Program Structure: 4 sessions per week × 2.5 hours each = 10 hours/week × 8 weeks = 80 total contact hours
Format: In-person group sessions (12-20 participants per cohort)
Education Module 1 (30 min total) - What is Pain? Nociception vs. Perception - Charles Sherrington’s definition of nociception (1906) - The International Association for the Study of Pain (IASP) definition - Why pain ≠ tissue damage
Movement Practice (30 min): Gentle Yoga - Body Awareness
Education Module 2 (30 min total) - The Pain Pathway - Nociceptors (peripheral receptors) - Dorsal root ganglion - Dorsal horn of spinal cord (Rexed laminae I-VIII) - Spinothalamic tract (decussation at anterior white commissure) - Thalamus (relay station) - Somatosensory cortex, insula, anterior cingulate cortex
Visual Aids Needed: - Anatomical diagram: Full-body nerve distribution - Cross-section of spinal cord showing dorsal horn - Brain diagram highlighting pain-processing regions - Nerve fiber comparison chart (A-δ, C, A-β)
Group Discussion Topics: - When you stub your toe, why do you feel sharp pain first, then aching? - Share experiences: What does your pain feel like?
Anti-Inflammatory Foods Focus: Introduction to omega-3 fatty acids (fish, walnuts, flaxseed)
Pre-Test: 10 MCQ on pain basics Post-Test: Same 10 MCQ to measure learning
Education Module 1 (30 min) - Gate Control Theory (Melzack & Wall, 1965) - The “gate” in the substantia gelatinosa - How large fibers (A-β) inhibit small fibers (A-δ and C) - Clinical application: Why rubbing helps
Movement Practice (30 min): Tai Chi - Introduction to flowing movements
Education Module 2 (30 min) - Descending Modulation - Periaqueductal gray (PAG) - Nucleus raphe magnus - Serotonergic and noradrenergic pathways - How stress affects pain (sympathetic vs. parasympathetic)
Visual Aids: - Gate Control Theory diagram (detailed) - Descending modulation pathway illustration - TENS unit demonstration (if available)
Group Discussion: - What non-medication strategies have you used to manage pain? - How does stress affect your pain levels?
Anti-Inflammatory Foods: Turmeric and ginger - natural COX-2 inhibitors
Assessments: Weekly BPI, ODI, Functional Assessment (baseline)
Education Module 1 (30 min) - Acute vs. Chronic Pain - Protective pain vs. pathological pain - Time course: acute (<3 months), chronic (>3 months)
Movement Practice (30 min): Qi Gong - Energy cultivation basics
Education Module 2 (30 min) - Neuroplasticity in Pain - How chronic pain changes the brain - Reorganization of somatosensory cortex - Emotional centers (amygdala, anterior cingulate) - Hope: The brain can “unlearn” pain patterns
Visual Aids: - Timeline: Acute to chronic pain progression - Brain imaging showing changes in chronic pain - Wind-up phenomenon animation/diagram
Group Discussion: - How has pain changed your daily life? - What triggers make your pain worse?
Anti-Inflammatory Foods: Leafy greens and antioxidants
Education Module 1 (30 min) - Understanding Pain Scales - Visual Analog Scale (VAS) - Numeric Rating Scale (0-10) - McGill Pain Questionnaire concepts - Brief Pain Inventory (BPI) walkthrough - Oswestry Disability Index (ODI) explanation
Movement Practice (30 min): Yoga - Stretch and flexibility focus
Education Module 2 (30 min) - Setting SMART Goals - Specific, Measurable, Achievable, Relevant, Time-bound - Realistic expectations for pain management - Function over pain elimination - Tracking progress
Visual Aids: - Pain scale examples - SMART goals worksheet - Progress tracking charts
Group Activity: Personal goal setting exercise
Anti-Inflammatory Foods: Berries and cherries (anthocyanins)
Education Module 1 (30 min) - Mechanism of Action - Inhibits cyclooxygenase in the brain (not periphery) - Affects hypothalamus for antipyretic effect - Does NOT reduce inflammation - Works on prostaglandin synthesis in CNS
Movement Practice (30 min): Tai Chi - Pain-relieving forms
Education Module 2 (30 min) - Toxicity & Metabolism - Normal metabolism: Glucuronidation and sulfation - Toxic pathway: CYP450 → NAPQI - Glutathione depletion - Hepatic necrosis mechanism
Visual Aids: - Metabolic pathway diagram (glucuronidation vs. CYP450) - Liver damage progression images - Statistics infographic (deaths, hospitalizations) - Combination product label examples
Key Statistics to Present: | Metric | Value | |——–|——-| | Weekly users in US | 60 million | | Maximum daily dose | 4,000mg (4g) adults; 90mg/kg children | | Toxic dose | >7,500mg single ingestion | | Annual ED visits | 56,000 | | Deaths per year | 500 | | Unintentional overdoses | ~50% |
Group Discussion: - Do you check labels for acetaminophen in combination products? - Have you ever taken more than the recommended dose?
Anti-Inflammatory Foods: Wild-caught salmon (omega-3s)
Pre/Post-Test: 10 MCQ on acetaminophen
Education Module 1 (30 min) - Mechanism of Action - Cyclooxygenase (COX) enzyme inhibition - COX-1: “Housekeeping” enzyme (gastric protection, platelet function) - COX-2: “Inflammatory” enzyme (induced by tissue damage) - Arachidonic acid cascade - Prostaglandin synthesis inhibition
Movement Practice (30 min): Qi Gong - Joint mobility focus
Education Module 2 (30 min) - Specific NSAIDs Comparison
| Medication | COX Selectivity | GI Risk | CV Risk | Renal Risk |
|---|---|---|---|---|
| Ibuprofen | Non-selective | Moderate | High (OR=2.25) | High |
| Naproxen | Non-selective | HIGH | Lower | High (OR=1.72) |
| Celecoxib | COX-2 selective | Lower | Moderate | Lower |
| Indomethacin | Non-selective | High | High | Highest (OR=1.94) |
Visual Aids: - COX-1 vs. COX-2 diagram - Arachidonic acid cascade flowchart - Risk comparison table - Mechanism of GI ulceration illustration
Key Statistics: - Ibuprofen >1200mg/day: Increased AKI risk - Combined NSAID use: OR=2.90 for AKI - Risk factors: Age >65, dehydration, heart failure, CKD, concurrent RAAS inhibitors
Group Discussion: - How often do you use NSAIDs? - Do you know your risk factors? - Have you experienced side effects?
Anti-Inflammatory Foods: Extra virgin olive oil (oleocanthal)
Assessments: Week 2 BPI, ODI, Functional Assessment
Education Module 1 (30 min) - History & Context - Ancient use of poppy - Morphine isolation (1804) - Synthetic opioids development - Opioid crisis context (perspective, not judgment)
Movement Practice (30 min): Yoga - Restorative poses
Education Module 2 (30 min) - Mechanism of Action - G-protein coupled receptors - Inhibition of adenylyl cyclase - Decreased cyclic AMP - Reduced neurotransmitter release (substance P, glutamate) - Hyperpolarization of neurons
Visual Aids: - Opioid receptor locations in brain and spinal cord - Molecular mechanism diagram - Endogenous opioid system illustration - Common opioids strength comparison chart
Group Discussion: - Understanding tolerance vs. addiction - Reducing stigma while acknowledging risks - Safe medication disposal
Anti-Inflammatory Foods: Nuts and seeds (vitamin E, magnesium)
Education Module 1 (30 min) - Topical Analgesics - Capsaicin: Substance P depletion - Lidocaine patches: Sodium channel blockade - Diclofenac gel: Local NSAID delivery - Effectiveness evidence
Movement Practice (30 min): Tai Chi - Balance and coordination
Education Module 2 (30 min) - Supplements & Nutraceuticals - Glucosamine & Chondroitin (limited evidence) - SAM-e (S-adenosyl methionine) - Fish oil (omega-3 fatty acids) - Curcumin (turmeric extract) - Vitamin D (deficiency association with pain) - Magnesium (muscle relaxation, nerve function)
Visual Aids: - Supplement efficacy chart (evidence ratings) - Drug-supplement interaction warnings - Vitamin D pathway in pain modulation
Anti-Inflammatory Foods: Dark chocolate (70%+ cacao, flavonoids)
Education Module 1 (30 min) - Exercise-Induced Analgesia - Endogenous opioid release - Endocannabinoid system activation - Reduced inflammation (decreased IL-6, TNF-α, CRP) - Improved blood flow to tissues - Neuroplasticity benefits
Movement Practice (30 min): Yoga - Gentle flow sequence
Education Module 2 (30 min) - Evidence for Movement Therapies - Tai Chi: SMD -0.54 for OA, -0.81 for LBP - Yoga: Effective for chronic low back pain - Qi Gong: Reduction in pain and disability - Minimum effective dose: 5-6 weeks, 2-3x/week
Visual Aids: - Meta-analysis results charts - Exercise intensity scale - Movement therapy comparison table
Assessments: Week 3 BPI, ODI, Functional Assessment
Education Module 1 (30 min) - History & Philosophy - Origins in martial arts - Yin-Yang balance - Qi (energy) cultivation - Mind-body integration
Movement Practice (30 min): Tai Chi - Extended practice with detailed instruction
Education Module 2 (30 min) - Biomechanics of Tai Chi - Weight shifting - Core engagement - Joint protection principles - Breathing coordination
Visual Aids: - Tai Chi form sequence photos - Proper vs. improper posture comparisons - Breathing pattern diagrams
Education Module 1 (30 min) - Traditional Chinese Medicine Context - Meridian system - Qi blockage and flow - Five elements theory - Modern interpretation
Movement Practice (30 min): Qi Gong - Full practice session
Education Module 2 (30 min) - Specific Forms for Pain - Eight Brocades (Ba Duan Jin) - Five Animal Frolics (Wu Qin Xi) - Stretching exercises - Acupressure points for self-care
Visual Aids: - Meridian map - Acupressure point diagrams - Qi Gong form illustrations
Education Module 1 (30 min) - Yoga Styles & Pain - Hatha (gentle, foundational) - Iyengar (alignment, props) - Restorative (relaxation, stress relief) - Yin (connective tissue focus)
Movement Practice (30 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 - Neck/shoulders: Thread the needle, shoulder rolls, neck stretches - Hips: Pigeon, figure-4, happy baby - Modifications: Using props, chair yoga
Visual Aids: - Pose modification charts - Common mistakes illustrations - Anatomical benefits of specific poses
Education Module 1 (30 min) - ANS Overview - Sympathetic: “Fight or flight” - Parasympathetic: “Rest and digest” - Balance is key to health
Movement Practice (30 min): Tai Chi - Slow, meditative movements
Education Module 2 (30 min) - Sympathetically Maintained Pain - Complex Regional Pain Syndrome (CRPS) - Chronic tension headaches - Fibromyalgia connection - Visceral pain amplification
Visual Aids: - ANS diagram (thoracolumbar vs. craniosacral) - Stress-pain cycle illustration - Cortisol effects on inflammation
Assessments: Week 4 BPI, ODI, Functional Assessment
Education Module 1 (30 min) - Vagus Nerve - Longest cranial nerve - “Wandering nerve” through body - Anti-inflammatory effects - Heart rate variability (HRV) connection
Movement Practice (30 min): Qi Gong - Breathing-focused exercises
Education Module 2 (30 min) - Techniques to Activate Parasympathetic - Deep diaphragmatic breathing (4-7-8 technique) - Progressive muscle relaxation - Meditation and mindfulness - Cold exposure (face in cold water) - Humming and singing
Visual Aids: - Vagus nerve pathway diagram - Breathing technique illustrations - HRV explanation and benefits
Group Practice: Guided progressive muscle relaxation
Education Module 1 (30 min) - The Stress-Pain-Sleep Triangle - How poor sleep increases pain - How pain disrupts sleep - How stress worsens both
Movement Practice (30 min): Yoga - Evening relaxation sequence
Education Module 2 (30 min) - Sleep Hygiene for Pain - Circadian rhythm optimization - Sleep environment (temperature, darkness, noise) - Pre-sleep routine - Mattress and pillow considerations - Position and support
Visual Aids: - Sleep architecture diagrams - Optimal sleep position illustrations - Circadian rhythm chart
Group Discussion: Sharing sleep challenges and solutions
Education Module 1 (30 min) - Meditation for Pain - Mindfulness-Based Stress Reduction (MBSR) - Loving-kindness meditation - Body scan meditation - Evidence: Changes in brain activity (fMRI studies)
Movement Practice (30 min): Combined Tai Chi, Qi Gong, Yoga flow
Education Module 2 (30 min) - Biofeedback - Heart rate variability training - Muscle tension monitoring - Temperature biofeedback - Apps and devices for home use
Visual Aids: - Brain changes with meditation (imaging studies) - Biofeedback mechanism diagram - Recommended apps and resources
Education Module 1 (30 min) - Types of Inflammation - Acute: Protective, short-term - Chronic: Pathological, long-term - Neurogenic inflammation
Movement Practice (30 min): Gentle Yoga - Joint mobility
Education Module 2 (30 min) - Diet’s Role in Inflammation - Western diet: High omega-6, processed foods - Mediterranean diet: Anti-inflammatory - Mechanisms: Arachidonic acid pathway - Glycemic index and insulin resistance
Visual Aids: - Inflammatory cascade diagram - Food pyramid: Anti-inflammatory diet - Omega-6 to Omega-3 ratio chart
Assessments: Week 5 BPI, ODI, Functional Assessment
Education Module 1 (30 min) - Top Anti-Inflammatory Foods 1. Fatty fish (salmon, sardines, mackerel) - EPA & DHA 2. Berries (anthocyanins) 3. Leafy greens (vitamins K, A, C) 4. Turmeric (curcumin) 5. Ginger (gingerols) 6. Extra virgin olive oil (oleocanthal) 7. Nuts and seeds (vitamin E, magnesium) 8. Green tea (EGCG) 9. Dark chocolate (flavonoids) 10. Tomatoes (lycopene)
Movement Practice (30 min): Tai Chi - Flowing movements
Education Module 2 (30 min) - Nutrients & Their Mechanisms - Omega-3s: COX-2 inhibition - Polyphenols: Antioxidant effects - Fiber: Gut microbiome support - Vitamin D: Immune modulation
Visual Aids: - Food nutrient content charts - Meal planning templates - Shopping lists for anti-inflammatory foods
Practical Activity: Meal planning workshop
Education Module 1 (30 min) - Pro-Inflammatory Foods 1. Sugar and refined carbohydrates 2. Processed meats 3. Trans fats and hydrogenated oils 4. Excessive alcohol 5. Refined vegetable oils (high omega-6) 6. Artificial additives and preservatives
Movement Practice (30 min): Qi Gong - Energy balancing
Education Module 2 (30 min) - Individual Food Sensitivities - Common triggers: Gluten, dairy, nightshades - Elimination diet approach - Food journaling - Working with healthcare providers
Visual Aids: - Food sensitivity symptom tracker - Elimination diet protocol - Label reading guide (hidden sugars, trans fats)
Group Discussion: Personal food trigger experiences
Education Module 1 (30 min) - The Microbiome-Gut-Brain Axis - 100 trillion microorganisms - Neurotransmitter production (90% of serotonin in gut) - Vagus nerve communication - Immune system modulation (70% in gut)
Movement Practice (30 min): Yoga - Digestive wellness sequence
Education Module 2 (30 min) - Optimizing Gut Health - Probiotics and fermented foods - Prebiotics (fiber for beneficial bacteria) - Diversity in diet - Avoiding antibiotics when possible - Stress management (gut-brain connection)
Visual Aids: - Gut-brain axis diagram - Fermented foods chart - Prebiotic/probiotic food sources
Practical Activity: Anti-inflammatory cooking demonstration (if facilities allow)
Education Module 1 (30 min) - Fundamental Concepts - Qi (energy/life force) - Yin and Yang balance - Five elements (Wood, Fire, Earth, Metal, Water) - Meridians (energy channels) - Acupoints
Movement Practice (30 min): Qi Gong - Meridian stretching
Education Module 2 (30 min) - Modern Interpretation - Fascia as meridian system? - Acupoints and neural structures - Neurochemical effects of acupuncture - Integrating TCM with Western medicine
Visual Aids: - Yin-Yang diagram - Five elements cycle - Full-body meridian map - Acupoint locations
Assessments: Week 6 BPI, ODI, Functional Assessment
Education Module 1 (30 min) - Key Acupoints for Pain - LI4 (Hegu): General pain, headache - GB20 (Fengchi): Headache, neck pain - LV3 (Taichong): Stress, headache - SP6 (Sanyinjiao): Lower back, gynecological - ST36 (Zusanli): Digestive, general wellness - PC6 (Neiguan): Nausea, anxiety - GV20 (Baihui): Mental clarity, headache
Movement Practice (30 min): Tai Chi with acupoint awareness
Education Module 2 (30 min) - Acupressure Techniques - Proper pressure (firm but not painful) - Duration (1-3 minutes per point) - Breathing coordination - Self-treatment routines - Contraindications and safety
Visual Aids: - Detailed acupoint location maps - Hand positions for pressure - Body region-specific treatment protocols
Hands-On Practice: Guided acupressure session (pairs or self-care)
Education Module 1 (30 min) - Cupping Therapy - Mechanism: Negative pressure, blood flow - Types: Fire, suction, silicone - Evidence and applications - Safety considerations
Movement Practice (30 min): Yoga - Myofascial release focus
Education Module 2 (30 min) - Other Modalities - Moxibustion (heat therapy) - Tuina (Chinese massage) - Chinese herbal medicine overview - Working with TCM practitioners
Visual Aids: - Cupping demonstration photos - Gua Sha technique videos/images - Safety and contraindication charts
Group Discussion: Experiences with complementary therapies
Education Module 1 (30 min) - Complementary Approaches - When to use TCM - When to use Western medicine - Combining treatments safely - Communication with all providers
Movement Practice (30 min): Combined practice - Tai Chi, Qi Gong, Yoga fusion
Education Module 2 (30 min) - Creating Your Personal Toolkit - Medication management - Movement practices - Nutrition strategies - TCM self-care - Stress management - Sleep optimization
Visual Aids: - Integration framework diagram - Personal wellness plan template - Resource directory (local practitioners, apps, books)
Group Activity: Draft personal wellness plans
Education Module 1 (30 min) - Pain Catastrophizing - Rumination - Magnification - Helplessness - Impact on pain intensity and disability - Pain Catastrophizing Scale (PCS)
Movement Practice (30 min): Gentle Yoga - Mindful awareness
Education Module 2 (30 min) - Fear-Avoidance Model - Fear of movement - Kinesiophobia - Avoidance behavior cycle - Gradual exposure therapy concepts
Visual Aids: - Pain catastrophizing cycle diagram - Fear-avoidance model flowchart - Self-assessment questionnaires
Assessments: Week 7 BPI, ODI, Functional Assessment, Depression/Anxiety screening
Education Module 1 (30 min) - Cognitive Restructuring - Identifying negative thought patterns - Challenging cognitive distortions - Reframing techniques - Positive self-talk
Movement Practice (30 min): Tai Chi - Meditative focus
Education Module 2 (30 min) - Behavioral Activation - Pacing activities - Value-based living - Pleasant activity scheduling - Avoiding boom-bust cycles
Visual Aids: - Thought record worksheets - Cognitive distortion examples - Activity pacing charts
Group Practice: Cognitive restructuring exercises
Education Module 1 (30 min) - Acceptance and Commitment Therapy (ACT) - Acceptance vs. resignation - Cognitive defusion - Being present - Values clarification - Committed action
Movement Practice (30 min): Qi Gong - Emotional balance
Education Module 2 (30 min) - Emotional Expression - Anger and chronic pain - Grief and loss - Anxiety management - Depression awareness - When to seek professional help
Visual Aids: - ACT hexaflex diagram - Values clarification worksheet - Mental health resources list
Group Discussion: Sharing emotional challenges (safe space)
Education Module 1 (30 min) - Holistic Pain Management Model - Biological factors - Psychological factors - Social factors - Biopsychosocial integration
Movement Practice (30 min): Free choice - Participant favorite practices
Education Module 2 (30 min) - Your Personal Formula - What worked best for you? - Barriers to overcome - Resources available - Realistic expectations - Celebrating progress
Visual Aids: - Biopsychosocial model diagram - Personal assessment summary (8-week data) - Progress charts (pain, function, mood)
Assessments: Week 8 FINAL - BPI, ODI, Functional Assessment, Program Evaluation
Education Module 1 (30 min) - SMART Goal Review - What goals were met? - What needs adjustment? - Setting new 3-month goals - 6-month and 1-year vision
Movement Practice (30 min): Tai Chi - Full form practice
Education Module 2 (30 min) - Daily Routines - Morning routine - Midday check-ins - Evening wind-down - Weekly planning - Monthly reviews
Visual Aids: - Goal achievement tracker - Daily routine template - Habit-stacking strategies
Group Activity: Finalize personal wellness plans
Education Module 1 (30 min) - Recognizing Warning Signs - Pain flare-ups - Stress increase - Sleep disruption - Mood changes - Activity avoidance
Movement Practice (30 min): Qi Gong - Energy maintenance
Education Module 2 (30 min) - Crisis Management Plan - When to use rescue medications - Emergency self-care strategies - When to call healthcare providers - Support person contacts - Hospital/ER considerations
Visual Aids: - Flare-up action plan template - Warning signs checklist - Emergency contact card
Group Practice: Problem-solving scenarios
Education Module 1 (30 min) - Program Review - Key learnings recap - Participant testimonials - Data summary (aggregate outcomes) - Continuing education resources
Movement Practice (30 min): Yoga - Gratitude and celebration flow
Education Module 2 (30 min) - Moving Forward - Alumni group options - Community resources - Ongoing support - Mentoring future participants - Research opportunities
Celebration Activities: - Certificate presentation - Potluck with anti-inflammatory foods - Sharing gratitude and victories - Group photo - Commitment cards (what will you continue?)
Final Assessments: - Program satisfaction survey - Long-term follow-up consent - 3-month, 6-month, 12-month check-in scheduling
Curriculum Version: 1.0
Last Updated: November 21, 2025
Status: Ready for Pilot Implementation
Next Review: Post-pilot feedback integration