SD Virtual Pain Summit Presenter Information
Keynote Tasha Stanton, Ph.D.
Title: Targeting Pain From Many Angles: a foray into language, sensory modulation, and brain trickery
Synopsis: Pain can be perplexing. While clearly an effective way to alert us of danger to, or damage of, our body tissues, what happens when pain doesn’t go away? In this presentation, I will discuss the concept of over-protection – the idea that changes occurring in the nociceptive and immune systems in chronic pain often result in elevated responses to innocuous or painful stimuli, and when combined with unhelpful beliefs about pain, can foster sustained over-protection. I will then discuss how we can use innate bodily systems that modulate over-protection to our advantage in treatment. Specifically, I will discuss how both explicit knowledge as well as how implicit sources of information (via sensory input about the body or the environment) can influence over-protection, ultimately exploring how we can embed these into clinical practice.
Bio: Associate Professor Tasha Stanton is the Osteoarthritis Research Theme Lead for IIMPACT in Health at The University of South Australia, Adelaide. A/Prof Stanton currently holds a National Health & Medical Research Council (NHMRC) Career Development Fellowship. She is a clinical pain neuroscientist, with original clinical training as a physiotherapist. She has received >$3.4m in competitive research funding, has published >65 peer-reviewed journal articles, and she has been a keynote/invited speaker at >80 national and international conferences. Her research has won both national and international awards, including the World Congress of Pain Ronald Dubner research award for the best series of papers as a trainee, the Australian Pain Society Rising Star Award and the Australian Physiotherapy Association Best New Investigator Award. Her research focusses on pain – why do we have it and why doesn’t it go away? She has a specific interest in cortical body representation, somatosensation, multi-modal illusions, and pain.
Philip Austin, Ph.D.
Title: Virtual reality for the treatment of chronic pain disorders
Synopsis: First, I will present current knowledge concerning mechanisms underlying the effects of VR on pain. Here I will discuss two known processes involved in distraction with short-term VR use and neuroplasticity in more long-term use. Second, I will present findings from recent clinical trials and systematic reviews on the effects of VR for the treatment of various chronic pain disorders. Third, I will present our current findings on the use of VR for neuropathic pain in spinal cord injury patients supported by secondary outcomes using EEG outputs.
Bio: Philip Austin is a postdoctoral research fellow and practicing osteopath who holds a PhD in pain medicine. Phil’s research interests include the analgaesic effects of virtual reality experiences in people with spinal cord injury and cancer pain and the assessment of endogenous pain modulation in people with chronic pain conditions. Phil’s clinical areas of interest include the effects of work-related stress on the severity and duration of musculoskeletal pain. Phil also work as an academic tutor for the Masters' postgraduate degree program in Pain Management at The University of Sydney and is a visiting fellow at Victoria University.
Felicity Braithwaite, Ph.D.
Title: The magic of placebo: Using the art of deception to improve blinding in clinical trials, and harnessing the benefits of non-specific effects in clinical practice
Synopsis: Placebo effects are a powerful collection of mechanisms that can shape clinical outcomes. Yet, these mechanisms remain poorly understood, and thus, poorly controlled in clinical trials and largely unharnessed in clinical practice. In the context of clinical trials, controlling for placebo effects is particularly important when assessing a subjective experience such as pain. However, the focus of intervention for pain has moved away from drug treatments and towards more complex interventions such as physical and psychological interventions. But, how do we mimic complex interventions to the standard required to achieve blinding? In this presentation I will discuss the use of innovative placebo interventions that can maximise both clinician and patient blinding for complex interventions, using the art of deception. I will specifically highlight how novel blinding strategies can blind individuals to normally painful treatments. I will also discuss how clinical outcomes can be enhanced using non-specific mechanisms.
Bio: Dr Felicity Braithwaite is a postdoctoral researcher at the Pain and Perception Lab (part of the Body in Mind lab) at the University of South Australia, Adelaide. She is currently lead trial coordinator for a multicentre randomised controlled trial investigating the effect of education and physical activity for knee osteoarthritis.
Dr Braithwaite’s research interests include pain, placebos (or ‘sham’ interventions), placebo effects, and blinding in clinical trials. Dr Braithwaite completed a Bachelor of Physiotherapy in 2014, and was awarded her PhD in 2018. Her PhD investigated novel strategies to improve blinding in clinical trials involving complex physical interventions - such as massage, joint manipulations, needling therapies - which are widely used in clinical practice to treat pain. She used magicians' expertise in deceptive techniques to help achieve this lofty aim! Dr Braithwaite has presented her research at international and national conferences, including the International Forum for Back and Neck Pain Research (Canada 2019), the Society for Interdisciplinary Placebo Studies Conference (Netherlands 2019), the World Congress on Pain (Japan 2016), and the Australian Physiotherapy Association Conferences (2015, 2017, 2019).
She has been invited to speak at 10 conferences and events, including the Australian Physiotherapy Association Conference (2019), and was a plenary speaker at the 2018 PainAdelaide Conference.
Title: Seek First to Understand: Navigating the Language of Persistent Pain
Synopsis: You’re a culturally-competent active listener who knows how to explain pain, so why doesn’t your patient get what you’re saying? Why can’t they accurately describe their pain experience, and what do they really mean when they give you a pain score? Effective communication is key to a successful therapeutic alliance, yet misunderstandings abound.
This engaging presentation from an individual living with persistent pain examines the difference between what clinicians say and what a patient may hear.
Explore the language of lived experience and learn how the words you use affect adherence and outcomes from a patient point of view.
Bio: Kathryn Gloor is learning to live well with persistent neuropathic pain. After her first diagnosis of a "chronic, progressive" pain disorder, she learned to meditate and somewhat navigate the healthcare system. After receiving her second, she began discovering pain science and is finding strength in (mostly gentle) movement. She has a special interest in the ways we communicate about pain but claims no expertise beyond her lived experience.
Kathryn has a French degree from a liberal arts college, which isn't particularly helpful when attempting to decipher medical research. She received a diagnosis of trigeminal neuralgia in 2015, and of CRPS in 2019. In her current role, she generates numbers for a pain scale that has no meaning to her and spends countless hours speaking to insurance adjusters. She has login credentials for six unique patient portals.
Sandy Hilton, DPT, MS
Title: Mind The Gap: What is Happening to Those Taken off Opioids and still having Unrelenting Chronic Pain
Synopsis: Objectives: Session attendees will be able to
- Connect patients/clients who are struggling with pain management after being taken off opioids to organizations dedicated to working on patient advocacy for pain control.
- Effectively communicate with other health professionals about the need for adequate pain control in the chronic/persistent pain population.
- Understand the global position on decreasing opioid use and continued care for those experiencing chronic and persistent pain.
- Describe how non-prescribing health care providers can help in the space between opioids and adequate pain control/management.
“I have been abandoned because my doctor was told he can’t prescribe opioids anymore, and there is nothing to replace them. They tell me to meditate, exercise, sleep, and eat well. I have been doing that all along. Now I’ve lost the thing that helped me be able to do all that and my pain is worsening. What is left for me but endless pain and empty words?”
The gap created for people who have been taken off of opioids to meet organizational pressures and regulatory guidelines has not been filled. As non-prescribing healthcare providers we need to be able to advocate for our patients/clients individually so that they can transition successfully away from opioids and have self-efficacy in pain management. We are also well positioned to advocate for the chronic/persistent pain community to have effective management policies.
Bio: Sandy Hilton, DPT, graduated from Pacific University (Oregon) in 1988 with a Master of Science in Physical Therapy and earned a Doctor of Physical Therapy degree from Des Moines University in December 2013. She has worked in multiple settings across the US with neurologic and orthopaedic emphasis combining these with a focus in pelvic rehabilitation for pain and dysfunction since 1995.
Sandy teaches Health Professionals and Community Education classes on returning to function following back and pelvic pain, and co-teaches Advanced Level Male Pelvic Floor Evaluation/Treatment for Entropy Physiotherapy as well as Neurodynamics and Sensory Integration for Pelvic Pain and a Practical Application of Pain Science course with Pelvic Health Solutions.
Sandy’s clinical interest is chronic pain with a particular interest in complex pelvic pain disorders for men and women. Sandy is also pursuing opportunities for collaboration in research into the clinical treatment of pelvic pain conditions. Sandy has co-authored two papers, 2 book chapters and "Why Pelvic Pain Hurts" a patient focused book.
Laura Rathbone, PT, MSc, BSc
Title: What about us? How psychologically flexible are we?
Synopsis: Psychological flexibility forms the core process within the Acceptance and Commitment Therapy framework which has become popular amongst Allied Health Professionals working with people living with persistent pain.
This talk will explore exactly that. What happens when healthcare clinicians hit their own cognitive dissonance? Why do we get stuck in the cycling of abuse vertically and horizontally? And what does this mean for our practice and understanding of the people suffering in front of us?
Bio: Laura Rathbone is a clinical specialist physiotherapist working in the field of persistent and complex pain and lives in Amsterdam, the Netherlands. She gained her MSc in Advanced Neuromusculoskeletal Physiotherapy from Kings College London in 2015. Here she was heavily influenced by the teaching of Prof Mick Thacker who introduced her to the wider philosophical discussion around human experience and pain.
She has held multiple Physiotherapy roles in London within 1st and 3rd contact environments working in clinics, GP practices, hospitals and a specialist programme. She worked as part of the multi-disciplinary team delivering the INPUT Pain Management programme at St Thomas’ Hospital under the management of Prof. Lance McCracken. Here she gained an in-depth working model of ACT and became skilled in session development for groups and individual work.
Laura is dedicated to the understanding and exploration of the science of pain. She is the host of the podcast Philosophers chatting with Clinicians which brings and is working on understanding the model of Embodied Cogniton and how pain might fit within this. She co-hosts Le Pub Scientifique in Amsterdam and guest lectures on the topic of pain and incorporating psychological frameworks into practice.
She is currently interested in the ‘how’ and ‘why’ people experience pain. She is exploring the philosophical discussions around conscious experience and how humans interact with their environment. She is particularly keen to explore how these models feed into the development of a modern, person-centred health care service.
Michael Ray, M.S., D.C.
Title: Pain: Exploring the Human Experience
Synopsis: Three primary objectives: 1) Examining language and pain 2) Models used to frame pain and understanding 3) Being a guide in clinical practice
Bio: Michael Ray is a chiropractor based out of Harrisonburg, VA. He owns and operate Shenandoah Valley Performance Clinic and specializes in the rehabilitation of neuromusculoskeletal issues,associated pain, and dysfunction. He enjoys helping people from various backgrounds return to their desired level of activity. His primary goals for working with clients, educate about their situation and collaboratively design a game-plan to move them from where they are at to where they want to be.
Education & Credentials
- M.S. in Exercise Science with a concentration in Motor Control and Rehabilitation
- Doctor of Chiropractic
Tim Salomons, Ph.D.
Title: Biomarkers of Vulnerability and Resilience to Pain
Synopsis: Pain is devastating for some sufferers while others manage to cope and even thrive despite pain. Furthermore, some individuals seem to be more likely to develop pain in the wake of physical trauma (e.g. surgery). I will describe a series of studies where we attempt to understand individual differences in vulnerability to pain using brain and behavioural markers.
Bio: Tim Salomons is interested in the cognitive and biological mechanisms that make pain salient and how individual differences in these mechanisms might underlie differences in coping and treatment response.
His work aims to understand how the brain and body interact to create the experience of pain, and why some people might be prone to develop pain while others are relatively resilient. He’s especially interested in the biological mechanisms that underlie cognitive and affective responses to pain and how this knowledge might help us treat pain.
Devra Sheldon, PT
Title: Persistent Pain: Shame and Stigma in Clinical Encounters
Synopsis: Shame and stigma are common reported experiences amongst patients, especially with persistent pain conditions. This presentation will review the literature exploring the emergence of this experience, the scope, the contributing factors, and the impact of these experiences on the individual. Well intended practitioners may be unintentionally yielding harm.
The iatrogenic effects of clinical encounters will be examined. This will include an exploration of provider thoughts, language, and mindset that could be contributing to this phenomenon. The goal of this presentation is to help us be more aware, and better serve the individuals we are aiming to support
Bio: Devra Sheldon is a physical therapist and owner of DevraJoy LLC. Through one on one mentoring, she guides learning experiences for clinicians who are working with patients who experience persistent pain. Within these interactions, she helps clinicians develop skills to address patient’s strategies for self-management in order to reclaim their joy and function. She has been in practice since 2004, and has been board certified in neurology since 2009.
Devra has served as an item writer for the neurologic clinical specialty certification exam, serves as a peer reviewer for Physiotherapy Canada, lectures at the university level on a range of topics, and has co-authored a paper on a neglect disorder in stroke.
Devra works in Chicago focusing on low-income and minority populations with persistent pain and neurological conditions. She has a special interest in the clinical impact of sensory processing on rehabilitation.
Catherine (Katie) Siengsukon, PT, Ph.D.
Title: The Relationship Between Sleep and Pain: What To Do?
Synopsis: Learning objectives:
- Consider the relationship between sleep disturbances and pain
- Select and implement appropriate screening tools for the most common sleep disorders
- Incorporate strategies into practice to promote clients’ sleep health
Bio: Catherine F. Siengsukon, PT, Ph.D., provides instruction in neuroscience, neurorehabilitation, and sleep health promotion in the physical therapy and rehabilitation science doctoral degree programs. She is currently the course director for PTRS 852 Neurologic Physical Therapy and Rehabilitation I.
Siengsukon is also co-director of the multiple sclerosis STEP UP program. She is frequently invited to present on promoting sleep health and integration of sleep health info physical therapy practice. She also has advanced training in cognitive behavioral therapy for insomnia (CBT-I) and utilizes CBT-I in her research.
As director of the Sleep, Health, and Wellness Laboratory, Siengsukon's line of research seeks to understand how sleep impacts function, learning, and overall health particularly with aging and in those with neurological conditions. She possesses a clinical background in outpatient physical therapy treating individuals with musculoskeletal and neurologic injury.
Siengsukon is an active member of the American Physical Therapy Association. She has served on the research committee for the association's Neurology Section, and she is past chair of the research committee for the Kansas Physical Therapy Association. She is also a reviewer for several journals.
Siengsukon earned a bachelor's degree in biology and a master's degree in physical therapy from Rockhurst University in Kansas City, Mo. She received her doctorate in rehabilitation science from the University of Kansas and is the first graduate from the medical center campus to receive the Marnie and Bill Argersinger Award for Outstanding Doctoral Dissertation.
Siengsukon received the 2014 Rising Star Award in Health Professions from the Women in Medicine and Science at KU Medical Center.
Jason Silvernail DPT, DSc, FAAOMPT
Title: Difficult Conversations and Patient Noncompliance
Synopsis: This lecture will review key topics on navigating challenges with patient adherence and interpersonal communication, with a focus on concrete and practical skills you can apply immediately. Dr Silvernail will review key themes from the literature and translate them to practical strategies you can employ today to deal with challenging professional issues. Included are topics of patient adherence to treatment, goal setting, expectation management, communication strategies, and managing interpersonal difficulty.
Bio: Jason Silvernail has been a practicing physical therapist since 1997, on duty in the United States Army as a career military officer with over 25 years of service. Dr. Silvernail has worked with a wide variety of patient populations and settings including orthopedic/sports, chronic pain, amputee and neurological rehabilitation, and strength and conditioning.
Dr Silvernail earned his Doctor of Physical Therapy degree from the University of Scranton, and his Doctor of Science from Baylor University. He is board-certified in Orthopedic Physical Therapy and is a Certified Strength and Conditioning Specialist. He is also a graduate of the prestigious Army-Baylor Army-Baylor Doctoral Fellowship in Orthopedic Manual Physical Therapy at Fort Sam Houston, earning him a Fellowship in the American Academy of Orthopedic Manual Physical Therapy.
A clinician and researcher, he has published clinical commentaries and original research in the medical literature (including the Journal of Orthopedic and Sports Physical Therapy, Manual Therapy, and the Journal of Manual and Manipulative Therapy) and he has a prominent professional presence online where you can connect with him on Facebook or Twitter.
Opinions expressed by Dr. Silvernail are his own and do not represent the official policy or position of the United States Army, the Department of Defense, or the United States Government.
Timothy Wideman, Ph.D., PT
Title: How to think about pain – toward a person-centered perspective
Synopsis: Pain is a complex phenomenon that is notoriously hard to manage. One way that researchers and clinicians cope with this complexity is by reducing pain to its component parts. We tend to reduce the multifaceted pain experience to narrow ratings of intensity and base our treatment on overly simplistic mechanisms. This reductionistic view of pain contributes to its overwhelming burden. For instance, the current opioid crisis can be linked to an over-emphasis on treatments that narrowly target reductions in pain intensity. While the widespread stigma associated with pain is largely directed toward patients that fail to align with known pain mechanisms. This presentation aims to highlight the need for a more comprehensive perspective that better integrates the complexity of pain within clinical practice. Toward this goal, participants will be introduced to the Multi-modal Assessment model of Pain (MAP). MAP offers a novel framework to understand how different assessment strategies relate to the subjective experience of pain and the essential role of the pain narrative in understanding fundamental aspects of pain and pain-related suffering. MAP aims to facilitate a more compassionate approach to pain management by providing a rationale for why all reported pain should validated, even when poorly understood.
Bio: Dr. Timothy Wideman is a physical therapist and assistant professor at McGill University in Montreal. The overarching goal of his work as a clinician, researcher and educator is to improve the clinical care offered to people living with persistent pain. He has aimed to cultivate a comprehensive perspective on pain throughout his training and clinical experience.
He completed his entry-level physical therapy training in 2003 and has practiced across a range of clinical settings, including homecare, private clinics and multi-disciplinary pain management programs. Driven by his interest in better understanding how psychological and neurophysiological factors relate to pain and disability, he completed his doctoral training in McGill’s experimental psychology program and focused his post-doctoral fellowship at Johns Hopkins on the clinical assessment of pain sensitization.
He joined McGill faculty in 2014 and his recent work has focused on developing a conceptual model for clinicians and researchers that aims to better integrate and address the subjective experience of pain within research and practice.
Dr. Wideman has received several national awards for excellence in research and clinical education and has presented his work in the leading international conferences and journals in the fields of pain and rehabilitation.
Breakout Session Leaders
Linda Crawford, OTR/L, CDWF, has been an occupational therapist for over 30 years with a wealth of experience in treating individuals with chronic and acute illnesses, injuries, and life altering health challenges. She has worked in a variety of settings including inpatient hospital, ICU, cardiac care, burns, orthopedic, neuro, and acute and long term rehabilitation units. She also developed outpatient neuro, wheelchair and specialized seating clinics, and has provided in-home therapy and home modification assessments. In addition to her current specialization in complex pain and health rehabilitation, Linda spent 10+ years specializing in brain injury and stroke rehabilitation.
She is also one of the few practitioners treating CRPS (Complex Regional Pain Syndrome) successfully using the latest clinical therapy techniques including Graded Motor Imagery.
Linda is also a Certified Daring Way™ Facilitator. As one of the few occupational therapists certified by Brené Brown, she has successfully adapted an integrated her Daring Greatly™ and Rising Strong™ work for the treatment of complex pain and health conditions.
Emily Peelgrane, B.OCC.,THY graduated from the University of Queensland in 2000 and has worked right across Australia, the USA, UK and Costa Rica. Her areas of interest and speciality are in neurology, complex and chronic care, research and adult education. She is passionate about teaching pain science to clients as well as training the next generation of therapists to ensure high quality, evidenced based and patient centered services for people experiencing chronic pain. Emily's interest in pain science was ignited when she conducted a project looking at teaching clinicians how to better screen and approach clients with chronic pain conditions to ensure they received better services. She has now done additional training in chronic pain including courses like GMI, motivational interviewing and "brave" training. Emily is a member of a number of chronic pain interest and research groups including "The pain masterminds network", "Exploring pain science" and "Pain cloud".
Stephanie Poulton, MSc, works as a Clinical Specialist Physiotherapist in Pain in the community based Locomotor Pain Service as part of Homerton University Hospital NHS Foundation Trust. She gained an MSc in Pain: Science and Society at King’s College London in 2010 and has previously worked in the pain teams at the National Hospital of Neurology and Neurosurgery, Queen Square and the Royal National Orthopaedic Hospital, Stanmore.
Teaching about pain is integral to her role in healthcare and as an accredited instructor for the Neuro Orthopaedic Institute (NOI) teaches pain related courses in the UK, Norway and Australia. Stephanie is passionate about using innovative ways to provide education around pain science for individuals and organisations and continues to deliver this under the banner of Pain and Performance as a co-founder since 2011, which has included the evening seminar series Le Pub Scientifique in London since 2013.
Dr. Mark Milligan, PT, DPT, is a board certified, fellowship-trainedorthopedic physical therapist. He specializes in the intelligent prevention and treatment of all human movement conditions.
He is a full-time clinician with multiple patient populations and is the Founder of Revolution Human Health, a non-profit physical therapy network. Helping others create the best patient experience and outcomes through his continuing education company specializing in micro-education is also a passion.
His latest venture is creating the easiest pathway to access healthcare for providers and patients with Anywhere Healthcare, a tele-health platform. He is an active member of the TPTA, APTA, and AAOMPT and has a great interest in the pain epidemic, public health, population health, and governmental affairs.
Natalie Rolle,MOT OTR/L has been helping people sleep using non-drug methods since 2015 when she began working with student Veterans at Colorado State University (CSU) at the Center for Community Partnerships. An important part of helping Veterans have successful higher education outcomes was the Restoring Effective Sleep Tranquility (REST) program that uses cognitive behavioral therapy for insomnia (CBTI). Natalie spends most of her time supporting Veterans with chronic insomnia to achieve better sleep quality resulting in improved daytime functioning and quality of life.
Natalie (MOT OTR/L) earned a Bachelor’s Degree in Biology with an organismal concentration from (CSU) in 2012 graduating cum laude. Natalie then went on to complete her Master’s Degree in Occupational Therapy (OT) from CSU in 2014. Subsequently she was trained in CBTI at the University of Pennsylvania Perelman School of Medicine in both basic and advanced courses. Natalie began seeing additional clients at Northern Colorado Sleep Consultants, LLC in early 2018 where she was trained by Dr. Moorcroft in another behavioral treatment for insomnia called guided mindfulness meditation with acceptance treatment for insomnia (GMATI). This added to her experience of working with mindfulness and meditation since 2015
Natalie has multiple publications as well as given numerous presentations locally, nationally, and internationally.
She uses the same behavioral methods for insomnia and sleep-related problems as Dr. Moorcroft and enjoys working with all people in addition to veterans.