by Manon Bolliger, facilitator & retired naturopath with 30+ years of practice | About Your Health, Addressing Your Pain
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...
by Manon Bolliger, facilitator & retired naturopath with 30+ years of practice | About Your Health
‘‘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...
by Manon Bolliger, facilitator & retired naturopath with 30+ years of practice | Addressing Your Pain
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...
by Manon Bolliger, facilitator & retired naturopath with 30+ years of practice | Addressing Your 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...
by Manon Bolliger, facilitator & retired naturopath with 30+ years of practice | Addressing Your 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...
by Manon Bolliger, facilitator & retired naturopath with 30+ years of practice | Addressing Your 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...
by Manon Bolliger, facilitator & retired naturopath with 30+ years of practice | Addressing Your Pain
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....
by Manon Bolliger, facilitator & retired naturopath with 30+ years of practice | About Your Health, Addressing Your Pain
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...
by Manon Bolliger, facilitator & retired naturopath with 30+ years of practice | About Your Health, Addressing Your 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,...
by Manon Bolliger, facilitator & retired naturopath with 30+ years of practice | About Your Health, Addressing Your Pain
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...
by Manon Bolliger, facilitator & retired naturopath with 30+ years of practice | About Your Health, Addressing Your Pain
As covered previously, the autonomic nervous system is comprised of both the parasympathetic and sympathetic nervous system. In chronic stress, the sympathetic system, through several hormonal and neural pathways, maintains a state of chronic stress. While...
by Manon Bolliger, facilitator & retired naturopath with 30+ years of practice | About Your Health, Addressing Your Pain
We’ve seen over the last several posts that the standard explanations for pain related to whip last, tending to identify it with lesions and their effects, is increasingly challenged in the research literature. Few insightful studies demonstrate successful...
by Manon Bolliger, facilitator & retired naturopath with 30+ years of practice | About Your Health, Addressing Your Pain
In the last couple posts we’ve seen how mechanical and structural explanations for persistent whip lash pain don’t stand up as well as does subjective and emotional explanations. It turns out than even muscular explanations are not as compelling as many might assume...
by Manon Bolliger, facilitator & retired naturopath with 30+ years of practice | About Your Health
I will never forget the patient I saw in Stouffville, Ontario, who was told by her chiropractor that the pain and lack of motion in her neck had to do with the osteophytes that had amassed on her cervical spine. After two series of 30 treatments, she came to see me...
by Manon Bolliger, facilitator & retired naturopath with 30+ years of practice | Addressing Your Pain
In my most recent posts I considered the brain science on pain and how it indicates that a patient’s perception and experience of pain cannot necessarily be reduced to assessment of specific lesion events or their presumed effects. Let’s get into this a little more...
by Manon Bolliger, facilitator & retired naturopath with 30+ years of practice | About Your Health, Addressing Your Pain
In my last post we looked at the brain science on pain. Among the facts we observed was that there were two distinct pathways associated with pain. I have a couple more thoughts to add on the brain science front before we turn to a consideration of what this means for...
by Manon Bolliger, facilitator & retired naturopath with 30+ years of practice | Addressing Your Pain
The pathways for pain transmission are complex. Generally, nociceptive information (pain-info) reports external and internal representation of the body’s physiological condition through two different components: The sensory-discriminative component, transmitted...
by Manon Bolliger, facilitator & retired naturopath with 30+ years of practice | About Your Health
Continuing with our discussion of the role of assessment in the doctor’s SOAP interview, I want to return to a topic discussed before: the character of pain. Pain is a good example of the conundrum doctors’ face with regard to “assessment.” The experience of pain is...
