“The experts in pain are the patients.”

Chiropractor, lecturer, expert federal chiropractic examiner, and supervising clinician, Michael Vianin (MSc, DC), is committed to ensuring clinicians and other healthcare professionals involved in the management of musculoskeletal disorders and pain syndromes have access to practical tools allowing them to apply a dispositionalism model of musculoskeletal care.

In this book, Michael discusses the components of the model, their significance, and how to address them with patients. Topics covered include:

the dispositionalism model
predictive processing
the clinical encounter
the self
social determinants of health
self-efficacy
communication

In-depth and evidence-based, Michael advocates for a patient-centered and collaborative approach to pain management and treatment.

Dispositionalism in Musculoskeletal Care provides a comprehensive understanding of the dispositionalism model of care and the tools that can be readily applied in the implementation of the model.

" I have been in pain research for nearly 25 years and this treatise is by far the most relevant and valuable for clinicians and patients. It will redefine pain management and millions of patients will owe their recovery in part to this masterful publication."

- Dr. Norman Kettner, DC, DACBR, FICC, Dean of Research, Professor Emeritus, Professor and Chair of the Department of Radiology, Logan University

"Great work; I truly liked it. The book brings the different concepts and constructs really nicely together."

- PD Dr.med Petra Schweinhardt, PhD, Head of Research, Department of Chiropractic Medicine, University of Zurich

"Great book. Great the way you structured the book and allow the reader to go on the journey with you, opening their realm of possibilities with ease and simplicity even by providing neurological bases and biochemical complex concepts … make the complex simple. Wow, a true gift."

-Dr. Dominique Hort, DC, CCN, Naturopath, developer of the Hort Method™, co-founder of X-CELS, and co-founder of Swiss Optimal Living Society (SOLS)

About the Author

Michael Vianin (MSc DC) - is a chiropractor with a Master’s degree in Rehabilitation Sciences who has fifteen years of experience working with people who suffer from musculoskeletal pain. He specializes in the management of complex cases, including post-operative care. Michael also has extensive teaching experience in the rehabilitation of MSK disorders and in mentoring interns and residents.

Dispositionalism in Musculoskeletal Care

The aim of this book is to discuss contextual factors and the mechanisms at play during the management of musculoskeletal disorders. Knowledge and understanding of these factors can help clinicians to better understand their patients, themselves, and the interactions taking place during patient-clinician exchanges. The awareness of these dispositions can help physicians improve themselves and the care they deliver to patients, leading to a true patient-centered collaborative therapeutic alliance. Physician-patient collaboration is, in turn, associated with better patient adherence and outcomes, and care, delivered in a positive context, produces better outcomes.

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The foundation section includes chapters about change in paradigm, the dispositionalism model, predictive processing, the common sense model, the clinical encounter, and contextual dispositions. This section provides the rationale for the book and describes the building blocks for the dispositionalism model of care.

The discovery section talks about unique characteristics of the patient and includes chapters about the self, culture, social determinants of health, health literacy, pain catastrophizing, depression, sleep quality, metabolic health, physical activity, self-efficacy, and locus of control. It also discusses unique features of the clinician and patient-clinician communication. This section describes in details dispositions at play during the clinical encounter and provides the backbone for understanding the dispositionalism model of care.

The mastery section brings together all the concepts developed in the foundation and discovery sections and illustrates the application of the dispositionalism model of care in the clinical setting. It also includes appendices with practical tools clinicians can use in everyday practice to further develop skills to implement the dispositionalism model of care.

Resources

Behavior Change

Patients suffering from musculoskeletal disorders often exhibit negative health behaviors that influence their symptoms and clinical outcomes. The recognition and confrontation of such risk factors is a central part of musculoskeletal care.

Models of behavior change

Patients can move from one stage to another stage in linear or non-linear fashion and can move forward or backward (relapse) on the stage continuum. Self-efficacy is a central disposition in how patients move through the stages of change.

Fostering Behavior Change

In order to support behavior change, clinicians should focus on building intrinsic motivation, promote and honor patient autonomy, increase feeling of competence, and increase social support. Positive psychology and motivational interviewing are two tools clinicians can use to support behavior change.