Chronic Musculoskeletal Pain

Chronic Musculoskeletal Pain

Take Course $49
30 days unlimited access

Course Description: 3 Hours (.3 CEUs)

This course is addressing chronic musculoskeletal pain. This is pain that extends beyond normal tissue healing time frames of the inflammatory, proliferative, and remodeling phases that is not related to systemic or rheumatic pathologies which are not amenable to physical therapy intervention. This presentation can benefit physical therapists and physical therapist assistants that are treating chronic musculoskeletal pain, and it demonstrates that the drivers of pain are often times related to multiple factors that are unrelated to the objective debility level (i.e. radiographic OA levels). This presentation will address the benefits and physiology of exercise, manual therapy, and side-effects of immobilization on chronic pain. This presentation will also provide specific exercise guidelines, but will raise awareness on the different classifications of pain according to a journal article by smart et al., and the spectrum of pain that chronic musculoskeletal patients fall under. The different pain classifications include: nociceptive pain, peripheral neuropathic pain, and central sensitization. Additionally, this presentation will expand on the role of pain science education in chronic pain patients and the importance of promoting wellness behaviors.

Course Outline

Course Outline:

Chronic Musculoskeletal Pain Course Outline: 3 Hours
Hour 1:
Chronic musculoskeletal pain a global problem (statistics and risk factors)
Genesis of chronic pain
Normal tissue healing versus chronic pain states
Inflammatory stage for soft tissues
Proliferative stage for soft tissues
Remodeling stage for soft tissues
Bony healing first stage/inflammatory stage
Bony healing second stagea/ reparative stage
Hour 2:
Bony healing third stage/ remodeling stage
Factors that affect tissue healing
Differential diagnosis somatic musculoskeletal diagnosis
Biochemical neuroplastic changes in response to nociceptive input
Differential diagnosis visceral diagnosis
Pain science education
TNE (therapeutic neuroscience education) effect
What now? (Describes ways to bridge the gap between classical musculoskeletal medicines with the new information)
Benefit of exercise
Hour 3:
Benefits of resistance exercise with chronic musculoskeletal pain applications
Benefits of aerobic exercise with chronic musculoskeletal pain applications
Exercise dosage for the general nociceptive pain
Exercise dosage for chronic musculoskeletal pain characterized with central sensitization
Mirror therapy for chronic musculoskeletal pain healing the damaged the somatosensory cortex found in the homunculus in post central gyrus
Manual therapy (classical osteopathic concept)
Manual therapy (modern manual therapy a more holistic approach a discussing a PT’s interaction with a pt’s nervous system.)
Manual therapy neurodynamics applications to facilitate neural and limb ROM
28-34. Works Cited/ CEU Test

Course Objectives:

Following completion of this course, the learner will demonstrate:
After completing this course the learner will have a better understanding of the following:
 1. The relevant epidemiology and the current evidence on the etiology of chronic musculosketal pain, and the evolution from the gate control theory of pain to a more comprehensive bio-psychosocial model of pain.
 2. Normal tissue healing.
 3. Differential diagnoses in order to rule out other pathologies.
 4. The variations in pain types according to smart et al. nociceptive pain, peripheral neuropathic pain, and central sensitization.
 5. The role of providing the patients with pain science education to reduce pain, and how increasing self-efficacy can reduce pain and increase function.
 6. The ability of exercise and load to help the patient achieve their functional potential.
 7. The role of manual therapy, and the evolution of osteopathic based manual therapy into modern manual therapy which takes into account the contribution of the central nervous system.

Presenter: Comet Mekonen PT, DPT, OCS, ACSM CPT

Graduated from the University of St. Augustine DPT program in 2014 with 3 years of clinical experience. Garnered the Orthopedic Clinical Specialist Certification in 2017. I have a great deal of passion for orthopedics, teaching, and evidenced based clinical practice. I currently work for Sentara Rockingham Memorial Hospital as a physical therapist performing rehabilitation on orthopedic, neuromuscular, and vestibular patients. My clinical focus is on orthopedics, extremities and spine, and post-operative patients. The presenter has been an instructor in human anatomy as lab teaching assistant at the University of Alabama-Birmingham, and additionally as a clinical instructor having facilitated students at the University of Shenandoah. I have also been invited to present my theory report on lumbar spine pain at the Virginia Physical Therapy Association National Conference en-titled, “Addressing chronic non-specific low back pain by addressing the nervous system primarily is key in regards to helping patients reduce their pain, and requires further specific research.”

Target Audience: Physical Therapists, Physical Therapy Assistants
Instructional Level: Beginner/Intermediate
*Handouts available for downloading/printing to all courses.
This course is presented in an online video format with audio lecture for each slide. Approximate length to take the course, including audio lecture, videos and all written material, is 3 hours.

Take Course $49
30 Days Unlimited Access