FC2O Episode 9 – Phil Austin Show Notes

0:00. Introduction

4:28. Master’s in Pain Management 2007, Edinburg University

Phil at the University of Edinburg – home of his Master’s training

5:10. The Question… Multidimensional Diagnostic Algorithms for Visceral Pain

6:29. The Roam Foundation: 60 types of functional GI Disorders…

13:22. Osteopathy vs Naturopathy…

14:36. Biopsychosocial approach & multidisciplinary vs interdisciplinary 

16:05. Easy to “think you’re being BPS / holistic.

16:44. Predicting who will get better and who will not… Catastrophisers versus those without meaning / purpose

18:56. Getting off opioids – The importance of an existential approach.

19:54. Resilience Program “Inner Core Strength”…

20:41. Questionnaires

21:21. It’s NOT all in your head!

There are many factors that influence your perception of pain from the health of the gut (and other organs) to the mental-emotional status, to beliefs around the pain and life, to the biochemistry of the body among many others. Often these factors summate in the dorsal horn of the spinal cord (red “explosion”) leading to central sensitivity and increased pain perception – even when the tissue has fully healed.
Image from Wallden, M., & Chek, P. 2018. “The Ghost in the Machine – Is Musculoskeletal Medicine Lacking Soul?” JBMT. April 2018.

22:12. Explain pain… Mainly in the brain…

23:15. Questionnaire: peripheral vs central pain

24:36. Conditioned Pain Modulation: Pain inhibits pain

28:08. Sensory cortex acute pain response

28:30. Emotional pain descriptors

28:57. Hypervigilance 

29:09. Catastrophising

30:12. Knowing when to refer out. 

30:49. Generalised guidelines:

Distressed but trying to get better…

Blaming the practitioner… BPD

31:32. Linking back in to the BPS model

34:11. Spiritual distress in terminally ill patients.

34:52. Death anxiety – religion vs spirituality

36:19. Blame and religion

36:42. A cultural “ghost”

39:20. The Virgin Mary in pain relief

40:49. Time perspective – fMRI transcendental future time perspective 

43:11. Persistent Pain & Past trauma 

Heightened HPA axis and inflammatory mediators 

46:00 epigenetic expression of pain

  • Decreased synaptic strength in inhibitory pathways and increased synaptic strength in pain facilitation pathways
  • Pain threshold decreased/pain perception increased

48:43. Bruce Lipton, brains and biomes

50:40. Core languages, epigenetics and the biopsychosocial model

52:12. Gut health, kimchi and central sensitivity.

56:15. Fecal transplants, biopsychosocial biomes, culture and colon(ie)s

57:43. Viscerosomatic reflexes and motor control.

101:53.  Spiritual factors in clinical work and the FACIT extended spiritual questionnaire*:

  • 1-8 Peace & meaning
  • 9-12 Faith
  • 13-23 Relationships

*Full title (search for) “Functional Assessment of Chronic Illness Therapy – Spiritual Well-Being, Expanded version”

1:06:50 The 1-2-3-4 approach: 1 Love / Legacy / Dream

1:08:18. The 2 Forces: Yin & Yang of Life – Catabolic:Anabolic Stressors

109:27. The importance of Life Purpose

  • Allostatic Load
  • Central Sensitisation

1:11:52. The Brain and the Mind

1:14:54. Psilocybin, God & Existential Anxiety

1:19:02. The brain as filter of reality?

1:21:22. Virtual reality, distraction and phantom pain

1:24:50 Generating order from chaos

Questionnaires:

  • DAS21 (depression anxiety depression)
  • Poster Australia/New Zealand Pain Society
Winning poster at the 2018 Australia / New Zealand Pain Society
  • “Pain Modulation Index” (Coming soon!)

To access Phil’s book “Chronic Pain – A resource for effective manual therapy” head over to Amazon. 

For clinical appointments with Phil at St Luke’s Clinic, Sydney, go to: https://www.osteopathy-chronicpain.com/contact-us.html

March 2020:

2020 Vision – Putting Persistent Pain Behind us in the Next Decade

Weekend Workshops with Matt Wallden, March 2020

Aukland: March Sat 7th / Sun 8th. Venue: UNITEC. Click here for more information or to secure your place.

Sydney: March Sat 14th / Sun 15th. Venue: TBC. Click here for more information or to secure your place.