pain biological and evolutive strategies

HANDFUN MEETING 2013 Carlos Rodríguez López

PAIN:BIOLOGICAL AND EVOLUTIVE STRATEGIES


¢ Neurological pathology and its connection with pain.

¢ We work on patient´s demand. Don´t we?? ¢ We have to be sure about what the patient needs.

That goes in our therapeutic intervention ¢ The patient has something that´s hurting and he/

she expects you to fix it. END OF THE STORY.

PAIN: BIOLOGICAL AND EVOLUTIVE STRATEGIES


¢  Our brain´s bright, we should trust him but, when pain arrives everything changes.

¢  “ Main function: learning” ¢ But how can we teach him:

�  Words �  Enviroment �  Our behaviour …

PAIN: BIOLOGICAL AND EVOLUTIVE STRUCTURES


¢ How does pain work? ¢ Symptom exagerating behaviour. Who would like

to exagerate their symptoms? ¢ Pain depends only on what the brain thinks ¢ Story 1. Biologically corrupt perspective: “make

pain up”. L. Moseley ¢ Any credible evidence about your body will make

changes on our brain´s beliefs


¢ Pain is an output of the brain. ¢ We should listen carefully to our patients: what

are their beliefs about their pain? It´s all about meaning!!

¢  Signature, neuromatrix.. ¢ Nora Kern: disability neuromatrix

PAIN: BIOLOGICAL AND EVOLUTIVE STRATEGIES. CASE 2

¢ Pain is 100% real, but not a perception of how the body is

PAIN: BIOLOGICAL AND EVOLUTIVE STRATEGIES.

¢ We can retrain the brain to regain precision: we have to teach him something else! He´s good at it but it depends on us to do it properly.

¢ When pain or disability appear in the brain, changes take place.

¢ Pain is NOT a conscious version of nociception

INN: BIOLOGICAL AND EVOLUTIVE STRATEGIES

DISABILITY: BIOLOGICAL AND EVOLUTIVE STRATEGIES

¢  INN perspective: Only with adaptable peripheral nerve structures you have the ability to reach out. Sometimes its mainly a mechanical thing and not so much a central issue.

DISABILITY AND PAIN: BIOLOGICAL AND EVOLUTIVE STRATEGIES

¢  If you have lost this ability in your structures for some time, your brain is no longer thinking of this strategy, that means no more reaching out-ideas but asking for, moving closer towards, ignoring etc.

¢ Think about pain. Can we contribute with our intervention to a lack of brain thinking on strategies to solve problems?


¢ Old studies about allodynia ¢ Sweeney J, Harms A. Persistent mechanical

allodynia following injury of the hand: treatment through mobilization of the nervous system. J Hand Ther. 1996;9:328–38.

PAIN: BIOLOGICAL AND EVOLUTIVE STRATEGIES. CASE 3

PAIN: BIOLOGICAL AND EVOLUTIONARY STRATEGIES

•  We need the knowledge so that we can put the patient into the realness of truth:

“One day this pain will make sense to you”

pain biological and evolutive strategies

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