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Warning Signs and the Perception of Pain

presented by Adriaan Louw

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Disclosure Statement:

Financial: Adriaan Louw receives compensation from MedBridge for this course. There is no financial interest beyond the production of this course.


 Non-Financial: Adriaan Louw has no competing non-financial interests or relationships with regard to the content presented in this course.

Satisfactory completion requirements: All disciplines must complete learning assessments to be awarded credit, no minimum score required unless otherwise specified within the course.

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Pain is a normal part of human existence: Everyone experiences it, but not everyone experiences it in the same way. Cultural differences, upbringing and gender can play a role in how pain is perceived by patients. Clinicians need to understand how underlying psychosocial factors, poor coping mechanisms, and faulty perceptions about pain affect prognosis and treatment. This course will explore the bio-psycho-social aspects of pain, with particular attention given to the psychosocial aspects of pain. Getting a handle on pain peculiarities will equip therapists to point their treatment plans in a direction that fosters meaningful change in the lives of their patients.

Meet Your Instructor

Adriaan Louw, PT, PhD

Adriaan, co-founder and CEO of ISPI, earned both an undergraduate as well as a master’s degree in research and spinal surgery rehabilitation from the University of Stellenbosch in Cape Town, South Africa. He is a guest lecturer/adjunct faculty at Rockhurst University, St. Ambrose University, and the University of Nevada, Las Vegas. In addition, he maintains…

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Chapters & Learning Objectives

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1. Introduction

A patient’s perception of their pain is shaped largely by the information they are given from those to whom they turn for help. This chapter compares and contrasts two possible pain journeys for a patient upon experiencing low back pain. It illustrates the importance of minimizing threat early on in an encounter with the health care system.

2. Yellow Flags

Yellow flags provide a snapshot of risk factors for long term disability and work loss, but do not constitute a complete psychological assessment. This chapter will explore yellow flags and describe how they contribute to a patient’s perception of pain.

3. Perceptions

Bio-medical models of pain are pervasive in modern medicine, and as such, most people believe pain comes from their tissues. This perception causes them to seek treatment after treatment directed at their tissues, long after tissues have healed, and perpetuates an unrealistic “magic bullet” mentality. This chapter dispels the myth of long-standing pain living in tissue, and describes how pain is actually an output of the brain. Upon understanding this truth, clinicians and patients alike stand a far better chance of effectively treating longstanding pain.

4. Sex, Gender, and Pain

Men and women experience pain differently, and as such, treating men and women in pain will be different. This chapter will provide background information to help clinicians understand gender differences related to pain, including differences in brain imaging, hormones, gender roles, and cognitive/affective variables.

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