PPA Pain Project



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 receive 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

The Physiopedia team is currently managing this project.

Project Dates

June 2014 onwards


As a participant in this project you will create (or update an existing) pain related page within Physiopedia.  You may choose to take part in this project as a personal contribution to your own professional development or you may wish to contribute evidence based information to develop this resource for our profession.  Your contribution will be reviewed by the PPA and once complete recognised by the award of a certificate of completion.

If you would like to take part in this project please follow the instructions below. 

If you have any questions, please do email us.


  1. Choose an article from the list below that you would like to develop.  Be sure that the article doesn't already have a name next to it.  
  2. 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 would like to work on.  Please feel free also to ask any questions that you have in relation to this project e.g. if you feel a new page needs adding.
  3. You will receive an email from Jo (the project co-ordinator) to confirm you participation in the project and also to confirm the page that you will develop.
  4. Once you have received this confirmation you are free to get on with working on your page:
    1. First you will need to sign up for a Physiopedia account so that you can make edits to the site.  You can request an account here.
    2. Once you have requested your account you will receive an email asking you to confirm your email address, please do that by clicking on the link.  Your account will then be activated and you will receive your login details.  This is a manual process and may take a couple of days.  If you do not receive the emails please check your spam folder and if they are not there please contact the course co-ordinator.
    3. When you are all set up with your Physiopedia account you will be given your own profile page on the site (the link to this will be in your joining email).  We recommend that you edit your profile to include your professional information.  Have a go at adding an image and a link.  This is a great way to practice editing and also provides you with a professional profile online to link to from your new page.  See the help tutorials.
    4. By now you should feel comfortable making edits in Physiopedia, now you are ready to work on your page!  You should create an evidence based article on the topic that you have been assigned.  Basically this means writing about your chosen topic and providing, where possible, the best references/evidence available for the content that you write.  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. What we would like you to do now is to think about your own persoanl learning outcomes as a result of taking part in this project.  These learning outcomes will be printed on your certificate.
  6. Once you have completed you article and listed your learning outcomes please email them to project co-ordinator.  
  7. Your article will then be reviewed by the PPA project team.  
  8. You will be emailed a response of approval or of amendments to be made.
  9. Once the article has been finally approved, it will be published and you will receive your certificate of completion.

If you have any questions please do email us.


Physiopedia is an online resource that provides evidence based, critically reviewed information for Physiotherapists across the world. It is a collaboratively developed project that is contributed to by physiotherapists all over the world.  The project has standards of writing that articles must adhere to in order to be published. As a collaborative activity, 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. 
  3. The article should be, wherever possible factual, not a piece to direct 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 we 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 related 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?  Aim to produce an article that critically introduces the key topics/ideas/themes relating to the article title. Use links and signposting to send interested readers to other sources and Physiopedia pages for more details....or, if you want to include a lot of detail about one sepcific element of your article, think about creating a seperate page for it. Consider your article to be somewhere a therapist wanting to get a crticial introduction to the topic might start their search.

Finally remember this project is about collaboration and harnessing of knowledge, so tap into 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!

IASP and British Pain Society resources might be a useful starting places for many of the articles below.


         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: CURRENT VOLUNTEER: SAKRINA VOHRA
    • 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. CURRENT VOLUNTEER: KISTEN STOWER
  14. Interactions between pain and motor function: Theories on the interactions between pain and motor function - describe/compare/contras CURRENT VOLUNTEER: KIRSTY WALKER

    The Psycho…
  15. 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. CURRENT VOLUNTEER: SHARINE BALICANTA

    The Socio…

  16. Sociological basis of pain

    Pain Assessment
  17. 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
  18. 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. CURRENT VOLUNTEER RACHEL VENARD

    Pain Management
  19. Multidiciplinary Care in Pain Management:
    • 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. CURRENT VOLUNTEER; MAGGIE WHITTAKER
  20. 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. CURRENT VOLUNTEER: EVE JENNER
  21. 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) CURRENT VOLUNTEER: MIKE STEWART
  22. Behavioural Approaches to Pain Management: Describe cognitive and physical aspects of behavioural approaches to pain management and how applied in practice.
  23. Psychological Approaches to Pain Management: Describe models/theories and how applied in practice e.g. self efficacy, readiness to change, acceptance, coping 
  24. Exercise and Activity in Pain Management: including exercise prescription and modification for pts in pain - reps/sets/duration/intensity/pacing/goal setting/motivation CURRENT VOLUNTEER: LINA PAABO
  25. Re-engagement in Life Roles with Pain Conditions links between pain and function/work lags model and barriers to re-engagement
  26. Workplace Related Pain: links between the workplace and pain and barriers to overcome the issue CURRENT VOLUNTEER: LINA PAABO
  27. Traditional Physiotherapy Interventions: electrotherapy/acupuncture/manipulation/massage/relaxation

    Specific Clinical Conditions
  28. Headache and Migraine
  29. Cancer pain
  30. Fibromyalgia
  33. Complex regional pain syndromes CURRENT VOLUNTEER : MARIA GALVE VILLA