Wednesday, February 6, 2008

Stopping Disc Spin

Paul Mintken gathered together a lot of articles to support his statement that imaging of funny looking discs and pain do not correlate particularly well. You can read his post here.

A good post, but I have a wee issue with this first statement:
"I just don’t know if we are ever going to be able to isolate the pain generator in the majority of patients with low back pain."

Um, how about the nervous system Paul?


Paul Mintken said...

Hi dermoneuromodulator "neuroplastician",
what part of the nervous system would you be talking about? For too long, we as PT's and other health care providers have been clinging to the simplistic model of pain as an "input." As David Butler urged at the recent American Academy of Orthopaedic Manual Physical Therapist Annual meeting, we need to begin viewing pain as an "output" of the central nervous sytem that is influenced by all sorts of thing, including beliefs, perceptions. Clinging to the pathoanatomical model is doing a disservice to ourselves and our patients. Care to elaborate on your thoughts?

Paul Mintken

dermoneuromodulator "neuroplastician" said...

Hi Paul, glad to have you drop by. I couldn't agree more with your message.

In my humble opinion, the nervous system itself is the generator of all "pain" felt by humans; Lorimer Moseley (Butler's compatriot) says, "Nociception is neither necessary nor sufficient for pain production."

I would be talking about the nervous system itself from skin synapse to prefrontal cortex, from the perspective of how it exists in "nature," as something that has no clue, usually, that it has been conceptualized into a bunch of different parts and bits. It's there to defend itself/its organism as a seamless, indivisible whole and from its perspective, that's what it does.

I reckon, as human primate social groomers, we've divided ourselves (based on our human perception/primate-based proclivities I guess) into various "troops" based on our conceptualizations of what we think we're affecting, and how, and why, but truly, the nervous system itself doesn't care about any of this societal overlay. It just wants to feel good again, so it drives its "person" into choosing some human primate social groomer to go see.

Some day I'd like to see all erroneous belief systems to do with "treatment" laid to rest. Oh yeah, that and I'd like to live happily ever after, too. And let's not forget world peace. :-)