Mechanical Discogenic Pain Course

Mechanical Discogenic Pain Course

This course looks at the largest patho-anatomical subgroup in the back pain spectrum. These are patients whose symptoms can be made to centralise, and/or display a repeatable and reversible directional preference when examined using a standardized repeated movement assessment.

*Prerequisite - First Activities and Introduction Course, Principles of Clinical Diagnosis Course and Radicular Syndrome Course.

 

 

The fact that mechanical loading in one direction decreases or centralizes pain, and the opposite direction has the opposite effect, and that this behaviour is both repeatable and rapidly reversible, is what gives rise to the labelling of this group of patients as having mechanical pain.

We know from our own diagnostic accuracy research that only patients with confirmed discogenic pain behave in this way. That is, almost all cases who are categorized as centralisers or show a directional preference will have positive provocation discography, which is the accepted reference standard for discogenic pain.

There are four formal lessons in this course:

  • Lesson one explores the biomechanics and patho-anatomy of the intervertebral disc as a baseline of understanding how it might be, that symptoms can be made to demonstrate this peculiar reversible and repeatable directional preference phenomenon.
  • Lesson 2 looks at the evidence and opinion regarding mechanical discogenic pain and how centralization has been observed and studied over the decades
  • Lesson 3 looks at case studies, mostly drawn from our own diagnostic accuracy research. Here we can see that not all discogenic pain cases centralize, and that discogenic pain is a broad category of painful patho-anatomy, with distinct subgroups of its own
  • Lesson 4 looks at the acquired deformities as distinct from the developmental ones like idiopathic scoliosis. Hypotheses and explanations for the lateral shift, acute lumbar kyphosis and acute fixed lordosis are discussed.
  • There is a 5th lecture which looks specifically at the diagnostic accuracy of directional preference, as distinct from centralization. This is not published in a journal, but was presented to a conference and revised to be put in the public domain.

There are several case study videos of management of the acute lateral shift, the acute kyphosis and acute fixed lumbar lordosis. There is one video of a fixed lumbar lordosis in a patient with more than 10 years of daily severe pain, that was rapidly reversible. He is being followed up still.

There is a quiz to complete so that you may test your understanding of this material.

*Prerequisite - First Activities and Introduction Course, Principles of Clinical Diagnosis Course and Radicular Syndrome Course.

Study time: 12 hrs (approx.)

Duration: 60 days
Price: NZ$230.00