PPA Pain Project

Description

The Physiotherapy Pain Association (PPA) is the Professional Network of the UK`s Chartered Society of Physiotherapy and part of its recently formed NeuroMusculoskeletal Alliance. It is both pleased and proud to lead this project by supervising development of the Physiopedia Pain section. 

As a project-in-development we intend to populate the site with practical, credible and thought-provoking information on the science of pain, its assessment and management. Much of our direction will be guided by the new IASP Curriculum Outline on Pain for Physical Therapy.

Any one is welcome to join in this project. You will be joining people from all over the world in contributing evidence based articles to create an evidence based reference on Pain.  In return for your efforts you will recieve a certificate of completion to help you evidence your learning through your involvement with this project.

We very much hope you will watch this space and ultimately find it a useful point of reference…..and if you do, we hope you will guide colleagues towards it!

Project Lead

Jo Etherton

Project Dates

June 2014 onwards

Instructions

1. Choose an article from the list below that doesn't already have a name next to it.  
2. Put your name next to the article (click edit, type in your name, click save).
3. At this point you should email the project co-ordinator to let them know that you would like to join the project and which page you have chosen.  Please feel free also to ask any questions that you have in relation to this project e.g. if you feel a new paage needs adding.
4. You should then create your evidence based article on the topic of your choosing.  Basicaly this means writing about your choosen topic and providing the best references/evidence available for your statements where possible.  It's just like Wikipedia!  We are not expecting fully comprehensive articles at this stage but if you can provide a good knowledge base for the article (use your judgement here) it can updated and broadened at a later stage in the project.  Have a browse through other Articles on Physiopedia to get an understanding of the type of articles that we like to create.  If you need help with editing please read the user tutorials or see tips below for writing guidance. 
5. Once you have completed you article (or if you have any questions in the process of creating your article)  email the project co-ordinator to let them know.  
6. Your article will then be reviewed by the PPA.  
7. Your will be emailed a response of approval or of amendements to be made.
8. Once the article has been approved, it will be published and you will receive your certicate of completion.

If you have any questions about becoming a part of this project please do email us.

Tips

Physiopedia is an encyclopedia providing evidence based, critically reviewed information for Physiotherapists across the world. As such it as standards of writing (?) that articles must adhere to in order to be published. This is a collaborative activity, so please do not feel dis-heartened if others make suggests or contributions to your articles over time, it helps maintain relevance and shares learning, it is not a criticism of you personally

With all this in mind here are 5 pieces of advice that we hope will give you some confidence about creating a PhysioPedia Pain article that will be valuable to Physiotherapists all over the world!

1)Look around PhysioPedia and work out what articles/pages you like and are more/less likely to engage with. Think about why this is. Is it about the title, the first sentence, layout, use of pictures/videos/presentations or something else? 2)Be mindful to reference your work and use quotation marks when appropriate. Plagerism is not good academic practice. Use the guidance in the PhysioPedia tutorial about referencing. Wherever possible add hyperlinks to your information sources in your text, this will also add credence to you work.Remember it is your job to be be critically selective about the sources you use. (see PhysioPedia tutorial for how to) 3)The article should be, wherever possible factual, not a piece to perused readers into one conclusion or another. Therefore adopt a neutral tone and voice and present other peoples arguments/references/facts and figures from all perspectives, leaving the final decision to the reader. 4) If you are concerned about the world seeing your article as your write and edit it, or you are not confident to write straight into PhysioPedia, you can compose your article as a word document and the project will translate into PhysioPedia for you. 5) A word on word count. This is for you to determine as is most appropriate for your topic and approach. Ideally not a 500 word summary of a topic, but equally not a 3000 essay. Use hyperlinks to other PhysioPedia pages and information sources tactically to help manage your word count and avoid avoid long winded explanations and signpost readers to more information/background reading. Keep in your mind the situation readers are likely to be in when accessing your information - a quick reference point for sit down with a cuppa?

Finally remember this project is about collaboration and harnessing of knowledge, so tap use your colleagues knowledge, skills - editing/proof reading, references and learn as you go together! Could make an interesting in-service training session, or team building exercise!

Articles

         Multidimensional Experience...

1. Multidimensional Nature of Pain: Define acute and chronic pain terms of a multidimensional pain experience.
2. Epidemiology of Pain: Describe pain epidemiology in terms of a public health problem with social, ethical, and economic considerations
   
   The Bio..
3. Nociception: Describe nociceptors and the need for adequate stimuli to activate nociceptors in different tissue types (i.e. skin, muscle, joint, viscera).
4. Peripheral sensitization: Describe peripheral sensitization and how these changes are associated with pain perception
5. Neurogenic Inflammation: Describe neurogenic inflammation, the neurotransmitters involved in this process, and how these neurotransmitters could contribute to peripheral pain processing
6. Processing of nociception:
   • 6a.Describe and explain the afferent innervations of the spinal cord from different tissue types, and how pain from different tissues is processed centrally.
   • 6b. Describe the changes and role of ion channels, excitatory neurotransmitters, and inhibitory neurotransmitters in the peripheral nervous system and in non-neuronal cells, and how these changes influence the processing of noceception.
7. Sensory discriminative and motivational affective component of pain: Describe the pain pathways involved in the sensory discriminative and motivational affective component of pain.
8. Central sensitisation: Describe and define central sensitization and how this is similar and different from peripheral sensitization.
9. Pain Behaviours: Describe the mechanisms that underlie pain behaviors: referred pain, primary hyperalgesia, secondary hyperalgesia, allodynia
10. Alteration of nociception transmission post injury: Describe the role of excitatory neurotransmitters, inhibitory neurotransmitters, and glia in the central nervous system in enhancement of pain transmission, and changes that occur as a result of tissue injury.
11. Descending pathways: Describe the descending pathways that modulate pain transmission
12. Pain facilitation and inhibition: Define and describe the the differences between them in terms of brain sites and neurotransmitters that play a role in this process. And how these pathways can be activated by non-pharmacological treatments.
13. Chronic pain and the brain: Describe and explain the long term impact of pain on the brain.
14. Neuroimaging: Describe imaging tools used and key brain regions underpinning the experience of pain, and how this changes depending upon the context, cognitive and emotional state of the individual.
15. Interactions between pain and motor function: Theories on the interactions between pain and motor function - describe/compare/contrast
    
    The Psycho…
16. Psychological basis of pain: Describe and explain current theories of the psychological basis of pain e.g……..fear avoidance, pain-related anxiety, pain catastrophising, stress. and learned helplessness.
    
    The Socio…
    
17. 
    
    Pain Assessment
18. Pain Assessment Tools:
    • 18a. Describe and explain the use of common tools used to measure each component of a pain experience: Sensory/Affective/Cognitive/Physiological/Behavioural
    • 18b. critique the commonly used measures for different pain dimensions: 1.Self-report measures as "accepted standard" not gold standard. 2. Physical performance measures including Functional Capacity Evaluations (FCEs). 3. Physiological/autonomic response measures
19. Complexities of Pain Assessment: Describe and explain the considerations that maybe required when assessing an individuals pain experience relating to : communication barriers, cognitive impairment, spirituality, ethnicity, age, pain type/state e.g. cancer pain or neuropathic pain.
    
    Pain Management
20. The team:
    • 20a. Multidisciplinary care: Describe and explain the role and responsibilities of the physical therapist in pain management and the integration of physical therapy into the interdisciplinary team.
    • 20.b. Roles and responsibilities of other health care professionals in the area of pain management and the merits of interdisciplinary collaboration.
21. Pharmacology in Pain Management : Describe the principles of the pharmacology of medications used to treat pain: non-opioid medications, opioids, adjuvants and topical analgesics and local anaesthetics. Including limitations of the pharmacological management of chronic pain.
22. Patient education in Pain Management: Describe the evidence base supporting the use of therapeutic neuroscience education and self-management as a critical part of pain management (this could include education styles: biomedical, psychological, neuroscience. Service delivery options: face to face, web-based, group education. Models used: stings of change theory etc)
23. Behavioural Approaches to Pain Management: Describe cognitive and physical aspects of behavioural approaches to pain management and how applied in practice.
24. Psychological Approaches to pain Management: Describe models/theories and how applied in practice e.g. self efficacy, readiness to change, acceptance, coping
25. Exercise and Activity in Pain Management: including exercise prescription and modification for pts in pain - reps/sets/duration/intensity/pacing/goal setting/motivation
26. Re-engagement with vocation/function: links between pain and function/work lags model and barriers to re-engagement
27. Traditional physiotherapy interventions: electrotherapy/acupuncture/manipulation/massage/relaxation
    
    Specific Clinical Conditions
28. Headache and Migraine
29. Cancer pain
30. Fibromyalgia
31. Myofascial pain
32. Neuropathic pain
33. Complex regional pain syndromes