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

Surgery in the US is ever-increasing. Outcome data indicates nearly 40% of patients have persistent pain and disability following lumbar surgery, while 20% of patients with total knee arthroplasty (TKA) suffer similarly with persistent pain. Postoperative rehabilitation has shown little efficacy in decreasing postoperative pain and disability and it has been shown that patients are not readily sent to physical therapy after lumbar surgery, but the trend is also now trending in TKA. Preoperative education has shown some effect in altering anxiety, stress and fear associated with surgery. Recent research in complex, non-surgical musculoskeletal pain has shown evidence for pain neuroscience education (PNE). PNE aims to help patients develop a greater understanding of their pain, the biology behind their pain and how pain is processed. A newly designed preoperative neuroscience education program by physical therapists has recently been developed and tested with lumbar surgery, TKA and shoulder surgery. Testing of the preoperative PNE program has shown immediate post-education improvements in fear-avoidance, pain catastrophization, pain knowledge, beliefs and expectations for the surgery, physical movements and reduction of brain activity associated with painful tasks. Upon completion of various randomized clinical trials, the physical therapy led preoperative PNE program has shown superior outcomes pertaining to patient satisfaction, but more importantly healthcare utilization for persistent pain at 1 and 3 years after surgery, with an average cost savings of over 30%. This lecture aim to introduce attendees to the development of the preoperative PNE program for spine surgery, TKA and shoulder surgery, the content and delivery methods, results and overall clinical application.

Course Outcomes