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Phantom Limb Pain
In the last post we started to explore the role of the brain in pain and recovery. An especially powerful aspect of this is the role of perception. A 2011 study established neural evidence for the brain’s role in controlling motor output (Tanaka et al., 2011, p.38)....
The Science of Pain
In the last several posts, from a variety of angles, we’ve examined the mind-body dimensions of treatment for pain, seeing how it is essential to treat the trauma rather than the symptoms. This has involved treating the body as a carrier of meaning, whose history...
Treating Fear in Accident Cases
In my last post I raised the issue of fear as a meaning invested in the body and its symptoms. The correlation of the body part with the fearful memory deeply connects and acknowledges the fear. Making explicit the mind-body connection helps release the traumatic...
A Shift in Perspective
In recent posts we’ve been discussing the value of a paradigm shift to thinking of the body as a carrier of meaning and the health care opportunities it affords. As one commentator observed: finding ways for patients to shift their perspectives, to achieve “…a shift...
If the Body has a History, What Can it Teach Us?
In the last post we looked at the research on the human body as a carrier of meaning, with a discernible history with lessons to teach us. Let’s look at this idea more closely. The work of Steen et al., “Generalized chronic musculoskeletal pain as a rational reaction...
Prescribing Empowerment
Our discussions in this blog have continually circled us back to the same set of questions. As a doctor, what is our responsibility for assessing the situation and exploring possible “prescriptions”? To how much of the patient’s story will you relate, and through...
The Jungle Prescription: Ayahuasca
In the last post we saw the findings on stress from mouse research. These findings were seen as providing optimism for the development of compounds to improve resilience to pain. A couple of thoughts come to mind in response to these ideas. On the one hand, yes, we...
The Biology of Stress
In recent posts we’ve been considering the therapeutic benefits to dealing with stress as a strategy for addressing pain and cancer. But what is the story behind these concerns with stress? Researchers have long questioned why some people are resilient to stress while...
Stress Causes Cancer
In a study funded by The National Institute on Aging and the National Cancer Institute, researchers interviewed 94 women whose breast cancer had spread (metastatic) or returned (recurrent) about the stress in their lives. David Spiegel, M.D., one of the study's...
The Benefits of Humor and Looking towards Better Research Protocols
In previous posts we’ve considered the benefits of stress relief in treatment. Humor can effectively relax patients, allowing them to better handle fear and anxiety. “Nurses find humor to be very beneficial for increasing their patients’ pain threshold, which helps...
The Relaxation Response
Recent posts have discussed the therapeutic benefits of patient self regulation. Patient self management of stress levels through relaxation response was pioneered in 1976 by Herbert Benson, M.D., head of the Mind/Body Medical Institute at New England Deaconess...
Discovering the Benefits of Patient Self Regulation?
In the last post we began to look the changing role of the Doctor in a health care approach that treated the patient as a whole and meaningful entity. As a person with a life experience that had a bearing upon their existing state of health. We saw that taking a full...
Time to Re-evaluate the Doctor’s Role
‘‘If a feeling becomes strong enough, it might become an image. This image can be of help for the mind.’’ (T.S. Elliot) As a doctor, what extent of responsibility do you have in assessing your patients’ situation and exploring possible “prescriptions”? How much of the...
Plan: Beyond Glorified Coping Skills and the Placebo Effect
“Medicine tells us as much about the meaningful performance of healing, suffering and dying as chemical analysis tells us about the aesthetic value of pottery,” Ivan Ilyich in Limits to Medicine. “We confine ourselves to a narrow realm indeed if we exclude from...
The Body is a Carrier of Meaning
While Steen and Haugli state that treatment programs do exist that approach chronic pain from a psychological point of view, promoting educational pain programs, as well as cognitive understanding of pain and pain models, in order for behaviors to be modified, has...
Some examples of the biopsychosocial approach to pain.
In the last couple posts we’ve explored the four dimensions of the biopsychosocial approach to pain. The upshot of the story is that tissue damage alone cannot reveal pain to us and in fact an approach is required that attends to a range of behavioural, psychological...
More on The Biopsychosocial Approach to Pain
In the last post, we started an introduction to the biopsychosocial approach to pain, seeing, in its first dimension, how there was no 1:1 relation between correlation between tissue damage and pain experience. The second dimension is pain perception: a...
The Biopsychosocial Approach to Pain
As psychoneuroimmunology has offered a conceptual and biological understanding of the mind-body connections the concept of pain has evolved from purely biomedical to a multi-dimensional understanding. Several authors have categorized management and treatment...
Can Any Drug be Legitimately Recommended for Back Pain?
A 2003 systematic review of antidepressant treatment for chronic back pain concluded they produce only moderate symptom reduction (Staiger et al., 2003). Another recent review concluded that many drugs used for back pain are no more, or only slightly more, effective...
The Legacy of Animal Models for Chronic Pain
Animal models for chronic pain are insufficient, despite pioneering work in the late ‘70s to mid-80s. These models have at least confirmed that chronic pain states are biological entities and not just patients’ imagination. Also, they allow for a mechanistic study of...
Chronic Pain: From Binary to Continuum
In their research, Korff and colleagues have observed a continuum of chronic pain, with no distinct class of chronic pain patients. No clear demarcation distinguished persons with possible or probable chronic pain from those with less significant and enduring pain....
If Chronic Pain Isn’t a Reliable Diagnostic Category What Can We Do?
In the last post we raised the issue of defining chronic pain. One suggestion was to define it in terms of duration. Van Korff & Dunn, in Chronic Pain Reconsidered (2008), argue that “while conceptually appealing, this approach has not produced reliable or valid...
The Difficulties in Defining Chronic Pain
Patients seeking care for pain want to know whether it is likely to improve or run a chronic course, not just its cause and how it might be relieved and managed. But it is difficult for the doctor to give a clear and reassuring answer. Korff and Dunn, in their book,...
Effective Pain Treatment Requires Motivated Patients
In my last post we saw that, regardless of whether the Autonomic Nervous System (ANS) deregulation is activated by physical or psychological triggers, such activation may have significant effects on nociceptive transmission and subsequent pain experiences. This was...