In a previous instalment we promised a few nuggets to add to your Explain pain library – to help you get on with the job of Explaining Pain after you have gathered the rich information from your Explain Pain Assessment.
Just in case – nuggets are short, quick, chunks of information, often related to an interesting bit of neuroscience. They are are easy to deliver and can form part of a broader Explain Pain curriculum. In Explain Pain Supercharged David and Lorimer have written 71 nuggets covering everything from Pain is a defender, not an offender (nugget No. 2), Your toes are next to your genitals in your brain (No. 32) and We grow grow like tress (No. 67). The 71 nuggets are divided into the categories of Broad \concepts, neuroscience and neuroanatomy, Tissue changes and nociception, Peripheral neuropathic pain, Central sensitisation, Homeostatic systems, Broad treatment nuggets and Scary Diagnoses and radiology reports – there’s a nugget for every situation.
Here’s one of our favourite nuggets from neuroanatomy:
“There are thousands of sensors (detectors) along your nerve cells. Some open up in response to stress chemicals, or to changes in temperature and others open up when you stretch. They sense the world for you, they look out for danger and they report to the brain. But these sensors are like butterflies – they only live for a few days, so your sensitivity is continually adjusting to your environment, So if you are really sensitive now, don’t worry – these sensors can change very, very quickly. You can help this process by removing DIMs in your life and seeking SIMs. You can do this all yourself, you don’t need any drugs.”
This nugget helps to explain the process of sensitivity. It provides hope and reassurance that nerves can quickly change their response properties. It also encourages people to seek out some of the less obvious contributions to their pain states. You’re welcome to change the words to fit your stories of course, or ad lib a little.
The beauty of nuggets is that they can be used while your doing all the other things that form part of your regular evidence based, patient centred, biopsychosocial treatment approaches!
What’s your favourite nugget?
Knowledge Driving Health
Love the butterflies. Such a simple way to introduce/explain neuroplasticity. Thank you!
I treat persistent pelvic pain . . A “nugget” I use is about having a “committee in the brain” that is constantly “discussing the evidence” regarding threats to the vagina when it comes to pain with sex. The various committee members are in direct communication with the bladder, bowel, vaginal tissue, pelvic floor muscles , prior “negative” occurrences etc. I educate my patients that the more we can send convincing evidence to the brain committee members (via normalizing bladder function, bladder function, counseling to address negative hx etc) – then the brain will start to realize sex is NOT a threat and can start to make some really fantastic changes. Thanks so much for your blogs – they are super helpful!
Nice one Karen!