Instructor:
Jay P. Shah, MD & John Srbely, DC PhD
Location:
Kinatex Sports Physio Sainte-Rose
4530 av de la Renaissance
Laval, QC. H7L 0J3
Instructors:
Jay P. Shah, MD
John Srbely, DC PhD
Course Date & Time:
Saturday October 5, 2024
8:30am – 5:30pm
Sunday October 6, 2024
8:30am-4:30pm
Course Cost:
$675 CAMPT Member
$700 OD Member
$750 Non-Member
+applicable tax
Registration Deadline:
Friday September 27, 2024
Course Description
Participants in this state-of-the-art course will acquire an in-depth understanding of the emerging research characterizing the pathophysiology and clinical manifestations of MPS. The curriculum will focus on a mechanism-based approach for the diagnosis and treatment of MPS, anchored in a neuro-segmental model that reflects the current understanding of the pathophysiology and clinical manifestation of central sensitization.
This course will also emphasize the application and interpretation of Quantitative Sensory Testing (QST) diagnostic methods, such as algometry and the windup technique. These office-based methods enable clinicians to effectively measure the degree of patient sensitization.
Such measures will be presented as objective, clinically-applicable, and grounded in the known mechanisms of MPS, thus equipping clinicians with mechanism-based assessment tools that they can seamlessly integrate “on Monday morning” into their diagnostic protocols for managing chronic myofascial pain syndrome.
Non-pharmacological approaches such as dry needling, physical modalities (electrical stimulation, therapeutic ultrasound), and manual mobilization/manipulation will be discussed, demonstrated and practiced by attendees. These techniques aim to deactivate painful MTrPs, desensitize affected segments and neuro-modulate subcortical dysfunction, providing more permanent pain and symptom relief. The diagnostic and treatment techniques presented in this workshop are applicable in the management of a variety of chronic myofascial and musculoskeletal pain conditions.
This course is aimed at any therapist wanting more tools to evaluate and treat patients with chronic MSK conditions and myofascial pain. Experience with dry needling is helpful, but not a requirement.
Learning Objectives:
In this workshop participants will learn:
- The unique neurobiology of muscle pain and the dynamic interplay of muscle nociceptors and endogenous biochemicals in the initiation, amplification, and perpetuation of peripheral and central sensitization and neurogenic inflammation.
(Specific topics include determining whether the MTrP is the primary pathology or secondary manifestation in the clinical presentation of MPS.)
- The pivotal roles of persistent nociceptive bombardment, central sensitization, neurogenic inflammation, wide dynamic range neurons, limbic system structures, and dysfunctional descending inhibition in mediating muscle sensitization, pain chronification, receptive field expansion, and somato-visceral interactions.
- How novel applications of diagnostic ultrasound can be used as objective, quantifiable and repeatable outcome measures for dry needling and electrical stimulation techniques. Specific topics include ultrasound imaging to visualize MTrPs, measure their stiffness properties (elastography) and local blood flow to differentiate them from normal muscle tissue.
- How to identify the reproducible manifestations of spinal segmental sensitization (involving dermatomes, myotomes, and sclerotomes) and examine the objective, quantifiable and reproducible physical findings of allodynia, hyperalgesia and referred pain patterns in MPS.
(Specific topics include how to clinically employ Quantitative Sensory Testing (QST) in assessing central sensitization, temporal summation (windup) and its unique somatosensory profile (allodynia, hyperalgesia). Application and interpretation of brush allodynia, algometry, mechanical pain thresholds (MPT) and windup ratio (WUR) using a novel weighted pinprick technique will be demonstrated.)
- How to design a mechanism-based treatment approach (e.g., dry needling [peripheral and paraspinal], trigger point release, manual mobilization/manipulation, electrical stimulation and therapeutic ultrasound) to desensitize involved segments, eliminate chronic MTrPs and alleviate chronic MPS.
- Insights into how clinicians can immediately integrate these concepts and techniques into a contemporary neurophysiologic paradigm for management of chronic pain into clinical practice.
Instructor Bios:
Jay P. Shah, MD is a physiatrist and clinical investigator in the Rehabilitation Medicine Department at the National Institutes of Health (NIH) in Bethesda, Maryland USA. His interests include the pathophysiology of myofascial pain syndrome and the integration of physical medicine techniques with promising complementary approaches in the management of neuro-musculoskeletal pain and dysfunction. He also completed the one-year UCLA Medical Acupuncture course and a two-year Bravewell Fellowship at the Arizona Center for Integrative Medicine.
Jay is a well-known lecturer on mechanisms of chronic pain syndromes (including chronic pelvic pain), myofascial pain, dry needling, neuro-anatomical acupuncture techniques and other related topics. He and his co-investigators have utilized novel microanalytical and ultrasound imaging techniques that have uncovered the unique biochemical milieu and viscoelastic properties of myofascial trigger points and surrounding soft tissue. Their studies have demonstrated objective, reproducible and quantifiable muscle tissue properties associated with MTrPs and the quantitative effects of dry needling of active MTrPs on these tissue properties, in addition to showing significant improvements in pain, range of motion and patient self-report outcomes in mental health and physical function.
In addition, Jay has done novel collaborative research studies (with a gynecologist and neurologist) on chronic pelvic pain and endometriosis at the NIH. He and his team have published several landmark papers in this area. Moreover, their work has been internationally recognized by the World Endometriosis Foundation who called it “transformative.” Their clinically impactful studies have helped shift the focus from studying endometriosis lesions to understanding how endometriosis and pain are related with emphasis on elucidating the underlying mechanisms of chronic pelvic pain.
Jay has given hundreds of invited lectures and hands-on courses nationally and internationally for physicians, physiotherapists, chiropractors, dentists (specializing in orofacial pain), acupuncturists, and massage therapists, among other professional groups. His presentations integrate the fascinating knowledge emerging from the basic and clinical pain sciences in order to optimize evaluation and management approaches to musculoskeletal pain and dysfunction.
Jay was selected by the American Academy of Pain Management as the 2010 recipient of the Janet Travell Clinical Pain Management Award for excellence in clinical care and by the National Association of Myofascial Trigger Point Therapists as the 2012 recipient of the David G. Simons Award for excellence in clinical research.
John Z Srbely DC PhD holds a full-time position as Associate Professor in the Department of Human Health and Nutritional Science at the University of Guelph, Ontario, Canada. His professional journey began in 1992 as a clinician practicing chiropractic and acupuncture, specializing in the treatment of chronic myofascial pain. This early clinical experience sparked his curiosity about the physiological effects and mechanisms of chronic musculoskeletal pain and drove him to receive his PhD in neurophysiology and biomechanics in 2008, marking the commencement of his research journey.
Dr. Srbely’s research interest focuses on the pathophysiological mechanisms of myofascial pain by employing both animal and human models. His unique perspectives as a clinician and scientist enable him to effectively bridge the gap between the basic and clinical sciences. His work specifically focuses on understanding the roles of central sensitization and neurogenic inflammation in the pathophysiology of myofascial pain. In particular, he has pioneered research demonstrating the potentially important contribution of degenerative spine and/or joint disease in the pathophysiology of myofascial pain, with potentially significant implications to the clinical diagnosis and management of chronic myofascial pain.
This comprehensive research approach aims to not only deepen our understanding of these complex mechanisms but also transform this knowledge into advancing clinically feasible, mechanism-based diagnostic techniques. He is actively studying ways of standardizing quantitative sensory testing (QST) methods that specifically target the underlying mechanisms of central sensitization and windup phenomena for use in the quantitative assessment of chronic pain patients. This initiative is part of his broader efforts supported by the HEAL
Initiative (NIH), reflecting his collaborations with researchers at George Mason University and the National Institutes of Health (NIH) targeting novel biomarkers for myofascial pain syndrome. His research has been internationally recognized, most notably through a prestigious Natural Sciences and Engineering Research Council of Canada (NSERC) Discovery Grant.
Questions? Contact Colleen Dorion at cdorion@physiotherapy.ca