In this episode, we expand upon 'Number Needed to Treat', tying that concept into overall therapeutic limitations and some other examples beyond medications, including one you are definitely going to want to hear about - the effect of pain neuroscience education in and of itself.

So how much does understanding pain actually decrease pain? It depends, but not as much as you'd think...We'll introduce a study that teases this apart and share a few different ways to interpret this so you can see how no one therapy is the be all end all of pain.

Hopefully, this information helps you better understand what aspects of pain you're treating in different situations so you can set better expectations, and make better decisions about the overall treatment plan.

Resources:

www.iniyh.com

https://www.instagram.com/iniyhpodcast/

Timestamps:

00:00 Official Intro

00:17 Therapeutic Limitations

01:27 Pain Neuroscience

03:00 SOPA Score

04:15 Original Paper Graph

06:56 Use these tools to improve components of pain

08:05 Pain isn't just in your head

10:02 Setting expectations for programs

12:19 Evidence-Based Medicine

15:23 Justine's Decision Making Process

17:21 A Future without the Ouch & Wrap Up

20:00 Disclaimer

The hard truth is it's normal for treatments, especially medications, not to work. But how many patients do you actually have to treat to improve things for just one even? This is where the concept 'number needed to treat' is critical to better understand so that expectations don't lead to resentments.

Managing expectations as a patient is hard, it's even harder when they're unrealistic. Unfortunately, there is little conversation around what is likely to work in various settings, and what their likelihood is to compared to other options. We'll go through how you should trial medications, ways to improve communications with your provider, touch on the ecological fallacy, explain how experienced clinicians can overcome some of this, and define what evidence-based medicine actually is and should look like.

Resources:

www.iniyh.com

https://www.instagram.com/iniyhpodcast/

Timestamps:

00:00 Official Intro

00:17 Intro - It's normal for treatments not to work

03:07 Number Needed to treat within Neuropathic Pain

05:06 Trial it for 6 weeks

06:07 Context is important in Number needed to treat

10:23 It's an Average - the ecological fallacy

15:00 Why do we do it this way?

16:04 The experienced Clinician can predict

18:15 Develop good communication with your Physician

19:18 Evidence-Based Medicine

20:34 Final Point

21:54 Disclaimer

In this episode, we will bring the different types of pain together in an alternative way to "Pain is a Sound System', introducing 'The Pain Pie' to tease apart the different aspects of pain that contribute to the output of symptoms patients experience.

As a provider, you can use this thinking tool to better see the different presentations as you go through the diagnostic process. As a patient, you can use it to start to better understand what you are experiencing and what interventions are most appropriate given the specific pieces of your pie.

Resources:

www.iniyh.com

https://www.instagram.com/iniyhpodcast/

Timestamps:

00:00 Official Intro

00:17 Intro to The Pain Pie

04:21 An Algorithm for Osteoarthritis

07:37 The Pain Pie

08:46 Neuropathic Pain

09:36 Nociplastic Pain

10:04 Associated features

11:53 How to use The Pain Pie & Wrap-Up

14:54 Disclaimer