This course is available as a standalone CE course or as an elective for our new Advanced Practice Certification.

With the advent of neuroscience exploring issues associated with neuroplasticity, it has become increasingly clear that in a certain patient population, physical touch and movement, essential for recovery, could actually pose a threat. It has been suggested that the pinnacle of this clinical scenario occur in complex regional syndrome (CRPS), or the previously named reflex sympathetic dystrophy (RSD). With persistent input to the central nervous system and brain, various long-lasting changes occur including cell death, change in brain maps of the body, neurotransmitters, receptors and various pathways associated with pain. These changes manifest themselves with clinical issues such as neglect, allodynia, hyperalgesia, mirror pains, spreading pain, widespread sensitization and problems with laterality recognition. Physical testing of patients with pathological changes in their mapping will include two-point discrimination, pressure-pain threshold testing, nerve palpation, localization, graphesthesia, neurodynamics, laterality and mapping of body parts. The same neuroplastic events associated with pain, however, produce unique avenues to treat patients often too sensitive for physical movement. The brain’s perception of threat can be altered with cognitions (pain neuroscience education), but also via other senses, directly aiming at the faulty mapping of the brain in pain. Treatments discussed will include graded motor imagery, sensory discrimination, mirror therapy, graphesthesia and neuroscience education.

Course Outcomes