Complex chronic pain conditions are often difficult to treat and can interfere with a variety of ADL/IADL, vocational, social, and other life tasks. In addition, people with persistent pain often have resulting secondary barriers as a result of disturbances to sleep, energy, mood, activity tolerance, ROM, memory, and various other factors. Research addressing “top down” approaches to pain treatment which utilize neuroplasticity to retrain the nervous system have increasing support in the literature and are an area for clinical practice development for OTs working in a variety of settings.

Part 1 of this two part series will focus on the use of graded motor imagery (GMI) to treat complicated pain conditions. It will cover the basic physiology of central sensitization and how to identify it in your patients during your evaluation. We will also discuss how to know which patients would benefit most from GMI. The approach to using GMI techniques including pain neuroscience education, laterality/ left right discrimination, motor imagery/ visualization, sensory retraining, and mirror therapy will be taught in preparation for Part 2 coming 3-21-18 which will focus on the hands on lab and application to various diagnoses. A case study outlining application to phantom limb pain will also be presented.

Complex chronic pain conditions are often difficult to treat and can interfere with a variety of ADL/IADL, vocational, social, and other life tasks. In addition, people with persistent pain often have resulting secondary barriers as a result of disturbances to sleep, energy, mood, activity tolerance, ROM, memory, and various other factors. Research addressing “top down” approaches to pain treatment which utilize neuroplasticity to retrain the nervous system have increasing support in the literature and are an area for clinical practice development for OTs working in a variety of settings.

Part 1 of this two part series focused on the theory behind GMI and the didactic presentation of the stages. Part 2 will focus on applying GMI techniques including pain neuroscience education, laterality/ left right discrimination, motor imagery/ visualization, sensory retraining, and mirror therapy in a hands on lab session. Time will be dedicated to applying treatment interventions to a variety of diagnoses including complex regional pain syndrome, shoulder pain, low back pain, neuropathy, pre-amputation, and others of interest to the participants.