Central Sensitization & Chronic Pain in Practice:

Know More, Do Better.

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Course Description  

Chronic pain is recognized by the World Health Organization (WHO) as a disease of the central nervous system. It is the most common and most expensive health problem in the Netherlands, but also in Belgium and other countries in Europe, Australia, and the US. Not only that, the consequences for the paining person are enormous. For example, people with chronic pain experience a reduced quality of life, more mental problems, more comorbitities, reduced social contacts, and greater financial problems.

Extensive scientific research confirms the major role that central sensitization, or the hypersensitivity of the central nervous system, plays in the maintenance and explanation of persistent pain symptoms. It is remarkable that scientific studies show that central sensitization plays a role in many different pain complaints including fibromyalgia, tendinopathy, osteoarthritis, pain after cancer, pelvic pain after childbirth, persistent pain after surgery, pain in children, back pain, neck pain, Ehlers-Danlos syndrome, headaches, rheumatoid arthritis, and possibly even long COVID. That is why the International Association for the Study of Pain (IASP) has recognized patients with central sensitization as a separate group of pain patients, distinct from patients with nociceptive and neuropathic pain.

During this course, we provide an overview of the current knowledge and insights regarding central sensitization and we teach the clinician how to diagnose central sensitization in pain patients. For this, we use the new clinical criteria for nociplastic pain of the IASP. We also elaborate on the questions: what are the clinical implications of central sensitization and what is important in the treatment of people with central sensitization? To this end, we examine the underlying factors of central sensitization, such as maladaptive cognitions, persistent stress, sleep problems, unhealthy diet and physical inactivity. Indeed, these lifestyle factors are known to enhance central nervous system sensitivity (central sensitization). As a participant, you will learn to recognize and treat these underlying factors in individual patients with chronic, nociplastic pain.

Course Objectives

Upon completion of this 2-day course, participants will be able to:

• Better understand central sensitization as an explanatory model for many pain complaints
• Recognize and distinguish patients with nociplastic pain from patients with dominant nociceptive and neuropathic pain
• Evaluate patients with nociplastic pain so that all underlying factors of central sensitization are recognized
• Explain central sensitization to patients with nociplastic pain
• Treat the underlying factors for central sensitization in patients with chronic pain

Course Structure

Day 1:

1. Learn to understand central sensitization as an explanatory model for pain

2. Recognize and distinguish patients with nociplastic pain from patients with dominant nociceptive and neuropathic pain

3. The clinical intake of patients with nociplastic pain and recognization of underlying factors of central sensitization

Day 2:

1. Explain central sensitization to patients with nociplastic pain

2. Treating the underlying factors of central sensitization in chronic pain patients:

⠀⠀⠀⠀a. Clinical reasoning based on casuistry

⠀⠀⠀⠀b. Exercise therapy in patients with nociplastic pain

⠀⠀⠀⠀c. Motivational interviewing in patients with nociplastic pain

⠀⠀⠀⠀d. Improvement of lifestyle in patients with nociplastic pain

Didactic Methods

This course uses a multitude of teaching methods to overcome any barriers to the implementation of evidence-based insights. This allows for a smooth transfer of knowledge and skills in implementing guidelines into clinical practice. This means that for this course we use the following methods:

• demonstrations
• didactic sessions
• practical skills training
• illustrations
• discussions and feedback sessions on clinical reasoning
• casuistry

Accreditation

This course is accredited by: Stichting Keurmerk Fysiotherapie (15 points), Pro-Q-Kine (24 points) and Kwaliteitshuis Fysiotherapie (15 points).

Meet your Teachers

Jo Nijs is a professor at the Vrije Universiteit Brussel, a physiotherapist at the University Hospital of Brussels and a visiting professor at the University of Gothenburg (Sweden). He holds the Chair of the Berekuyl academy, focused on oncological rehabilitation. His research and clinical activities are focused on chronic pain in cancer survivors and musculoskeletal pain. He has (co-)authored more than 280 peer-reviewed publications (including papers in The Lancet, JAMA Neurology and The Lancet Rheumatology), has received 11 million euros in research grants, is the supervisor of 21 PhDs, and has spoken more than 300 times at (inter)national conferences in 25 different countries (incl. 36 keynotes).

Amarins Wijma is a physiotherapist and holds an MSc. in Physiotherapy Science and a PhD from the Vrije Universiteit Brussel. Her scientific work includes the treatment of patients with chronic pain, with a particular interest in the patient-centred approach, pain education, and transdisciplinary teamwork. She is a member of the Pain in Motion research group. She has co-authored several chapters in (inter)national books. She is also the author of 7 SCI-indexed full-text papers of which she published 4 as first author.

Recommended Literature

Both course instructors are accomplished researchers. An overview of their publications can be found here:

Hoogleraar Jo Nijs: publications

Amarins Wijma PhD: publications

Location

This course is currently only offered in Amsterdam.

Language of Instruction

This course is taught in Dutch. 🇳🇱