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When it comes to promoting better, safer ways to manage chronic pain, the physical therapy profession is motivated and enthusiastic—and that's exactly the kind of energy that needs to be applied to pursuing evidence that supports physical therapy's role in transforming care, say authors of a guest editorial in an upcoming issue of PTJ (Physical Therapy) devoted exclusively to pain and pain management. The editorial was released ahead of issue publication.

The special May issue "serves as a reminder that there are lessons still to learn about optimizing nonpharmacological pain management," write guest co-editors Steven George, PT, PhD, FAPTA, an APTA member and director of medical research at the Duke Clinical Research Institute; and Arlene Greenspan, PT, MPH, DrPH, associate director of science and injury prevention and control at the Centers for Disease Control and Prevention (Greenspan's contributions were made as a personal outside activity). They describe the upcoming issue as "a good indication of the current state and possible future" of nonpharmacological approaches to pain.

According to George and Greenspan, articles in the special issue are rooted in 4 basic priorities that have emerged as pain management and the use of opioids have received national attention: gaining a better understanding of how acute pain becomes a chronic condition; ensuring better access to frontline nonpharmacological treatments; developing ways to foster self-management of chronic pain; and advancing implementation of strategies proven to be clinically effective.

But that doesn't mean the papers are repetitive in focus or approach. "Because pain is an individual phenomenon with tremendous variation in its presentation, the papers in this special issue cover different approaches, techniques, and philosophies," the editors write. Topics in the issue include psychologically informed practice, mechanism-based approaches, and sleep disturbances, with original research papers on topics including pain neuroscience education, rates of health care use after physical therapy, and the effectiveness of a home-based, telephone-supported physical activity program.

"These papers showcase diversity in approaches, techniques, and philosophies needed to make meaningful progress," write George and Greenspan. "Perhaps most important, these papers convey the complexities involved with providing effective nonpharmacological options for pain relief."

George and Greenspan believe that, collectively, the articles in the pain issue support the physical therapy profession's commitment to positive change.

"Our profession's vision is to transform society by optimizing movement to improve the human experience," they write. "At this time in history, few societal needs are more urgent than improving a physical therapist's ability to deliver effective nonpharmacological pain management."

PTJ is APTA's scientific journal, available for free to all APTA members. The journal is published online. Look for the special issue on pain in late April.

Want to understand the basics of pain and the role for physical therapy? Check out George's online course "A Primer on Pain for the Practicing Physical Therapist," available in the APTA Learning Center. And be sure to catch this year's Rothstein Roundtable at the 2018 NEXT Conference and Exposition, "Physical Therapy Decreases Opioid Use: What Will It Take to Change Policy?"

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