CHRONIC PAIN “IS REAL” says a Professor of Pain Medicine at Stanford. It is the most prevalent “disease” in the world he implies.
Dr. Sean Mackey, MD, PhD, made this assertion for PainNews. It would seem that a world-class University Medical Center offering this proclamation would also have a world-class Plan for defeating/curing this disease.
Absent public pronouncements reviewing a Stanford “Manhattan-Project-like Plan” for significantly treating Chronic Pain, I am not aware there is a “Plan” even in the development stage at Stanford.
Two clinical trajectories for pain control put forth by Stanford include work of Psychologist, Beth Darnell, who seems to focus on ability of mind to think pain away, via Cognitive Behavior Therapy, CBT. Judging by international feedback, the method seems to have not caught on.
The 2nd trajectory seems to be the functional MRI (fMRI) work of Dr. Mackey; posited to show that pain registration is function of brain neuro-plasticity; causing a perverse cognitive magnification of pain called “Central Sensitization”. His theory is widely espoused as “proven”.
About 2-3 years ago, Dr. Mackey announced plans to use real-time imaging of lit-up MRI pain centers as biofeedback information to engage focused mental cognitive functions to turn pain off. No word of success as yet.
These two Stanford pain management programs are each focused on training neural/mental functions of the brain to evoke remission of chronic pain.
However, a Principle of chronic pain might be that pain is registered in periphery body-part nociceptive transducers, & as a function of local tissue injury; with registered intensities as scaler functions of local neural injury & pain stimulations.
To wit: peripheral neural systems readily recognize & identify nefarious targeting stimulations & various dealings of disruptive pain stimulation. Greater numbers of transducers activated, then greater number of brain centers that light up. No studies have disproven this theory.
It might be the case that brain center activations are a consequence of nociceptive pain functions & perturbations.
My advice: the generous assets of the Stanford Pain Center, a national treasure, might better focus on the multitude of bio-mechanical/chemical injuries that evoke chronic pain & attempt to defeat pain in the trenches & messy battles of musculoskeletal & soft tissue injuries.
My studies indicate: most chronic pain results from soft tissue injuries to radiolucent body parts not measurable via MRI images. Best instrument to determine etiology of chronic pain is a physician who uses sensitive touch to examine soft tissues as they function in real time.
The causes of chronic pain are multifactorial. Fibromyalgia is a premiere chronic pain syndrome. The cause of Fibromyalgia is multifactorial (see my various @threadreaderapp unrolls of explanation).
In that the etiology of chronic pain is multifactorial, therapeutic efficacies/benefits are multifactorial. Amongst the efficacious therapies are certain cognitive therapies, but these are not the most powerful therapeutic efforts for chronic pain.
Secrets of therapies for chronic pain, including Fibromyalgia & CRPS, is that the therapies must be staged in an hierarchical fashion. Certain gentle therapies set stage for introduction of more exertive & industrious subsequent therapies.
Western model of chronic pain therapy is fashioned upon use of jackhammers & chemicals; surgery, electrodes, & synthetic poisons. What is needed is escalating efforts of tissue rehabilitation via principles of progressive exercises & applications of nutrition & subtle energies.
Understanding inflammation includes that intestinal microbiome is intimately involved in autoimmune reactions & chronic disabilities. Simple sugars, insulin resistance, & immune dysfunctions are intertwined with neural dysfunctions, & pain via bio-mechanical assaults of obesity.
@threadreaderapp unroll
