A World of Hurt: Central Nervous System Pain Mechanisms Patient Education & Exercise Prescriptions

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A World of Hurt: Central Nervous System Pain Mechanisms Patient Education & Exercise Prescriptions


DATE: NOV 9-10, 2019

This price includes the course text book: A World of Hurt: A Guide to Classifying Pain” and continental breakfast both days

CEU: 14.75



1121 4th St NW, Albuquerque, NM 87102

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This two-day course focuses information critical to the assessment and treatment of patients dominated by Central Nervous System (CNS) Pain Mechanisms.  The course will aid the sub grouping of CNS mechanisms into Central Sensitivity, Affective and Motor / Autonomic mechanisms. Incorporating the scientific literature and strategies for Cognitive Behavior Therapy (CBT), Acceptance and Commitment Therapy (ACT) and Motivational Interviewing (MI) approaches promoting when best utilized for each pain sub group.  This course will present specific patient motivational pain science education approaches, specific functional exercise prescriptions and CNS sensorimotor retraining. Outlining Chapter Six, Seven & Eight of “A World of Hurt:  A Guide to Classifying Pain”, pain clinicians will learn how to assess and classify CNS pain mechanisms including, Central Sensitivity, Affective and Motor / Autonomic utilizing psychometric measures, outcome measures, CNS sensory and motor evaluations. This course will focus on specific interventions of pain science patient education topics; patient readiness questionnaire, motivational interviewing strategies, graded exposure functional return and sensorimotor retraining for each CNS dominated pain mechanism. Video, paper cases and live patient demonstrations (when available) will aid application to each clinician’s practice by understanding the importance of the “words” and “moves” necessary to reverse CNS pain mechanisms.


Physical and Occupational Therapists, Chiropractors, Osteopaths, Physical Therapist Assistants, Occupational Therapy Assistants, Medical Doctors, Psychologists, Athletic Trainers, Massage Therapists, Personal Trainers and any other practitioners who are involved in treating musculoskeletal pain.


Upon completion of the course, participants will be able to apply the principles directly into their clinical practice. At the conclusion of this course, participants should be able to:

1)  Differentiate subjective and objective clinical characteristics for the CNS pain mechanisms: central sensitization, affective and motor/autonomic.

2)   Apply pain mechanism classification principles to CNS live, paper and video patient cases.

3)  Classify CNS pain mechanisms utilizing Yellow Flag Risk Form and prescribe individualized patient education and active care interventions.

4)  Administer and interpret patient rated psychometric outcome measures, readiness questionnaire for patient education.

5)  Communicate pain science education for all CNS pain mechanisms.

6)  Perform evaluation tests for motor/autonomic sensorimotor dysfunctions.


Course Instructors:

Annie O’Connor, MSPT, OCS, Cert. MDT is Chief Clinical Officer at the Shirley Ryan Ability Lab formerly known as the Rehabilitation Institute of Chicago. Annie has co-authored 2018, Pain Mechanism Classification Chapter, Rehabilitation of The Spine: A Patient Center Approach 3e, Liebenson C (ed). Wolters Kluwer Philadelphia publisher. She has co-authored 2017, Therapeutic Exercise Chapter, Orthopedic Knowledge Update Spine 5, American Academy for Orthopedic Surgeons publisher. This chapter specifically is dedicated to helping Medical Doctors understand pain mechanism classification and the importance in therapeutic exercise selection.  She has co-authored 2015 book “A World of Hurt: A Guide to Classifying Pain” and September 2016 Journal Article in JMMT “Validation of a pain mechanism classification system (PMCS) in physical therapy practice”. Both publications offer a research supported “paradigm shift” in managing Musculoskeletal Pain promoting effective and efficient outcomes with significant cost savings.  She is an Orthopedic Clinical Specialist (OCS) of the American Physical Therapy Association and has a Certification in Mechanical Diagnosis and Therapy in the McKenzie Method (Cert. MDT). She lectures nationally and internationally on musculoskeletal pain mechanism classification and intervention, neurodynamic evaluation and treatment, mechanical diagnosis and therapy of spine and extremities, kinetic chain evaluation, functional manual therapy and exercise prescription. She was instrumental in establishing the Pain Mechanism Classification System approach for musculoskeletal pain and neurological spasticity at the Shirley Ryan Ability Lab formerly known as the Rehabilitation Institute of Chicago. She is a member of American Physical Therapy Association in the orthopedic section and canine special interest group, the North American Spine Society (NASS), and McKenzie Institute. She continues to treat orthopedic, neurological patients, and canines with pain to achieve the best life possible.

Melissa Watson, MSPT, Cert. MDT received her Master’s in Physical Therapy and her Bachelor’s in Exercise Physiology from Ohio University. Melissa practices at the Shirley Ryan Ability Lab formerly known as the Rehabilitation Institute of Chicago Burr Ridge Outpatient Center with 16 years of clinical experience in neurological rehabilitation. Melissa has been helping to lead RIC’s Clinical Ladder Program where she mentors other clinicians on their professional and clinical development. She is a certified clinical instructor and consistently mentors clinicians and students in clinical practice. She is practicing clinically in the Day Rehabilitation setting with an interest in musculoskeletal pain and applying both pain classification and MDT principles within the neurological population for spasticity. She is currently leading a Day Rehab Pain Group Committee where she is mentoring other Day Rehab clinicians on running pain groups that are focusing on pain education and active care treatment for patients with centrally dominated pain throughout 6 sites of care and facilitating a standard for education through Inpatient clinicians. She certified in Mechanical Diagnosis and Treatment – McKenzie Method. She has been and instructor of the Pain Mechanism Classification System outlined in the book “A World of Hurt: A Guide to Classifying Pain” and uses both sub grouping methods exclusively in her neurological clinical practice to guide patient education and exercise prescription to facilitate functional return.