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.
The debate that seems to be raging in the pain education science is what type of education benefits patients most. The two major types of education being often discussed in the literature are biomechanics/pathology and pain neuroscience. Is one better than the other ?
Leeana Mirko
Oct 16, 2024
The unwillingness to experience distress (distress intolerance), can lead to avoidance behaviors that result in maladaptive coping strategies. Self-efficacy for tolerating negative emotions and willingness/unwillingness to experience distress are important factors to consider in determining engagement or avoidance behaviors. These aspects of the modulation of the pain experience represent clinical targets in the management of pain.
Leeana Mirko
May 8, 2024
The understanding of pain has been dominated by a brain-centric paradigm focused on nociceptive processing. This reductionist interpretation of pain needs to be balanced by the multiple processes outside of the central nervous system involved in the experience of pain. Assigning the whole experience of pain to one organ, the brain, fails to account for the complexity of the phenomenon. Pain is better understood when assigned to the whole itself and to the interactions of the components of the system.
Leeana Mirko
Jan 31, 2024
Management strategies directed towards simply treating the muscles in pain are insufficient since the muscles are the end point of a large and complex sensorimotor system that is influenced by many biopsychosocial factors, and so a more holistic approach needs to be considered.
Leeana Mirko
Jan 23, 2024
Clinicians need to develop their skills in patient-centered communication and develop therapeutic collaboration with patients to achieve meaningful results. The literature clearly shows that better therapeutic outcomes are achieved that way.
Leeana Mirko
Mar 22, 2023
14 articles
The debate that seems to be raging in the pain education science is what type of education benefits patients most. The two major types of education being often discussed in the literature are biomechanics/pathology and pain neuroscience. Is one better than the other ?
Leeana Mirko
Oct 16, 2024
The unwillingness to experience distress (distress intolerance), can lead to avoidance behaviors that result in maladaptive coping strategies. Self-efficacy for tolerating negative emotions and willingness/unwillingness to experience distress are important factors to consider in determining engagement or avoidance behaviors. These aspects of the modulation of the pain experience represent clinical targets in the management of pain.
Leeana Mirko
May 8, 2024
The understanding of pain has been dominated by a brain-centric paradigm focused on nociceptive processing. This reductionist interpretation of pain needs to be balanced by the multiple processes outside of the central nervous system involved in the experience of pain. Assigning the whole experience of pain to one organ, the brain, fails to account for the complexity of the phenomenon. Pain is better understood when assigned to the whole itself and to the interactions of the components of the system.
Leeana Mirko
Jan 31, 2024
Management strategies directed towards simply treating the muscles in pain are insufficient since the muscles are the end point of a large and complex sensorimotor system that is influenced by many biopsychosocial factors, and so a more holistic approach needs to be considered.
Leeana Mirko
Jan 23, 2024
Clinicians need to develop their skills in patient-centered communication and develop therapeutic collaboration with patients to achieve meaningful results. The literature clearly shows that better therapeutic outcomes are achieved that way.
Leeana Mirko
Mar 22, 2023
People experiencing pain try to make sense of their experience to gain control of the pain experience and its impact on their life. In order to make sense of their experience, patients form a cognitive representation of their symptoms that undergoes predictive processing in the brain.
Leeana Mirko
May 4, 2022
Overdiagnosis is one of the most harmful and costly problems in modern healthcare. Musculoskeletal care has been plagued by over-detection, overdiagnosis, and overtreatment of structural anomalies to try to manage patients’ complaints.
Leeana Mirko
Apr 6, 2022
Physical activity and/or physical exercise can bring health benefits in patients living with osteoarthritis by preventing cartilage degeneration, inhibiting inflammation, and by improving pain, stiffness joint dysfunction and muscle weakness.
Leeana Mirko
Feb 27, 2022
Specific factors such as catastrophizing and fear, depression and anxiety, pressure-pain thresholds, thermal pain thresholds and functional brain connectivity were significantly different in non-specific chronic low back pain compared to pain-free controls.
Leeana Mirko
Feb 16, 2022
Maladaptive emotion regulation, such as rumination, can shift the pain response from BAS-dominant to BIS-dominant, therefore promoting pain catastrophizing. Pain catastrophizing can then lead to pain-related fear and activity avoidance, eventually resulting in disability (disuse and depression).
Leeana Mirko
Feb 2, 2022
Yap, Z., Summers, S., Grant, A., Moseley, G., & Karran, E. (2021). The role of the social determinants of health in outcomes of surgery for low back pain. A systematic review and narrative synthesis. The Spine Journal. doi: 10.1016/j.spinee.2021.11.013
Leeana Mirko
Dec 7, 2021
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.
Leeana Mirko
Nov 12, 2021
According the Transtheoretical Model (TTM), behavior change happens over a five-stage process linked to readiness to change. Understanding what motivates patient to change is another key element to behavior change. Self-Determination Theory (SDT) suggests that motivation exists on a continuum going from amotivation (a reduction in the motivation to initiate or persist in behavior change), to extrinsic motivation, to intrinsic motivation.
Leeana Mirko
Nov 12, 2021
Clinicians involved in musculoskeletal care have the opportunity to create behavior change in their patients to reduce the burden of their disorders and to promote self-management strategies. In order to achieve such changes, clinicians need to shift paradigm from a disorder fixer mindset to a health coaching function.
Leeana Mirko
Nov 12, 2021