Pain from joints? or joints that just coincidentally hurt

[Diane]

On another board, Doug Bourne, a fellow Vancouverite, has just returned from IFOMT and has published some notes about the trip. Here is an excerpt, which when I read it, I was reminded of Nari's finger (different thread):

"Bill Vicenzino talked about some of the mechanisms of mobilization with movement techniques. He talked about evidence for neurophysiological and positional faults. For neurophysiolgical mechanism he came to similar conclusions as Wright, that the mechanism was a non-opioid descending pathway and that there were sympathoexitatory effects. As for positional faults, he came to the conclusion that there was no evidence supporting positional faults. He presented an interesting case study with a patient with a positional fault of the right 1st MCP joint. A therapist examined her and came up with a MWM technique that reduced her pain. An MRI confirmed that the technique actually reduced the positional fault. After three weeks of treatment the symptoms completely resolved. A followup MRI showed that the positional fault was exactly the same as before treatment."

Hmmnnn..... can't be the poor joint's fault then, the pain must be a separate issue from joint position....

For more of Doug's impressions you can go to
http://www.manipulativetherapy.org/camt.php?page=lit-lit-ifomt

We also have Paul Hodges saying that lack of transversus doesn't mean your back will fall apart. (High time you mentioned that Paul...)
:),
Diane

[bernard]

Diane,

the mechanism was a non-opioid descending pathway

Is it really necessary that a descending pathway exist?

[Diane]

Bernard, it wasn't me that wrote that, it was someone at IFOMT called Bill Vicenzino. (You'll see that I included quote marks around the bit I copied and pasted from Doug's write-up.) I don't quite know the ramifications either.
Diane

[bernard]

Diane,

Often they speak about descending pathways but are they necessary? Many time, CNS has decided and its action has not to be transmitted in lower centres?

[nari]

Diane

What a good job Vincenzio is doing (he is a Queensland research PT) in steering people's thinking away from the obvious culprits! of pain!

I tried any number of times to open the manip therapy site but the browser here at work is deadly slow at times. Will try at home.

Today I saw a fellow with 5 year old low back pain. The only thing that gives effective pain relief is reflexology. Instant reduction to below 50% he reckons, and it can last up to a day. That HAS to be more than placebo, doesn't it? Especially as he experiences instantaneous reduction of pain...

nari

[nari]

Hi again Diane

Very interesting papers at the conference.
I like Vincenzio's research as he is looking at a hypothesis that I have suspected for a long time - ie the pain around a certain area is not necessarily originating from there.
His statements fit the picture of my silly finger much better; and he is highly regarded in Aust as a prominent researcher into pain phenomenon.
I suspect joint pain is not always originating from the joint (qv Rheumatoid arthritis) but my understanding of the process is naturally rather deficient!
It is exciting stuff, and although we must pay some attention to the site of pain in the periphery, (eg a joint dysfunction) I have a sneaky feeling we may miss the boat if that is all we do. David always stressed in his lectures that we should try to calm the offending site by whatever means, but realise that central forces are at work and should be acknowledged.

Was that joint simply another AIGS - and I wonder what the chiropractors would think of this work in relation to their theory of subluxation and pain??


Nari :?