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Assessment of pain mechanisms

Treatments for persistent pain have a clinically significant effectiveness in a minority of patients. It has been suggested that one of the causes may be a poor classification of pain, based solely on signs and symptoms or on a diagnostic label based on a structural pathology. Diagnostic labels, although they may be useful, provide little information on the underlying mechanisms of pain. Because both physical treatments such as exercise or manual therapy, such as pharmacological ones, have an effect on the mechanisms, an assessment of them becomes necessary. This assessment has been used in research through the so-called Quantitative Sensory Testing (QST). The QST consists in the systematized application of a series of stimuli on the person, and the subsequent measurement of the sensory response. The QST has shown that it can offer reliable, repeatable and diagnostic useful assessment protocols with some of its modalities, providing information on the gain or loss of function of the sensory system and more specifically, of the nociceptive system and pain. Although the use of clinical QST is controversial due to the variable reliability in this area and a high cost apparatus, knowing simple and low cost ways to assess the mechanisms of pain, can provide the clinician with useful resources. In addition, it can open a window to clinical practice in which the mechanisms of pain are assessed and integrated into the assessment and treatment of patients with pain. In this workshop, you will learn the basis for assessing these mechanisms.

Víctor Doménech

  • Víctor Doménech has a Diploma in Physiotherapy from the University of Zaragoza in 2008.
  • Master in Research in Primary Care and Master in Orthopedic Manual Therapy.
  • He is a member of the Spanish Association of Physiotherapy and Pain (SEFID) and a member of the Spanish Society of Pain (SED).
  • He currently combines teaching on assessment and treatment of musculoskeletal pain at San Jorge University with the clinic, where he treats patients with musculoskeletal pain from the framework of the biopsychosocial model since 2008.
  • In addition, he develops his research work in the iPhysio group of the University of St. George and the Center for Neuroplasticity and Pain of the University of Aalborg (Denmark), where he investigates the mechanisms of musculoskeletal pain.
  • He has published articles on the assessment of pain mechanisms after injury in international journals with a high impact factor and made papers at international conferences.
  • In addition, it has received research funding and participates in development projects financed through public calls.

Víctor Doménech

  • Víctor Doménech has a Diploma in Physiotherapy from the University of Zaragoza in 2008.
  • Master in Research in Primary Care and Master in Orthopedic Manual Therapy.
  • He is a member of the Spanish Association of Physiotherapy and Pain (SEFID) and a member of the Spanish Society of Pain (SED).
  • He currently combines teaching on assessment and treatment of musculoskeletal pain at San Jorge University with the clinic, where he treats patients with musculoskeletal pain from the framework of the biopsychosocial model since 2008.
  • In addition, he develops his research work in the iPhysio group of the University of St. George and the Center for Neuroplasticity and Pain of the University of Aalborg (Denmark), where he investigates the mechanisms of musculoskeletal pain.
  • He has published articles on the assessment of pain mechanisms after injury in international journals with a high impact factor and made papers at international conferences.
  • In addition, it has received research funding and participates in development projects financed through public calls.

Assessment of pain mechanisms

Treatments for persistent pain have a clinically significant effectiveness in a minority of patients. It has been suggested that one of the causes may be a poor classification of pain, based solely on signs and symptoms or on a diagnostic label based on a structural pathology. Diagnostic labels, although they may be useful, provide little information on the underlying mechanisms of pain. Because both physical treatments such as exercise or manual therapy, such as pharmacological ones, have an effect on the mechanisms, an assessment of them becomes necessary. This assessment has been used in research through the so-called Quantitative Sensory Testing (QST). The QST consists in the systematized application of a series of stimuli on the person, and the subsequent measurement of the sensory response. The QST has shown that it can offer reliable, repeatable and diagnostic useful assessment protocols with some of its modalities, providing information on the gain or loss of function of the sensory system and more specifically, of the nociceptive system and pain. Although the use of clinical QST is controversial due to the variable reliability in this area and a high cost apparatus, knowing simple and low cost ways to assess the mechanisms of pain, can provide the clinician with useful resources. In addition, it can open a window to clinical practice in which the mechanisms of pain are assessed and integrated into the assessment and treatment of patients with pain. In this workshop, you will learn the basis for assessing these mechanisms.