Pain and the brain - 'neuro orthopaedics'

[rsser]

Normally my joint problems get dealt with in conjunction with the physio and sometimes meds as well. On one occasion the physio said the way I was breathing was stopping improvement in my back. I thought this was mind-over-matter bullcrap but the guy was right. I was getting out of bed and tensing up expecting pain. But when I got out breathing freely the back eased off and the problem went.

I now have neck and shoulder pain and four months of physio and HD meds has reduced it and thrown up some interesting stuff. A pill will stop the pain for the rest of the day, even after it's worn off. If I do some light work when the tightness and pain start to fire up it will often stop for the rest of the day.

My GP suggested looking at a cortisone injection. I've had these in the hip but they only lasted a week. I looked up the systematic reviews of spine use studies and there were only two old ones, relating to facet joints in the low back. Both concluded that the major factors explaining improvement were your mind and your context.

The physio suggested looking at some of the recent research on pain. An Aussie is a world leader in the field. He's a good speaker. Here's a Youtube vid:



If that got your interest, take a look as well at the talk by Tasha Stanton at the same event. She goes into therapies that follow from that kind of thinking. Still very early days though.

If you like Moseley, he's co-written a couple of books:

Explain Pain, $22 as an ebook via Google Play, or in hard copy
and the funny Painful Yarns, $16.50 as a PDF book at http://www.noigroup.com/en/Product/EPPYB

[jhovel]

Great presentation!
Some medical professionals have already incorporated this evidence from earlier research into their practice. When I had a hip replacement (for severe osteo) in 2000, the surgeon asked me how sure I felt if the procedure would remove the pain, despite the risks and potential for new pain form the introduction of a foreign body. He then said that I should think about that a lot and do some reading, and call him to make the appointment for the surgery when and if I was sure it would fix my pain.
To start off with that confused me a lot. But the more I thought and read about it, the more it became obvious that if I was expecting to wake up form the surgery with the same hip pain, it would be there! It took me a few weeks to convince myself.
However, I also have osteo in my back (and have had two back operations - one before and after the hip thing). A day or so before the scheduled surgery I moved a pile of firewood and hurt my back. I'm sure most of it was muscular because I hadn't been very active because of the hip for a long time. On the day of the surgery, the backpain was quite overwhelming. The anaesthetic went into my back in theatre (intrthecal aneasthetic) before they put me to sleep. The anaesthetic was a total relief of the backpain instantaneously (for obvious reasons: that injection blocked ALL transmission to and from the brain), and I remember thinking to myself at the time "thank God that's finally stopped it. When I wake up it won't come back".
And it didn't.
The hip pain didn't either. In fact I had one single Panadol post-operatively as pain relief being transported by ambulance home - and that was to stop them nagging me that I should have proper pain relief in case the pain came back, as it most certainly would. It never did! I had absolutely convinced myself that the removal of the arthritic bone surfaces would cut out all the messages to the brain to warn me of impending agony and injury.
The backpain stayed away for several years as well (until a bony growth into the spinal canal actually trapped my spinal chord).

I've observed this on lots of patients since then (I was a nurse): if there was an element of disbelief or suspicion that the treatment was not going to work, it almost never did.
Worth keeping in mind if you ever need to deal with chronic pain!

Thanks for the link and the thread!

[rsser]

Pleasure Joe, and thanks for sharing your story.

It should be stressed that according to this research pain is not a result of tissue damage but is the brain's interpretation of the stimuli from that along with other data (notably 'experience') done with a view not to measure damage but to assess the threat to the human. That interpretation is almost instantaneous and unconscious.

[Foo]

The mind is a powerful thing and if you can harness its power the you're on a winner.

When I was a competitive cyclist, I manage to block out the pain when in big races but it did take some months of working on this.

Foo