Carey Rothschild

ObjectivePain is a multifaceted phenomenon; therefore, innovative, multisystem approaches are recommended as a path to pain recovery. Pain Resilience Therapy (PRT) was developed as a novel, resilience-focused approach to pain management. MethodsThree people with chronic pain received tele-physical therapy using PRT. The primary aim of PRT was to facilitate the development of pain resilience. Addressing vulnerability was a secondary aim. Treatment results were assessed using validated self-report measures for pain intensity, resilience, vulnerability, interference, patient outcome expectations, expectancies, and perspectives. ResultsAll patients demonstrated a reduction in pain intensity and pain interference (PROMIS®) with associated improvements in activity, sleep, mood, and stress measured by the Defense and Veterans Pain Rating Scale (DVPRS 2.0). Resilience (positive affect/coping) and self-efficacy increased, as measured by the Pain Self-Efficacy Questionnaire (PSEQ), Self-Efficacy for Rehabilitation (SER), Chronic Pain Acceptance Questionnaire (CPAQ), and the Pain Resilience Scale (PRS). Certain measures related to vulnerability (negative mood and fear avoidance) also improved. The PRT intervention was safely delivered and patients reported their health as very much improved measured by the Patient Global Impression of Change (PGIC) survey. ConclusionThis case series supports the application of PRT’s resilience-focused approach to attenuate pain and vulnerability while improving physical and psychological well-being. Although there is a need for research elucidating change mechanisms, assisting patients/clients in accessing resources that facilitate resilience is a valid pathway to pain recovery. This case series is a step toward integrating an understanding of resilience within the broader context of pain and disability.

Several mechanisms may influence recovery and act as a complementary intervention to regenerative medicine. One area of consideration that may improve clinical outcomes in patients receiving regenerative medicine treatments is the utilization of supplementary interventions referred to as regenerative rehabilitation. One such intervention may be the use of light therapy also known as photobiomodulation (PBM). Terms synonymous with PBM include low-level light therapy (LLLT), low-power laser irradiation or cold laser. As a musculoskeletal intervention, PBM is administered via a mechanism that creates light through optical amplification. These interventions describe a form of PBM or light therapy that uses specific param-eters to target tissues through direct or indirect contact with or without heat or structural tissue alterations. PBM may improve treatment outcomes based on synergistic effects that are thought to modulate inflammation and facilitate cellular repair. This manuscript provides an overview of the current evidence supporting the use of PBM as a complementary intervention to regenerative medicine with a focus on managing conditions related to the musculoskeletal system.