The Modern Pain Podcast

Diego Hidalgo a Spanish physiotherapist and osteopath discusses their recent paper - ‘It’s all connected, so it all matters’ - the fallacy of osteopathic anatomical possibilism.In the podcast they discuss:• Anatomical Possibleism in Osteopathy and PT• Anatomy, Pathologization, and Pain Discussion• Pain Treatment and Cultural Differences• Concerns Over Over-Diagnosing and Anatomical Possibleism• Addressing Chronic Pain Challenges•  Holistic Approach to Pain Management•  Evidence-Based Approach and Transition to Modern Practice Challenges‘It’s all connected, so it all matters’ - the fallacy of osteopathic anatomical possibilismJarvik study*********************************************************************📸 - Follow us on Instagram - https://www.instagram.com/modernpaincare/🐦 - Follow us on Twitter - https://www.twitter.com/modernpaincare/🎙️ - Listen to our Podcast - https://www.modernpaincare.com____________________________________Modern Pain Care is a company dedicated to spreading evidence-based and person-centered information about pain, prevention, and overall fitness and wellness

In this conversation, Mark Kargela interviews Michael Shacklock about his journey and influences in the field of neurodynamics. They discuss the transition from the traditional view of neural tension testing to neurodynamics, the influence of pain science on clinical practice, and the importance of integrating the biological examination with psychosocial factors. Michael also shares his focus on lumbar radiculopathy in his PhD research, specifically looking at unloading the nerve root for pain relief. In this conversation, Michael Shacklock discusses the use of neurodynamic techniques in the treatment of radiculopathy. He explains that movement-related pain should respond quickly to movement, and shares his favorite patient profile for this type of treatment. Shacklock emphasizes the importance of ruling out contralateral tests if they provoke pain, as this indicates reduced cord movement. He also discusses the role of radiology in diagnosing radiculopathy and the challenges of interpreting radiology reports. Shacklock addresses the misconceptions around neurodynamic tests and highlights the need for a comprehensive approach that integrates neurodynamics with musculoskeletal function. He concludes by discussing the application of neurodynamic techniques in acute radiculopathy and the importance of adapting treatment to the individual patient's needs.If you are looking to go deeper on topics, get training, and become a better pain care clinician, then check out our community at https://modernpaincare.com**TIMESTAMPS**00:00:00 Start00:02:04 Interview Begin00:07:15 The movement to neurodynamics versus neural tension00:10:37 How has pain science influenced MIchael's approach00:14:40 There is a time to specifically treat the tissues00:18:51 Michael's PhD focus00:23:32 Crossed straight leg raising as treatment00:26:50 Differneces between mechanical compresison and inflammtory nerve root issues00:32:05 Difficulties with radiolgy00:34:16 Where physios are missing the mark in application00:38:51 Use of neurodynamics in irritable patients00:42:04 Michael's view on other movement approaches00:45:09 Michael's courses and where to find him next*********************************************************************📸 - Follow us on Instagram - https://www.instagram.com/modernpaincare/🐦 - Follow us on Twitter - https://www.twitter.com/modernpaincare/🎙️ - Listen to our Podcast - https://www.modernpaincare.com____________________________________Modern Pain Care is a company dedicated to spreading evidence-based and person-centered information about pain, prevention, and overall fitness and wellness

To go deeper and get support in your practice make sure you check out our community In this conversation, Mark Kargela interviews Jason Silvernail about the definition and description of Orthopedic Manual Physical Therapy (OMPT). They discuss the misconceptions and misunderstandings surrounding manual therapy and how OMPT differs from other forms of manual therapy. They also highlight the distinguishing characteristics of OMPT, including advanced subspecialty training, focus on clinical judgment, expertise in examination and treatment, and a patient-centered long-term mindset. The conversation emphasizes the importance of evidence-based practice and the need for a nuanced understanding of OMPT. In this conversation, Jason Silvernail and Mark Kargela discuss the value and benefits of OMPT (Orthopaedic Manual Physical Therapy) fellowship training. They highlight the importance of clinical judgment and critical thinking in the practice of manual therapy. They address the misconception of elitism associated with advanced training and emphasize the need for accurate information and informed decision-making. The conversation provides insights into the distinguishing characteristics of OMPT and its role in providing high-quality, evidence-based care for patients.Helpful Links:Link to paper  Clinical reasoning paper in OMPT Jason's website Jason's X profile *********************************************************************📸 - Follow us on Instagram - https://www.instagram.com/modernpaincare/🐦 - Follow us on Twitter - https://www.twitter.com/modernpaincare/🎙️ - Listen to our Podcast - https://www.modernpaincare.com____________________________________Modern Pain Care is a company dedicated to spreading evidence-based and person-centered information about pain, prevention, and overall fitness and wellness

In this conversation, Mark Kargela interviews Ian Harris, an orthopedic surgeon and researcher, about the challenges and problems in healthcare. Ian discusses his journey from being a practicing surgeon to becoming interested in the scientific method and evidence-based medicine. He talks about the resistance he has faced in challenging the status quo and the difficulties in changing the way surgeons think. They also discuss the placebo response in surgery, the blurring of normal and disease states in healthcare, and the overuse of procedures like spinal fusion and regenerative medicine. Ian shares his projects on placebo studies for rotator cuff repair and spine fusion, which aim to provide high-quality evidence to change practice.TakeawaysThe scientific method and evidence-based medicine are crucial in improving healthcare practices.Surgeons often face resistance when challenging the status quo and trying to change the way they think.The placebo response in surgery is complex, and contextual factors play a significant role.The blurring of normal and disease states in healthcare leads to unnecessary interventions and medicalization of normal conditions.Procedures like spinal fusion and regenerative medicine are often overused despite limited evidence of their effectiveness.Placebo studies for rotator cuff repair and spine fusion aim to provide high-quality evidence to guide practice.Books (Affiliate Links)Surgery: The Ultimate PlaceboHippocrasy: How Doctors are Betraying Their Oath*********************************************************************📸 - Follow us on Instagram - https://www.instagram.com/modernpaincare/🐦 - Follow us on Twitter - https://www.twitter.com/modernpaincare/🎙️ - Listen to our Podcast - https://www.modernpaincare.com____________________________________Modern Pain Care is a company dedicated to spreading evidence-based and person-centered information about pain, prevention, and overall fitness and wellness

In this episode, physiotherapist Adam Dobson discusses lumbar radiculopathy and its management. He highlights the challenges in assessing and diagnosing lumbar radiculopathy, emphasizing the importance of precise terminology and understanding mixed presentations.  Adam also explains the role of the neurological examination and the stepped-care approach in managing lumbar radiculopathy. He emphasizes the need for an economical approach to treatment, focusing on patient preferences and activities that are meaningful to them. Adam also discusses the role of physiotherapy in supporting patients' recovery and the importance of balancing tissue-based and biopsychosocial approaches.Schmid AB, Tampin B, Baron R, et al. Recommendations for terminology and the identification of neuropathic pain in people with spine-related leg pain. Outcomes from the NeuPSIG working group. *Pain*. 2023;164(8):1693-1704. doi:[10.1097/j.pain.0000000000002919](https://doi.org/10.1097/j.pain.0000000000002919)Konstantinou K, Lewis M, Dunn KM, et al. Stratified care versus usual care for management of patients presenting with sciatica in primary care (SCOPiC): a randomised controlled trial. *Lancet Rheumatol*. 2020;2(7):e401-e411. doi:[10.1016/S2665-9913(20)30099-0](https://doi.org/10.1016/S2665-9913(20)30099-0)Stynes S, Konstantinou K, Ogollah R, Hay EM, Dunn KM. Clinical diagnostic model for sciatica developed in primary care patients with low back-related leg pain. *PLoS One*. 2018;13(4):e0191852. doi:[10.1371/journal.pone.0191852](https://doi.org/10.1371/journal.pone.0191852)*********************************************************************📸 - Follow us on Instagram - https://www.instagram.com/modernpaincare/🐦 - Follow us on Twitter - https://www.twitter.com/modernpaincare/🎙️ - Listen to our Podcast - https://www.modernpaincare.com____________________________________Modern Pain Care is a company dedicated to spreading evidence-based and person-centered information about pain, prevention, and overall fitness and wellness

Simon Kelly discusses his journey as a healthcare professional and his exploration of the role of physiotherapy in pain management. He questions the necessity of physiotherapy for every individual and the challenges of building a virtual practice. Simon also delves into the limitations of the biomedical model of medicine and the need for a more holistic approach.*********************************************************************📸 - Follow us on Instagram - https://www.instagram.com/modernpaincare/🐦 - Follow us on Twitter - https://www.twitter.com/modernpaincare/🎙️ - Listen to our Podcast - https://www.modernpaincare.com____________________________________Modern Pain Care is a company dedicated to spreading evidence-based and person-centered information about pain, prevention, and overall fitness and wellness

SummaryIn this conversation, Mark Kargela interviews Seth Peterson about various topics in physical therapy practice and education. They discuss the challenges of PT education, the role of manual therapy, the influence of social media on PT practice, the importance of mentorship, the value of communication in PT practice, the state of continuing education in PT, and the role of PTs as primary care musculoskeletal practitioners.Takeaways- PT education should focus on developing safe clinicians and providing mentorship to help clinicians become skilled practitioners.-  There is value in manual therapy, but it should be used in conjunction with other interventions and tailored to the individual patient.-  Social media can create idea cults and confusion for young clinicians, but mentorship and critical thinking can help navigate these challenges.-  Communication skills are essential for PTs and should be emphasized in education and practice.-  Continuing education in PT should be evidence-based and focus on developing clinical reasoning and case management skills.-  PTs have the potential to serve as primary care musculoskeletal practitioners, but there are barriers that need to be addressed, such as expanding PTs' scope of practice.Check out Seth on X*********************************************************************📸 - Follow us on Instagram - https://www.instagram.com/modernpaincare/🐦 - Follow us on Twitter - https://www.twitter.com/modernpaincare/🎙️ - Listen to our Podcast - https://www.modernpaincare.com____________________________________Modern Pain Care is a company dedicated to spreading evidence-based and person-centered information about pain, prevention, and overall fitness and wellness

Dr. Howard Schubiner discusses the link between childhood trauma and pain, as well as the brain's role in creating pain. He highlights the challenges in training healthcare professionals to understand and address mind-body pain. Dr. Schubiner introduces the symptom perception model and explains the process of pain reprocessing therapy. He emphasizes the importance of ruling out structural problems and using the FIT criteria to determine if the pain is functional, inconsistent, and triggered. This conversation explores the revolutionary data on non-structural pain and the importance of transitioning to understanding the emotional piece of chronic pain. It delves into the role of emotional awareness and expression in pain management and the challenges clinicians face in incorporating a mind-body approach. The conversation also highlights the healthcare system challenges and available resources for clinicians and patients. Finally, it discusses the future of mind-body approaches and training opportunities.***Helpful Links***Dr. Sarno's BooksDr. Schubiner's WebsiteJAMA Psychiatry Study on Pain Reprocessing Therapy*********************************************************************📸 - Follow us on Instagram - https://www.instagram.com/modernpaincare/🐦 - Follow us on Twitter - https://www.twitter.com/modernpaincare/🎙️ - Listen to our Podcast - https://www.modernpaincare.com____________________________________Modern Pain Care is a company dedicated to spreading evidence-based and person-centered information about pain, prevention, and overall fitness and wellness

In this conversation, Derek discusses his journey in pain rehabilitation and the challenges faced in providing comprehensive care. He emphasizes the need for prevention and early intervention in pain management, as well as the importance of addressing the biopsychosocial factors that contribute to pain. Derek also shares strategies for introducing new narratives to patients and overcoming barriers to implementing a multidisciplinary approach. The conversation concludes with a discussion on the frontier of pain care and the potential impact of understanding the neuroimmune system on patient care. In this conversation, Derek Griffin discusses the complexity of pain and the challenges of understanding its underlying mechanisms. He emphasizes the importance of bringing complex topics to the patient's context and using relatable examples, such as allergies and the flu, to explain the body's protective responses. Derek also highlights the limitations of pain neuroscience education and the need for a more comprehensive approach to treatment. He discusses the skill set required for psychologically informed care, including active listening, dealing with uncertainty, and acknowledging the patient's expertise. Derek concludes by emphasizing the importance of continuous learning and collaboration in improving patient care.Derek's X Profile - https://twitter.com/DerekGriffin86*********************************************************************📸 - Follow us on Instagram - https://www.instagram.com/modernpaincare/🐦 - Follow us on Twitter - https://www.twitter.com/modernpaincare/🎙️ - Listen to our Podcast - https://www.modernpaincare.com____________________________________Modern Pain Care is a company dedicated to spreading evidence-based and person-centered information about pain, prevention, and overall fitness and wellness

Join the Modern Pain Pro communityIn this conversation, Mark Kargela and Logan Buckley discuss the importance of communication in physiotherapy and how improv can enhance patient care. Logan shares his journey from being a physical therapist to discovering improv and how it has impacted his communication skills. They explore the role of communication in working with persistent pain patients and the influence of improv on navigating uncertainty and complexity. They emphasize the importance of authenticity and finding one's own voice in communication. The conversation concludes with a discussion on the complexity of communication compared to interventions and the power of purposeful curiosity. In this conversation, Mark and Logan discuss the importance of being authentic and vulnerable in patient interactions. They highlight the value of admitting when you don't have all the answers and being a real person rather than a paternalistic authority figure. *********************************************************************📸 - Follow us on Instagram - https://www.instagram.com/modernpaincare/🐦 - Follow us on Twitter - https://www.twitter.com/modernpaincare/🎙️ - Listen to our Podcast - https://www.modernpaincare.com____________________________________Modern Pain Care is a company dedicated to spreading evidence-based and person-centered information about pain, prevention, and overall fitness and wellness

This episode dives into the shifting paradigms around strength exercise in managing shoulder pain and what is behind the positive effects we see clinically.  Jared Powell, a Ph.D. candidate, and shoulder physio specialist, joins us to discuss this and helps us get an understanding of the current state of evidence and how he positions exercise in his practice along with how he communicates it.  Jared's Publications Mentioned in the EpisodeThe Shoulder Physio WebsiteJoin the Modern Pain Pro Community*********************************************************************📸 - Follow us on Instagram - https://www.instagram.com/modernpaincare/🐦 - Follow us on Twitter - https://www.twitter.com/modernpaincare/🎙️ - Listen to our Podcast - https://www.modernpaincare.com____________________________________Modern Pain Care is a company dedicated to spreading evidence-based and person-centered information about pain, prevention, and overall fitness and wellness

Join our exclusive Modern Pain Pro community where we go deep on all things pain In the episode "Beyond Techniques: Transforming Pain Care" of the Modern Pain Podcast, the focus is on the limitations of relying solely on new techniques in pain management. It emphasizes the importance of understanding the broader context of a patient's life and experiences. The discussion revolves around integrating holistic approaches into patient care, highlighting the need for long-term strategies that go beyond immediate pain relief techniques. This approach aims to foster more sustainable and effective pain management, offering a deeper insight into the complexities of pain care.*********************************************************************📸 - Follow us on Instagram - https://www.instagram.com/modernpaincare/🐦 - Follow us on Twitter - https://www.twitter.com/modernpaincare/🎙️ - Listen to our Podcast - https://www.modernpaincare.com____________________________________Modern Pain Care is a company dedicated to spreading evidence-based and person-centered information about pain, prevention, and overall fitness and wellness

Join our exclusive Modern Pain Pro community - where we go deep on all things pain This episode offers insights for physical therapists, especially new graduates, on thriving in professional environments where colleagues may have differing treatment philosophies. It emphasizes the importance of understanding clinic culture, respecting diverse treatment approaches, and integrating evidence-based methods into traditional practices. The video provides practical advice on building professional relationships, adapting to various physical therapy techniques, and effectively managing complex pain cases. It encourages open communication and continuous learning from peers to enhance patient outcomes and personal career growth.*********************************************************************📸 - Follow us on Instagram - https://www.instagram.com/modernpaincare/🐦 - Follow us on Twitter - https://www.twitter.com/modernpaincare/🎙️ - Listen to our Podcast - https://www.modernpaincare.com____________________________________Modern Pain Care is a company dedicated to spreading evidence-based and person-centered information about pain, prevention, and overall fitness and wellness

Go deeper in our Modern Pain Pro Community The Client Experience CompanyIn this conversation, Mark and Jerry discuss the need for upstream thinking in healthcare and the barriers that prevent clinicians from seeing beyond the clinic. They emphasize the importance of managing expectations and building alliances with patients. They also explore the value of consumer-facing resources and the resistance to change in the healthcare system. The conversation highlights the potential impact of giving more than you get and the need for a shift from illness care to wellness care. Jerry discusses the importance of charging for services and the challenges of pricing. He emphasizes the need for the work to be on him to find ways and people that can benefit the consumer. Jerry also mentions the work he does with his company, Client Experience Company, which focuses on managing the patient journey and setting expectations. He highlights the importance of moving conversations upstream and ensuring that information travels with the patient. Jerry shares the results of his work, including increased patient success and improved business outcomes. He also mentions his current research on misalignment in organizations and the impact on patient care.*********************************************************************📸 - Follow us on Instagram - https://www.instagram.com/modernpaincare/🐦 - Follow us on Twitter - https://www.twitter.com/modernpaincare/🎙️ - Listen to our Podcast - https://www.modernpaincare.com____________________________________Modern Pain Care is a company dedicated to spreading evidence-based and person-centered information about pain, prevention, and overall fitness and wellness

The PRISM Model The Integrative Pain Science InstituteThe Modern Pain Pro Community SummaryIn this conversation, Joe discusses the development of the PRISM model, a comprehensive approach to pain management. He explains the evolution of the biopsychosocial model and the need for a more expansive model that addresses the complexities of pain. Joe also highlights the importance of a process-based approach to pain care and the domains and processes of the PRISM model. He discusses the barriers to integrating a holistic approach and the discomfort that clinicians may experience when moving away from traditional interventions. Joe emphasizes the importance of resilience in pain care and provides contact information for further inquiries. In this conversation, Mark Kargela interviews Joe about chronic pain and its treatment. They discuss the importance of understanding chronic pain, the biopsychosocial model, and various treatment approaches. The conversation provides valuable insights for both clinicians and patients struggling with chronic pain.TakeawaysThe PRISM model is a comprehensive approach to pain management that addresses the complexities of pain and incorporates a process-based approach.The biopsychosocial model has evolved over time, and the PRISM model aims to build upon it by incorporating new research and understanding.The PRISM model consists of six domains: person context, purpose, pain literacy, pain mindset, physical activity, and physiology.There are 18 processes within the PRISM model that support the domains and help guide the treatment and management of pain.Barriers to integrating a holistic approach to pain care include education, reimbursement systems, and individual resistance to change.Embracing discomfort and uncertainty is necessary for clinicians to expand their thinking and provide more effective care.Resilience is a key component of the PRISM model, and helping patients access their own resilience can lead to positive growth and recovery. Chronic pain is a complex condition that requires a comprehensive understanding of its underlying causes and contributing factors.The biopsychosocial model emphasizes the interaction between biological, psychological, and social factors in the experience of chronic pain.Treatment approaches for chronic pain should be multidimensional, addressing physical, psychological, and social aspects of the condition.Collaboration between clinicians and patients is crucial in developing effective treatment plans for chronic pain.*********************************************************************📸 - Follow us on Instagram - https://www.instagram.com/modernpaincare/🐦 - Follow us on Twitter - https://www.twitter.com/modernpaincare/🎙️ - Listen to our Podcast - https://www.modernpaincare.com____________________________________Modern Pain Care is a company dedicated to spreading evidence-based and person-centered information about pain, prevention, and overall fitness and wellness

Be part of the Modern Pain Pro Community Jamie's Website Had an enlightening chat with Jamie Johnston on our latest Modern Pain Podcast episode. From his journey in embracing pain science to the integration of mental health in therapy, Jamie's insights are a great example for any healthcare practitioner. Tune in to discover how we can revolutionize pain management together!*********************************************************************📸 - Follow us on Instagram - https://www.instagram.com/modernpaincare/🐦 - Follow us on Twitter - https://www.twitter.com/modernpaincare/🎙️ - Listen to our Podcast - https://www.modernpaincare.com____________________________________Modern Pain Care is a company dedicated to spreading evidence-based and person-centered information about pain, prevention, and overall fitness and wellness

Join the community waitlist Welcome to another episode of the Modern Pain Podcast. In this episode, Dr. Mark Kargela discusses the shortcomings of continuing education (Con Ed) in pain management and proposes solutions for clinicians.Key Topics:• Mismatch Between Con Ed and Clinical Practice: the environments of Con Ed courses often don't resemble real clinical settings, limiting their applicability in managing complex pain cases.• Isolation in Clinical Practice: Many clinicians find themselves isolated when applying modern pain science and techniques, lacking peer support and mentorship in their practices.• Logistical and Financial Challenges: Con Ed often imposes financial and lifestyle burdens on clinicians, making it difficult to integrate continuous learning into their lives.*********************************************************************📸 - Follow us on Instagram - https://www.instagram.com/modernpaincare/🐦 - Follow us on Twitter - https://www.twitter.com/modernpaincare/🎙️ - Listen to our Podcast - https://www.modernpaincare.com____________________________________Modern Pain Care is a company dedicated to spreading evidence-based and person-centered information about pain, prevention, and overall fitness and wellness

Join host Mark Kargela as he and Dr. Liebenson dive deep into the evolution of pain care and reveal strategies they both used and teach to help them transform their practices and those of their students..Craig shares his journey from traditional chiropractic methods to a revolutionary, holistic approach. He illuminates the often-overlooked psychological and physiological aspects of pain, challenging conventional wisdom and opening new pathways for treatment.Whether you're a healthcare professional seeking to enhance your practice, or someone struggling with pain, this video offers invaluable insights. Learn about the future of healthcare, the importance of patient-centered care, and the clinician's evolving role in this dynamic field.Helpful Links:First Principles of Movement (Craig's website) Craig's threads profile Craig's X profile Youtube *********************************************************************📸 - Follow us on Instagram - https://www.instagram.com/modernpaincare/🐦 - Follow us on Twitter - https://www.twitter.com/modernpaincare/🎙️ - Listen to our Podcast - https://www.modernpaincare.com____________________________________Modern Pain Care is a company dedicated to spreading evidence-based and person-centered information about pain, prevention, and overall fitness and wellness

Have you felt like you've rode the pendulum of manual therapy? If you listen to social media it either sucks or it remains the bedrock of good pain care.Which is it?Well in this episode you'll hear Mark talk to Dr. E (Erson Religioso) about the transformation his views and use of manual therapy have made throughout his career. Listen in and find out how we have grown from traditional theory of jedi hand skills to a more person-centered approach.You'll come out of this episode with a better view on manual therapy and where it may fit in modern pain care. Check out Dr. E and Modern Manual Therapy at:InstagramFacebookXYouTube*********************************************************************📸 - Follow us on Instagram - https://www.instagram.com/modernpaincare/🐦 - Follow us on Twitter - https://www.twitter.com/modernpaincare/🎙️ - Listen to our Podcast - https://www.modernpaincare.com____________________________________Modern Pain Care is a company dedicated to spreading evidence-based and person-centered information about pain, prevention, and overall fitness and wellness

This episode features a conversation with Ben Whybrow, a physiotherapist specializing in pain management at an NHS pain clinic. Ben discusses the multidisciplinary approach to treating complex pain cases, emphasizing the importance of patient communication and empathy. He shares insights into managing difficult conversations around ingrained beliefs, the effectiveness of group dynamics in treatment, and strategies for addressing emotional challenges in the clinical setting. The discussion also explores the evolution of physiotherapy in the context of pain management, offering valuable perspectives for clinicians in this field.HELPFUL LINKS:Ben's InstagramBen's TIkTokBen's X *********************************************************************📸 - Follow us on Instagram - https://www.instagram.com/modernpaincare/🐦 - Follow us on Twitter - https://www.twitter.com/modernpaincare/🎙️ - Listen to our Podcast - https://www.modernpaincare.com____________________________________Modern Pain Care is a company dedicated to spreading evidence-based and person-centered information about pain, prevention, and overall fitness and wellness