Pain is an inevitable part of existence, but severe debilitating or chronic pain is a pathological condition that diminishes the quality of life. The Brain and Pain explores the present and future of pain management, providing a comprehensive understanding based on the latest discoveries from many branches of neuroscience.
Pain Neuroscience Education: Teaching People About Pain
Evidence shows that patients who better understand their pain and what pain truly is experience less pain, have less fear, move better, exercise more and can regain hope.
This physical therapy textbook explains how to teach your patients about pain and how to integrate pain neuroscience education into your practice.
This is why asking people with chronic pain issues what their pain scale number is doesn't work.
When I did my shoulder injury, there was a definite POP sound, & the pain was about a 2/10.
I ignored it for about 4 months before going to the doctor, bc while it was still sore & I couldn't' move it quite properly, I knew that my doctor would tell me it was probably a sprain or a strain & that they could take some months to heal.
My doctor said exactly that, & when I pointed out that it had already been 4 months, sent me for an XRay and ultrasound, decided it was bursitis & sent me for a cortisone injection. The pain was maybe a 4/10 on the worst days at this stage. My range of motion was impaired, & the pain being constant day after day was wearing on me, as was only sleeping a couple of hours at a time... but hey, I have a chronic pain condition. I can just suck it up.
6 months after the cortisone injection I go back to the doctor bc of the pain, it had gotten slightly better for a while, but now it was about a 6/10 & by this point had been going for nearly a year. He explained that cortisone often needs a second course, & that 6 months is about normal for it to 'wear off', so we'll do another cortisone treatment, & this time refer me to physio as well (to start a few weeks after the cortisone so that the swelling etc was settled).
The cortisone dropped the pain back to maybe a 2/10 most days, but I was still not sleeping properly and my range of motion was getting worse.. or maybe I'm just getting more tired of being in pain all the time? I don't know. At this point I started wondering if maybe this is just what 'old' is for me, & maybe I was being a sook & didn't have such a high pain tolerance after all.. especially if the pain is like a 2/10 & I'm getting this upset about it.
It never occurred to me that I was getting so upset about it bc my pain was NOT only a 2/10.
After another 3 months of physio not really doing anything, I went back to the doctor & asked for an MRI.
The MRI shows:
the shoulder had dislocated
one high-grade tendon tear with a significant retraction of the tendon
3 other tendon tears
muscle volume loss
bursitis
mild arthritis with degenerative changes and joint effusion and thickening
a SLAP tear with fraying in two places
two lesions where the bones smacked against each other in two different spots during the dislocation
a muscle and a tendon sprain
2 other effusions
another thickened and frayed ligament
All of this should be able to be dealt with via physio rehab, except the SLAP tear, which will need a surgical review & will (best case) be able to be dealt with via an arthroscopy.. but might need a more serious & invasive surgery.
That's 18 months of pain, sleep loss, & inability to function to my normal level because the experiences of someone with a chronic pain disorder can't be summed up with "between 1 and 10 how painful is it?"
Refused meds by GP who promised to prescribe until I found a new GP (he dropped me because my case is too complex). Changed his mind! Now have 13 days to find any doctor to write a script or #withdrawal agony for me & no #pain control.
Refused meds by GP who promised to prescribe until I found a new GP (he dropped me because my case is too complex). Changed his mind! Now have 13 days to find any doctor to write a script or #withdrawal agony for me & no #pain control.
Across two cohorts of medical students and emergency nurses, we found that healthcare experience affects neural processes in Anterior #Insula coding specifically for one's own and others' #pain