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Five Questions

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  • I think that Mosely wrote this in the same spirit as the original "five questions," i.e. in an effort to simplify this complex issue without being simplistic.

    The power point is amazing and clearly displays an understanding of the deep model I do not possess. Remember, he approaches the subject from the perspective of a clinician/brilliant researcher and I approach it as a clinician/juggler.

    What I find lacking in what I've read is any appreciation for ideomotion and resting posture - my fourth and fifth questions. I'd like his opinion of these, but have never been able to engage his community in that way.
    Barrett L. Dorko


    • Originally posted by Diane View Post
      We could start with just one origin- the nervous system.

      The way I understand it is, it hurts because it isn't getting enough oxygen. It's a system that comprises only 3% of the body mass but uses 20% of the oxygen taken in.

      AIGS as physiologic change to increase the effectiveness of the warning system, occur whether the pain is benign, i.e. strictly mechanical/nocioceptive, or pathologic/neuropathic, i.e.:
      1. referred to sensate portions from non-sensate portions (e.g., in viscera) which are undergoing mechanical irritations from pathology, such as tumor compression;
      2. the nerve axons are infected e.g. herpes
      3. the nerve axons are being killed off e.g. diabetes
      4. of central origin e.g. deafferentation.

      The pathologic manifestations can be ruled out/referred on through history-taking, because "pathologic" pain of any category behaves differently than "benign" pain (single category). AIGS can be confusing, can make the nocioceptive and neuropathic categories seem to overlap a bit. But they will clean up within 3 days of effective motion (motion is lotion) if they are part of the mechanical pain scenario. People can have pathologic and benign pain at the same time. What we can offer patients will clear up only the benign type; although the pathologic sorts of pain may be ameliorated by more motion/better oxygenation, the conditions giving rise to them will not.

      This concurrent NOI thread might as well be brought here.
      Thanks for this. I begin my courses by identifying the first two and then introduce the third during a brief examination of Ramachandran's writing, principally his opinion of Patrick Wall on page 18 of A Brief Tour of Human Consciousness.

      The third origin (AIGs) you've identified intrigues me and may one day enter into my thinking, but at the moment I remain unconvinced that these are distinct from a combination of chemical and mechanical irritation as it is eventually manifest in the nervous tissue itself. My understanding is that such things occur in the presence of persistant chemical and/or mechanical abnormalities and are perpetuated by an absence of their reversal.

      link removed to free movies
      Last edited by Diane; 29-07-2010, 10:11 PM. Reason: to take out active, possibly spam, or porn, link.


      • Who are you?

        I see you've appropriated my use of Ramachandran's text precisely as I originally devised it years ago. You're welcome to it - but did you know where this manner of teaching came from?
        Barrett L. Dorko


        • macrylinda1,

          Here's a link to the Welcome thread for your convenience.

          Just click on the "New Thread" button on the left under the Soma Simple banner and task bar, and please tell us more about yourself and your interest in this site.
          John Ware, PT
          Fellow of the American Academy of Orthopedic Manual Physical Therapists
          "Nothing can bring a man peace but the triumph of principles." -R.W. Emerson
          “If names be not correct, language is not in accordance with the truth of things. If language be not in accordance with the truth of things, affairs cannot
          be carried on to success.” -The Analects of Confucius, Book 13, Verse 3


          • Guys, check the signature "link" of macrylinda....
            We don't see things as they are, we see things as WE are - Anais Nin

            I suppose it's easier to believe something than it is to understand it.
            Cmdr. Chris Hadfield on rise of poor / pseudo science

            Pain is a conscious correlate of the implicit perception of threat to body tissue - Lorimer Moseley

            We don't need a body to feel a body. Ronald Melzack


            • Originally posted by Luke Rickards View Post
              There are only 4 origins, so that narrows it down a bit.

              1. Mechanical deformation - most common. Pain that changes with position or use.
              2. Chemical irritation - common, may occur concurrently with pain of mechanical origin. Pain is generally constant in nature, may be associated with local heat and/or swelling, often worse at night.
              3. Abnormal axonal impulse generation / Ectopic discharge - often occurs after peripheral nerve injury. Hyperalgesia along nerve trunk and/or cutuneuos distribution. Often varied or odd descriptors of pain sensation and altered stimulus/response relationship.
              4. Central deafferentation - rare.
              Can abnormal axonal impulse generation elicit a spurious muscle contraction? Is it possible for the impulse to occur prior to a peripheral nerve injury? Maybe simultaneously?

              Ford Erika Platform
              Last edited by regnalt deux; 30-01-2011, 04:59 AM.
              “Don’t believe everything you think.”