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Old 07-05-2012, 11:52 PM   #1
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Old 07-05-2012, 11:57 PM   #2
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What is your take on this?
It probably isn't a waste of time for everybody, but I'm not going to put any time into it.

Toward what end?
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Old 08-05-2012, 03:09 AM   #3
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Pain: a neuroimmunological sensory experience caused by a cortical decision to protect tissues based upon multiple variables including but not limited to those which are related to biological, psychological and social threats.
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Old 08-05-2012, 04:48 AM   #4
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Nice one Joe. I probably would take out "sensory". The experience is more than that and the word appears to introduce that peripheral system.
Then I would not use "tissues" but rather "the living being".

Otherwise - excellent and I couldn't have come with it. Thanks for letting me ride along.
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Old 08-05-2012, 05:06 AM   #5
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Originally Posted by joebrence9 View Post
Pain: a neuroimmunological sensory experience caused by a cortical decision to protect tissues based upon multiple variables including but not limited to those which are related to biological, psychological and social threats.


WAAYYYY better than anything that was bouncing around my head. My only issue was with "tissues" (as the brain can try to "protect" tissues that may not actually exist), but Bas makes a nice suggestion.

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Old 08-05-2012, 01:47 PM   #6
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The purpose of Morten's exercise is to point out that: we can`t isolate pain from fear or anxiety.
Quote:
pain is (as opposed to other feelings) localised in the body
Pain relates to reliable information about survival (e.g. if you experience that you are in danger of injury)
Pain motivates behaviour change
These suggestions are indicators that this is an exercise to demonstrate what pain ISN`T.

At least that is what I get out of this. Looks like a neat way to make those unfamiliar with the neuromatrix or modern pain sciences (no one here) to discover through study and thinking, that pain is what it really is (see Joe`s definition).
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Old 08-05-2012, 08:06 PM   #7
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I think if we differentiate pain from experiences like emotional pain (sadness, grief, loss, etc) then the elements of fear and pain are similar. Complex, unpleasant, subjective. What is different is that pain is perceived as a physical stimulus and the unpleasant sensation is associated with tissue damage, nociception or a noxious stimulus. I'm not sure which of those is most accurate. Of course, it is only the perception of these physical factors, but the perception is one that is physical.

So perhaps if we take the definition of fear and add "with the unpleasant sensation being perceived as if manifested physically" or "with the perception of (tissue damage, nociception, noxious stimulus) being present".
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Old 08-05-2012, 08:16 PM   #8
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When did we start to ignore any mention of the effect of movement?

If I'm feeling fear moving some body part isn't going to change that.
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Old 08-05-2012, 08:17 PM   #9
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Originally Posted by joebrence9 View Post
Pain: a neuroimmunological sensory experience caused by a cortical decision to protect tissues based upon multiple variables including but not limited to those which are related to biological, psychological and social threats.

I might only add neuroendocrine with neuroimmunological.
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Old 09-05-2012, 12:25 AM   #10
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For some old and new thoughts on this issue, look at Bronnie's blog:
http://healthskills.wordpress.com/20...sciency-stuff/
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Old 09-05-2012, 02:58 AM   #11
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Revised based upon great suggestions...

Pain: a neuroimmunological experience caused by a cortical decision to protect the body based upon multiple variables including but not limited to those which are related to biological, psychological and social threats.
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Old 09-05-2012, 03:20 AM   #12
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Quote:
Originally Posted by Barrett Dorko View Post
When did we start to ignore any mention of the effect of movement?

If I'm feeling fear moving some body part isn't going to change that.
As I understand it, the pain of a burn, or cancer would not be effected by motion. If my understanding is correct, then the effect of movement would not apply to the definition of pain.

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Old 09-05-2012, 04:43 PM   #13
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Originally Posted by joebrence9 View Post
Revised based upon great suggestions...

Pain: a neuroimmunological experience caused by a cortical decision to protect the body based upon multiple variables including but not limited to those which are related to biological, psychological and social threats.
Hi Joe,
After thinking about this for awhile, I would replace the word "cortical" with something else.
Todd Hargrove suggests "prerational", while in the past, I've used the term "critter brain".

I think the term "cortical" (as a descriptor) should be reserved for the more rostral parts of brain that can disengage, reflect, and strategize a solution, and also capable of inhibiting the dorsomedial thalamus directly. This boils down to the late-to-arrive-on-the-scene, both evolutionarily and developmentally, dorsolateral prefrontal cortex, the only part that could possibly be considered as "rational" - everything else, pretty much, varying by shades and degrees, being pretty much categorizable as "pre" rational.
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Old 09-05-2012, 05:08 PM   #14
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"Pain is an unpleasant, individual, multifactorial, conscient experience, felt somewhere in the body and which serves to protect this part of the body."

This definition has been given by Lorimer Moseley in Paris last week-end.
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Old 09-05-2012, 08:45 PM   #15
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What is wrong with the definition from the IASP?
Gil

sorry, I just saw the part about not using existing definitions. I'm with Barrett. What is the sense of this exercise if it has already been done.

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Old 10-05-2012, 06:41 PM   #16
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Adam,
Thoughtful points and they remind me of our exchange recently on the output=defense thread. Anxiety/ fear are obviously on the L hand side of the NM as is nociception. Care is not restricted to correcting this side only.

"A relevant issue in the clinic is trying to understand why the patient is in pain."

Certainly, this can be true, but all care is not limited to this view. If output is seen as corrective why would we want to get rid of it? This was my point on the defense topic. It has been my experience that if patients experience a way of moving which relieves pain they will also experience a reduction in anxiety. By anxiety I mean the lack of choice. If patients were unaware of the way to move to relieve their pain and with a certain kind of handling experienced this "analgesic movement", then we could quite easily "kill two birds with one stone".
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Old 10-05-2012, 06:47 PM   #17
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I see it as a useful exercise. It gives people a chance to be inventive, start to actually think about what it all means. Once they see the definition arrived at by IASP is actually pretty good given the current state of knowledge, and is still capable of further evolution depending on what is discovered next, they may invest in it much more, because it has now become a neurotag they can accept. They've learned to "do by doing." They can see the official definition is more verb than noun.
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Old 11-05-2012, 12:58 AM   #18
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I really like that definition and the resulting conversation. Perhaps I focus more on the communicative aspect of pain aka Wittgenstein.

Pain is word which is used to communicate an unpleasant, threatening or potentially threatening experience. The sensory stimulus (input) responsible for such an experience are multimodal and multivariate. The behavioral, neurological, immunological and biological response (output) to this experience is multivariate. The processing between (input) and (output) is unique to each individual's genetics, neural architecture and priori of previous experiences.
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