Medical Pain in the peripheral nervous system

[Math Is Hard]

Mirror therapy gives good results:
http://content.nejm.org/cgi/content/full/357/21/2206
http://www.mirrorboxtherapy.com/

Thanks, soma. That's what I was thinking of.

 

[Mashes]

Vagus nerve belongs to CNS but CNS contain ANS that is Autonomic Nervous System. The ANS is the real subconscious nervous system. It may act against your will (and it does).
Vagus nerve has little to do with pain.

In what cases does the Vagus nerve have to do with pain, besides parasympathetic nausea and stomach cramp reactions?

 

[somasimple]

In what cases does the Vagus nerve have to do with pain, besides parasympathetic nausea and stomach cramp reactions?

None, IMHO.
http://en.wikipedia.org/wiki/Vagus_nerve

 

[zoobyshoe]

The connotation of psychosomatic and psychological that you brought is not scientific at all. Freund and all are not sciences and actually criticized by neuro-scientists. See Damasio...

This is pretty much my point. You can't separate psychology from "Freud and all". I am not the one giving that word that connotation. The definition I offered is from a well respected dictionary.

I am sure that there is a better term to replace "psychological" that comes from Neuro-Science. It might be "experiential" .

Hence: "All experiential pain is real pain." Meaning: When a person has the experience of pain it should be considered real pain.

The "psychological" interpretation of pain draws the opposite conclusion: "It's all in your mind. It's not real. It will go away if you talk to a therapist or simply stop thinking about it."

 

[zoobyshoe]

Also part of the grieving process is denial, could having pains in a part of your body that aren't even there anymore be considered a physiological form of denial?

As Ramachandran and his colleages demonstrated it is the result of the neurons which would usually receive stimuli from the limbs receiving it from the surrounding neurons instead. For example, the thumb and parts of the face are located right next to each other on the sensory homunculus. Touching the cheek of a person with no hand will give them the sensation the missing thumb is being touched. Authentic stimuli is bleeding over to the adjacent location, as it were. That adjacent location, it is reasoned, is vulnerable to this because it is starved of the stimuli it would normally be receiving.

There must certainly be a purely psychological component: it must take a long time to overcome the expectation of having a limb where it has always been. However, as in the case of Turbo, these phantom sensations can occur exclusively from insult to the brain with all limbs intact and undamaged.

 

[somasimple]

This is pretty much my point. You can't separate psychology from "Freud and all". I am not the one giving that word that connotation. The definition I offered is from a well respected dictionary.

I am sure that there is a better term to replace "psychological" that comes from Neuro-Science. It might be "experiential" .

Hence: "All experiential pain is real pain." Meaning: When a person has the experience of pain it should be considered real pain.

The "psychological" interpretation of pain draws the opposite conclusion: "It's all in your mind. It's not real. It will go away if you talk to a therapist or simply stop thinking about it."

In our daily practice we see patients who experience pain without anybody damage: My low back hurts since I lost my job! Is he a liar? Not at all! His body hurts.
Comments?
http://www.somasimple.com/forums/showthread.php?t=4944

As Ramachandran and his colleages demonstrated it is the result of the neurons which would usually receive stimuli from the limbs receiving it from the surrounding neurons instead. For example, the thumb and parts of the face are located right next to each other on the sensory homunculus. Touching the cheek of a person with no hand will give them the sensation the missing thumb is being touched. Authentic stimuli is bleeding over to the adjacent location, as it were. That adjacent location, it is reasoned, is vulnerable to this because it is starved of the stimuli it would normally be receiving. There must certainly be a purely psychological component: it must take a long time to overcome the expectation of having a limb where it has always been. However, as in the case of Turbo, these phantom sensations can occur exclusively from insult to the brain with all limbs intact and undamaged.

Many babies were born without limbs and unfortunately their missing limbs hurt.
There must certainly be a purely psychological component? In utero?

 

[zoobyshoe]

In our daily practice we see patients who experience pain without anybody damage: My low back hurts since I lost my job! Is he a liar? Not at all! His body hurts.
Comments?

Are you stipulating that it's psychosomatic?

Many babies were born without limbs and unfortunately their missing limbs hurt.
There must certainly be a purely psychological component? In utero?

Despite being born without limbs they were born with places on their sensory strip to process stimuli from limbs. All the same neurological causes of phantom pains in amputees exist in this case.

However, since they never had limbs they don't experience the purely psychological upset of missing something they used to have. I don't miss my Mercedes, because I never had a Mercedes.

 

[somasimple]

Are you stipulating that it's psychosomatic?

Did I? You're making distinctions between pains. I do not.
This man experiences pain. His pain is real. His pain is located in the lower back.
I may consider only his pain and I'll fail to help him.
I'm considering a man who lost his job and he is suffering from that.
I will communicate with him (brain) or with his body (brain) and perhaps it will help.

Any event may have painful consequences.

 

[turbo]

Remember the "neural induction" device used by the witch in Dune to test the duke's son? It induced a feeling of burning in his hand so real that he should have withdrawn his hand from the box in self-preservation. His refusal to do so was "proof" that he was a superior being.

I fear that sadists in the medical field will find ways to induce pain this way, and sell it to governments so they can torture people with no detectable tissue damage. Far-fetched? Don't think so.

 

[zoobyshoe]

You're making distinctions between pains.

No. Between causes.

 

[somasimple]

No. Between causes.

Does that change the result: Pain?

 

[Monique]

Somasimple, I think it should be very clear that the cause of the pain should dictate the type of treatment. It seems to be that you are saying that pain is like a dream that is imagined by the brain and that if you 'wake' someone that the pain will be gone. Pain is something physically real. You don't tell a seeing person to ignore his sight and expect him to go blind.

 

[somasimple]

Somasimple, I think it should be very clear that the cause of the pain should dictate the type of treatment. It seems to be that you are saying that pain is like a dream that is imagined by the brain and that if you 'wake' someone that the pain will be gone. Pain is something physically real. You don't tell a seeing person to ignore his sight and expect him to go blind.

A favorite of mine from this book:
ALL PAIN IS REAL!

It seems that I didn't say something like that.
And you may search something about http://www.ampainsoc.org/pub/bulletin/spr05/inno1.htm" .

Virtual Reality analgesia is not limited to burn patients, however. Immersive VR distraction is being used to treat a growing number of painful procedures:

Reality? Not a bit but brain doesn't care.

 

[Proton Soup]

having been woke up from my sleep recently with sinus pain, it seems awfully real to me, dreaming or not.

and FWIW, pain receptors can cause real physiological symptoms whether you feel the pain in your brain or not. let's say you're a paraplegic, and you want to cheat at wheelchair racing. one thing that might be done is to put tacks in your seat so that when you sit on them, the body responds by increasing your blood pressure and cardiac output. (disclaimer: do not do this. you will get tetanus and be a very unhappy camper.) there may not be nerve conduction through your damaged spine, but there is still a pain response. and i get odd stuff from my sinus pain, too. i can have quite a bit of inflammation, and not really feel it. yet, my heart rate is elevated, my mood is depressed, and thinking is sluggish. you can distract people all you want, but that doesn't mean their bodies aren't responding to what's being done to them.

 

[somasimple]

there may not be nerve conduction through your damaged spine, but there is still a pain response.

No message in nerves and still in pain? Where could it be produced?
You do not understand that pain is a reponse... not an incoming stimulus and there is no pain receptors: Nociception is not pain.
Cramps come spaticity and a spastic muscle creates chemical products. Pain is a complex response that may content endocrines.

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.

 

[somasimple]

let's say you're a paraplegic, and you want to cheat at wheelchair racing. one thing that might be done is to put tacks in your seat so that when you sit on them, the body responds by increasing your blood pressure and cardiac output.

And your example is rather silly and far from reality.
Many paraplegics have http://en.wikipedia.org/wiki/Bedsore" and they do not feel any pain.

 

[Monique]

You do not understand that pain is a reponse... not an incoming stimulus and there is no pain receptors: Nociception is not pain.

Would you disagree that there is a highly specialized neuron that only responds to noxious stimuli, who communicates this information accurately to the CNS? And that this stimulus would result in a variety of autonomic responses and may result in the experience of pain?

 

[somasimple]

Would you disagree that there is a highly specialized neuron that only responds to noxious stimuli, who communicates this information accurately to the CNS? And that this stimulus would result in a variety of autonomic responses and may result in the experience of pain?

You do not understand that pain is a reponse... not an incoming stimulus and there is no pain receptors: Nociception is not pain.

And that this stimulus would result in a variety of autonomic responses and may result in the experience of pain?

Did you said "may"? That is not mandatory in that case.

 

[Proton Soup]

No message in nerves and still in pain? Where could it be produced?
You do not understand that pain is a reponse... not an incoming stimulus and there is no pain receptors: Nociception is not pain.
Cramps come spaticity and a spastic muscle creates chemical products. Pain is a complex response that may content endocrines.

well, yes, not an actual pain receptor but, say, a pressure or temperature sensor. and when noxious stimuli send them over some threshold, there are physiological responses beyond the simple perception of "pain" in the brain.

in any case, the effects of stimuli that cause pain go beyond the perception in the brain, and do not require metabolic byproducts of muscle stimulation.

 

[Monique]

And that this stimulus would result in a variety of autonomic responses and may result in the experience of pain?

Did you said "may"? That is not mandatory in that case.

I think it should be very clear that nociceptors send a signal and that the brain respond to that.

 

[zoobyshoe]

A favorite of mine from this book:
ALL PAIN IS REAL!

No one has disputed this.

It seems that I didn't say something like that.
And you may search something about http://www.ampainsoc.org/pub/bulletin/spr05/inno1.htm" .

Psychological treatment of physiological pain has been explored for years, particularly pain control by hypnosis. The results have always been mixed: different patients exhibit differing levels of responsiveness. The fact it can work to some extent does not mean the original physiological pain was psychological!

As far as I can tell we are in complete agreement about everything except the meaning of the word psychological. You seem to be asserting that everything that happens in the brain is psychological.

All psychological experiences arise from physiological processes but no physiological processes are psychological. This is true because of the meaning of the words. I posted the meaning of the word psychological quoting directly from the dictionary, and you rejected that meaning. That's idiosyncratic, to say the least.

 

[somasimple]

well, yes, not an actual pain receptor but, say, a pressure or temperature sensor. and when noxious stimuli send them over some threshold, there are physiological responses beyond the simple perception of "pain" in the brain.

in any case, the effects of stimuli that cause pain go beyond the perception in the brain, and do not require metabolic byproducts of muscle stimulation.

No. Pressure or heat is transmited by nerves => No message => No pressure or heat.

I think it should be very clear that nociceptors send a signal and that the brain respond to that.

No. It will respond if necessary.

The fact it can work to some extent does not mean the original physiological pain was psychological!

I just said the contrary. I said (one more time) that all pain is real and I added that all psychological events are real too (are physical).

 

[somasimple]

I posted the meaning of the word psychological quoting directly from the dictionary, and you rejected that meaning.

I reject its meaning because it is outdated.

 

[Monique]

I don't think there is any reason to continue this discussion, as it is going nowhere.

 

[somasimple]

I don't think there is any reason to continue this discussion, as it is going nowhere.

Really? It is going to the actual knowledge about brain and pain but you may follow your own way if you want. That is tolerance.
I prefer to believe in knowledge taught by the IASP (International Association for the Study of Pain) than an obsolete definition that needs a serious refinement.
Science evolves. It is an unpleasant thing for many...

 

[Proton Soup]

i don't think anyone sees what your point is. it's somewhat interesting that you can use a psychological means to cope with pain. but it doesn't actually fix anything, it's just a coping mechanism.

 

[somasimple]

i don't think anyone sees what your point is.

I'm in the same condition.

 

[turbo]

Really? It is going to the actual knowledge about brain and pain but you may follow your own way if you want. That is tolerance.
I prefer to believe in knowledge taught by the IASP (International Association for the Study of Pain) than an obsolete definition that needs a serious refinement.
Science evolves. It is an unpleasant thing for many...

You seem to be remarkably able to ignore some medical facts and re-interpret them as wanted. It is possible (as I can well-attest, since I live with it) to have real localized brain injuries that result in the perception of pain when no tissue damage is being experienced. In my case, my right foot feels like it is being roasted 24/7 because of a stoke that damaged a small part of my brain-stem.

The pain is a result of physiological damage, and it won't go away, nor can it be lessened by any drugs that my doctors tried. There is no psychological component to the damage (which was very evident in the MRIs) nor is there a psychological component regarding treatment options unless my doctors have been in a coma for the last 15 years or so. Our perception of pain arises not in peripheral tissues, but in the brain, and if the brain is injured, we can be forced to experienced pain, no pain, discomfort, etc, in parts of our bodies that are far removed from that injury.

 

[somasimple]

You seem to be remarkably able to ignore some medical facts and re-interpret them as wanted. It is possible (as I can well-attest, since I live with it) to have real localized brain injuries that result in the perception of pain when no tissue damage is being experienced. In my case, my right foot feels like it is being roasted 24/7 because of a stoke that damaged a small part of my brain-stem.

You seem to be remarkably able to ignore all my posts. I'm just saying the things you're telling us.

https://www.physicsforums.com/showpost.php?p=2044691&postcount=6

Many people report pain in the absence of tissue damage or any likely pathophysiological cause; usually this happens for psychological reasons. There is usually no way to distinguish their experience from that due to tissue damage if we take the subjective report. If they regard their experience as pain and if they report it in the same ways as pain caused by tissue damage, it should be accepted as pain. This definition avoids tying pain to the stimulus. Activity induced in the nociceptor and nociceptive pathways by a noxious stimulus is not pain, which is always a psychological state, even though we may well appreciate that pain most often has a proximate physical cause.

Did I said either that Medicine is a miracle provider? No. Unfortunately there are many cases where we have no solution, actually.

 

[Monique]

I think what turbo-1 is describing is neuropathic pain (a chronic pain as a result from an injury to the nervous system), which is different from nociceptive pain.