Pain Medicine & Clinical Neuroscience

Above all, pain medicine and clinical neuroscience represent an area of sustained clinical and academic engagement, approached through the intersection of medicine, neuroscience, and the lived experience of chronic illness.

Accordingly, Dr. Fábio Luiz Vieira has pursued additional training in pain medicine, neuromodulation, and behavioral approaches to chronic pain through scientific congresses, international courses, and clinical training programmes.

 

Pain Medicine Neuroscience: A Clinical and Neuroscientific Problem

Chronic pain represents one of the most demanding areas of clinical medicine. Furthermore, it is among the most frequently mismanaged. Its complexity lies not in diagnostic obscurity. Rather, it requires holding simultaneously in view the biological mechanisms of nociception, the neuroplastic changes that accompany chronicity, the psychological dimensions of suffering, and the social and cultural contexts that shape how pain is experienced, expressed, and treated. Pain medicine neuroscience offers the most comprehensive framework for understanding this complexity.

Dr. Vieira’s engagement with pain medicine neuroscience developed from within Family Medicine — the clinical environment in which chronic pain presentations are most frequently encountered. In addition, they are most often inadequately addressed and most in need of integrative thinking. Consequently, this engagement evolved over time into a structured area of clinical focus, academic participation, and continuing professional development.

 

Clinical Training and Academic Engagement in Pain Medicine Neuroscience

This clinical interest naturally led to a structured engagement with pain medicine over time — specifically through congress participation, university teaching, and training in internationally recognised programmes. Along the way, complementary courses in pain management consequently extended both the theoretical understanding and the therapeutic repertoire brought to clinical practice.

For example, among these was a course on alternative approaches to pain organised by the Associação Paulista de Medicina (APM) in São Paulo — one of several educational experiences that contributed to building a more integrative perspective on pain management.

Brazilian Pain Medicine Congresses

Participation in scientific congresses has supported continued engagement with developments in pain medicine and its evolving evidence base in Brazil. Dr. Vieira has participated in national meetings organized by the Sociedade Brasileira para o Estudo da Dor (SBED), including the Brazilian Pain Congress (Congresso Brasileiro de Dor). In addition, he attended academic events such as Sábado da Dor and the Simpósio de Dor – 100 Anos da FMUSP, reflecting ongoing involvement with the Brazilian pain medicine community and its multidisciplinary perspectives.

 

Certificates include:

• • 9º Congresso Brasileiro de Dor — SBED (Fortaleza, CE – 2010)

• • 10º Congresso Brasileiro de Dor — SBED (Salvador, BA – 2012)

• • Sábado da Dor — SBED (São Paulo, SP – 2010)

• • Simpósio de Dor — USP 100 Anos / FMUSP — FMUSP (São Paulo, SP – 2012)

• • Farmacologia — 9º CBDOR — SBED (Fortaleza, CE – 2010)

• • Terapia Comportamental Cognitiva para Dor Crônica — SBED (Salvador, BA – 2012)

University Teaching and Lecturing

In addition to formal university teaching, Dr Fábio Luiz Vieira has contributed to continuing medical education and multidisciplinary pain management initiatives in both Brazil and Angola.

During his clinical work in São Paulo, he participated in a structured chronic pain management programme at AE Pedreira outpatient clinic, involving electrotherapy approaches and group-based interventions for patients with persistent pain. This activity was documented in an institutional publication by the Associação Congregação de Santa Catarina.

His international academic engagement includes delivering lectures on chronic pain management at medical events such as the II Medical Congress of Clínica Girassol in Luanda (Angola, 2014), reflecting his involvement in global health training and cross-national professional exchange in pain medicine.

Furthermore, he is author of a chapter on chronic pain management in a published medical work — a contribution that reflects formal recognition within the academic medical community and a commitment to advancing knowledge in this field beyond individual clinical encounters.

 

NOI Group — Neuroscience of Pain Training

Dr. Vieira’s engagement with advanced and internationally recognised training programmes was moreover pursued across multiple countries. Specifically, he has completed courses with the NOI Group — the internationally recognised body founded by neuroscientist and physiotherapist David Butler, responsible for developing and disseminating the neuroscience of pain education framework globally. Notably, NOI’s approach — grounded in the science of central sensitisation, neuroplastic changes in chronic pain, and the clinical application of pain neuroscience — represents the current frontier of evidence-informed pain management. As a result, training with NOI reflects an approach to pain that goes beyond symptom management toward a mechanistic and educational understanding of how the nervous system generates and maintains pain.

SCENAR and RITMScenar — Electrotherapy and Neuromodulation Training

Furthermore, complementing neuroscience-informed approaches to pain management, Dr. Vieira completed structured training in SCENAR (Self-Controlled Energo Neuro Adaptive Regulation) therapy, a form of electrotherapy and neuromodulation with documented applications in pain management and rehabilitation. Training was undertaken through accredited programmes including Foundation, Advanced, and Trainer levels delivered by international institutions in the United Kingdom, the Netherlands, and Russia, reflecting exposure to different clinical approaches to neuromodulation.

Certificates include:

• • SCENAR Foundation Level One — Ritmedic (Worthing, UK – 2009)

• • SCENAR Foundation Level Two — Ritmedic (Worthing, UK – 2010)

• • SCENAR Masterclass: Therapy, Stress and Electrodes — SCENAR Academy (Essex, UK – 2010)

• • RITMScenar Level Three — Kosmed (Netherlands – 2010)

• • RITMScenar Level Four — Kosmed (Vlissingen, Netherlands – 2010)

• • SCENAR Trainers Course — SCENAR Academy (Moscow, Russia – 2011)

Integrating Neuroscience and Therapeutic Practice

Taken together, the combination of neuroscience-informed clinical reasoning with complementary therapeutic training represents a coherent approach: understanding pain at the level of the nervous system, and applying that understanding through a range of evidence-informed and clinically validated interventions.

 

Clinical Engagement in Chronic Pain

An early component of Dr. Fábio Luiz Vieira’s clinical trajectory involved dedicated work in the care of patients with chronic pain conditions. This experience contributed to the development of a deeper understanding of symptom complexity, functional neurological presentations, and the biopsychosocial dimensions of persistent pain.

A significant part of this work took place at the Pain Control Program at AE Pedreira, a public multidisciplinary service under SUS in São Paulo (2011), where he worked alongside a team of specialists across Rheumatology, Orthopaedics, Neurology, Nutritionists, Psychologists, Occupational Therapists, and Social Workers. The programme combined individual consultations with structured group-based psychoeducational sessions for chronic pain — defined as pain persisting beyond three months — delivered over 8 weeks in 16 twice-weekly encounters, with patient understanding of pain mechanisms as a central therapeutic principle.

 

 

 

During this period, he also led educational initiatives aimed at improving patient awareness and engagement in pain management, including the creation of the platform Atenção em Dor, designed to provide accessible medical information and support for individuals living with long-term pain syndromes.

This early clinical focus continues to inform his interest in integrative approaches to symptom management, digital health communication, and patient-centred neurological care.

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The Connection Between Pain and Neurodevelopmental Conditions

Indeed, one of the most clinically significant insights that emerged from sustained work in pain medicine neuroscience is the frequency with which chronic pain presentations — particularly those involving widespread symptoms, fatigue, sleep disturbance, and cognitive difficulties — co-occur with neurodevelopmental conditions, most notably ADHD.

Moreover, this clinical observation is supported by a growing body of neuroscientific research. These studies point to shared mechanisms: altered central pain processing, dysregulation of the dopaminergic system, and overlap in the neurobiological pathways involved in attention, executive function, and pain modulation. In clinical practice, therefore, this means that chronic pain assessment — particularly in adults presenting with complex, multi-system symptomatology — must include evaluation of neurodevelopmental history and current cognitive and attentional functioning.

Consequently, this intersection informed the gradual incorporation of ADHD assessment and management into clinical practice, approached not as a departure from pain medicine but as a natural extension of the same integrative, neuroscience-informed clinical reasoning.