Reign of Pain from Coursera

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Syllabus

Understanding pain

Welcome to Module 1, "The Reign of Pain Lies Mainly in the Brain: Applying New Concepts in Neuroscience to Chronic Painful Conditions," presented by Howard Schubiner, MD. Throughout this course, our primary objectives are to expand your understanding of pain, particularly chronic pain, and its connection to the brain. Our exploration begins with "The Experience of Pain," where we delve into the profound aspects of pain, including its reality, intensity, and its relationship with injuries. We'll also examine historical data from the Beecher study to broaden our perspective. In "How the Brain Works: Predictive Processing," we'll uncover the brain's role in shaping our sensory experiences, from sight and sound to touch. We'll explore how the brain anticipates and reacts to our environment, sometimes sacrificing accuracy for efficiency. Lastly, in "What is Pain?" we'll delve into the necessity of pain as a protective mechanism, its brain-generated nature, and its role as an alarm system. We'll consider how the brain can produce a range of symptoms, even in response to non-physical threats.Throughout these modules, you'll engage in quizzes, reflective exercises, and readings, fostering a comprehensive understanding of the brain's influence on pain. So, let's embark on this enlightening journey into the intriguing world of pain and neuroscience. "The reign of pain lies mainly in the brain: Applying new concepts in neuroscience to chronic painful conditions." –Howard Schubiner, MD March, 2023.

Stress and emotions can cause pain

Welcome to Module 2, "Stress and Emotions Can Cause Pain," where we explore the intriguing interplay between stress, emotions, and pain perception. In this module, our objectives are to understand how the brain determines pain occurrence, recognize the role of stress and emotions as pain triggers, define neural circuits in pain perception, and describe how the brain activates and deactivates these circuits. Through the engaging video "Understanding Pain in Three Stories," we examine narratives ranging from painless injuries to emotional triggers, backed by studies like Kross and Eisenberger. In "How the Brain Learns Pain," we delve into neural circuits' role in learning and their potential for triggering and extinguishing pain. Join us in unraveling the complexities of pain in Module 2.

What causes chronic pain?

Welcome to Module 3, "What Causes Chronic Pain?" In this module, we delve into the origins of chronic pain, exploring the critical role played by neural circuits, emotions, and our reactions in its development. Our objectives include recognizing how the brain learns and perpetuates pain, understanding the persistence of neural circuits in chronic pain, and identifying the influence of emotions and reactions. In "Part One: Reinforced Neural Circuits after an Injury," we analyze the story of Lorimer Moseley's snakebite and the factors contributing to the enduring pain, such as stress, fear, and the "six Fs." We emphasize that while injuries heal, neural circuit conditions can persist, lasting for extended periods. In "Part Two: Linkage of Emotions to Pain in Absence of an Injury," we explore how stress and emotions can give rise to pain, linking feelings to physical symptoms and highlighting the emotional triggers underlying pain. Join us in unraveling the complexities of chronic pain's origins in Module 3.

Conditions that can be nociplastic

Welcome to Module 4, "Conditions That Can Be Nociplastic," where we delve into the concept of symptoms with symbolic origins and explore the mechanisms for understanding pain's location. Our objectives include recognizing the symbolic nature of specific symptoms, identifying common nociplastic syndromes, and understanding that imaging studies can reveal conditions like arthritis without accompanying pain. In Video One, we examine illustrative stories of chronic pain, highlighting the role of emotions and past experiences. The quiz challenges assumptions, and an exercise prompts reflection on trauma and chronic pain in individuals. In Video Two, we explore various pain syndromes, distinguishing primary from secondary causes. The quiz tests knowledge of pain syndromes, and an exercise encourages reflection on someone's diagnosis. Join us in demystifying nociplastic conditions in Module 4.

How does a doctor assess for neural circuit disorders?

Welcome to Module 5, "How Does a Doctor Assess for Neural Circuit Disorders?" In this module, our objectives include recognizing how doctors can rule out structural conditions, as well as identifying ways to rule in a nociplastic condition using both circumstantial and confirmatory evidence. In Video One, "Ruling Out a Structural Problem," we emphasize the importance of thorough medical history, physical examinations, and testing to detect significant structural disorders while avoiding overdiagnosis based on common abnormalities in normal individuals. In Video Two, "Ruling In a NC Disorder—Circumstantial Evidence," we explore additional data beyond traditional medical assessments, such as body maps, associated conditions, and links to stressful life situations. Video Three, "Ruling In a NC Disorder—Confirmatory Evidence," introduces the FIT criteria (Functional, Inconsistent, Triggered) as confirmatory "tests" for identifying neural circuit or mind-body conditions. Quizzes and exercises provide opportunities for reflection, and readings offer further insights into this diagnostic approach. Join us in understanding the assessment of neural circuit disorders in Module 5.

Treatment of chronic painful conditions

Welcome to Module 6, "Treatment of Chronic Painful Conditions." In this module, we'll explore current methods of coping with chronic pain and why they have limitations. We'll also delve into emerging models of treatment that offer more effective approaches. Our objectives include identifying common current treatments, such as opioids, injections, surgery, and psychological therapies, and discussing their effectiveness and limitations. We'll then introduce two promising therapies: Pain Reprocessing Therapy (PRT) and Emotional Awareness and Expression Therapy (EAET). PRT involves careful assessment, education about pain, and exercises to calm the brain's danger signal, while EAET focuses on understanding the role of emotions in pain, identifying and expressing suppressed emotions, and promoting self-compassion. Through quizzes, exercises, and readings, we'll reflect on the various treatment options and their potential impact on chronic pain management. Join us in Module 6 to explore these innovative approaches to chronic pain treatment.

Conclusions: Associated conditions and resources

Welcome to Module 7, "Conclusions: Associated Conditions and Resources." In this final module, we'll expand our understanding of this model's applicability to various other conditions beyond chronic pain, including fatigue, insomnia, POTS, tinnitus, anxiety, depression, and more. Our objectives include recognizing the broad range of conditions this model can apply to and identifying valuable resources for individuals dealing with chronic pain and associated conditions. We'll emphasize the importance of cautious assessment to rule out structural conditions and explore resources like PPDA, TMS wiki, and books for both patients and professionals. As we conclude this course, we'll reflect on the knowledge gained, its practical implications, and the hope it can provide for those facing chronic pain and related challenges.

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Explores the brain's role in pain perception and management, which is highly relevant to understanding chronic pain conditions

Emphasizes the connection between neural circuits, emotions, and pain

Provides practical knowledge and strategies for addressing chronic pain, which can be helpful for individuals seeking relief

Taught by Howard Schubiner, MD, who is a renowned expert in chronic pain management

Covers topics that are relevant to healthcare professionals, such as pain assessment, diagnosis, and treatment

The course title accurately reflects the content and objectives, which can be helpful for learners who are looking for specific information about chronic pain

Activities

Be better prepared before your course. Deepen your understanding during and after it. Supplement your coursework and achieve mastery of the topics covered in Reign of Pain with these activities:

Watch a video tutorial on pain reprocessing therapy

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Watching a video tutorial on pain reprocessing therapy will introduce you to a promising new approach to treating chronic pain.

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Search for a reputable video tutorial on pain reprocessing therapy
Watch the video and take notes on the key concepts
Discuss the video with a friend or colleague

Review your knowledge of pharmacology

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Reviewing your knowledge of pharmacology will help you better understand the role of medications in chronic pain management.

Browse courses on Pharmacology

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Use a medical textbook or online resources to review the principles of pharmacology
Focus on the pharmacology of pain medications
Identify the different classes of pain medications and their mechanisms of action

Review anatomy of the nervous system

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Reviewing the anatomy of the nervous system will build a stronger foundation for understanding the role of neural circuits in chronic pain.

Browse courses on Neural Circuits

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Use a medical textbook or online resources to review the structure and function of the nervous system
Focus on the anatomy of the spinal cord, brain, and peripheral nerves
Identify the major divisions of the nervous system and their functions

Five other activities

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Complete a pain assessment

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Completing pain assessments will help you develop the skills necessary to accurately assess and diagnose chronic pain conditions.

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Review the principles of pain assessment
Use a pain assessment tool to practice assessing patients
Compare your assessments with those of experienced clinicians

Attend a support group for individuals with chronic pain

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Attending a support group will provide you with an opportunity to connect with others who are experiencing similar challenges and learn from their experiences.

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Find a local support group for individuals with chronic pain
Attend the group regularly
Participate in discussions and share your own experiences

The Body Keeps the Score

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This book provides insights into the connection between trauma, stress, and chronic pain.

View The Body Keeps the Score: Brain, Mind, and Body... on Amazon

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Read the book and take notes on the key concepts
Discuss the book with a friend or colleague
Apply the principles of the book to your own experiences

Develop a patient education sheet on chronic pain management

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Creating a patient education sheet will help you synthesize your knowledge of chronic pain management and communicate it effectively to patients.

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Gather information on chronic pain management from reliable sources
Organize the information into a logical and easy-to-understand format
Write the patient education sheet in clear and concise language

Develop a personalized pain management plan

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Developing a personalized pain management plan will give you the opportunity to apply your knowledge and skills to your own life and improve your own health and well-being.

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Set specific goals for your pain management plan
Identify the different strategies that you will use to achieve your goals
Create a schedule for implementing your plan
Track your progress and make adjustments as needed
Evaluate the effectiveness of your plan and make changes as needed

Career center

Learners who complete Reign of Pain will develop knowledge and skills that may be useful to these careers:

Neuroscientist

A Neuroscientist studies the nervous system, focusing on the brain and spinal cord, and how they control thoughts, behaviors, and emotions. Neuroscientists may conduct research to better understand the brain or work in clinical settings to diagnose and treat disorders of the nervous system. A course on Reign of Pain can be helpful to someone in this career because it provides a comprehensive understanding of the brain, how it works, and how it connects to the rest of the body and outside forces.

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Medical Doctor

Medical Doctors diagnose and treat disease and injuries and develop treatment plans for patients. While Medical Doctors generally specialize in a specific medical area, the knowledge of a variety of medical conditions is crucial. A course on Reign of Pain can help Medical Doctors broaden their medical understanding and better understand conditions that other specialists treat, like Neurologists and Pain Physicians.

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Medical Writer

A Medical Writer creates written content for a variety of audiences, including healthcare professionals and patients. They may write about new medical discoveries, clinical trials, and new treatments. A course on Reign of Pain can provide a Medical Writer with a better understanding of the scientific research behind the latest pain management treatments, which can help them to write more informative and engaging content.

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Clinical Psychologist

Clinical Psychologists treat mental, emotional, and behavioral disorders and help patients understand how their thoughts, feelings, and behaviors affect their physical and mental health. Understanding the mind-body connection is essential for a Clinical Psychologist, and a course on Reign of Pain may help them better understand the neural network connections between thoughts, feelings, and behavior.

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Neurologist

A Neurologist studies the brain and nervous system and focuses on preventing, diagnosing, and treating disorders that affect the nervous system, including the brain, spinal cord, nerves, and muscles. Disorders that a Neurologist typically treats include seizures, strokes, and multiple sclerosis, among others. Thorough understanding of the brain and nervous system is essential for success in this career field. Knowledge gained from a course on Reign of Pain can provide a better understanding of how different parts of the brain work and how that relates to neurological pain.

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Nurse

A Nurse provides care to patients in a variety of settings, including hospitals, clinics, and long-term care facilities. A Nurse helps patients manage their illnesses and injuries and provides emotional support to patients and their families. A course on Reign of Pain can be helpful for a Nurse as it can help them better understand the pain their patients are experiencing and develop more effective ways to manage their pain.

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Pain Physician

A Pain Physician is responsible for managing pain through therapies, medication, and interventional procedures. This role is highly specialized, and the work can be challenging and complex. A course on Reign of Pain can help future Pain Physicians understand the underlying mechanisms of pain and how pain is perceived and processed by the brain. This is especially important in cases where the underlying cause of a patient’s pain cannot be easily diagnosed, requiring more sophisticated interventions.

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Massage Therapist

A Massage Therapist uses massage to manipulate the soft tissues of the body to promote relaxation and relieve pain. Understanding the underlying mechanisms of pain is essential for a Massage Therapist to perform their job effectively. A course on Reign of Pain can help a Massage Therapist better understand how the body responds to pain and how to use massage as a treatment.

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Physical Therapist

A Physical Therapist helps patients restore movement and function after an injury or illness. They may use a variety of techniques, including exercise, massage, and electrical stimulation. A course on Reign of Pain can help a Physical Therapist better understand the underlying mechanisms of pain and how to develop more effective treatment plans for their patients.

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Occupational Therapist

An Occupational Therapist helps patients improve their ability to perform everyday activities and tasks. This may involve teaching patients new ways to do things, providing them with adaptive equipment, or helping them to develop coping mechanisms for pain. A course on Reign of Pain can help an Occupational Therapist better understand the challenges faced by patients with chronic pain and develop more effective strategies for helping them.

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Chiropractor

A Chiropractor is a healthcare professional who diagnoses and treats neuromusculoskeletal conditions that affect the nervous system and the musculoskeletal system. They use spinal adjustments and other manual therapies to improve function and reduce pain. A course on Reign of Pain can be helpful for a Chiropractor as it can help them better understand the underlying mechanisms of pain and how to treat it through manual interventions.

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Data Scientist

A Data Scientist collects, analyzes, and interprets data and uses their findings to answer questions and solve problems. While Data Science can be applied across a wide variety of fields, one in particular is the field of healthcare. A course on Reign of Pain can be beneficial for Data Scientists in the healthcare sector as it can help them better understand the data they’re analyzing and identify trends that could have otherwise been overlooked.

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Yoga Instructor

A Yoga Instructor teaches yoga poses and breathing techniques to students. Yoga is often used as a form of exercise and stress relief, but it can also be used to manage pain. A course on Reign of Pain can help a Yoga Instructor better understand the mechanisms of pain and how yoga can be used to relieve it.

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Pharmaceutical Sales Representative

A Pharmaceutical Sales Representative promotes and sells pharmaceutical products and services to healthcare professionals, including physicians, nurses, and pharmacists. To succeed in this role, a deep understanding of the drugs being sold is essential. A course on Reign of Pain can help a Pharmaceutical Sales Representative better understand the medications they sell and how they affect the nervous system and how pain is perceived.

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Pharmacist

A Pharmacist dispenses prescribed medications and provides information on drug interactions, side effects, and proper usage. They also provide support and advice on managing medications and improving overall health and wellness. A course on Reign of Pain can be useful for a Pharmacist as it can help them better understand the medications they dispense and how they affect the nervous system and how pain is perceived.

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