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Not a very exciting title, but it's a link to a very referenced book chapter that carefully explains the difference between nociception and pain.
Furthermore, it contains the following footnote:
"Whereas virtually all nociceptors are A-delta and C-fibers, not all A-delta and C-fibers are nociceptors. It is thus both inaccurate and incorrect to generically refer to C-fibers as “pain” fibers."
Behind the scenes at SomaSimple the moderators study continuously, deal with the issues inherent to our task and decide together how we can advance our mission of sharing relevant and rational information about therapy theory and practice.
Recently Luke Rickards listed ten things he felt we now know about the nature of painful sensation. It has since been modified and referenced and you’ll see the document below. We have had an intricate and prolonged conversation about each point, and now invite your questions and commentary. The following list has been compiled in an effort to present you with succinct points derived from contemporary pain related research so that you may better understand the view points of the moderators and many of the regular posters at SomaSimple. The list is subject to change as our understanding improves.
As with all statements born of scientific reasoning these are provisional, but we feel at least a few will stand the test of time. For those interested in gaining a more detailed understanding of the generalized items on the list, we recommend reading the material referenced in the bibliography.
Signed,
The Moderators
Nothing Simple - Ten Steps to Understanding Manual and Movement Therapies for Pain
1. Pain is a category of complex experiences, not a single sensation produced by a single stimulus.
2. Nociception (warning signals from body tissues) is neither necessary nor sufficient to produce pain. In other words, pain can occur in the absence of tissue damage.
3. A pain experience may be induced or amplified by both actual and potential threats.
4. A pain experience may involve a composite of sensory, motor, autonomic, endocrine, immune, cognitive, affective and behavioural components. Context and meaning are paramount in determining the eventual output response.
5. The brain maps peripheral and central neural processing into each of these components at multiple levels. Therapeutic input at a single level may be sufficient to resolve a threat response.
6. Manual and movement therapies may affect peripheral and central neural processes at various stages:
- transduction of nociception at peripheral sensory receptors
- transmission of nociception in the peripheral nervous system
- transmission of nociception in the central nervous system
- processing and modulation in the brain
7. Therapies that are most likely to be successful are those that address unhelpful cognitions and fear concerning the meaning of pain, introduce movement in a non-threatening internal and external context, and/or convince the brain that the threat has been resolved.
8. The corrective physiological mechanisms responsible for resolution are inherent. A therapist need only provide an appropriate environment for their expression.
9. Tissue length, form or symmetry are poor predictors of pain. The forces applied during common manual treatments for pain generally lack the necessary magnitude and specificity to achieve enduring changes in tissue length, form or symmetry. Where such mechanical effects are possible, the clinical relevance to pain is yet to be established. The predominant effects of manual therapy may be more plausibly regarded as the result of reflexive neurophysiological responses.
10. Conditioning for the purposes of fitness and function or to promote general circulation or exercise-induced analgesia can be performed concurrently but points 6 and 9 above should remain salient.
Bibliography
Books:
Pain: The Science of Suffering - Patrick Wall
The Challenge of Pain - Patrick Wall, Ronald Melzack
Explain Pain - David Butler, Lorimer Moseley
The Sensitive Nervous System - David Butler
Phantoms in the Brain - V. S. Ramachandran
Topical Issues in Pain Vol's 1-5 - Louis Giffiord (ed)
The Feeling of What Happens - Antonio Damasio
Clinical Neurodynamics - Michael Shacklock
Eyal Lederman - The Science and Practice of Manual Therapy
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