What is it about?
The nervous system has evolved to warn us about potential or actual threat to the body. It does this by creating sensations such as pain. Normally it doesn't produce constant pain because the brain regulates the warning system that produces it. Some people do experience constant or chronic pain and this paper presents a model that might explain why this happens. People who develop other kinds of long term conditions such as chronic fatigue or irritable bowel syndrome have been shown in previous work to demonstrate certain behaviours such as a tendency to push themselves too hard, perhaps overriding the normal 'warning systems' and over time it is suggested that this weakens the brain's ability to regulate them. Under certain triggering conditions, the suggestion is that the warning system can become unregulated or over-sensitive, where sensations such as pain are constantly created in response to things that are not actually dangerous.
Featured Image
Why is it important?
The model outlined here draws on previous work that has shown how other conditions can transition from short term ( acute) to long term (chronic) but this work has not previously been applied to pain. If the model is accepted as valid it has important implications for how best to help people dealing with such problems.
Perspectives
NHS clinics in England have seen an increase in people reporting combinations of pain and fatigue in recent years. The article is focused on chronic or long term pain, but suggests that the same model could be applied to other long term conditions such as chronic fatigue, fibromyalgia and some functional neurological conditions, often referred to as 'medically unexplained' . My view is that people experiencing these kinds of difficult conditions, for which there is no effective medical treatment, need an understandable explanation of their experiences that makes sense, in order to move forward. This paper was an attempt to create a model that was based on current neuroscience, but was simple and practical enough for health professionals and their patients to use as a basis for developing effective and sustainable self-management.
Dr Patrick Hill
Royal United Hospital Bath NHS Foundation Trust
Read the Original
This page is a summary of: Chronic pain: a consequence of dysregulated protective action, British Journal of Pain, September 2018, SAGE Publications,
DOI: 10.1177/2049463718799784.
You can read the full text:
Resources
Body in Mind
Website from University of South Australia reporting on research into the role of the brain and mind in chronic pain
ESC Enabling Self Care
ESC develops, trains, coaches and supports health and social care professionals in collaborative partnership working with people with persistent (chronic) pain and other long term health conditions.
Live well with pain
A resource website developed by clinicians, for clinicians to help them support your people towards better self management of their long term pain.
The Pain Toolkit
The pain toolkit website contains links a a number of useful resources for clinicians and people living with long term pain
Contributors
The following have contributed to this page
