Issue link: https://www.massageandbodyworkdigital.com/i/1417136
50 m a s s a g e & b o d y wo r k n ove m b e r/d e ce m b e r 2 0 2 1 Layers of language What is sometimes said The problem How to "translate" better 1: Researcher language Interdisciplinary multimodal pain therapy (IMPT) programs for chronic back pain are effective and recommended. The patient-centered and biopsychosocial nature of IMPT is grounded in contemporary understanding that chronic pain states reflect heightened sensitization of the nervous system rather than an issue in the tissue. Teaching patients about pain is part of IMPT programs, though a clinical guideline is lacking. Conclusion: The additional pain neuroscience education (PNE) lecture did not lead to pain reduction beyond the usual IMPT. However, the PNE did increase pain-related knowledge and, therefore, might be helpful in coping with pain after the IMPT program. 6 Complex language will be understood only by those who are research literate. See below. 2: Clinician to clinician It looks like there's some good in PNE; let's try it in the clinic. The evidence is still weak but it can't do much harm. Or: Let's educate the patients; if they understand their pain, it'll make them feel better. There's evidence in favor of it now. Skims the detail. This is a type of shorthand often used between professionals, where the speaker assumes the listener is aware of the caveats. If both clinicians read the article and pay attention to the details, these statements are not problematic. If they do not, the listener will assume the evidence is solid and will then pass it on or apply it inaccurately. • Be more specific about the actual results and effects. • Clarify that the benefit is on a cognitive level. • Don't be afraid to note caveats: This is one single study; the multimodal approach is critical. • Recommend close reading before application. 3: Clinician to patient You have to think about your pain differently. Let's do some extra PNE sessions that will teach you how to control your pain. There's evidence it will help you cope. • Paternalistic and overbearing. Tells; doesn't explain or give patient options. • Inaccurate: This is not what the article says. • Misleading: It is the interdisciplinary and multimodal aspect that has supporting evidence; PNE benefits remain speculative. "Let's try to understand what's happening with your nervous system to make you feel pain. We'll tackle the pain through various techniques, but understanding what's happening might help you think about the pain differently so you have more control over how you look at it." 4: Clinicians to the general public on social media Look at the research! Pain neuroscience education helps patients! Neuroscience is the way forward; forget manual therapies! Follow the science! They've ignored the critical "interdisciplinary multimodal" context in which the PNE was applied. They've ignored the fact that adding PNE did not lead to pain reduction, and they have not specified the difference between knowledge and pain reduction. "Might be helpful" is only speculation. If sharing on social media without more careful explanation, this is misleading and irresponsible. Adding PNE to an IMPT program won't reduce pain, but it could help patients understand and cope with pain better. Sounds like a plan! The responses are examples reflecting the tone often seen in different encounters. They are fictional and not attributed to any individual. The Four Levels of Health-Care Conversations