Chronic pain is at epidemic levels and has become the highest-cost condition in health care. This course uses evidence-based science with creative and experiential learning to better understand chronic pain conditions and how they can be prevented through self-management in our cognitive, behavioral, physical, emotional, spiritual, social, and environmental realms. The goal of this course is to blend creative, experiential, and evidence-based teaching strategies to help participants understand chronic pain conditions and how a human systems approach can be applied to self-management strategies to reduce risk factors, enhance protective factors, and prevent chronic pain. There are four major objectives to the course; 1. Describe the prevalence, personal impact, and health care dilemma associated with chronic pain. 2. Recognize the clinical characteristics and underlying etiology of several common pain conditions and the peripheral, central, and genetic mechanisms of chronic pain 3. Based on the literature associated with risk and protective factors in the seven realms of our lives, learn specific strategies in each realm that can be employed daily to prevent chronic pain and enhance wellness. 4. Appreciate the value of a human systems approach to health care and how it can provide a basis for integrative, interdisciplinary, and individualized care to preventing pain and enhancing wellness. CONTINUING EDUCATION CREDIT OPTION Accreditation Statement: University of Minnesota, Interprofessional Continuing Education is accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. American Medical Association (AMA) The University of Minnesota, Interprofessional Continuing Education designates this enduring material for a maximum of 24.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. American Nurses Credentialing Center (ANCC) This activity is awarded up to 24.0 ANCC contact hours. Other Health Care Professionals Other health care professionals who participate in this CE activity may submit this certificate statement of participation to their appropriate accrediting organizations or state boards for consideration of credit. The participant is responsible for determining whether this activity meets the requirements for acceptable continuing education. Registration and disclosure information is available here at http://z.umn.edu/chronicpain and pay the additional fee. Then, email your Coursera certificate statement of completion to cme@umn.edu.
Video Exercise: Guided Relaxation
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From the course by University of Minnesota
Preventing Chronic Pain: A Human Systems Approach
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From the lesson
Risk and Protective Factors in the Seven Realms (Week 8)
Meet the Instructors
Dr. James Fricton, DDS, MSProfessor and Pain Specialist
University of Minnesota, HealthPartners Institute, and Minnesota Head and Neck Pain Clinic
Hi, this is James Fricton again.
 One of the things that we find ourself doing all the time, is feeling tense,
 and hurrying about our day, trying to get the things done that we need to do.
 But sometimes we just need to take a breath, take a break, and relax.
 So this module, is about teaching you how to reduce the strain,
 the tension, to slow down a bit, and to learn to relax.
 So right now, what I want to do, is to teach that to you.
 So, what I'd like you to do is just
 to get comfortable right now, as you listen to me.
 You don't even have to watch me right now.
 But just listen to what I have to say.
 Readjust yourself.
 Move your chair.
 Close your eyes.
 And take a slow, deep breath.
 And as you take a slow, deep breath, I would
 like you to picture yourself at the top of a staircase.
 Ten steps.
 And you're looking down at the staircase.
 Your eyes are closed, you're talking a slow deep breath.
 And take four more slow deep breaths, as you
 see yourself at the top of the staircase, that's right.
 A deep, slow breath, and just exhale all the way out.
 And then take another slow deep breathe.
 That's right.
 Breath in, and then breathe out, and each time you exhale, I
 wonder if you're surprised to notice, that you become just a little bit more relaxed.
 I don't know how you'll feel more relaxed.
 Maybe, you'll feel it in your hands first.
 Maybe, you'll feel it in your back.
 Maybe, you just feel it in your jaw.
 I don't know, but each breath that you take, I wonder if you'd be surprised
 to notice, how much more comfortable you
 become, as you see yourself up the staircase.
 And in a minute, we're going to walk down that staircase, and each step down
 the staircase, all I'd like you to do is just notice what is happening.
 There's nothing to do, no one to please,
 no one to satisfy, nobody to do anything for.
 But just take a few minutes right now, to just sit there, and listen.
 And notice what is happening, as you continue to breathe slowly and deeply.
 With nothing to bother, and nothing to disturb.
 So let's step down that staircase.
 And each step down the staircase, again, just notice what is happening.
 So now one, one step down the staircase.
 Feeling yourself stepping down your staircase, as
 you see yourself stepping down the staircase.
 That's correct.
 Now, take two, two steps down the staircase.
 That's right.
 Continue to relax with your breathing, slowly in, slowly out.
 And wondering if anything at all is happening.
 Some people relax fast, some people relax slow, some people don't relax at all.
 But it doesn't really matter.
 Nothing matters right now, because all you're
 doing is simply sitting there, and listening.
 With nothing to bother, nothing to disturb as you continue to go down the staircase.
 Three, three steps down the staircase.
 And perhaps feeling a, a coolness across your forehead.
 Or maybe a warmth in your fingers.
 Or maybe a tingling in your toes.
 Or maybe you feel like adjusting yourself to be
 even more comfortable and relaxed than you currently are.
 I don't know what you need to do.
 And it doesn't really matter.
 Just listening.
 Four, four steps down the staircase.
 Each step down the staircase, more comfortable and
 more relaxed, with nothing to bother, nothing to disturb.
 Five, five steps down the staircase, halfway down
 the staircase, and perhaps even more than halfway relaxed.
 And really beginning to enjoy this experience.
 Just taking a few minutes break from your normal routine.
 Perhaps this few minutes feels like it's, ten minutes or 15 minutes, because
 it's all so refreshing, and energetic, and relaxing mostly.
 Six, six steps down the staircase and perhaps you notice
 certain areas of your body being more relaxed than others.
 Maybe your shoulders are still a little bit
 tight, and you move them around to relax
 even more, or maybe the back of your neck, and you adjust yourself to be comfortable.
 Do whatever you need, to feel more comfortable, more
 relaxed with nothing to bother, and nothing to disturb.
 Seven, seven steps down the staircase.
 And more relaxed.
 And enjoying the experience.
 Maybe your right hand is more relaxed than your left hand.
 Or maybe they feel heavier, on the left hand, than the right hand.
 Or maybe they feel equally heavy, or maybe they even feel light.
 It really doesn't matter what's your experience.
 All it is, is just sitting there, relaxed,
 comfortable with nothing to bother, and nothing to disturb.
 No one to please, no one to satisfy.
 No one to listen to, to write down your notes or lectures.
 Just to relax.
 Eight, eight steps down the staircase.
 Almost to the bottom of the staircase.
 And wondering, what will happen at the bottom of the staircase?
 But then not really caring, because it's all just, enjoyable.
 Nine, nine steps down the staircase.
 Almost to the bottom of the staircase.
 And noticing the sensations that you feel throughout your body.
 Maybe those noises that once were distracting becomes less so.
 Maybe they feel like they are a 1,000 miles away, and
 that you're just sitting so still, and so quiet right now.
 Perhaps, even surprised, pleased.
 But whatever you experience, it's all natural, to
 just let go, for just a few minutes.
 Finally, ten, ten steps down the staircase, bottom of the staircase.
 Very relaxed, very comfortable, with nothing to bother, and nothing to disturb.
 And curious right now, being at the bottom of the staircase.
 How long could you just stay like this, relaxed, comfortable?
 With no one to do anything for.
 Well can achieve this same relaxation, any time you
 want to, whenever you take a slow deep breath.
 Whenever you feel tension in your shoulders, your neck,
 or you're clenching your teeth, or your back feels tight.
 By taking a slow, deep breath, exhaling all the way out,
 and then breathing all the way in, that these sensations, these feelings of
 warmth, of relaxation, or letting go, of not
 a worry in the world, will come back to you.
 By taking a slow deep breath, this relaxation
 will come, and your muscles and your shoulders
 will loosen up, and your back will feel
 comfortable, and the pain that you had goes away.
 And everything that you're doing right now,
 becomes part of your relaxation and comfort.
 WIth nothing to bother, and nothing to disturb.
 And as at you're at the bottom of the staircase,
 I want to encourage you to continue to enjoy the course.
 And to continue to learn about your risk factors and protective factors.
 And I wonder if you'll be surprised to notice how important that becomes.
 When you care for patients, or care for family, or friends.
 When you help others, achieve the same degree of
 comfort, relaxation, with nothing to bother, nothing to disturb.
 So, in a few minutes, we're going to go back up the staircase,
 and each step up the staircase, you'll become more aware, and awake.
 But refreshed, almost as if you've had a full night's sleep.
 Bottom of the staircase, looking up.
 Ten.
 Bottom of the staircase, you can see the steps going up.
 Nine, nine steps up the staircase.
 I can, see yourself taking one step after another.
 Going up higher, eight, eight steps up the staircase.
 Becoming a little more awake, little more aware of your surroundings.
 Seven, six steps up the staircase.
 Going at your own pace.
 There is no hurry, to get our of relaxation.
 It's such a pleasurable experience, with nothing to bother, and nothing to disturb.
 Six, five steps up the staircase.
 Being aware more of the people around you, of
 their computer, of the class, the course, the chair.
 Four, four steps up the staircase but still, very relaxed and
 comfortable, almost as if you are refreshed, from a deep sleep.
 Four, three steps up the staircase, two, almost to the top of the staircase.
 Ready to open your eyes, and become completely aware and awake with all normal
 sensations, but still your muscles relaxed and
 refreshed, two, finally, one, top of the staircase.
 You can open your eyes.
 You can become more awake and aware.
 And, take your time.
 As much time as you need, to come back to all your normal sensations and feelings.
 And just to enjoy it for a minute.
 Thank you very much.
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