In response to chronic pain, there are documented changes in the brain, including a decrease in matter integrity, alterations in neurotransmitters, leading to vulnerabilities in interaction with pain-related input. Essentially, the brain becomes a maladaptive expert in pain. Encouraging evidence suggests that alterations in the brain, associated with chronic pain, are malleable with effective clinical interventions. Pairing pain treatment interventions with strategies that can increase neuroplasticity and optimize the brain’s ability to learn, adapt, and implement new information, may improve treatment outcomes. Dr. Cureton will explore this research and some strategies relevant to supporting this alternative to opioid pain management.

Dr. Fuller will update our understanding of the key relationship between magnesium and pain, offering us an alternative to opioid pain management strategies.

After a solid review of magnesium biochemistry, we will look at magnesium deficient conditions and magnesium as therapy, particularly as relevant to pain, especially magnesium sulfate in IV delivery. Finally, a robust discussion of safety concerns and side effects relevant will take place.

The gains of this workshop will be simple: using manual techniques to regulate and support inflammatory process related to pain.

Initially, however Dr. Agger will present the biology- the research/efficacy of down regulatory modulation and central cortical modulation and how they commonly present in the clinic and the problems of maintaining these with common opioid and pharmacy-based standards of care. Alternative adjunctive measures will also be considered. We will then engage some practical strategies.

Attendees will leave this presentation with a robust clinical biological and technique update on how they can impact their patient population through manual medicine and adjunctive modalities.

Assessment with the Primary Pain Generator: Using experience garnered as AOM practitioner and pain management FNP, Chris will explore the primary pain generator as means of assessment. This lecture will consider AOM and allopathic anatomy to look at pain and then pain typologies while also interacting considerably with standards of care relevant to dominant (opioid dominated) pain management strategies.

Dr. Misha Kleronomos will discuss the complexities of mental health diagnosing in medical practice as these intersect with pain. She will review common challenges in mental health prescribing including the issues relevant to decreasing dependence. She will discuss the complex relationship between psychotropic prescribing and mental health support in general but especially as relevant to pain.

Diagnostics connected to pain can prove expensive and time consuming while offering confusing results. Ultrasound technology has progressed rapidly, resulting in reduced cost of the machine, all the while better image quality. If one has a diagnostic ultrasound in their clinic, they can use it as a Point of Care extension of their physical exam to quickly rule in/out common causes of pain. This presentation will discuss the foundations of diagnostic ultrasound, discuss the units that are available and affordable, how to bill for exams, and common conditions that can be diagnosed using ultrasound point of care without having to send the patient for further imaging or testing.

Interdisciplinary Standard of Care Documentation in Pain Management - Case Study: Pain management is often integrated with many practitioners trying to communicate across record keeping technologies. Because Dr. Kleronomos works with varied ND, LAc, and NP in his pain management clinic, he often sees challenges. Using the case of bee venom therapy, he will review how to translate concerns and insights of the practitioner into the challenging and often reductionist systems of clinical record keeping so that alternative therapies can be properly supported, welcomed, justified, paid for – and thus used.

Dr. Foxe takes a surprising look at ice and its effects on pain. This study was motivated by his own journey with difficult pain following a hand injury. Chinese Medicine will offer useful insights that will help us reassess current ice management practices. These will be connected to updates in best practice research. Dr. Foxe's research on ice for pain management is considered groundbreaking.