Recap
• All pain experiences are a normal response to
what your brain thinks is a threat.
• The amount of pain you experience does not
necessarily relate to the amount of tissue
damage.
• The construction of the pain experience of the
brain relies onmany sensory cues.
• Phantom limb pain serves as a reminder of
the virtual limb in the brain.
Recap
• Danger sensors are scattered all over the body.
• When the excitement level within a neurone
reaches the critical level, amessage is sent
towards the spinal cord.
• When a dangermessage reaches the spinal
cord it causes release of excitatory chemicals
into the synapse.
• Sensors in the dangermessenger neurone are
activated by those excitatory chemicals and
when the excitement level of the danger
messenger neurone reaches the critical level,
a dangermessage is sent to the brain.
• Themessage is processed throughout the brain
and if the brain concludes you are indanger and
youneed to take action, itwill produce pain.
• The brain activates several systems that work
together to get you out of danger.
Recap
• Tissue damage causes inflammation, which
directly activates danger sensors andmakes
neuronesmore sensitive.
• Inflammation in the short term promotes
healing.
• Tissue healing depends on the blood supply
and demands of the tissue involved, but all
tissues can heal.
• The peripheral nerves themselves and the
dorsal root ganglion (DRG) can stimulate
danger receptors. Normally, pain initiated by
dangermessages from the nerves and DRG
follows a particular pattern.
Recap
• When pain persists, the danger alarm system
becomesmore sensitive.
• The dangermessenger neurone becomesmore
excitable andmanufacturesmore sensors for
excitatory chemicals.
• The brain starts activating neurones that
release excitatory chemicals at the dorsal
horn of the spinal cord.
• Response systems becomemore involved and
start contributing to the problem.
• Thoughts and beliefs becomemore involved
and start contributing to the problem.
• The brain adapts to become better at producing
the neurotag for pain (the ‘pain tune’).
• Danger sensors in the tissues contribute less and
less to the dangermessage arriving at the brain.
Recap
• Modernmanagement models incorporate the
current scientific knowledge and do not focus
solely on tissues.
• Thesemodels recognise the importance of
alarm system sensitivity, fears, attitudes and
beliefs in a chronic pain state.
• How you understand and cope with pain
affects your pain as well as your life.
• Many people with persistent pain relate to
‘avoid pain’ or ‘try to beat pain’ (boom-bust)
approaches. While understandable, these
approaches are not helpful and lead to drastic
limitation of activity andmeaning in life.
Recap
•
Education and understanding are critical for
you to overcome pain and return to life.
•
A key is to understandwhy your hurts won’t
harm you and that your nervous system now
uses pain to protect at all costs, not to inform
you about damage.
•
By being patient and persistent, you can use
smart activities to gradually increase your
activities and involvement in life.
•
Purposefully seek out activities that produce
danger-reducing chemicals.
•
You can quickly learn to exercise the virtual
body as well as the actual body.
•
Bymastering your situation and then planning
your return to normal life, youwill be able to
do so. The research shows that it canwork.
1
3
5
2
4
6
