Understanding Pain: Reducing Perceived Threat by Changing Perception

Course Description

Understanding pain science is a critical aspect of successful patient care. However, pain science is often too focused on the science and not directly applicable to helping your patients get better. This course will enhance the treatment you provide by helping you better understand pain, as well as how to talk to your patients about it in a way they understand, embrace and don't fear.


This course dives deep into what pain is and why we have it, then will provide you with evidence-based strategies on how to use pain neuroscience education to improve patient outcomes. You'll learn metaphors and stories that help nudge patients in the right direction, depending on their readiness to make a behavior change. We'll also cover neurodynamics (movement of the nervous system) and how to treat a sensitive nerve. Finally, we'll discuss strategies to talk patients down from the "osteoarthritis/disc pathology cliff" when they are fixated on these issues and ignoring what can improve their pain and function.


You'll leave this course with the ability to immediately apply the information and elevate your approach to treating patients' pain!

At the completion of this course, participants will be able to...

  • Correctly and independently explain the difference between actual pain and perceived pain.
  • Correctly and independently explain how a pain experience is generated.
  • Correctly and independently explain why we cannot depend on imaging alone to guide our clinical judgement.
  • State 5 metaphors used to explain pain to patients.
  • Correctly identify the stages of behavior change as well as how to guide a person through them.
  • Correctly and independently explain both osteoarthritis and disc pathologies and how they relate to each other.



Doors Open


Lecture: What is Pain?


Lecture: Basics of the Nervous System


Lecture: Pain Neuroscience Education


Lecture: The Transtheoretical Model and Motivational Interviewing


Lecture: Neurodynamics


Lunch (on your own)


Lab: Neurodynamics and Treatment of Neural Containers


Lecture: Talking a Patient off of the Osteoarthritis Cliff


Lecture: Talking a Patient down from the Disc Pathology Cliff


Review: Pain Neuroscience Education Metaphors and Neurodynamics



Course Instructors

Karl Buche


Karl completed his undergraduate degree in Exercise Science from Michigan Technological University in 2012, then went on to graduate with his doctorate in physical therapy from Central Michigan University in 2016. He works at Probility Physical Therapy, which is based in southeast Michigan, and is the director of the Pinckney Clinic. After obtaining his CIMT credentials in 2019, he began teaching and assisting courses for GLS, with his main area of expertise being pain neuroscience. He believes in an eclectic treatment approach, including many styles of manual therapy, pain education, and individualized exercise. He cares deeply about the manner in which we communicate with our patients, and loves teaching others how to minimize nocebo effects during patient interactions. He lives in Chelsea, MI with his wife, Catherine, and puppy, Olive. He enjoys treating all orthopedic dysfunctions, and loves to incorporate breathwork into his practice.

Karl Buche

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