Dr. Robert Vining: Pain Education as an Essential Tool

Robert Vining, DC, DHSc, is associate dean of clinical research at Palmer College of Chiropractic. He will present “Pain Education: An Essential Tool for Chiropractic Practice” in person on Friday, Feb. 4 at Engage 2022. In this ACA Blogs Q&A, we learn more about the importance of pain education for those suffering from chronic pain and how Dr. Vining applies his diverse background in research, clinical practice and education to help providers empower their patients to manage pain more effectively.

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How is the topic you are presenting at Engage 2022 relevant to today’s chiropractor?

Dr. Vining: Chronic pain is highly prevalent, affecting one in five Americans. People with chronic pain are at greater risk for opioid dependence and chronic back and neck pain are the leading causes of disability, both globally and in the United States. Therefore, virtually every doctor of chiropractic has opportunity to engage people who experience chronic pain.

However, much of how chronic pain has been historically conceptualized and treated contrasts with what is currently known about pain neurobiology. Pain education is a relatively new intervention informed by pain neuroscience. Multiple clinical trials have consistently reported pain education improves pain severity, disability, fear-avoidance, and catastrophizing for patients with chronic musculoskeletal pain. Pain education is more effective when used in conjunction with manual therapies, making it a natural fit for chiropractic care.

Is there any relevant research you can share for those who would like to learn more?

Dr. Vining:

  • Dahlhamer et al., 2016, Prevalence of chronic pain and high-impact chronic pain among adults – United States, 2016. MMWR Morb Mortal Wkly Rep 2018;67:1001–1006.
  • GBD 2017 Disease and Injury Incidence and Prevalence Collaborators, Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017, Lancet. 392 (2018) 1789–1858.
  • S. Safiri et al., Cross, Global, regional and national burden of osteoarthritis 1990-2017: a systematic analysis of the Global Burden of Disease Study 2017, Ann. Rheum. Dis. (2020). https://doi.org/10.1136/annrheumdis-2019-216515
  • Louw, et al., The efficacy of pain neuroscience education on musculoskeletal pain: A systematic review of the literature, Physiother. Theory Pract. 32 (2016) 332–355. https://doi.org/10.1080/09593985.2016.1194646
  • Watson, et al., Pain Neuroscience Education for Adults With Chronic Musculoskeletal Pain: A Mixed-Methods Systematic Review and Meta-Analysis, J. Pain. (2019). DOI:https://doi.org/10.1016/j.jpain.2019.02.011
  • Wood, et al., A systematic review and meta-analysis of pain neuroscience education for chronic low back pain: Short-and long-term outcomes of pain and disability, Eur. J. Pain. 23 (2019) 234–249. https://doi.org/10.1002/ejp.1314

What background do you have in respect to your topic area?

Dr. Vining: I hold Doctor of Chiropractic and Doctor of Health Science degrees and I have clinical experience in solo private practice, and in multidisciplinary and clinical research settings. I have experience as a classroom instructor and teaching clinician at two chiropractic colleges. I have served as co-investigator on numerous federally funded clinical trials and as principal or co-principal investigator on several privately funded studies focused on developing decision-making tools for clinicians, integrating chiropractic care into multidisciplinary settings, and chiropractic education.

I am also an author on over 50 peer-reviewed scientific publications. The combination of my training and experience supported my capacity to lead a scoping review of the scientific literature reporting on pain education, which was recently published in the journal Patient Education and Counseling. (Ziegler AM, Minkalis A, Langdon ER, Vining R. Learning the neurobiology of pain: A scoping review of pain education from an instructional design perspective. Patient Education and Counseling. Online ahead of print.)

What practical knowledge or skills can attendees take away from your presentation and start using immediately in their practices? And how will what they take away make them better doctors?

Dr. Vining: Though education is a key component of chiropractic care, most practitioners are not trained educators. This presentation will facilitate learning about an education-based therapeutic tool through a clinician/educator’s lens. Such a perspective has the potential to help providers develop a greater awareness of and capacity to incorporate key learning activities consistent with distinct phases of pain education, as recommended by internationally recognized experts.

Can you share an anecdote from your own career to demonstrate how greater knowledge of your topic can make a difference for patient care and/or professional success?

Dr. Vining: It can be extremely satisfying to know that you have helped someone better understand their chronic pain and to observe the empowerment that accompanies the capacity to better self-monitor and self-manage symptoms because of that understanding.

What do you enjoy about presenting educational programs?

Dr. Vining: I enjoy the opportunity to present relevant scientific information with the potential to facilitate evidence-based clinical decision making. I also enjoy the opportunity to learn from and understand the challenges and concerns of other practitioners. As someone who functions both as a clinician and researcher, connecting with and staying current with practicing colleagues is an important aspect of my work.

Engage 2022 offers an unmatched education program, featuring 19 virtual and in-person sessions that offer high-quality, innovative presentations. A total of 21 CE credits are available through several of the programs. Learn more and register here.