These interventions include:
- Education programs that support knowledge and self-care strategies;
- Exercise programs;
- Spinal manipulative therapy, Physiotherapy, and Massage (Chiropractors generally offer all three);
- Psychological therapies, such as cognitive behavioral therapy (CBT); and
- Medicines, such as non-steroidal anti-inflammatory medicines.
NSAIDs continue to be the only recommended pharmacotherapy. Among the medication interventions the guideline recommends against are opioids, antidepressants (tricyclic, serotonin and noradrenaline reuptake inhibitor), skeletal muscle relaxants, injectable local anaesthetics and pharmacological weight-loss medications. Acetaminophen, benzodiazepines and cannabis- related pharmaceutical preparations received “no recommendation,” while listing potential harmful effects including “cardiovascular, renal and gastrointestinal harms and increased mortality risk” for acetaminophen; “potential harms including memory impairment, misuse, overdose deaths from respiratory depression, somnolence, fatigue and light-headedness potentially leading to falls” for benzodiazepines; and “evidence of possible adverse events, including harms associated with its nonmedicinal use” for cannabis-related pharmaceutical preparations.
- While the WHO guideline was discipline neutral, it is designed to be used by “clinical staff including medical doctors, nurses, allied health workers including chiropractors, occupational therapists, physiotherapists, pharmacists, psychologists and community health workers, as well as public health program and system managers.” What remains to be seen in the U.S. is will the INSURANCE companies follow the science for those involved in the medical management of chronic primary LBP to finally acknowledge that the preponderance of evidence and guideline recommendations and refer to a Chiropractic Physician (DC) prior to prescribing antiquated failed treatments and continue to prescribe OPIOIDS which fail miserably and continue to help fuel our OPIOID crisis?
Our Founding Physicians have more than 40 years collective experience in healthcare
At some point in life, virtually everyone experiences some type of pain. Musculoskeletal pain affects muscles, ligaments, tendons, nerves, and bones. It can have rapid onset or can be a longstanding problem, and can be of localized as in neck or low back pain or widespread as in chronic pain, fibromyalgia etc…
Pain neuroscience and the missing link for Chronic Pain Patients that show signs and symptoms of central sensitization.
Many patients have been to many types of physicians with little or no help of improving their conditions. Many have a history of physical or emotional trauma, and prior doctors that have not helped. Many chronic pain patients just never get or stay better. You might hear the term “chronic pain syndromes” used as an umbrella term to refer to all chronic pain conditions. Neuroplasticity, also known as brain plasticity, is the ability of neural networks in the brain to change through growth and reorganization Positive Neuroplasticity or increase the chronic pain in Maladaptive Neuroplasticity, also known as central sensitization or nociplastic pain.
We understand the importance of listening to understand your unique pain experience which requires proper pain assessment, allowing appropriate management thus improving quality of care. The physicians and staff focus on Non-Surgical treatments, and are committed to superior patient care. Our practice is guided by state-of-the-art technology yet grounded in philosophy of a hands on approach customized to each patient’s unique needs. Our highly trained physicians are Board Certified and dedicated to providing outstanding care.
Central sensitization is one of the major underlying mechanisms of nociplastic pain, but they are not synonyms.
Maladaptive neuroplasticity and their effects:
- It links normal sensory feedback signals to the emotional part of the brain.
- It alters afferent and efferent sensory signals changing the perception of pain.
- It delays trunk muscle recruitment, making it easier for chronic pain patients to be more easily injured again.
- Maladaptive efferent motor signals also affect the multifidi and other deep segmental stabilizing muscles, causing segmental instability, i.e., treatment/s that do no improve patients quality of life (QOL).
How do we change brain wiring?
Pain Neuroscience Education (PNE) is being embraced with rapidly growing awareness in the medical community. There are two clinical indications for initiating Pain Neuroscience Education (PNE):
- the clinical picture is dominated by central sensitization
- illness coping mechanisms or poor illness perception is present
Treatment Options
PNE really consists of two overall components:
- Patient education: teaching the patient that chronic pain can be from the brain, not the body.
- Treatment: teaching the patient skills to address underlying beliefs and emotions about their pain or that is causing their pain, and retraining the central nervous system (CNS) and musculoskeletal systems to respond appropriately to life.
We start off with a comprehensive evaluation which includes a detailed history and a thorough exam to determine what is causing your pain (the underlining problem). We have X-ray, MRI, CT scan, and Ultrasound conveniently located on campus and can provide same day services. We offer second opinions and work with surgeons if your case dictates, and whatever each day brings we will be there to advise and instruct you for optimum health. Advanced Care Physicians Group, P.A. ultimate goal is to help you be pain free however in many that is not a realistic option and with them we will work to get you a close to pain free and teach you coping skills via positive neuroplasticity so you can enjoy improved QOL.
