Excerpt: Pain, the brain and your amazing protectometer Lorimer Moseley
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- Опубликовано: 8 авг 2022
- Excerpt from Dec 2018 video: There have been some amazing pain discoveries over the last 20 years and they've opened up new opportunities for people in pain. This talk will explain that when pain persists, your body learns pain and becomes over protected, but you can use proven strategies to slowly retrain your pain system to be less protective. To begin, you need to rethink what pain actually is, what factors contribute to your pain and how you can tailor make your own retraining program.
Prof Lorimer Moseley is currently Professor of Clinical Neurosciences and Foundation Chair at the University of South Australia. He has authored 300 papers and five books on pain and rehabilitation. Professor Moseley is particularly interested on how education about pain can lead to better pain-related outcomes and strongly supports public and health professional engagement, as exemplified in such initiatives as the ‘Pain Revolution’, ‘Tame the Beast’ and ‘Body in Mind
Brilliant!
I'm a "true believer" in Dr. Moseley's perspective. There is no "one-size-fits-all," of course. Suggest you check out the recording from Jan 2022 support group meeting with Dr. David Clarke (published 2/10/22). See ruclips.net/video/mZjM4Hp8tmE/видео.html
Mike Foxworth
I'm still watching but if pains job is to protect us from danger before it can seriously hurt us, are we then not feeling pain for serious injuries because the body already is in serious danger?
I'm not positive I understand your question, but, indeed, if you are dealing with a crisis (running from a hungry lion, dealing with a wailing child, trying to put out a kitchen fire, etc.) you very understandably might not immediately "feel pain" from a physical injury. Later, former crisis over but unusual sensations still coming from the injured body part, your brain would probably (and helpfully) "create pain" to prompt you to check out those sensations.
"Pain" is created by a complex system. Some parts of that system are used to alert you to all kinds of danger, not just physical signals but emotional threats too (a big hospital bill, criticism from someone you thought was a friend, breaking up a love relationship).
Moseley is most concerned by the challenge of "chronic" pain. Pain that causes us to unnecessarily restrict our life (and enjoyment of it) even when there is no or little immediate risk of physical harm.
Neither Moseley nor anyone else I am aware of have taken head-on the challenge of neuropathic pain. Pain where there is no "proof" or "measurement" of signaling from our sensory nerves and certainly no "immediate" danger to our physical health. Yet a significant minority of people with neuropathic damage report lives seriously disrupted by pain or discomfort. Why only some and not all? The default assumption (largely ignoring the role of the brain and its "protectometer") is that there is some physical difference in those reporting serious pain. As far as I can tell, the proof of such difference is simply not there. On the other hand, there is lots of evidence of vast differences in the lifetime experience of patients, all of which can affect the way our brain "handles" sensory signals.
@@peripheralneuropathysuppor8948 thank you for your response and let me try to clarify! Pain's job is to protect us from life threatening or serious injury, which was established in this video. But say, in the hammer example, the hammer is already seriously injuring you. Therefore the brain knows it can't protect from the danger of having the hammer in your neck, because it's already there but there is no other danger to escape there.. In the example of needing to keep running from danger after serious injury it would make sense that your brain isn't going to alert you to pain if you still have danger to escape because it would cripple you. But does this mean, that in the hammer example, your brain is still protecting you from some perceived further danger by not sending you pain signals, and then only when it has time to realize you're not in any further immediate danger you start to feel pain? Or is it protecting you from what that level of pain would do to you? Because then why does he feel the knee pain so acutely and hasn't yet started feeling his neck?
Too much stand up comedy stuff which isnt appropriate in my opinion as many watching this are probably borderline suicidal.
Looks like the main point like always is ignoring and pushing through the pain, plus knowing that it is just a warning signal. So what? It will ruin your life regardless.
The theory is nice but sadly is unproven, preying on our despair
I think your basic point is important: How can Moseley's message ("chronic pain can be treated!") be conveyed in a way that draws the patient in instead of pushing the patient away, feeling further dismissed and adding more psychological damage to what is (in many cases) an already heavy burden? It is a challenge that none of the chronic pain researchers have good answers for yet.
Research (MRI's etc.) suggests that ignoring chronic pain is exactly the wrong approach. The longer the human is left swinging in distress the more the brain and spinal cord neuron cells grow additional receptors. This adds additional signals that our sensory processing centers and amygdala must try to cope with. You might want to invest in Moseley's book "Explain Pain."
Moseley is the emotional face and sometimes leader of a growing worldwide attempt to deal with chronic pain.
The basic question that few doctors address is "what is pain?" It has proved to be a rich and difficult question. Traditional medical teaching reinforces the natural interpretation we learn as a child: pain is something the body creates where the only role of the brain is to tell us "Where". The growing consensus is that the stresses of an entire lifetime (and genetics) sets many up to be unable to accept the reality that there is nothing that can be done to repair damage and then go on to focus on the positive. That aggressive pain relief early, when damage is first detected and treatment started, can bring the patient back into a functioning state before chronic pain starts causing additional changes to the nervous system's pain processing system.
Please check out the video of David Clarke's presentation to our meeting in early 2022. And his book "They Can't Find Anything Wrong!"
Mike
When considering PN pain it is important to recognize that current medical technology has no way to actually see the signaling from our sensory neurons. It can measure speed of large fiber signals and count density of skin neurons. But the brain is reacting to sensory information (or its absence with numbness). But the brain can over-react to innocent signals or create pain (a sense of impending danger) without any sensory signals. What is going on here? Why do some have such elevated pain/perception of danger? Conventional medicine always assumes a physical damage (which is what needs to be checked first), but almost never looks at the whole patient and his full history.
Mr. Moseley has not (as of the last time I checked, more than a year ago), attempted to look at neuropathic pain. I'm still looking for someone to tackle PN pain using the perspective of modern chronic pain researchers. I (a non-scientist) tried my best with pnsnetwork.org/chronic-pn-pain/
Mike
His message is not to push through pain. That causes flare ups that are completely disabling.
His message is that you can reduce chronic pain by very gradually exposing the body to movement and nervous stimulus and allowing the brain to relearn an appropriate sensitivity to the stimulus.
This should be coupled with cognitive therapies that allow the brain to be convinced that the threat is not as bad as it perceives.
I don't know if/how this relates to PN as that involves changes to the integrity of the nerves, but I have been through 3 years of very disabling back pain and come out the other side over the course of 6-9 months.
Unfortunately I now have some symptoms of CRPS in my knee and leg and it's a whole other level of complexity and disability when it comes to trying the same therapies.