Why Don't More PTs Include Pain Science Education for Chronic Pain Patients – and How MDs Can Help?  (Part 1)

Traditional PT Training Primarily Focuses on Body Tissues, not the Neuro-immune System and Brain.

Most physical therapists view pain as a mechanical, body-tissue issue. This traditional approach, deeply rooted in PT training, revolves around the belief that pain indicates a weak, tight, injured muscle or joint that needs fixing, releasing, and adjusting unless there is an underlying disease like cancer. While effective for acute injuries, this approach falls short for most persistent pain conditions.

With persistent pain, the real issue isn't just in the body—it's how the nervous and immune systems process incoming danger signals and how the brain restructures to become overprotective.  Danger signals aren't just physical, emotional, psychological, and social factors can also trigger them.

If the brain continuously receives danger signals—whether from movement, stress or revisiting a past traumatic experience—it can keep pain dialed up, even when there's no actual tissue damage.

This information is a crucial part of pain neuroscience education (PNE). When MDs introduce this concept to their persistent pain patients, it can increase patient acceptance and support physical therapists' incorporation of PNE with their expert manual and movement therapies, further enhancing the healing process of chronic pain conditions.

💡 How MDs can help: " Your PT will teach you why the brain sends persistent pain and show you the skills to improve body movements and at-home strategies to reduce the sensitivity of the nervous system"

References

"I wish I knew then what I know now" - pain science education concepts important for female persistent pelvic pain: a reflexive thematic analysis. pubmed.ncbi.nlm.nih.gov

Effectiveness of Pain Neuroscience Education in Patients with Chronic Musculoskeletal Pain and Central Sensitization: A Systematic Review. https://pmc.ncbi.nlm.nih.gov/articles/PMC10001851/#sec1-ijerph-20-04098

Physiotherapists Using the Biopsychosocial Model for Chronic Pain: Barriers and Facilitators—A Scoping Review/ https://www.mdpi.com/1660-4601/20/2/1634