Learning about why things hurt helps things hurt less!
Written by Mitchell Robinson
There are nearly two billion people in the world with an ongoing pain state. Part of the reason why modern medicine is struggling to meaningfully reduce physical pain is that ...it's complicated! And while it is complicated, there are a lot of smart people attempting to address this. One such group is the Neuro Orthopaedic Institute (NOI) Australasia. NOI are a highly qualified group of experts and clinicians whose vision is to seed ‘healthy notions of self through neuroscience knowledge’ worldwide.
Underpinning this vision are the following five important conceptual changes;
1. Injury or disease does not mean that you feel pain,
2. The nervous system moves and stretches as we move,
3. Pain, stress and performance are outputs of the brain,
4. Knowledge and movement are the greatest pain and stress liberators, and
5. Nervous system plasticity gives new hope and technique.
The basis for NOI's educational philosophy is the biopsychosocial approach - the merging of the biology of human pain, stress and performance with the psychological and social environment. In other words, human's are complicated things and appropriate care necessitates an holistic approach that incorporates the psychological and social, not simply the biological.
"Chronic pain and stress are experienced by approximately 20% of the population. The cost is huge and dollar/pound/euro figures do not cover the impact on families and loss of creativity and productivity and its social impact. Despite overwhelming evidence for biopsychosocialism, biomedicalism (ie. pathoanatomical searches for a singular cause for chronic problems) persists. The public still seeks a passive [manual therapy, medications etc.] answer for many problems and active [exercise, mindfulness techniques etc.] answers are not often provided." - NOI Group
Here are 10 key concepts from NOI that are important to grasp for understanding and therefore improving your pain:
1. Pain is normal, personal, and always real.
- All pain experiences are normal and are an excellent, though unpleasant response to what your brain judges to be a threatening situation. Read more here.
2. There are danger sensors, not pain sensors.
- The danger alarm system is just that - there are no pain sensors, pain pathways or pain endings. Read more here.
3. Pain and tissue damage rarely relate.
- Pain is an unreliable indicator of the presence of extent of tissue damage - either can exist without the other. Read more here, here and here.
4. Pain depends on the balance of danger and safety.
5. Pain involves distributed brain activity.
- There is no single pain centre in the brain. Pain is a conscious experience that necessarily involves many brain areas across time.
6. Pain relies on context.
- Pain can be influenced by the things you see, hear, smell, touch and taste, things you say, things you think and believe, things you do, places you go, people in your life and things happening in your body. Read more here, here and here.
7. Pain is one of many protective outputs.
- When threatened the body is capable of activating multiple protective systems including the immune system, endocrine, motor, autonomic, respiratory, cognitive, emotional and pain. Any or all of these systems can become overprotective. Read more here.
8. We are bioplastic.
- While all protective systems can become turned up and edgy, the notion of bioplasticity suggests that they can change back, through the lifespan. It is biologically implausible to suggest that pain can't change. Read more here.
9. Learning about pain can help the individual and society.
- Learning about pain is therapy. That means you're treating your pain right now by reading this blog! When you understand why you hurt, you hurt less. If you have a pain problem, you are not alone - millions of others do too. But there are many researchers and clinicians working to find ways to help.
10. Active treatment strategies promote recovery.
- Once you understand pain, you can begin to make plans, explore different ways to move, improve your fitness, eat better, sleep better, demolish DIMs, find SIMs and gradually do more. Read more here, here and here.
(Moseley and Butler, 2003)
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Butler, D. S., & Moseley, G. L. (2003). Explain pain. Adelaide: Noigroup Publications.