn how differently trained and licensed healthcare practitioners can implement an integrative, evidence-informed clinical process for managing SRDs by incorporating an efficient and practical assessment process. Specific attention will be given to psychosocial assessments including the STarT back screening tool, SCP neck screening tool and patient-specific functional scale. Focused examination procedures with high specificity and sensitivity will be described, demonstrated and practiced. Sample case presentations will be used to make clinical decisions and prescribe management focusing on patient self-care. Rationale: Spine-related pain disorders (SRDs), low back and neck pain, are the first and fourth leading causes of disability in the world, respectively, with enormous global economic impact. Increasing expenditures have not resulted in improved clinical outcomes. Patients and clinical practitioners are faced with a wide array of differing approaches and treatment options yet few have documented success in the majority of patients. There is evidence supporting a clinical model based on relationshipcentered care that incorporates the psychosocial needs of patients concurrently with evidence-informed physical evaluation and management strategies. Objectives: The objectives of this study are to: Understand the global scope, magnitude and economic consequences of spinerelated pain and disability; Recognize factors that have contributed to the current dysfunctional state of spine care, with consideration of the biomedical model of disease; Recognize how academic and professional silos and healthcare policies have created barriers to effective care; and Learn how to employ emerging strategies that emphasize patient self-efficacy and offer the potential for improved value. Topic Areas: The workshop incorporates evidence-based themes into a framework suitable for differently licensed practitioners to apply standardized spine care management by incorporating practical psychosocial and physical assessments and treatments strategies. Session/Method Outlines: The two speakers will team teach in a conversational and interactive format. Topics are: (1) Economics and epidemiology of SRDs; (2) Factors leading to the current dysfunctional state of spine care; (3) Psychosocial assessment questionnaires - [3a] Introduced; [3b] Instruction in scoring, interpretation and application in patient management; [3c] Scoring and Decision-making exercise; (4) Patient Interviewing - a structured approach to stratify care and referrals; (5) Physical Assessment - [5a] Specificity and Sensitivity of examination procedures- Why it matters [5b] Demonstration and practice of select physical assessment techniques; (6) Diagnosis-based clinical decisions- [6a] Stratification [6b] Management sub-classifications; [6c] Practical decision-making exercise; (7) Chronic and refractory cases - a consideration of perpetuating factors; and (8) Putting it all together Materials: Resources used in practical exercises will include: (1) STarT back screening tool; (2) Spine care partners neck screening tool; (3) Patient-specific functional scale; (4) Selected physical assessment descriptions; (5) Pain drawings with casepresentations; and (6) Links for online references. Equipment: One examination or therapy table for demonstration and practice of physical assessment procedures.

Biography

Email: robbrussell@scuhs.edu