Nugget 5 “Your muscles are dry”
“Your muscles are dry” – this short, sharp and novel metaphor is sure to get attention. This is all about ischaemic nociception. Simply, sit for a long time or hold your head in one position, you will force fluid out of tissues and pH will drop. Acidosis in tissues is a noxious by-product of ischaemia, lactic acid and inflammation. Nociception occurs via acid sensing ion channels. There is quite a gang of these ASIC channels right though the nervous system but here we are referring to them in the peripheral tissues. They are quite sensitive, reactive to a pH of less than 7. (Remember “normal” pH is around 7.4).
This simple nugget can get people moving. It makes me move when I think about dry, acidic muscles ligaments and other tissues. Sometimes tissues need a good “flush out” and that is why you wriggle your bum a bit if you are sitting on a chair for a while or bend backwards a few times when you get out of the car. Forget the pills – in most situations, movement is the medicine backed by knowledge that it is going to be OK and there is plenty you can do for it. The nugget might only take a minute to deliver.
Neuroscience nuggets are information nuggets – pieces of biological information based on statement or metaphor that can be used as educational analgesia, explicit education or part of overall story telling. We have collected over 100 of these for a book and will release one or two a week with a short description and references if appropriate.
Explain Pain 2nd Ed, the Graded Motor Imagery Handbook and all noigroup courses are all bursting at the seams with the latest and greatest neuroscience nuggets; click on the links to get your hands on a copy or to find a course near you
Yes. “Fresh blood flushing through muscles” – I think patients really grok nicely with this visual.
This is my canned material: “You know when you get writer’s cramp because you’re gripping the pen too tightly and the blood doesn’t get through?” [nod] “That’s what is happening in your back. When we do this movement, the muscle relaxes and the blood flows”. Talking about muscles and blood flow is a far nicer way to describe a back pain than “torn ligament” or “bulging disc”. It just feels better. Gets integrated better.
“fresh” is such nice word to use in the clinic – fresh blood, fresh CSF, fresh fluids, fresh brain activity . I love freshening up when I go out too.
Excellent NOI nugget… Great way to describe ischaemic nociception to patients. We use this metaphor at PSI in Chicago…thanks Dave!!
Motion is lotion……
Very helpful concept