Program Structure: 80 total contact hours - Format: 4 sessions per week × 2.5 hours each = 10 hours/week - Duration: 8 weeks (32 total sessions) - Cohort Size: 12-20 participants per group - Setting: In-person group sessions
Education Module 1 (30 min) - What is Pain? Nociception vs. perception - Pain pathway: Transduction → Transmission → Modulation → Perception - Acute vs. Chronic pain distinctions
Movement Practice (45 min): Gentle stretching and body awareness
Education Module 2 (30 min) - Pain Types: - Nociceptive (tissue damage) - Neuropathic (nerve damage) - Nociplastic (central sensitization) - Mixed presentations
Group Discussion (30 min): Personal pain experiences and patterns
Assessments: Baseline BPI (Brief Pain Inventory) and ODI (Oswestry Disability Index)
Visual Aids Needed: - Pain pathway diagram (nociceptor → spinal cord → brain) - Pain types comparison chart - Acute vs. chronic pain timeline
Education Module 1 (30 min) - Peripheral Nociceptors: A-delta (sharp, fast), C fibers (dull, slow) - Spinal Cord Processing: Dorsal horn, wide dynamic range neurons - Ascending Tracts: Spinothalamic, spinoreticular, spinomesencephalic
Movement Practice (45 min): Introduction to Tai Chi basics
Education Module 2 (30 min) - Brain Processing Centers: - Sensory cortex (location, intensity) - Limbic system (emotional response) - Prefrontal cortex (meaning, context) - Pain as a Threat Response: Evolutionary perspective
Group Discussion (30 min): How emotions affect pain perception
Visual Aids Needed: - Brain pain processing diagram - Spinothalamic tract pathway illustration - Emotional brain regions (limbic system) chart
Education Module 1 (30 min) - Melzack & Wall 1965: Revolutionary pain theory - The “Gate” Mechanism: Substantia gelatinosa in dorsal horn - A-beta Fibers: Large, fast fibers that “close the gate” - How Rubbing Helps: Non-painful input blocks pain signals
Movement Practice (45 min): Qi Gong introduction
Education Module 2 (30 min) - Descending Modulation: Brain can “turn down” pain - Periaqueductal gray (PAG) - Rostral ventromedial medulla (RVM) - Endogenous opioids, serotonin, norepinephrine - Practical Applications: - Heat/cold therapy - TENS units - Massage - Movement
Group Discussion (30 min): What makes pain better or worse for you?
Visual Aids Needed: - Gate Control Theory diagram - Descending pain modulation pathway - Practical gate-closing techniques chart
Education Module 1 (30 min) - Wind-Up: Repeated C-fiber input → amplified response - NMDA Receptor Activation: Glutamate signaling changes - Microglial Activation: Neuroinflammation in spinal cord - Clinical Manifestations: - Hyperalgesia (increased pain to painful stimuli) - Allodynia (pain from non-painful stimuli)
Movement Practice (45 min): Gentle yoga introduction
Education Module 2 (30 min) - Reversibility: Central sensitization CAN be reduced - Strategies: - Gradual movement (not rest) - Stress reduction - Sleep optimization - Pain neuroscience education - Expectations: Progress is gradual, not linear
Group Discussion (30 min): Signs of central sensitization in your experience
Visual Aids Needed: - Central sensitization progression diagram - Hyperalgesia vs. allodynia illustrations - Wind-up mechanism chart
Education Module 1 (30 min) - Brief Pain Inventory (BPI): - Pain severity (4 items: worst, least, average, current) - Pain interference (7 domains: activity, mood, walking, work, relationships, sleep, enjoyment) - Scoring: 0-10 numeric rating scale - Clinical significance: ≥2 point change
Movement Practice (45 min): Tai Chi - Weight shifting
Education Module 2 (30 min) - Oswestry Disability Index (ODI): - 10 sections: pain intensity, personal care, lifting, walking, sitting, standing, sleeping, social life, traveling, employment/homemaking - Scoring: 0-50 total (0-20% minimal, 21-40% moderate, 41-60% severe, 61-80% crippled, 81-100% bed-bound) - Sensitivity: Detects 10-point changes
Group Discussion (30 min): Completing your first BPI and ODI
Assessments: Week 2 BPI/ODI/Functional assessments
Visual Aids Needed: - BPI form walkthrough - ODI interpretation chart - Pain interference domains illustration
Education Module 1 (30 min) - What to Track: - Pain intensity (0-10) - Location and quality - Activities performed - Medications taken - Sleep quality - Mood - Triggers identified - Relief strategies used
Movement Practice (45 min): Qi Gong - Breathing coordination
Education Module 2 (30 min) - Pattern Recognition: - Time of day patterns - Activity-pain relationships - Weather influences - Stress connections - Medication effectiveness - Digital vs. Paper: Apps vs. journals (participant choice)
Activity (30 min): Start your pain journal - first entry together
Visual Aids Needed: - Sample pain journal pages - Pattern recognition examples - Trigger identification flowchart
Education Module 1 (30 min) - SMART Framework: - Specific: “Walk 15 minutes daily” not “exercise more” - Measurable: Quantifiable outcomes - Achievable: Realistic given current function - Relevant: Meaningful to YOUR life - Time-bound: Specific timeline
Movement Practice (45 min): Yoga - Balance and stability
Education Module 2 (30 min) - Types of Goals: - Functional (activities of daily living) - Physical (strength, flexibility, endurance) - Emotional (mood, stress management) - Social (relationships, participation) - Avoiding Common Pitfalls: - Too aggressive initially - Pain-contingent (don’t wait for pain to be gone) - All-or-nothing thinking
Activity (30 min): Write your first 3 SMART goals
Visual Aids Needed: - SMART goal template - Good vs. poor goal examples - Goal progression ladder
Education Module 1 (30 min) - The Boom-Bust Cycle: - Good day → Overdo → Pain flare → Rest excessively → Decondition → Repeat - Breaking the cycle - Activity Pacing Principles: - Consistent baseline activity (even on good days) - Gradual progression (10% rule) - Planned rest breaks - Task modification/delegation
Movement Practice (45 min): Tai Chi - Flow and continuity
Education Module 2 (30 min) - Energy Conservation Techniques: - Body mechanics (lifting, bending) - Ergonomics (workspace, sleep environment) - Assistive devices (when appropriate) - Time management - Pacing Examples: - Vacuuming: 10 min intervals with 5 min breaks - Gardening: Use kneeling pad, alternate tasks - Grocery shopping: Use cart, multiple trips if needed
Activity (30 min): Identify your boom-bust patterns and create pacing plan
Visual Aids Needed: - Boom-bust cycle diagram - Activity pacing timeline example - Proper body mechanics illustrations
Education Module 1 (30 min) - Exercise-Induced Analgesia (EIA): - Endogenous opioid release (beta-endorphins) - Endocannabinoid system activation - Reduced inflammatory cytokines (IL-6, TNF-alpha) - Increased anti-inflammatory markers (IL-10) - Neuroplasticity: Movement retrains pain pathways
Movement Practice (45 min): Yoga - Gentle flow sequence
Education Module 2 (30 min) - Evidence for Movement Therapies: - Tai Chi: SMD -0.54 for osteoarthritis, -0.81 for low back pain - Yoga: SMD -0.48 for chronic pain conditions - Qi Gong: Significant pain reduction in fibromyalgia, neck pain - Minimum Effective Dose: 5-6 weeks, 2-3x/week, 30+ min/session
Group Discussion (30 min): Overcoming barriers to movement
Assessments: Week 3 BPI/ODI/Functional assessments
Visual Aids Needed: - EIA mechanism flowchart - Meta-analysis forest plots (Tai Chi, Yoga effectiveness) - Progressive exercise timeline
Education Module 1 (30 min) - History & Philosophy: - Origins in martial arts and Taoism - Yin-Yang balance principle - Qi cultivation and flow - Mind-body integration - Core Principles: - Slow, continuous movement - Weight shifting - Relaxed but upright posture - Mental focus/meditation
Movement Practice (60 min): Extended Tai Chi practice session
Education Module 2 (30 min) - Biomechanics of Tai Chi: - Weight distribution (60/40, 70/30) - Core engagement without tension - Joint protection through proper alignment - Breathing coordination with movement - Common Forms: Yang style (most common for pain management)
Visual Aids Needed: - Tai Chi form sequence photos - Proper vs. improper posture comparisons - Breathing pattern diagrams
Education Module 1 (30 min) - Traditional Chinese Medicine Context: - Meridian system overview - Qi blockage and pain - Five elements theory - Modern scientific interpretation - Types of Qi Gong: - Medical (healing) - Martial (strength) - Spiritual (meditation)
Movement Practice (60 min): Qi Gong - Full practice session
Education Module 2 (30 min) - Specific Forms for Pain: - Eight Brocades (Ba Duan Jin): Classic health maintenance - Five Animal Frolics (Wu Qin Xi): Biomimicry movements - Six Healing Sounds: Organ-specific practices - Acupressure Points for Self-Care: - LI4, GB20, LV3, SP6, ST36, PC6
Visual Aids Needed: - Meridian map with common pain points - Acupressure point location diagrams - Qi Gong form step-by-step illustrations
Education Module 1 (30 min) - Yoga Styles for Pain: - Hatha: Gentle, foundational poses - Iyengar: Alignment-focused, uses props extensively - Restorative: Passive poses, deep relaxation - Yin: Long holds targeting connective tissue - Chair Yoga: Modifications for limited mobility
Movement Practice (60 min): Yoga - Mixed style practice
Education Module 2 (30 min) - Key Poses for Common Pain Sites: - Low Back Pain: Cat-cow, child’s pose, supine twist, bridge - Neck/Shoulders: Thread the needle, shoulder rolls, eagle arms - Hips: Pigeon, figure-4 stretch, happy baby - Arthritis: Gentle joint mobility sequences - Prop Use: Blocks, straps, bolsters, blankets for support and accessibility
Visual Aids Needed: - Pose modification charts (3 levels: beginner, intermediate, props) - Common mistakes illustrations - Anatomical benefits diagrams for specific poses
Education Module 1 (30 min) - ANS Overview: - Sympathetic: “Fight or flight” - arousal, activation - Parasympathetic: “Rest and digest” - recovery, restoration - Balance = health; imbalance = dysfunction - Sympathetic Activation Effects on Pain: - Muscle tension increases - Blood vessel constriction → reduced tissue oxygenation - Heightened sensitivity to pain signals - Inflammatory cytokine release
Movement Practice (45 min): Gentle Tai Chi - Focus on relaxation
Education Module 2 (30 min) - Chronic Stress & Pain Cycle: - Pain → Stress → Sympathetic activation → More pain → More stress - HPA axis dysregulation (cortisol) - Allostatic load accumulation - Clinical Evidence: - Heart rate variability (HRV) reduced in chronic pain - Elevated cortisol in fibromyalgia, chronic back pain
Group Discussion (30 min): Recognizing your stress-pain patterns
Assessments: Week 4 BPI/ODI/Functional assessments
Visual Aids Needed: - ANS balance diagram (sympathetic vs. parasympathetic) - Stress-pain cycle flowchart - HPA axis illustration
Education Module 1 (30 min) - Vagus Nerve: The parasympathetic superhighway - Longest cranial nerve - Innervates heart, lungs, digestive system - Anti-inflammatory effects - Vagal Tone: - Higher vagal tone = better stress resilience - Measured by HRV - Can be improved with practice
Movement Practice (45 min): Restorative Yoga - Deep relaxation
Education Module 2 (30 min) - Ways to Activate Parasympathetic System: - Deep diaphragmatic breathing - Extended exhale (2:1 ratio) - Cold water face immersion - Humming/singing - Meditation - Gentle movement - Social connection
Activity (30 min): Practice vagal toning techniques
Visual Aids Needed: - Vagus nerve pathway diagram - Diaphragmatic breathing technique illustration - HRV measurement interpretation
Education Module 1 (30 min) - Respiratory Physiology & Pain: - Breath rate affects autonomic balance - CO2/O2 regulation influences pain perception - Chest vs. diaphragmatic breathing patterns - Breathing Dysfunctions in Chronic Pain: - Shallow, rapid breathing (stress response) - Breath-holding patterns - Paradoxical breathing
Movement Practice (45 min): Qi Gong - Breathing-focused practice
Education Module 2 (30 min) - Specific Breathing Techniques: - 4-7-8 Breath: Inhale 4, hold 7, exhale 8 (relaxation) - Box Breathing: 4-4-4-4 (stress reduction) - Coherent Breathing: 5-6 breaths/min (HRV optimization) - Alternate Nostril: Balance left/right hemisphere - Ujjayi (Ocean Breath): Controlled resistance breathing
Practice (30 min): Guided breathing technique practice
Visual Aids Needed: - Diaphragm movement diagram - Breathing technique step-by-step guides - Breath rate vs. ANS state chart
Education Module 1 (30 min) - Progressive Muscle Relaxation (PMR): - Developed by Edmund Jacobson (1930s) - Tense-release technique - Systematic progression through body regions - Reduces muscle guarding and tension - Mechanism: Teaches discrimination between tension and relaxation
Movement Practice (45 min): Guided PMR session (full body)
Education Module 2 (30 min) - Body Scan Meditation: - Mindful awareness without manipulation - Non-judgmental observation - Interoceptive accuracy training - Acceptance-based approach - Applications: Pain flare management, pre-sleep routine, anxiety reduction
Practice (30 min): Guided body scan meditation
Visual Aids Needed: - PMR muscle group progression chart - Body scan pathway illustration - Tension vs. relaxation sensation comparison
Education Module 1 (30 min) - Inflammatory Cascade: - Acute inflammation (healing response) - Chronic inflammation (disease state) - Pro-inflammatory cytokines: IL-1, IL-6, TNF-alpha - Prostaglandins and pain sensitization - Dietary Influence on Inflammation: - Food as medicine vs. food as trigger - Evidence: Mediterranean diet reduces CRP, IL-6
Movement Practice (45 min): Tai Chi - Flow practice
Education Module 2 (30 min) - Biomarkers of Inflammation: - C-reactive protein (CRP) - Erythrocyte sedimentation rate (ESR) - Cytokine profiles - Clinical Studies: - Diet modification → 30-50% reduction in inflammatory markers - Correlates with pain reduction in OA, RA, fibromyalgia
Group Discussion (30 min): Current dietary patterns and pain levels
Assessments: Week 5 BPI/ODI/Functional assessments
Visual Aids Needed: - Inflammatory cascade diagram - Pro- vs. anti-inflammatory foods chart - Mediterranean diet pyramid
Education Module 1 (30 min) - Top 10 Anti-Inflammatory Foods: 1. Fatty Fish (omega-3: EPA, DHA) - salmon, sardines, mackerel 2. Berries (anthocyanins) - blueberries, strawberries, blackberries 3. Leafy Greens (vitamins, minerals) - kale, spinach, collards 4. Turmeric (curcumin) - 500mg daily 5. Ginger (gingerols) - fresh or powdered 6. Olive Oil (oleocanthal) - extra virgin, first cold press 7. Nuts/Seeds (healthy fats, vitamin E) - walnuts, flaxseed, chia 8. Green Tea (EGCG) - 3-4 cups daily 9. Dark Chocolate (flavonoids) - 70%+ cacao 10. Tomatoes (lycopene) - cooked for better absorption
Movement Practice (45 min): Yoga - Energizing sequence
Education Module 2 (30 min) - Nutrients & Mechanisms: - Omega-3 Fatty Acids: COX-2 inhibition, resolvins - Polyphenols: Antioxidant effects, gene expression - Fiber: Gut microbiome support, SCFA production - Dosing & Preparation: - Cooking methods that preserve nutrients - Supplement considerations (when diet insufficient)
Activity (30 min): Anti-inflammatory meal planning workshop
Visual Aids Needed: - Food-nutrient-mechanism chart - Serving size guide with photos - Sample meal plans
Education Module 1 (30 min) - Pro-Inflammatory Foods: 1. Sugar & Refined Carbs: Glucose spikes, AGEs formation 2. Processed Meats: Nitrates, saturated fat, sodium 3. Trans Fats: Partially hydrogenated oils 4. Excessive Alcohol: Liver stress, gut permeability 5. Refined Vegetable Oils: High omega-6 ratio (corn, soybean) 6. Artificial Additives: MSG, artificial sweeteners - Mechanisms: Oxidative stress, NF-kB activation, gut dysbiosis
Movement Practice (45 min): Qi Gong - Detoxification focus
Education Module 2 (30 min) - Individual Food Sensitivities: - Common triggers: gluten, dairy, nightshades, lectins - Not universal - highly individual - Elimination Diet Approach: - Remove suspected foods 3-4 weeks - Systematic reintroduction - Food-pain journaling - Balance vs. Restriction: Avoiding orthorexia
Activity (30 min): Identify your potential trigger foods
Visual Aids Needed: - Pro-inflammatory foods list with alternatives - Elimination diet timeline - Food sensitivity symptom tracker
Education Module 1 (30 min) - Microbiome-Gut-Brain Axis: - 100 trillion microorganisms in gut - 90% of body’s serotonin produced in gut - Vagus nerve: Bidirectional communication highway - Gut permeability (“leaky gut”) and systemic inflammation - Dysbiosis & Pain: - Altered microbial diversity in IBS, fibromyalgia - Lipopolysaccharide (LPS) triggers inflammation
Movement Practice (45 min): Yoga - Digestive wellness sequence
Education Module 2 (30 min) - Optimizing Gut Health: - Probiotics: Live beneficial bacteria (yogurt, kefir, sauerkraut, kimchi) - Prebiotics: Fiber that feeds good bacteria (garlic, onions, bananas, asparagus) - Diversity: Eat 30+ different plant foods/week - Fermented Foods: Enhance microbial richness - Supplements: When appropriate (strain-specific probiotics)
Group Discussion (30 min): Gut symptoms and pain connections
Visual Aids Needed: - Gut-brain axis diagram - Probiotic vs. prebiotic comparison - Fermented foods guide
Education Module 1 (30 min) - Fundamental TCM Concepts: - Qi (Chi): Life force energy - Yin-Yang: Balance of opposites - Five Elements: Wood, Fire, Earth, Metal, Water - Meridians: Energy channels connecting organs - Pain in TCM: “Where there is blockage, there is pain; where there is free flow, there is no pain”
Movement Practice (45 min): Qi Gong - Meridian stretching sequence
Education Module 2 (30 min) - Modern Interpretation: - Fascia as meridian pathways? - Acupuncture points = neurovascular bundles - Neurochemical effects: Endorphins, adenosine release - Evidence Base: - Acupuncture effective for chronic pain (meta-analyses) - Mechanisms partially understood through Western science
Group Discussion (30 min): Openness to complementary approaches
Assessments: Week 6 BPI/ODI/Functional assessments
Visual Aids Needed: - Yin-Yang and Five Elements diagram - Major meridian pathways map - Acupuncture mechanism illustration (Western perspective)
Education Module 1 (30 min) - Key Acupressure Points for Pain: - LI4 (Hegu): Hand web, general pain relief, headaches - GB20 (Fengchi): Base of skull, neck pain, headaches - LV3 (Taichong): Foot, stress reduction, headaches - SP6 (Sanyinjiao): Inner ankle, lower back, menstrual pain - ST36 (Zusanli): Below knee, general wellness, digestive issues - PC6 (Neiguan): Inner wrist, nausea, anxiety - Contraindications: Pregnancy points, bleeding disorders, skin conditions
Movement Practice (45 min): Tai Chi with acupoint awareness
Education Module 2 (30 min) - Acupressure Techniques: - Proper pressure: Firm but not painful - Duration: 30 seconds to 2 minutes per point - Breathing: Exhale as you apply pressure - Bilateral vs. unilateral stimulation - Self-Treatment Routines: - Morning energy boost - Stress/anxiety relief - Pain flare management - Pre-sleep relaxation
Hands-On Practice (30 min): Guided acupressure on self and partner
Visual Aids Needed: - Detailed acupoint location photos - Pressure technique demonstration - Quick reference acupoint card
Education Module 1 (30 min) - Cupping Therapy: - Negative pressure technique - Types: Glass, silicone, fire cupping - Mechanisms: Increased blood flow, myofascial release - Evidence: Moderate for neck/back pain - Gua Sha (Scraping): - Tool-assisted soft tissue mobilization - Promotes microcirculation - Releases muscle tension - Evidence: Effective for chronic neck pain
Movement Practice (45 min): Yoga - Myofascial release techniques
Education Module 2 (30 min) - Other TCM Modalities: - Moxibustion: Heat therapy using mugwort herb - Tuina: Chinese medical massage - Chinese Herbal Medicine: Individualized formulations - Safety & Contraindications: - When to avoid these techniques - Working with qualified practitioners
Demonstration (30 min): Gua Sha self-care techniques (neck, shoulders, forearms)
Visual Aids Needed: - Cupping types and placement guide - Gua Sha tool use demonstration - TCM modality comparison chart
Education Module 1 (30 min) - Complementary Approaches: - TCM + conventional medicine = integrative care - When to use which approach - Not either/or but both/and - Examples of Integration: - Acupuncture + physical therapy for back pain - Herbal supplements + pharmaceuticals (with MD guidance) - Tai Chi + strength training
Movement Practice (45 min): Fusion practice - Yoga/Tai Chi/Qi Gong blend
Education Module 2 (30 min) - Creating Your Personal Integrative Toolkit: - Western: Medications, PT, injections - Eastern: Acupressure, herbs, movement practices - Both: Nutrition, stress management, sleep - Finding Qualified Practitioners: - Acupuncturist: L.Ac., NCCAOM certified - Herbalist: Training and credentials - Integrative MD: Board certified + additional training
Activity (30 min): Design your personalized integrative pain plan
Visual Aids Needed: - East-West integration Venn diagram - Practitioner credential guide - Integrative treatment decision tree
Education Module 1 (30 min) - Pain Catastrophizing: - Three components: Rumination, magnification, helplessness - Pain Catastrophizing Scale (PCS) - Impact: Predicts pain intensity, disability, opioid use - Cognitive Distortions: - All-or-nothing thinking - Overgeneralization - Emotional reasoning - Catastrophic thinking
Movement Practice (45 min): Gentle Yoga - Mindful body awareness
Education Module 2 (30 min) - Fear-Avoidance Model: - Pain → Fear of pain → Avoidance of activity → Deconditioning → More pain - Kinesiophobia: Fear of movement - Breaking the cycle through gradual exposure - Research Evidence: Fear-avoidance predicts long-term disability better than pain intensity
Group Discussion (30 min): Identifying catastrophizing patterns
Assessments: Week 7 BPI/ODI/Functional + Depression/Anxiety screening
Visual Aids Needed: - Pain catastrophizing components diagram - Fear-avoidance cycle flowchart - Cognitive distortion identification chart
Education Module 1 (30 min) - Cognitive Restructuring: - Identify automatic negative thoughts - Challenge cognitive distortions - Develop balanced, realistic thoughts - Thought records (ABC model) - Examples: - “I’ll never get better” → “Progress is gradual; I’m learning skills” - “This pain is unbearable” → “This is difficult but I can manage it”
Movement Practice (45 min): Tai Chi - Meditative focus
Education Module 2 (30 min) - Behavioral Activation: - Activity scheduling (not contingent on pain level) - Value-based living - Avoiding boom-bust cycles - Positive reinforcement strategies - Pleasant Activity Scheduling: Daily activities that bring meaning/enjoyment
Practice (30 min): Cognitive restructuring exercises with thought records
Visual Aids Needed: - ABC model worksheet - Thought record template - Behavioral activation activity list
Education Module 1 (30 min) - Acceptance and Commitment Therapy (ACT): - Acceptance vs. resignation (different concepts) - Psychological flexibility - Cognitive defusion: Thoughts are not facts - Values clarification: What matters most to you? - Committed action: Living according to values despite pain - Mindfulness in ACT: Present moment awareness without judgment
Movement Practice (45 min): Qi Gong - Emotional balance focus
Education Module 2 (30 min) - Emotional Expression & Pain: - Emotions are valid: Anger, grief, frustration, anxiety, depression - Emotional suppression increases pain - Healthy expression strategies - When to seek professional mental health support - Self-Compassion: Treating yourself with kindness during difficult times
Practice (30 min): Values clarification exercise and defusion techniques
Visual Aids Needed: - ACT hexaflex model - Values clarification worksheet - Self-compassion break script
Education Module 1 (30 min) - Biopsychosocial Model Review: - Biological: Medications, physical therapies, movement - Psychological: CBT, ACT, mindfulness, emotional regulation - Social: Support networks, communication, meaningful activities - Your Personal Formula: What worked best for YOU? - Reviewing your pain journal patterns - Identifying most effective strategies - Recognizing early warning signs of flares
Movement Practice (45 min): Participant favorites - You choose the practice
Education Module 2 (30 min) - Multimodal Approach: - No single “silver bullet” - Synergistic effects of combined strategies - Adjusting approach as needs change - Evidence Review: Multimodal > single intervention
Group Discussion (30 min): Share your most valuable lessons learned
Assessments: Week 8 BPI/ODI/Functional (final program assessments)
Visual Aids Needed: - Biopsychosocial model diagram - Personal strategy success tracker - Multimodal treatment effectiveness chart
Education Module 1 (30 min) - Pain Flares are Normal: - Not a failure or “back to square one” - Part of the natural course - Skills learned are not lost - Early Warning Signs: - Increased pain intensity/frequency - Sleep disturbance - Mood changes - Returning to old patterns (boom-bust, avoidance) - Social withdrawal
Movement Practice (45 min): Restorative practice - Self-care focus
Education Module 2 (30 min) - Flare Management Action Plan: - First 24-48 hours: Gentle movement, not bed rest; breathing, relaxation; ice/heat; reach out for support - Days 3-7: Resume baseline activities gradually; review pain journal; identify triggers; adjust as needed - Week 2+: Return to full routine; troubleshoot barriers; celebrate resilience - When to Seek Medical Attention: Red flags (new symptoms, trauma, fever, numbness/weakness)
Activity (30 min): Create your personal flare management plan
Visual Aids Needed: - Warning signs checklist - Flare management timeline - Medical red flags list
Education Module 1 (30 min) - Community Resources: - US Pain Foundation: Support groups, educational webinars - American Chronic Pain Association: Self-management resources - PainBC: Online courses and tools - NHS Pain Toolkit: 12 self-management tools - Professional Resources: - Pain specialty clinics - Integrative medicine centers - Licensed acupuncturists, massage therapists - Mental health providers specializing in chronic pain
Movement Practice (45 min): Integration practice - All modalities
Education Module 2 (30 min) - Continued Education: - Recommended books (Explain Pain, The Pain Management Workbook) - Podcasts (Like Mind, Like Body; Pain Reframed) - Apps (Curable, Pathways, Headspace) - Online courses (PainED, Pain U) - Staying Current: New research, emerging therapies
Group Discussion (30 min): Building your post-program resource list
Visual Aids Needed: - Resource directory (local and national) - Recommended reading/app list - Professional credentialing guide
Education Module 1 (30 min) - Measuring Progress: - BPI/ODI change from baseline - Functional improvements (SMART goals achieved) - Increased confidence and self-efficacy - New skills acquired - Connections made - Progress ≠ Perfection: Celebrating all wins, large and small
Movement Practice (45 min): Celebratory group practice - Participant-led
Education Module 2 (30 min) - Your Personal Pain Management Plan: - Daily practices (movement, breathing, mindfulness) - Weekly practices (support group, meal prep, review goals) - Monthly practices (reassess progress, adjust strategies) - Emergency practices (flare management) - Staying Connected: Alumni group, ongoing support options
Celebration (30 min): - Certificate of completion - Sharing circle: One thing you’ll take with you - Group photo - Resource packet distribution
Final Assessments: Post-program BPI/ODI/Functional + Program Evaluation Survey
Visual Aids Needed: - Progress tracking dashboard - Personal pain management plan template - Certificate of completion
Week 1: 12 diagrams/charts Week 2: 9 diagrams/charts Week 3: 9 diagrams/charts Week 4: 9 diagrams/charts Week 5: 9 diagrams/charts Week 6: 9 diagrams/charts Week 7: 9 diagrams/charts Week 8: 9 diagrams/charts Total: 75+ unique visual aids needed
Minimum Requirements: - Licensed healthcare professional (PT, OT, RN, MD, DO) OR - Certified health coach with chronic pain specialization - Certification in at least one movement modality (Tai Chi, Yoga, Qi Gong) - Training in motivational interviewing and group facilitation - CPR/First Aid certified - HIPAA training
Preferred: - Pain psychology training (CBT, ACT) - Experience with chronic pain population - Bilingual (if serving diverse communities)
Primary Outcomes: - BPI change (minimal clinically important difference: 2 points) - ODI change (minimal clinically important difference: 10 points) - Functional goals achieved (%)
Secondary Outcomes: - Depression/anxiety symptom change - Medication use changes - Healthcare utilization - Program satisfaction - Attendance/completion rate - Skills acquired/confidence gained
Movement Therapies: - Tai Chi: Cochrane review, 33 RCTs, effective for OA, LBP, fibromyalgia - Yoga: Meta-analysis, 40+ studies, moderate effect size for chronic pain - Qi Gong: Systematic review, positive effects for neck pain, fibromyalgia
Mind-Body Interventions: - CBT: Gold standard psychological treatment, large effect sizes - ACT: Growing evidence, especially for pain acceptance and function - Mindfulness: Effective for pain catastrophizing, emotional regulation
Nutrition: - Anti-inflammatory diet: Reduces CRP by 30-50% - Mediterranean diet: Improves pain in RA, reduces cardiovascular risk - Omega-3 supplementation: Modest benefit for inflammatory conditions
Integrative Approaches: - Acupuncture: Effective for chronic pain per meta-analyses - Massage: Short-term benefit for musculoskeletal pain - Multimodal approach: Superior to single interventions
Attendance Policy: Participants expected to attend 28/32 sessions (87.5%) for completion certificate
Make-Up Sessions: One-on-one review available for missed sessions by appointment
Progression: Content builds week-to-week; early attendance critical
Individualization: While group-based, strategies adapted to individual needs and preferences
Safety: All movement practices designed for chronic pain population with modifications offered
Medical Clearance: Participants screened for contraindications; physician clearance may be required
Confidentiality: Group agreements established in Session 1.1; HIPAA compliance maintained
Total Curriculum Pages: 32 detailed session plans Total Contact Hours: 80 hours over 8 weeks Evidence-Based: All content supported by peer-reviewed research Patient-Centered: Focus on self-management skills and empowerment Holistic: Addresses biological, psychological, and social dimensions of pain