Neil is a skilled compassionate physical therapist, an engaging expert educator, and a leader in pain
management in Canada. He is also a Clinical Assistant Professor at UBC, yoga therapist, author, and faculty
member in international yoga therapy training programs. He is the first physical therapist to win the
Excellence in Inter-Professional Pain Education Award from the Canadian Pain Society, and the founding
Chair of the Canadian Physiotherapy Pain Science Division. He is a past Board member of Pain BC. In addition
to his volunteer work, and offering workshops and pain science education through Canada and
internationally, he has worked for the Doctors of British Columbia, teaching pain management to primary
care MDs and specialists.
1. Tell us a bit more about your
areas of work and what you’re most passionate about.
I have two main areas that I’m passionate about:
1) Helping people in pain, specifically with physiotherapy and understanding the importance of regular self care.
2) Helping physiotherapists broaden their perspectives and shift their paradigm. I help physiotherapists understand that there is so much more we can do for people with chronic pain. The model under which we provide physiotherapy needs to be expanded to include the biopsychosocial model.
Reference: Blickenstaff C, Pearson N. Reconciling movement and exercise with pain neuroscience education: A case for consistent education. Physiotherapy Theory and Practice. 2016 32(5):396-407.
2. What’s something you’ve recently learned that you’re really excited to implement into your practice?
I have 3 recent learnings I'd like to share. I recently read a research study comparing the effectiveness of mindfulness meditation to sham meditation on acute pain. Read the full study here.
A quick summary of the research:
(1) To determine whether pain reduction during mindfulness meditation is associated with unique and specific brain mechanisms. (2) To determine whether the analgesic effects of meditation are simply associated with the nonspecific components (posture, breathing, beliefs, intervention setting) of participating in a meditation intervention.
Randomly assigned 75 healthy, human volunteers to 4 days of the following: (1) mindfulness meditation: for 20 minutes per day subjects were instructed to focus on the changing sensations of the breath while employing a non-evaluative cognitive state (2) placebo conditioning (3) sham mindfulness meditation: subjects were lead to believe they were practicing mindfulness meditation without the instructions related to mindfully attending to the breath in a non-evaluative manner (4) book-listening control intervention.
Mindfulness-meditation-related pain relief was associated with greater activation in brain regions associated with the cognitive modulation of pain
Sham mindfulness meditation-induced analgesia was not correlated with significant neural activity, but rather by greater reductions in respiration rate
Implications for Practice:
These findings demonstrate that mindfulness meditation reduces pain through unique mechanisms and may foster greater acceptance of meditation as an adjunct pain therapy.
This study is so exciting because there are multiple neurophysiological pathways which we can change pain.
This study shows there are differences between mindfulness meditation, sham meditation and the placebo.
One of my passions is yoga, which incorporates movement, mindfulness, breath and placebo. I recently read a study comparing yoga to physiotherapy to education for chronic low back pain which I found interesting. The study compared the effects of a 12-week treatment program of yoga, physical therapy, and education on those with chronic low back pain.
They found that those receiving private physiotherapy and those receiving yoga therapy had the same results.
I recently learned about a stress-relieving mobile app geared toward helping you get back on course when life gets in the way. Unfortunately, this app, GPS for the Soul App is currently not available in Canada. This app takes several measures of your current stress levels: heart rate and heart rate variability and then connects you with the things that helps you course correct (ex: music, photos).
What does the next year of your
professional life look like?
1) I am finding key centres to teach at instead of jumping from location to location.
2) I am going to offer Advanced Pain Care Yoga that goes deeper into yoga therapy for different clinical conditions
3) I am going to start to mentor individuals who have gone through my trainings and would like to learn more.
4) I am going to enhance the online resources that I’ve made. Now that Pain Care for Life is established I can start to improve the resources and my offerings. For those who haven't hear of Pain Care for Life, it's a healthcare education and technology company. We support people living with chronic pain, as well as the health professionals, movement therapists and yoga teachers who help them.
Integrating pain science, the lived experience of pain, and mindful movement approaches, we offer courses, retreats, products, and online services while supporting the development of interactive communities to share new ideas and develop innovative evidence-based pain self care processes.
4. What’s one course or event that you’re planning to attend in the next year that you’re really looking forward to?
1) I'd like to attend the International Association of Pain
2) I'm really excited to attend The International Yoga Teachers Association conference. This is one of the oldest Yoga Associations in the world. There are so many yoga teachers in this group that live a in our world and carry out 'regular lives', but they are so humble, wise and have so much to teach.
3) I just learned about a documentary called Trial by Fire that I'm looking forward to watching.
5. What’s one book that you think other practitioners should read?
I would recommend Bud Craig's book How do you feel? This is a book about interoception and brings together startling evidence from neuroscience, psychology, and psychiatry to present revolutionary new insights into how our brains enable us to experience the range of sensations and mental states known as feelings.
I would also recommend Stephen Porges's The polyvagal theory, which provides new insights into the way our autonomic nervous system unconsciously mediates social engagement, trust, and intimacy.
6. What’s been one big ‘Aha’ moment that you’ve had in your professional life?
The biggest aha moment that I’ve had have comes from 2 separate places.
My early career was in the neonatal ICU unit and my role was to evaluate what stimulus would soothe the newborns and what stimulus would agitate them. I would then teach the family members and nursing staff how to use these stimuli to calm the newborns. Each newborn had different stimuli that soothed vs aggravated them.
When I started to teach yoga, which was long after I became a physiotherapist, people would stay with me for much longer and would come to my classes for years. I observed that people started to get better when they found peace, when they found the things that soothed them. This was a different approach from traditional physiotherapy where we are trying to move people forward from point A to point B as quickly as possible, but sometimes the way to move forwards is to find the sense of peacefulness first. For some of us, if we fight too much we can't get better.
7. What’s something that you learned the hard way that you would like to share with others?
I've stepped outside of physiotherapy and have been on an entrepreneurial journey to share my knowledge with more people. What I have learned is that there are a lot of people out there who say they can do the work you need done who don’t actually know how to do the work. I’ve had to learn to ask more questions. In clinical practice I would never jump to a conclusion - I would ask a lot of questions and get them to show me things objectively. I learned how to apply this same principle in business the hard way.
8. What's the most valuable piece of advice you've ever received?
Technology & Innovation
9. Are there any blogs, podcasts or websites that you regularly follow?
The commonality between all resources that I seek out is that they are about the lived experience. Here are 3 blogs that I follow:
1) Health Skills by Ronnie Thompson, an occupational therapist in New Zealand 2) My Cuppa Jo by Joletta (Jo) Belton, a retired firefighter who writes to share her path through life with chronic pain 3) Pain Talks, a collection of stories of resilience, support and the resources to fill in the blanks on the subject of hurting and health care.
10. What role do you believe technology can play in rehabilitation for both practitioners and patients?
To be able to get good care to those who otherwise wouldn’t be able to access good care. For example, those who are physically isolated, those who don’t have the financial means and those who physically can't get to the location they need to be (ie: those living in remote regions).
Technology allows us to reach all of those people we wouldn’t be otherwise be able to access it
To increase the capacity of practitioners. How do we get enough physiotherapists in Canada to integrate pain neuroscience into their practice in an effective way?
Technology gives us the capacity to reach more people and teach physiotherapists through online methods.
Neil Pearson has added his content to healthSwapp including guided meditations and patient education. To access his content sign up here.