Wellward Way Conference

Outline: Pain Management was founded on a false promise of pain-free damage and degeneration. The outcome of this has been siloes of healthcare that have failed to integrate the complexity of orthopedic and neurologic problems. With a few simple gaps, physical therapy and rehabilitative services have had a more complete picture of healing degenerative and chronic pain than most fields of conventional medicine. This talk will highlight those gaps and introduce a model of care that augments Physical Therapy outcomes thereby preventing exposure to opioids and reducing reliance on surgery.

Time: 45 minutes

Objectives:

• Attendees will understand current shortcomings in the healthcare system management of chronic pain
• Attendees will be able to identify gaps in healthcare management that have led to failures in chronic pain management
• Attendees will be able to identify situations in which a bridge between pain management, regenerative medicine, and skilled rehabilitation will optimal benefit the patient in a manner that exceeds the current healthcare model

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Outline: Regenerative Medicine is founded on the concept of tensegrity and integrative biomechanics of the body. This talk will explain the Tensegrity model and how small injuries accumulate over time to develop chronic, degenerative orthopedic problems. By looking upstream from the patient's presentation of chronic pain and understanding the root cause of what is typically seen as a degenerative process means that new treatment methods can be applied. These can leverage an multidisciplinary integrative approach that reverse degenerative problems and prevent them from occurring.

Time: 45 minutes

Objectives:

• Attendees will understand the concept of tensegrity in human movement
• Attendees will understand the links in biomechanics that allow optimal movement
• Attendees will better understand local failures in tissue and the effects on the biomechanics proximally and distally
• Attendees will be able to describe treatments to best manage the identified areas of biomechanical dysfunction

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Outline: The diagnosis of nonspecific low back is outdated and flawed. Adapting interventional pain management techniques and using his own back injury as a living laboratory, Dr. Danesh discusses a more thorough diagnostic process to understand the origins of low back pain from multiple different causes. Combining this diagnostic insight with Regenerative Medicine techniques can drastically reduce failed rehabilitation and help explain why treatments sometimes fail.

Time: 45 minutes

Objectives:

• Attendees will be able to verbalize the flaws associated with the non-specific term mechanical low back pain as a terminal diagnosis
• Attendees will better understand methods for better identifying pain generators in low back pain
• Attendees will better understand non-surgical treatment strategies that can be utilized with low back pain

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Outline: Traditional pain management often fails to treat the psychological impact of chronic, debilitating pain. Patients lose a sense of identity as pain cannibalizes their career, relationships, and an overall sense of purpose. This talk dissects the common pathways in which patients experience a loss of identity and yield psychological barriers such as catastrophizing mindset or hopelessness that hinder recovery.

Time: 45 minutes

Objectives:

• Attendees will understand the framework of the biopsychosocial model
• Attendees will understand the process of chronic pain and loss of personal identity
• Attendees will be able to identify a catastrophizing mindset in a patient
• Attendees will be understand treatment options for patients with mental health elements impacting their recovery

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Outline: Exercise and tissue loading has been shown to be effective in functional improvement for patients with tendon dysfunction.  Additionally, new literature has shown appropriate loading strategies have a regenerative effect on tissue. Patient selection, mechanism of action in loading, prescriptive guidance, and positions to optimally load common areas of tendinopathy will be discussed.

Time: 45 Minutes

Objectives:

• Attendees will be able to identify which patients will best benefit from loading strategies
• Attendees will understand the mechanisms of action in which load affects a change in tendon morphology
• Attendees will understand the concepts of stress shielding and stress relaxation
• Attendees will understand the concept of loading position of the outcome of a tendon

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