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  • #76
    So here's a question: What needs to happen for an AIG to get "better"? I mean, what closes the holes that have appeared, making the nervous membrane less like canvas and more like lace?

    Does it heal normally when offered appropriate metabolic economy?
    Barrett L. Dorko

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    • #77
      So here's a question: What needs to happen for an AIG to get "better"? I mean, what closes the holes that have appeared, making the nervous membrane less like canvas and more like lace?

      Does it heal normally when offered appropriate metabolic economy?
      I don't know if any one knows for certain, but Butler says, blood flow to nerve. This makes perfect sense evolutionarily, thermodynamically, metabolically, physiologically, even mechanically.
      1. Evolutionarily, the two % of the body which is nervous system requires 20% percent of all the O2. (Domisse)
      2. Thermodynamically, life exists to be a gradient reducer. Blood flow moves stuff around reducing gradients of all sorts everywhere at all times. Its role as an O2 provider is consistent with the role of life itself.
      3. Metabolically, if a neuron can't breathe it will die. It makes sense evolutionarily that if it "thinks" or "senses" it can't breathe, it will "think" it might die. I've used anthropomorphic language, but it holds true at the systems level and at a chemical level - the nervi nervorum will report decreased available O2 in the nerve's "environment", and the n. system will be notified/may try to mount a rescue effort/behavioral response at a CNS level. At the neuronal level, various substances such as fractalkine* are produced by/expressed on the membrane of the stressed neuron, which activate microglia in the dorsal horn synapse, which are thought to be involved in upregulating the signal at cord level (bothering the secondary ascending neurons).

      4. Mechanically and 5. physiologically, consider blood flow for a moment, as it is part of a neuron's "environment".
      Blood flow does way more than just deliver O2, although that would be huge for the neuron and the cell that wraps it, Schwann. It's like a river that brings everything good to the neuron and carries everything bad away. It carries away metabolites. It carries away "swelling." (Nerves have no lymph drainage.) These can bother neurons physically, mechanically, on the inside of the axon.
      Once mechanical pressures are relieved (outside and in) and overall pressures (inside and outside) are normal, and the stress metabolites like fractalkine are carried off by the improved circulation, the microglia will de-activate, the signal to the brain stops, the neuron recovers. Physiologically it's a sick, unwell neuron, so it takes a few days. It's membrane must re-regulate.

      It's crude, but that's my understanding at present.
      Our therapy job is to help with this, from outside the body, by helping the CNS at a cord level on up. Not by banging away on the spine as if it were some sort of magic black box, but by nerves out in the body where they can be handled, especially at a skin level where you can get at them interoceptively AND exteroceptively, and stay out of the way of self-correction meanwhile.

      *(This is supposedly a picture of what fractalkine might look like.)
      * From Nature.com glossary: FRACTALKINE A membrane-bound chemokine that is highly expressed on activated endothelial cells, and is both an adhesion molecule and an attractant for T cells and monocytes.
      Last edited by Diane; 16-09-2008, 08:24 PM.
      Diane
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      "Rene Descartes was very very smart, but as it turned out, he was wrong." ~Lorimer Moseley

      “Comment is free, but the facts are sacred.” ~Charles Prestwich Scott, nephew of founder and editor (1872-1929) of The Guardian , in a 1921 Centenary editorial

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      • #78
        Originally posted by Jon Newman View Post
        I think the distinguishing feature of transduction is the conversion of one form of energy into another. Transmission is the journey that new energy form takes. Would it be correct to say that a new round of transduction occurs at each new synapse?

        For more see Diane's post on the Molecular Mechanisms of Nociception
        Consider this article also (free PDF available there also.)
        "I did a small amount of web-based research, and what I found is disturbing"--Bob Morris

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        • #79
          I'm looking, but haven't found much in the literature yet.

          I did find this (SA stands for spontaneous action potential):

          Our finding that type I SA remains after the cell body is pulled away from the ganglion suggests that it is not maintained by chemical factors released from neighboring cells or mechanical stresses on the cell (Rydevik et al., 1989)
          in this full text.
          Cory Blickenstaff, PT, OCS

          Pain Science and Sensibility Podcast
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          • #80
            I thought I'd bump this because something on Facebook generated a lot of interest in it.
            Barrett L. Dorko

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            • #81
              This thread deserves a bump.

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              • #82
                Thanks Mikal.

                In post #18 Bas quoted the words of many of our colleagues:

                "I treat dysfunction, NOT pain."
                I was in Atlanta when Paris coined this. At least, he gave no one else credit. It sounded good in '76 because we knew nothing of pain. Certainly not of its complexity.

                Decades later we're still hearing it.
                Barrett L. Dorko

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                • #83
                  I have heard that quote repeatedly in our profession. The problem I see now is that the patient comes to us BECAUSE of the pain, not their dysfunction. Odd to think of it that way- when we say we treat dysfunction, not pain, we are directly opposite of why the patient has come in... so who is most likely wrong? The person whom is experiencing the pain? Or the meatwad sitting across from the patient, trying to prove they are a fountain of knowledge (and trying to prove that they know more about the patient than the patient themselves)?
                  Roy
                  El Paso, Texas

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                  • #84
                    The turning of our profession toward the sensibilities of the hairdresser, not there's anything wrong with hairdressers, might have been foreseen.

                    I wish I could find the old short story in Omni magazine. It concerned some future in which astronauts from the earth landed on a distant planet and soon had the "aliens" there dressing and trying to look like human beings. Did anyone else read this? Maybe the early
                    80s?

                    Anyway, the point it made was that cultural changes exceeded the power of all others.

                    It haunts me.
                    Barrett L. Dorko

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                    • #85
                      How depressing!

                      "I treat dysfunction, NOT pain."
                      Substitute dysfunction with subluxation!
                      Welcome to my world/nightmare/challenge/favourite blood sport!
                      How depressing!
                      :vomit:
                      "In god I trust! Everyone elde must bring data!"

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