Assessment-Treatment-Prevention Chronic Musculoskeletal Pain Disorders & Disability

(Regional Application of the Duffy-Rath System©)

Brief Description of the Course:

The Duffy-Rath System© (DRS) is a unique approach to the assessment, treatment and prevention of musculoskeletal disorders (MSD) and disability. Developed in 1984 by Wayne and Jean (Duffy) Rath, the system is currently utilized at outpatient clinics and industrial sites across the United States and internationally.

This workshop provides the clinician with a system to improve their effectiveness and efficiency in assessment and treatment of activity-related chronic musculoskeletal pain disorders and disability. All the treatment strategies are oriented towards recovery of activity tolerance and long-term self-efficacy (i.e. secondary, tertiary and quaternary prevention).

This is solely an online course. There are 5 sections the participant must complete with an ‘open-book’ test to pass and a critique that must be submitted prior to awarding a certificate of completion. The focus of this course is to chronic activity-related lower back and cervico-brachial pain disorders.

Workshop Goal:Promote a systematic, prevention-oriented and non-operative approach to the assessment, treatment and prevention of activity-related chronic musculoskeletal pain disorders and disability that is effective, efficient, accountable and long-term focused.

Workshop Instructional Objectives – upon completion of this activity, participants will be able to:

1. Identify relevant epidemiology for chronic musculoskeletal pain and disability.
2. Identify the patient intrinsic risk factors for chronic pain and disability that need to be recognized during the course of evaluation and treatment.
3. Identify the distinguishing clinical characteristics required for differential diagnoses related to chronic mechanical and non-mechanical MSDs.
4. Identify the care-giver risk factors that can facilitate chronic pain and disability during the course of evaluation and treatment.
5. Identify a strategic plan for implementation of the Duffy-Rath Function Treatment Strategy for legally involved and not legally involved chronic musculoskeletal disorders.
6. Identify the most common cautions and contraindications related to chronic musculoskeletal pain disorders and methods for rapid identification.
7. Identify the role of objective assessment of function, surgery and alternative methods of healthcare in the treatment and prevention of chronic musculoskeletal pain disorders and disability.

Workshop Outline:

Topic	Description
Online Registration and Orientation	Participants register online and are directed to an orientation section that identifies the goals and objectives for the workshop, and the structure and process for completing the course. The participant is then directed to the start of the course.
Section 1: Introduction	Identify the scope of the problem and contributing factors that place patients at an increased risk for chronic musculoskeletal pain and disability; including a thorough review of “Yellow Flags”. Define key terms and concepts used throughout the workshop. Overview our experience and findings in managing chronic pain problems based on our outcome assessment system in clinical practice > 30 years. Promote integration of the biopsychosocial model for better outcomes.
Section 2: DRS Assessment Process	Review the basic components of the DRS assessment process and the importance of standardizing the process and having operative definitions. Identify and demonstrate how to use the system to distinguish the characteristics of three sub-groups of patients with activity-related chronic pain: 1) mechanical chronic pain, 2) non-mechanical chronic pain with and without legal involvement and 3) those with a combination of mechanical and non-mechanical chronic pain. Identify the most appropriate Duffy-Rath treatment strategies to optimize effectiveness and efficiency of outcomes by application of the DRS algorithm. Review methods to identify when patients have more than one MSD interfering with their level of function and activity simultaneously.
Section 3: Chronic Mechanical Pain	Review the three corresponding treatment strategies for chronic activity-related mechanical back and neck pain disorders: Reduction strategy and provide clinical examples of rapidly resolvable chronic pain disorders. Remodeling strategy and provide examples of nerve root adherence and entrapment, and chronic local soft-tissue disorders and the cumulative improvements and recovery of activity tolerance expected. Stabilization strategy and provide clinical examples and the cumulative improvements and recovery of activity tolerance expected.
Section 4: Chronic NonMechanical Pain	Review modern pain neuroscience and common findings with patients that present with chronic non-mechanical back and neck pain disorders. Review implementation of the DRS function treatment strategy with clinical examples for the following two groups: Non-mechanical chronic pain with no legal involvement examples; participants need to identify strategy and tactics that facilitate an acceptable level of recovery. Non-mechanical chronic pain with legal involvement examples; participants need to identify strategy and tactics that facilitate an acceptable level of recovery. Identify methods to objectively measure physical performance and function before, during and after treatment of chronic musculoskeletal pain disorders.
Section 5: Summary	Review the predisposing factors, and the steps in the assessment process that lead to identification and management of mechanical and non-mechanical chronic back and neck pain disorders Identify methods for problem solving failure to recover to potential or respond in an appropriate timeframe. Review cautions and contraindications with chronic back and neck pain. Review the prevention continuum and long-term musculoskeletal self-efficacy. Identify resources for further study and information.
Test	Open-book test covering each section – 100% passage required, multiple opportunities (i.e. as many as needed) provided.
Study Time	8-10 hours