Preventing Chronic Pain: A Human Systems Approach

About this course: Chronic pain is at epidemic levels and has become the highest-cost condition in health care. This course uses evidence-based science with creative and experiential learning to better understand chronic pain conditions and how they can be prevented through self-management in our cognitive, behavioral, physical, emotional, spiritual, social, and environmental realms. The goal of this course is to blend creative, experiential, and evidence-based teaching strategies to help participants understand chronic pain conditions and how a human systems approach can be applied to self-management strategies to reduce risk factors, enhance protective factors, and prevent chronic pain. There are four major objectives to the course; 1. Describe the prevalence, personal impact, and health care dilemma associated with chronic pain. 2. Recognize the clinical characteristics and underlying etiology of several common pain conditions and the peripheral, central, and genetic mechanisms of chronic pain 3. Based on the literature associated with risk and protective factors in the seven realms of our lives, learn specific strategies in each realm that can be employed daily to prevent chronic pain and enhance wellness. 4. Appreciate the value of a human systems approach to health care and how it can provide a basis for integrative, interdisciplinary, and individualized care to preventing pain and enhancing wellness. CONTINUING EDUCATION CREDIT OPTION Accreditation Statement: University of Minnesota, Interprofessional Continuing Education is accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. American Medical Association (AMA) The University of Minnesota, Interprofessional Continuing Education designates this enduring material for a maximum of 24.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. American Nurses Credentialing Center (ANCC) This activity is awarded up to 24.0 ANCC contact hours. Other Health Care Professionals Other health care professionals who participate in this CE activity may submit this certificate statement of participation to their appropriate accrediting organizations or state boards for consideration of credit. The participant is responsible for determining whether this activity meets the requirements for acceptable continuing education. Registration and disclosure information is available here at http://z.umn.edu/chronicpain and pay the additional fee. Then, email your Coursera certificate statement of completion to cme@umn.edu.

Created by:  University of Minnesota

• Taught by:  Dr. James Fricton, DDS, MS, Professor and Pain Specialist

  University of Minnesota, HealthPartners Institute, and Minnesota Head and Neck Pain Clinic

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University of Minnesota The University of Minnesota is among the largest public research universities in the country, offering undergraduate, graduate, and professional students a multitude of opportunities for study and research. Located at the heart of one of the nation’s most vibrant, diverse metropolitan communities, students on the campuses in Minneapolis and St. Paul benefit from extensive partnerships with world-renowned health centers, international corporations, government agencies, and arts, nonprofit, and public service organizations.

Syllabus


WEEK 1


Introduction to the Course (Week 1)



In this first module, we will introduce you to the course and present an overview of the topics to be discussed and format of the course. We will also present information about receiving Continuing Education, joining the International Myopain Society, and supporting the Campaign for Preventing Chronic Pain


9 videos, 6 readings expand

1. Reading: Weekly Overview
2. Reading: Getting Started
3. Reading: Syllabus
4. Reading: Paper on Preventing Chronic Pain: The MOOC
5. Reading: Meet the Faculty
6. Video: Promo Video for the Course
7. Video: Course Overview (v2)
8. Video: Introduction to the Last Scroll (v2)
9. Video: International Myopain Society Introduction
10. Video: The Campaign for Preventing Pain and Addiction
11. Discussion Prompt: Discussion: Introduce Yourself
12. Video: 1 The Prevalence of Chronic Pain
13. Video: 2 The Health Care Dilemma that Chronic Pain Poses
14. Video: 3 A New Paradigm
15. Video: Preface to The Last Scroll (v2)
16. Discussion Prompt: Discussion: Barriers to dealing with chronic pain
17. Reading: Outline of The Dilemma of Chronic Pain

Graded: Module Quiz: Health Care Dilemma

WEEK 2


The Problem of Chronic Pain (Week 2)



16 videos, 3 readings expand

1. Reading: Weekly Overview
2. Reading: Outline:The Personal Impact of Chronic Pain
3. Video: 1 Assessment of Pain using a Transformative Care Model
4. Video: 2 Characteristics of a Pain Evaluation
5. Video: 3 Patient Interviews
6. Video: 4 Assess Your Seven Realms
7. Video: Last Scroll: The Nightmare from The Last Scroll
8. Video: Patient Interview 1: Angie
9. Video: Patient Interview 2: Bernie
10. Video: Patient Interview 3: Lorrie
11. Video: Patient Interview 4 : Chantelle
12. Video: Patient Interview 5: Lydia
13. Discussion Prompt: Discussion: Personal Impact
14. Reading: Outline: The Balance between Health and Illness
15. Video: 1 The Biomedical Model versus a Human Systems Approach
16. Video: 2 Holistic complexity: "The whole is greater than the sum of its parts"
17. Video: 3 Chaos Theory: Small changes, big impact
18. Video: 4 How do you want to be?
19. Video: Cybernetics: the cycles of our lives
20. Video: Last Scroll: Balance in the Seven Realms v2
21. Discussion Prompt: Discussion: Human Systems, cybernetics, and chaos theory

Graded: Module Quiz: Personal Impact of Chronic Pain
Graded: Module Quiz: The Balance Between Health and Illness

WEEK 3


Common Pain Conditions and their Mechanisms (Week 3)



14 videos, 3 readings expand

1. Reading: Weekly Overview
2. Reading: Outline: Myofascial Pain
3. Video: 1 Myofascial Pain: Clinical characteristics
4. Video: 2 Myofascial Pain: Causes
5. Video: 3 Myofascial Pain: Perpetuating factors
6. Video: 4 Myofascial Pain: Trigger point examination
7. Video: 5 Myofascial Pain: Management strategies
8. Video: Clinic Trigger Points Demo
9. Video: Last Scroll: The Rule of Moderation v3
10. Discussion Prompt: Discussion: Trigger Points
11. Reading: Handout: TMD and Orofacial Pain
12. Video: 1 The Impact
13. Video: 2 Common Orofacial Disorders
14. Video: 3 Temporomandibular Disorder
15. Video: 4 Risk and Protective Factors
16. Video: 5 Treatment of TMD
17. Video: 6 Prevention of TMD
18. Video: Last Scroll: Rule of Being: Virtues, Vices, and Energy v2l
19. Discussion Prompt: Discussion: Temporomandibular and Orofacial Pain

Graded: Module Quiz: Myofascial Pain
Graded: Module Quiz: TMD and Orofacial Pain

WEEK 4


Common Pain Conditions and their Mechanisms (Week 4)



16 videos, 3 readings expand

1. Reading: Weekly Overview
2. Reading: Handouts for Headache
3. Video: 1 What You Can Do to Prevent Headaches: An introduction
4. Video: 2 Understanding Your Headache
5. Video: 3 Headache Diagnosis
6. Video: 4 Headache Triggers and Contributing Factors
7. Video: 5 What About Muscle Dysfunction?
8. Video: 6 Transformation of Episodic to Chronic Heachache
9. Video: 7 Managing Headaches: An individualized treatment plan
10. Video: 8 Treatment Planning: Simple to complex
11. Video: Last Scroll: The Vacation v2
12. Discussion Prompt: Discussion Question: Headache
13. Reading: Handout: New Developments in the Management of Fibromyalgia Syndrome
14. Video: 1 Presentation
15. Video: 2 Diagnosis
16. Video: 3 Severity
17. Video: 4 Misconceptions
18. Video: 5 Medication Management (1:02:57)
19. Video: 6 Lifestyle Management
20. Video: Last Scroll: The Rule of Gatherings
21. Discussion Prompt: Discussion: Fibromyalgia

Graded: Module Quiz: Headache
Graded: Module Quiz: Fibromyalgia

WEEK 5


Common Pain Conditions and their Mechanisms (Week 5)



11 videos, 2 readings expand

1. Reading: Weekly Overview
2. Reading: Handout on Arthritis
3. Video: 1 Arthritis: Understanding and expectations
4. Video: 2 Arthritis: Risk and protective factors
5. Video: 3 Strategies to Manage Arthritis Pain
6. Video: 4 Screening for Functional Mobility
7. Video: Last Scroll: The Attraction v2
8. Discussion Prompt: Discussion: Barriers to recovery
9. Video: 1 Chronic Pain Scope and Nature of the Problem
10. Video: 2 Peripheral and Central Neural Mechanisms of Pain
11. Video: 3 Molecular Pathways of Persistent Pain
12. Video: 4 The Overlapping Features of Chronic Pain Conditions
13. Video: 5 Personalized Care for Chronic Pain
14. Video: Last Scroll: The Human Spirit v2
15. Discussion Prompt: Discussion: Chronic pain mechanisms

Graded: Module Quiz: Arthritis
Graded: Module Quiz: Chronic Pain Mechanisms

WEEK 6


Risk and Protective Factors in the Seven Realms (Week 6)



13 videos, 3 readings expand

1. Reading: Weekly Overview
2. Reading: Handouts on the Body
3. Video: 1 Musculoskeletal Pain Mechanisms
4. Video: 2 Repetitive Strain
5. Video: 3 Postural Strain
6. Video: 4 Exercise
7. Video: 5 Preventing Injury
8. Video: Clinic Demo: Exercises
9. Video: Clinic Demo: Stretching
10. Video: Last Scroll: The Blessing of Health
11. Discussion Prompt: Discussion: Exercise, posture, and reducing strain
12. Reading: Outline for The Mind
13. Video: 1 The Cognitive Dimension of The Pain Experience: Understanding and expectation
14. Video: 2 Self-efficacy and Self-management
15. Video: 3 Resilience and Adaptation to Change
16. Video: 4 Embracing Change: Improving resilience
17. Video: Last Scroll: Energy Thieves v2
18. Discussion Prompt: Self-efficacy

Graded: Module Quiz: Body
Graded: Module Quiz: The Mind: The Cognitive Dimension

WEEK 7


Risk and Protective Factors in the Seven Realms (Week 7)



12 videos, 3 readings expand

1. Reading: Weekly Overview
2. Reading: Handouts for Society and Pain
3. Video: 1 The Cycles of the Social Lives We Live
4. Video: 2 Neuroplasticity: Mechanisms for Social Risk
5. Video: 3 Abuse, Conflict, and Social Stressors: Inner Conflict and Pain
6. Video: 4 Post-Traumatic Stress (PTSD) and Chronic Pain
7. Video: 5 Occupational Stress, Secondary Gain, Disability and Chronic Pain
8. Video: 6 Social Support and Positive Relationships: Protective Factors
9. Video: Last Scroll: The Conflict
10. Discussion Prompt: Discussion: Social support and pain
11. Reading: Handouts for Emotions and Pain
12. Video: 1 Negative Emotions are Risk Factors for Chronic Pain
13. Video: 2 Protective Factors: Managing negative emotions and harnessing positive psychology for healing
14. Video: 3 Self-management of Chronic and Daily Emotional Challenges for Physical Relief
15. Video: 4 Experiential Exercises for Self Regulation
16. Video: Last Scroll: Emotion and Fear v2
17. Discussion Prompt: Positive Psychology: Applied

Graded: Module Quiz: Society
Graded: Module Quiz: Emotional Challenges

WEEK 8


Risk and Protective Factors in the Seven Realms (Week 8)



16 videos, 3 readings expand

1. Reading: Weekly Overview
2. Reading: Handout: Lifestyles and Pain
3. Video: 1 The Lifestyle Treadmill
4. Video: 2 Sleep and Chronic Pain
5. Video: 3 Diet and Chronic Pain
6. Video: 4 Obesity, Eating Disorders, and Chronic Pain
7. Video: 5 Chemicals: Medication, Smoking, Alcohol and Recreational Drug Use
8. Video: 6 Daily routines (Activity Level, Balance, Pacing, Timing, and Variation)
9. Video: Video Exercise: Guided Relaxation
10. Video: Last Scroll: Prosperity v2
11. Discussion Prompt: Discussion: Lifestyle Improvements
12. Reading: Handout: Environment and Pain
13. Video: 1 Environmental Risks and their Impact on Chronic Pain
14. Video: 2 Motor Vehicle Accidents and Chronic Pain
15. Video: 3 Personal Accidents and Chronic Pain
16. Video: 4 Medical and Dental Treatment Risks and Chronic Pain
17. Video: 5 Infection Risk: Staying Clean, Infection Free, and Healthy
18. Video: 6 Pollution: Air, Noise, Vibration, and Weather
19. Video: 7 Protect Yourself: Environmental Changes to Prevent Chronic Pain
20. Video: Last Scroll: The Festival v2
21. Discussion Prompt: Discussion: Environmental Circumstances

Graded: Module Quiz: The Lifestyle Realm
Graded: Module Quiz: The Environment

WEEK 9


Risk and Protective Factors in the Seven Realms (Week 9)



13 videos, 3 readings expand

1. Reading: Weekly Overview
2. Reading: Handout: Spirit and Pain
3. Video: 1 Restoring Wellbeing: The Roles of Hope and Purpose in Recovering from Chronic Pain
4. Video: 2 The Perils of Perception: The Effects of Stress on Mind, Body, and Emotions
5. Video: 3 Coming Back to Yourself: The Efficacy of Compassion and Mindfulness
6. Video: 4 Exercises: Breathing, Relaxation, and Mindfulness Meditation
7. Video: Last Scroll: The Blessing of Love v2 Last
8. Discussion Prompt: Discussion: Effects of Stress
9. Reading: Handout: The Patient's Story
10. Video: 1 Outcome Present State Test (OPT) Model
11. Video: 2 Knowledge Representation and Framing
12. Video: 3 Clinical Reasoning Web
13. Video: 4 Listening and Understanding People's Stories
14. Video: 5 Creating and Activating Clinical Reasoning Dynamics
15. Video: 6 The Complementary Nature of Problems and Outcomes
16. Video: 7 The Four Cs of Clinical Judgment
17. Video: Last Scroll: The Leaning Tower and Fear v2
18. Discussion Prompt: Understanding the patient's story

Graded: Module Quiz: Spirit: Gaining insight, hope, and purpose
Graded: Module Quiz: The Patient's Story

WEEK 10


Implementing Transformative Care (Week 10)



20 videos, 4 readings expand

1. Reading: Weekly Overview
2. Reading: Handout: Implementing Transformative Care
3. Video: 1 Addressing Issues the with our Current Health Care System
4. Video: 2 Implementing Transformative Care: The Case of Mona Lisa
5. Video: 3 What Interventions Work for Chronic Pain?
6. Video: 4 What about Opioids to Prevent Chronic Pain?
7. Video: 5 What about Surgery to Prevent Chronic Pain?
8. Video: 6 Developing a Transformative Treatment Plan
9. Video: 7 Take-home Messages about Chronic Pain
10. Video: Last Scroll: Energy of the 7 Realms v2
11. Video: Transformative Care: Patient Interview 1: Janet
12. Video: Transformative Care: Patient Interview 2: Brianna
13. Discussion Prompt: Discussion: Transformative Care
14. Video: 1 Provider Interview: Dr. Karen Lawson
15. Video: 2 Provider Interview: Dr. Miles Belgrade
16. Video: 3 Provider Interview: Dr. Stefan Friedrichsdorf
17. Video: 4 Provider Interview: Dr. Mary Jo Kreitzer
18. Video: 5 Provider Interview: Dr. Matt Monsein
19. Video: 6 Provider Interview: Dr. Bill Manahan
20. Reading: Handout: Improving the health care system
21. Video: 1 Why improve our health care system?
22. Video: 2 Barriers to improving health care
23. Video: 3 Transforming our health care system
24. Video: 4 Who can improve the health care system?
25. Discussion Prompt: Discussion: Changing Health Care
26. Reading: Course Evaluation

Graded: Module Quiz: Transformative Health Care