Neuroscience

Pain Questionnaire Answers

About a week ago I put up a pain questionnaire.  


As promised, we're providing the answers, courtesy of Zac Cupples, PT.

Zac 
Cupples, a physical therapist in Plainfield, IL, had such great answers to these 
questions that I asked him if I could borrow them and he agreed. A few sentences were edited out for brevity and to keep it where we non-PT folks can understand. Read his unedited answers and the rest of his article on pain education here. Also highly recommended is his series on the book Explain Pain. If you haven't read it, this is a great chapter-by-chapter summary. If you have, it's a great review.

Thanks, Zac! 

And now for the answers:

“The best way to treat chronic pain is to prevent it.”

 

Pain receptors convey the pain message to your brain: FALSE

How Well Do You Know Pain Science?

How well do you understand how pain works? Answer these questions and find out. We'll publish the answers after the pain education class this Saturday.

Pain Neuroscience Questionnaire

True or False?

1 When part of your body is injured, special pain receptors convey the pain message to your brain.

2 Pain only occurs when you are injured.

3 The timing and intensity of pain matches the timing and number of signals in danger messages.

4 Nerves have to connect a body part to the brain in order for that part to be in pain.

5 In chronic pain, the central nervous system becomes more sensitive to danger messages from tissues.

6 The body tells the brain when it is in pain.

7 The brain can send messages down your spinal cord that can increase the danger messages going up the spinal cord.

8 Nerves can adapt by increasing their resting level of excitement.

9 Chronic pain means an injury hasn’t healed properly.

10 Receptors on nerves work by opening ion channels (sensors) in the wall of the nerve

Pain Education Class, 4/12/14: Registration is now open

Chronic pain is epidemic. It is estimated that 25% of American adults live with chronic pain and the costs in terms of medical expense and lost productivity run into billions of dollars every year. It is impossible to calculate the cost in terms effect on the quality of so many people's lives. 

We are excited to be offering a two hour pain education class at Forest Park Community College on Saturday, April 12, 2014. The class, Explaining Pain: Help Manage Chronic Pain, is for anyone who lives with chronic pain, anyone who lives or works with individuals with chronic pain, or anyone who wants to better understand chronic pain. Professionals, non-professionals, people with pain or people without pain are all welcome.

This two hour lecture will introduce you to what modern pain science has learned about chronic pain and ways that may help you manage it more effectively. The class will be based on the book Explain Pain by Butler and Moseley. 

Neurocentrism: A Unified Field Theory?

 If all you have is a hammer, everything looks like a nail.

There are many modalities in the field of manual therapy. All of them sometimes work yet many of their explanations contradict each other. 

A massage therapist is trained to treat trigger points. When a client comes to them seeking relief for a pain problem, the therapist will look for trigger points, will inevitably find them, and attempt to resolve them. The client often feels some relief after the treatment. Both client and therapist conclude that the pain was a result of trigger points and that the trigger points have been resolved, at least temporarily.

Another therapist is trained in myofascial release. A client comes seeking relief from pain. The therapist will look for and inevitably find fascial restrictions. The client may feel better at the end of the session, may even find long-lasting relief. Both assume that the pain was the result of fascial restrictions that have now been properly treated and resolved.

Let Us Now Praise Those Who Challenge Us

A massage therapist recently asked the question, "Who was your mentor and what did you learn from them?" Immediately, a particular individual came to mind and I began to think of how I would answer that question. Then I thought of the first massage therapist I considered to be a mentor. And then the second one. Shortly after, I thought of two individuals who came into my life a couple of years ago. They challenged me in ways that changed and improved my thinking. I thought back to my science-minded father who did little experiments with me and bought an encyclopedia for me when I was five years old. The list kept growing longer. It seemed to have no end.

A Massage Therapist's Guide to SomaSimple

The SomaSimple forums are one of the best resources available for any manual therapist working with clients with chronic pain. However, massage therapists who find their way to the SomaSimple site are often overwhelmed at first by the enormity of the material, intimidated by the level of discussion, and confused about where to start. Having been through that and survived, I'd like to help make it easier for those curious massage therapists who come behind me. Why? Because I think that what SomaSimple has to offer is of enormous value and can't be found anywhere else. It is one of the best resources I've found for learning about current pain science and how to apply it in your practice.

What is SomaSimple?

SomaSimple is a website of forums and archived material for science-minded manual therapists. The majority of members are physical therapists (called physiotherapists outside of the U.S.). Other professions are also represented: osteopaths, chiropractors, massage therapists, yoga instructors, personal trainers, coaches. What they have in common is an interest in pain science and science relevant to manual therapists.

Interview with Massage Talk Radio

On Monday, May 6, Kathryn Merrow interviewed me for 30 minutes for Massage Talk Radio. We had a lot of fun. She asked about how I got into massage, about my training and experience, and how I've evolved to incorporate the various things I've learned over the years into my practice. We talked about how my understanding of trigger points has changed and I was particularly happy to speak about what I've learned about pain science in recent years. I appreciated the opportunity to tell my fellow massage therapists that even though learning something new that contradicts what we've believed to be true can be uncomfortable at first, it does not have to be threatening and, in fact, when we embrace understanding how the body actually works, it's exciting and liberating.

Book Review: Explain Pain by David Butler and Lorimer Moseley

If I could make only one recommendation to individuals living with chronic pain, it would be to read the book Explain Pain by David Butler and Lorimer Moseley.

Directed at both clinicians who work with chronic pain patients and patients who live with chronic pain, Explain Pain shows how the discoveries of modern pain science can be put to practical use. Written in understandable language with a touch of lighthearted humor, Butler and Moseley take a complex subject and make it possible for the average person to understand and use. One client remarked that she thought it would be hard to read and was delighted that she did not find it difficult at all. 

Taking Time with Clients

One of the things I particularly enjoy about having my own independent practice is that I'm able to take time with my clients. Most of the time I have to stay within the bounds of a schedule or my day would be unmanageable. However, I'm able to control my schedule so that I don't have to feel rushed. If something comes up near the end of a session, I can take a few extra minutes if that seems necessary. 

Not long ago a new client came with a difficult pain problem. She had a complicated history. I wanted to be able to listen to it carefully, to be able to ask pertinent questions, and not be rushed. I had a break after the appointment so I asked the client if she was in a hurry. Even if I had the time, perhaps she didn't. However, she had no appointments to keep and so we were both able to relax and discuss her history in detail. 

During the past couple of years I've learned a lot about how pain works and have become convinced that pain education can make a valuable contribution to managing chronic pain. I thought this particular client might find this information helpful, so we discusses how pain works and how she might make use of that.