It’s been two decades since we started studying the role of central nervous and immune systems in patients with chronic pain. Back then, we could not imagine what massive, global impact pain science would have on our profession and healthcare for patients suffering from pain in general. However, pain science continues to evolve and clinicians continue to struggle to implement pain science in clinical practice. This inspired the Editorial Board of the Brazilian Journal of Physical Therapy, now one of the leading journals in the field of rehabilitation, to dedicate an Editorial Series to pain science in clinical practice. The Comprehensive Pain Management Editorial Series aims at contributing to the implementation of pain science in clinical practice and facilitating clinicians around the globe to provide individually-tailored multimodal lifestyle interventions for the many patients suffering from chronic pain. More specifically, the editorial series contributes to a paradigm shift from a tissue and disease-based approach towards individually-tailored multimodal lifestyle interventions for patients with chronic pain.1,2 Besides contributions from leading Pain in Motion researchers, the Comprehensive Pain Management Editorial Series includes contributions from world leading pain science researchers such as Paul Hodges, Tomohiko Nishigami, Rob Oostendorp, and Lorimer Moseley.
In support of the global open science movement, the Brazilian Journal of Physical Therapy fosters free access to the contributions of the Comprehensive Pain Management Editorial Series, and therefore published them in open access. Below an overview of the Comprehensive Pain Management Editorial Series is provided, including weblinks to the full-texts.
The first editorial introduces the editorial series, including reflecting on the global pain science revolution, the paradigm shift from a tissue and disease-based approach towards individually-tailored multimodal lifestyle interventions for patients with chronic pain, as well as stretching the scope of our profession for the sake of patients with pain.3
Nijs J, Lahousse A. Introducing the comprehensive pain management editorial series. Braz J Phys Ther. 2023;27(2):100506. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10172...
The second part of the comprehensive pain management editorial series provides a terminology update regarding central sensitization and nociplastic pain in a clinically applicable way.4
Nijs J, Malfliet A, Nishigami T. Nociplastic pain and central sensitization in patients with chronic pain conditions: a terminology update for clinicians. Braz J Phys Ther. 2023;27(3):100518. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10314...
In the third episode of the comprehensive pain management editorial series3, we built on the second editorial4 to explain why pain phenotyping is of potential relevance and for which patients pain phenotyping might be useful. This editorial also explains how clinicians can differentiate between predominant nociceptive, neuropathic, and nociplastic pain, and adapt pain management accordingly.5
Nijs J, De Baets L, Hodges P. Phenotyping nociceptive, neuropathic, and nociplastic pain: who, how, & why? Braz J Phys Ther. 2023;27(4):100537. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10470...
In the fourth episode, it is explained how clinicians can account for various lifestyle factors concomitantly into an individually-tailored multimodal lifestyle intervention for people with chronic pain.1 Clinicians are encouraged to apply an individually-tailored multimodal lifestyle intervention for chronic pain by explaining five key consecutive steps in the clinical reasoning process.1
Nijs J, Lahousse A, Malfliet A. A paradigm shift from a tissue- and disease-based approach towards multimodal lifestyle interventions for chronic pain: 5 steps to guide clinical reasoning. Braz J Phys Ther. 2023;27(5):100556.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10682...
The fifth contribution of the Comprehensive Pain Management Editorial Series focuses on the potential role of pain science education to facilitate a lifestyle approach in the management of chronic pain.6 It includes an update on the state of the patient pain education field and discusses the importance of promoting two-way communication, for example via motivational interviewing techniques, to promote behaviour change before, during, and after pain education.6
Roose E, Nijs J, Moseley GL. Striving for better outcomes of treating chronic pain: integrating behavioural change strategies before, during, and after modern pain science education. Braz J Phys Ther. 2023;27(6):100578.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10727...
The sixth paper in the Comprehensive Pain Management Editorial Series discusses the importance of and how clinicians can account for sleep disturbances as part of an individually-tailored multimodal lifestyle intervention for people with chronic pain.7
Nijs J, Mairesse O, Tang NKY. The importance of sleep in the paradigm shift from a tissue- and disease-based pain management approach towards multimodal lifestyle interventions for chronic pain. Braz J Phys Ther. 2024;28(1):100594. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10877...
In addition to dealing with sleep problems, many clinicians feel uncomfortable dealing with stress (intolerance) in patients with chronic pain, leaving plenty of room to implement stress science in clinical practice. Therefore, the seventh contribution of the Comprehensive Pain Management Editorial Series discusses the emerging role of stress (intolerance) and its management in patients with chronic pain.
Nijs J, Wyns A, Hendrix J. The importance of stress in the paradigm shift from a tissue- and disease-based pain management approach towards multimodal lifestyle interventions for chronic pain. Braz J Phys Ther. 2024;28(2):101061. https://www.sciencedirect.com/science/article/abs/...
Upcoming editions of the Comprehensive Pain Management Editorial Series will address the following topics:
Pain clinicians around the globe, let’s unite and combat the chronic pain pandemic!
Jo Nijs1,2,3
1 Pain in Motion Research Group (PAIN), Department of Physical therapy, Human Physiology and Anatomy, Faculty of Physical Education & Physical therapy, Vrije Universiteit Brussel, Belgium
2Chronic pain rehabilitation, Department of Physical Medicine and Physical therapy, University Hospital Brussels, Belgium
3 Department of Health and Rehabilitation, Unit of Physical therapy, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden
References
1. Nijs J, Lahousse A, Malfliet A. A paradigm shift from a tissue- and disease-based approach towards multimodal lifestyle interventions for chronic pain: 5 steps to guide clinical reasoning. Braz J Phys Ther 2023; 27(5): 100556.
2. Nijs J, Malfliet A, Roose E, Lahousse A, Van Bogaert W, Johansson E, Runge N, Goossens Z, Labie C, Bilterys T, Van Campenhout J, Polli A, Wyns A, Hendrix J, Xiong HY, Ahmed I, De Baets L, Huysmans E. Personalized Multimodal Lifestyle Intervention as the Best-Evidenced Treatment for Chronic Pain: State-of-the-Art Clinical Perspective. Journal of clinical medicine 2024; 13(3).
3. Nijs J, Lahousse A. Introducing the comprehensive pain management editorial series. Braz J Phys Ther 2023; 27(2): 100506.
4. Nijs J, Malfliet A, Nishigami T. Nociplastic pain and central sensitization in patients with chronic pain conditions: a terminology update for clinicians. Braz J Phys Ther 2023; 27(3): 100518.
5. Nijs J, De Baets L, Hodges P. Phenotyping nociceptive, neuropathic, and nociplastic pain: who, how, & why? Braz J Phys Ther 2023; 27(4): 100537.
6. Roose E, Nijs J, Moseley GL. Striving for better outcomes of treating chronic pain: integrating behavioural change strategies before, during, and after modern pain science education. Braz J Phys Ther 2023; 27(6): 100578.
7. Nijs J, Mairesse O, Tang NKY. The importance of sleep in the paradigm shift from a tissue- and disease-based pain management approach towards multimodal lifestyle interventions for chronic pain. Braz J Phys Ther 2024; 28(1): 100594.