After reading the recent NOI notes on Blackberry Thumb I reckon I had a bit of “ladder foot” last week after I spent two weeks of my ‘holiday’ renovating at home.
I spent hours standing, heel of workboots hooked on the rung, weight bearing though arch, on a ladder rung which I think must have made my plantar nerves real cranky – the pain at times was really crippling (but transient)!
Interestingly, I recall thinking about this; I hate heights – a real bloody chicken with heights, and the third rung, the one which I spent all the time on is my absolute limit.
So, a bit of nociception coming in to a brain with an already active amygdala and other bits of the limbic system – “is this important? Is it worth having pain right now??”, my nervous system clearly thought it was. Here’s the thing – I could alleviate some pain by standing on the first and second rung!!!
I think sometimes its ALL context!
We are a lazy lot aren’t we? – you remind me that I should have analysed my blackberry thumb a little better – I jumped to the diagnosis. So many pain states are categorised in terms of presumed injuring activity, thus we also see “strawberry picker’s hand”, “mouse user’s wrist” ,” tennis elbow”, “moviegoer’s knee”, “tight jean disease” etc. etc. A patient told me once that he had a “wanker’s elbow.” (google it and see!) . Note that a feature of these diagnoses is usually blame on an external agent and rarely an analysis of pathobiological processes that will be always be personalised to the person in trouble. At noigroup, we are big on deconstruction of labels into something biological to target therapy at. I know you are too.
Models to assist deconstruction include the orchestra model (neuromatrix, neurosignatures), pain mechanism model, onion skin and fear avoidance models – all being remodelled by science as we write and topic of future posts.
I wish you well with your ladder foot!