How did you learned Pain?

[rolf]

Hi!
One of my main goals in communucation with my patients is pain education.How to understand their own pain is particularely important.
What cind of pain,and how to controll it on their own is fundamental in my way of treating my patients.Fear avoidens education.They have to learn that the mind and body are insepreable and most of us have pain NOT due to physical overuse but emotional stress!(and combinations of these two)Most of my chronick pain patients have never learned that their way of thinking(worriing,anxiety etc)will increase muscular tension etc and be the reason for their pain or increase their pain experience.Most of them have a dualistic view on the body/mind connection.
RIN
:wink: :wink: :wink:

[nari]

When I was a student eons ago, pain was something which occurred as a result of a somatic insult of some kind, from appendicitis to a sprained wrist. It passed from the site to the brain and went away through medical intervention or passage of time.
In 1990, it suddenly dawned on me that our approach to pain was missing big chunks - (Butler's first course)-and I tried to keep going from there.
In 2003 a lot of the missing chunks were materialised in my mind, and I have been rather evangelisitc since then.

Now, except in South Australia, students from most physio schools learn about the basics of pain, how it affects a person and how to treat it. They understand that cognitive processes can change the nature of pain and to some extent, its duration, but are not taught as a rule, to manage the pain except through local applications, be it manual therapy, EPA, taping.
Yellow flags are just starting to creep in, it seems. Those who read outside the square, pick up the new stuff, but are still uncertain of their role in the new neurobiology - like all of us. Neural tension tests are done, but not in the first instance; eg, epicondylopathy = local stretches and exercises and US; and are still prime choices of treatment.

Rin is right - very few patients are not Cartesian in their thinking. It takes a large leap for them to realise the role emotions play, and it is not just an old wives' tale or their imagination. Most are very relieved when they understand the pain is real, and that is the biggest gain.

[Physiorob]

Hi

It is still very new subject, students are still taught the "Gate Theory" but when you here Prof Wall and Ron Malzak speak even they can not understand that there theory has not moved on.

As an educator to students i teach my students all about pain and yellow flags.

Here is a question to you all:-

"How do patients learn pain?"

[BB]

Hello,

I am in the US, and I was lucky to be trained by a PT who is a very effective treater of those in pain.
"Psychosocial" is a term used often here (is that common elsewhere?) to describe emotional, social, etc., impact on pain and perception of pain.
This teacher taught us many manual therapies and feldenkrais treatments as well as share some of his past cases (incredible how many of those in chronic pain had been abused!)

Overall, I feel the US has a "give me the quick fix" attitude about many things including pain. This attitude toward pain I feel contributes to its becoming chronic as the underlying problems are not addressed until it is well developed.

Cory

[Green Hornet]

An old Eastern society delt with pain well. They know what it means and had an attitude to understand it from all aspects, including physical, mental, and spiritual. I don't see that much any more in a modern Eastern (Japan).

I think that one of the biggest problems is that we know that we have pain but we don't know what it means. Some of us don't even understand that it is a message. People are at loss, when facing their pain. They don't turn inside to ask themselves what the pain is telling; they only look outside and look for a quick fix.

[nari]

Bernard

Why have the patients with acute back pain been 'blocked' from physiotherapists in France?


Nari

[bernard]

Nari,

Reasons are protocols =>

1/ try rest + painkillers.
2/ after a week if rest does not helped then NSAIDs
3/ 3 weeks, if failed then RX
4/ change drugs
5/ if medicine failed then try PT!

[nari]

Bernard -

That's scary. But, as in the old English song:

.."It's the same the whole world over....." .."ain't that a crying shame..."


Nari

[rolf]

hi Bernard!

It seems to me that iam living in heven compared to you,bernard
Here in Norway we do more or less as we like with both acute or chronic pain patients.!The GP has nothing to do with our way of practising MT orPT.They often send us patients but we can also get the patients just from the "street".
In two years now the government have been trying something new in the first line duty.In some parts of norway the MT is able to send the patient directly to MR,CTxrays and write sick note for 6 weeks,without even talking to aGP.
In these areas of Norway,the sick note,has decreased compared to the rest of the country!!!
:wink: :wink: :wink:
RIN