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Pain Neuroscience Education: Part 1

Why the mailman? I'll explain in a sec.

Pain Neuroscience education is an important part of treatment for people suffering from persistent pain. Not everyone needs this education, but in some cases when it is necessary, we can spend up to 4-5 hours teaching. This post is a little part of one section.

Acute pain is sudden onset, sharp rise and short course. Usually lasts a few days, maybe weeks. Examples of acute pain are a sprained ankle, touching a hot stove, wisdom teeth growing in, bruised muscle, muscle spasm etc... Acute pain can be very helpful. It is the body's way of communicating. The body is asking for protection until it is done working its healing magic.

The biomedical model of pain: This was the traditional way of thinking.

Pain = Tissue Damage = Disability. If we treat the tissue damage, we eliminate the pain and decrease the disability. This model can explain acute pain... However, what about pain that persists, even after the tissues are healed? This model isn't accurate when talking about chronic pain because it is no longer a one-to-one relationship between pain and tissue damage. There are additional factors that come into play when suffering from chronic pain.

The Biopsychosocial model of pain (Waddell 2004):

Pain is ALWAYS influenced by a unique set of BIOLOGICAL, PSYCHOLOGICAL, SOCIAL inputs. Biological = Actual & potential tissue damage. Psychological=Thoughts & feelings information. Social / Environment= Context information.

Pain is an output of the brain, it is influenced by a unique set of inputs.

The brain can modulate pain, and pain processing changes with time.

When someone is in pain, it is VERY real. Things hurt for real. However, in some cases when there is no longer a physical injury, it becomes critical to understand that the pain isn't coming from the tissue, it is coming from the brain. Therefore, we don't really need to treat the tissue, we need to "treat" the brain.

Now let me explain this concept through my mailman analogy.

A mailman delivers. Brings packages from a to b. The mailman doesn’t open the package to look inside, he simply delivers. Once the package is received by the recipient, it is their choice what to do with it... The recipient decides.

A nociceptor is a sensory nerve. A nociceptor delivers chemical, mechanical and thermal information from the skin to the brain through a process called nociception. Nociception alone is not enough to cause pain. Just like the mailman delivers the package to the recipient, a nociceptor delivers information to the brain. In both cases, it is the recipient that controls what to do with the package / information.

Pain doesn’t equal tissue damage, it is very complex and takes time to understand. When we grasp the concept that there is no longer a threat, no longer the need to protect, no longer a danger, we are better equipped for recovery from chronic pain.

Kapish?! If this doesn't fully make sense, that's okay! I am still learning also! And remember this is only part 1, a tiny glimpse into the whole picture

Also.... shoutout to all the workers at Canada Post, this time of year can be very intense and demanding....Thank you for delivering! <3

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