San Diego Pain Summit Bridges Research and Practice

San Diego, California, may be famous for many things, such as Balboa Park, the San Diego Zoo, the Chargers, and year-round mild weather that rarely sees any ice and snow. Among manual therapists, which includes physical and massage therapists, “America’s Finest City” may now be famous for the first annual San Diego Pain Summit (www.sandiegopainsummit.com) that took place last weekend.

The three-day event featured Dr. Lorimer Moseley as the keynote speaker. Mosley leads a team of pain researchers at the University of South Australia in Adelaide, where they study the role of the mind and the brain in chronic pain. His keynote speech covered the placebo effect, biopsychosocial influences of pain perception, and his current unpublished research. He also explained pain with a story of his own brush with death after he was bitten by a poisonous snake in his left leg while walking through the Australian bush and wearing only a sarong.

The San Diego Pain Summit is the first of its kind in the U.S. One hundred thirty-five healthcare and wellness professionals attended the event, including 65 physical therapists, 38 massage therapists, six personal trainers, three athletic trainers, two physicians, and three chiropractors, from Canada, Brazil, England, Australia, Denmark, and Portugal. 

Chronic pain costs the United States a whopping $550 to $635 billion each year in medical costs and treatment, according to the Institute of Medicine Report from the Committee on Advancing Pain, and current costs may be much higher now than it was four years ago. Rather than finding the “miracle cure” for chronic pain, many healthcare professionals want to understand what causes pain and what pain really is. Hence, the San Diego Pain Summit bridged the gap between the current understanding and new research behind pain science with clinical practice.

Last January, I organized a double feature class with Diane Jacobs teaching DermoNeuroModulation  for three days and Barrett Dorko teaching Simple Contact for two days,” said massage therapist Rajam Roose, HHP, who is the executive director and founder of the San Diego Pain Summit. (HHP stands for Holistic Health Practitioner, which is a unique license issued for massage therapists by the City of San Diego.)

“During a break in Barrett’s class, Barrett was speaking with some of the participants who were all physical therapists. He asked them if they had even heard of Melzack, Butler, Moseley, etc. The students said they had learned about the famous pain researchers in physical therapy school, but they had no clue how to put the info into practice.”

This sparked the idea in Roose’s head about creating the San Diego Pain Summit. “This is the first conference of its kind in the United States. It should be an educational, inspiring, and a highly motivating event. This will be the first of many, I hope, that I plan on organizing to help bridge the gap between research and treatment protocols in the clinic.” 

Jason Erickson, president of the American Massage Therapy Association’s Minnesota chapter, served as the Master of Ceremony for the pain summit. He and Roose teamed up to make sure everything ran on schedule and prepared the speakers for their presentations. “One truly generous thing that Rajam did is give me a long leash to run on. She trusted my judgment about how to open and close the event, and just asked me to communicate certain information at various points throughout the event,” Erickson commented. “This made it much easier for me to be myself and have fun with the crowd.”

With most pilot events, there are some things that can be improved. “The biggest complaint was the WiFi issue because the venue was upgrading their system on the same weekend while we were there,” said Roose. “Most of the other complaints are from people who didn’t realize that info about the speaker bio’s, schedule, and other information had been available on the website for some time.”

There were also some issue with folks not reading or receiving their info email packets or reading the online info and were confused about the set up when they arrived,” Roose added. “Some organizational issues can be improved and are easy to correct. Overall, I think it went very well.

There were even complaints that some of the speakers did not talk long enough, and Roose think that shows how much the audience enjoyed listening to them. “I would have liked to have hands-on time but had invited too many speakers for that to happen. Next year, I plan on doing a three-day pre-conference of hands on and two days of conference lectures,” Roose said.

Kara Barnett, who was one of the speakers and is a physical therapist at Kaiser Permanente in San Diego, thought that mainstream physicians are catching up to the more recent pain science that goes beyond just injuries or pathologies. “I think that physicians are getting more savvy with regards to prescribing more appropriate pain medications for persistent symptoms,” Barnett said. “I also agree that increasing numbers of physicians and other clinicians are realizing that the language that they use with patients can have significant impacts, particularly when describing imaging results and efficacy expectations with certain treatments. We have about 60 physical therapists in San Diego Kaiser and more clinicians are seeing the value of a biopsychosocial model and the usefulness in explaining pain science, especially in the more chronic patients. In my practice, we offer individual pain education, as well as in a class setting.”

Many attendees believe that the San Diego Pain Summit can help manual therapists go beyond what they learned in school and help them get out of dogmatic thinking and learning. “We need to get really honest about who we are, what we are providing,” said massage therapist Beret Kirkeby, who attended the summit and practices in New York City at Body Mechanics Orthopedic Massage. “If you truly want to help people, you have to hold events like this because while we are all asking the same questions about why. There may not be one answer. And if there is an answer, it’s probably not locked behind a treatment room door.”

The thing that struck me most keenly was the sheer enthusiasm and unswerving commitment of those who attended toward improving their knowledge not only for themselves, but for their professions and for those whom they ultimately serve,” said Phil Greenfield, who practices manual therapy at Core Alignment Bodywork in Derby, U.K. “Real flesh-and-blood friendships were being made.”

Even massage therapy educators, like Brent Jackson who teaches at Central Carolina Technical College in Sumter, South Carolina, found a simpler explanation of chronic pain to teach his students. He also encourages them to use science to question everything. “The online comments were encouraging to see that we are all on a learning curve,” Jackson said. “The posts that we viewed as a class were encouraging to students that life-long learning is essential. They were excited to see therapists with PhD’s and physical therapists posting the excitement of learning new material. It was very encouraging. I would strongly encourage students, massage therapists, and educators to attend.”

Plans for next year’s San Diego Pain Summit is already taking place with speakers confirmed, including neurobiologist Dr. Robert Sapolsky from Stanford and registered occupational therapist Dr. Bronnie Thompson from the University of Otago Christchurch in New Zealand. Dr. V.S. Ramachandran from the Psychology Department and Neurosciences Program at the University of California, San Diego, may be the keynote speaker, but it is not confirmed yet, according to Roose.

“Next year there will be wonderful speakers and extra days for hands-on classes,” Roose projected. “Michael Shacklock will teach an upper and lower body neurodynamics. And there’s going to be a third day that I’m planning to offer two classes, but I have to confirm the instructors before I can announce them. The networking event went really well, so there will be another one so that colleagues can continue to meet and share knowledge.”

Erickson, in particular, will return to attend next year’s summit. “Though it was a lot of work, I would gladly do it all over again – and a good thing, because I’ve already accepted an invitation to be the Master of Ceremonies in 2016,” Erickson exclaimed. “I’m barely coming down from the last one, and I’m already getting excited for the next one!”

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