Thinking beyond muscles & joints 2.0: A lifestyle approach for managing chronic musculoskeletal pain

Jo Nijs^1,2,3

¹ Pain in Motion International Research Group (www.paininmotion.be), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Belgium

³ Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Belgium

⁴ Department of Neuroscience and Physiology, University of Gothenburg, Sweden

Learning objectives:

At the completion of this course, learners will be able to:

1. Identify the relevant lifestyle factors in patients with chronic musculoskeletal pain;
2. Assess lifestyle factors in patients with chronic musculoskeletal pain;
3. Apply a lifestyle approach for managing chronic musculoskeletal pain in clinical practice;
4. Improve their clinical reasoning by integrating lifestyle factors for patients with chronic musculoskeletal pain – this way learners will learn to think beyond muscles & joints;
5. Treat relevant lifestyle factors in patients with chronic musculoskeletal pain;
6. Address various lifestyle factors concomitantly into an individually-tailored multimodal lifestyle intervention for people having chronic musculoskeletal pain.

Content:

Chronic musculoskeletal pain, including but not limited to low back pain, headache, neck pain, osteoarthritis, shoulder pain, fibromyalgia, temporomandibular disorders, has a tremendous personal and socioeconomic impact. Lifestyle factors such as physical (in)activity, sedentary behaviour, stress, poor sleep, unhealthy diet, and smoking are associated with chronic musculoskeletal pain severity and sustainment^1-5. This applies to all age categories, i.e. chronic musculoskeletal pain across the lifespan. Yet current treatment options often do not, or only partly address the many lifestyle factors associated with chronic musculoskeletal pain, or attempt to address them in a standard format rather than providing an individually tailored multimodal lifestyle intervention^1,6,7.Therefore, this course addresses this lacuna by teaching clinicians to address various lifestyle factors concomitantly into an individually-tailored multimodal lifestyle intervention for people having chronic musculoskeletal pain. Such a lifestyle approach is lots of fun for clinicians, especially when to succeed in engaging their patients into the treatment program⁸. This course is dedicated to learning clinicians to enjoy their work with musculoskeletal pain patients more. Ultimately, this should lead to a higher clinical impact with higher effect sizes and subsequently decreasing the psychological and socio-economic burden of chronic musculoskeletal pain in the Western world.  

Programme:

09.00 Introduction

09.15 Lifestyle and chronic musculoskeletal pain: the role of stress, sleep, physical activity, diet, alcohol & smoking

11.00 Coffee-break

11.15 Lifestyle factors in patients with chronic musculoskeletal pain in clinical practice: skills training identification, assessment, and clinical reasoning skills using case studies

13.00 Lunch

14.00 Treatment of relevant lifestyle factors in patients with chronic musculoskeletal pain part 1: physical (in)activity

15.30 Coffee break

15.45 Treatment of relevant lifestyle factors in patients with chronic musculoskeletal pain part 2: dietary support & stress intolerance

17.00 End of course

Educational modes:

The course content will be delivered through a mixture of methods, including:

- interactive lectures
- demonstrations
- practical skills training
- illustrations
- case studies

The course uses a combination of educational modes in order to optimize implementation in clinical practice and to address implementation barriers⁹.

Key references:

1. Nijs J, D'Hondt E, Clarys P, et al. Lifestyle and Chronic Pain across the Lifespan: An Inconvenient Truth? PM & R : the journal of injury, function, and rehabilitation 2020; 12(4): 410-9.
2. Malfliet A, Marnef AQ, Nijs J, et al. Obesity Hurts: The why and how of Integrating Weight Reduction with Chronic Pain Management. Physical therapy 2021.
3. Vitiello MV, McCurry SM, Shortreed SM, et al. Cognitive-behavioral treatment for comorbid insomnia and osteoarthritis pain in primary care: the lifestyles randomized controlled trial. Journal of the American Geriatrics Society 2013; 61(6): 947-56.
4. Okifuji A, Hare BD. The association between chronic pain and obesity. Journal of pain research 2015; 8: 399-408.
5. Torres-Ferrus M, Vila-Sala C, Quintana M, et al. Headache, comorbidities and lifestyle in an adolescent population (The TEENs Study). Cephalalgia : an international journal of headache 2018: 333102418777509.
6. Nijs JG, SZ; Clauw, DJ; Fernández-de-las-Peñas, C; Kosek, E; Ickmans, K; Fernández Carnero, J; Polli, A; Kapreli, E; Huysmans, E; Cuesta-Vargas, AI; Mani, R; Lundberg, M; Leysen, L; Rice, D; Sterling, M; Curatolo, M. . Central sensitisation in chronic pain conditions: Latest discoveries and their potential for precision medicine. The Lancet Rheumatology 2021; 3: e383-92.
7. Nijs J, Mairesse O, Neu D, et al. Sleep Disturbances in Chronic Pain: Neurobiology, Assessment, and Treatment in Physical Therapist Practice. Physical therapy 2018; 98(5): 325-35.
8. Nijs J, Wijma AJ, Willaert W, et al. Integrating Motivational Interviewing in Pain Neuroscience Education for People With Chronic Pain: A Practical Guide for Clinicians. Physical therapy 2020; 100(5): 846-59.
9. Stander J, Grimmer K, Brink Y. Training programmes to improve evidence uptake and utilisation by physiotherapists: a systematic scoping review. BMC medical education 2018; 18(1): 14.