Explain Pain - David Butler and Lorimer Moseley

TiredSam

TiredSam

Committee Member
My wife has just been talking to a helpful friend and the subject of (my) headaches popped up. According to the helpful friend when we suffer pain our brain retains a memory of it, or something, so in future pain is also influenced by memories of past pain, I think. My wife remembers learning this during her training as a nurse too.

I've never heard of this idea, and was immediately suspicious (apparently I have a "hobbyhorse"). I started googling and came up with expressions such as "pain neurotag", and ended at an apparent bible in the "science of pain", the book mentioned in the title, which is universally praised at Amazon and all over the internet.

I don't know how I've remained ignorant about this concept (brain retaining a memory of pain which affects perception of pain in the future), but somehow I have. I would appreciate the opinion of knowledeable forum members (or anyone who just fancies a rant) on the subject.
 
Kind of reminds me of Plato's Theory of Recollection.

https://en.wikipedia.org/wiki/Plato...ew everything, but,one must overcome the body.

"The Platonic doctrine of recollection or anamnesis, is the idea that we are born possessing all knowledge and our realization of that knowledge is contingent on our discovery of it. Whether the doctrine should be taken literally or not is a subject of debate. The soul is trapped in the body. The soul once lived in "Reality", but got trapped in the body. It once knew everything, but forgot it. The goal of Recollection is to get back to true Knowledge. To do this, one must overcome the body. This doctrine implies that nothing is ever learned, it is simply recalled or remembered. In short it says that all that we know already comes pre-loaded on birth and our senses enable us to identify and recognize the stratified information in our mind."
 
TiredSam said:
My wife has just been talking to a helpful friend and the subject of (my) headaches popped up. According to the helpful friend when we suffer pain our brain retains a memory of it, or something, so in future pain is also influenced by memories of past pain, I think. My wife remembers learning this during her training as a nurse too.

I've never heard of this idea, and was immediately suspicious (apparently I have a "hobbyhorse"). I started googling and came up with expressions such as "pain neurotag", and ended at an apparent bible in the "science of pain", the book mentioned in the title, which is universally praised at Amazon and all over the internet.

I don't know how I've remained ignorant about this concept (brain retaining a memory of pain which affects perception of pain in the future), but somehow I have. I would appreciate the opinion of knowledeable forum members (or anyone who just fancies a rant) on the subject.
Click to expand...

I cant be sure but i think that is what the 'central sensitisation' theory is based on?
 
Ariel said:
Kind of reminds me of Plato's Theory of Recollection.

https://en.wikipedia.org/wiki/Platonic_epistemology#:~:text=The Platonic doctrine of recollection,on our discovery of it.&text=It once knew everything, but,one must overcome the body.

"The Platonic doctrine of recollection or anamnesis, is the idea that we are born possessing all knowledge and our realization of that knowledge is contingent on our discovery of it. Whether the doctrine should be taken literally or not is a subject of debate. The soul is trapped in the body. The soul once lived in "Reality", but got trapped in the body. It once knew everything, but forgot it. The goal of Recollection is to get back to true Knowledge. To do this, one must overcome the body. This doctrine implies that nothing is ever learned, it is simply recalled or remembered. In short it says that all that we know already comes pre-loaded on birth and our senses enable us to identify and recognize the stratified information in our mind."
Click to expand...


That slice of Plato, in the context of a thread which shows the domain of pain being held captive by psychologists whose main interest is “pain beliefs”, makes me think of the extraordinary range of subjects which philosophers got to play with in their glory days, before physics and neuroscience moved on from fun speculation to empirical drudgery, leaving them with only boring questions of language and meaning to play with, and I hope that one day psychologists will be similarly kicked out of pain studies.
 
Shadrach Loom said:
makes me think of the extraordinary range of subjects which philosophers got to play with in their glory days, before physics and neuroscience moved on from fun speculation to empirical drudgery, leaving them with only boring questions of language and meaning to play with
Click to expand...

It's really only as boring as you make it! I think this is somewhat of a misconception. Although I agree that many went about it in a very boring (and dogmatic) fashion. There are still some fun and interesting topics!

As for the psychologists, perhaps we should replace them with analytic philosophers. We'd get better questionnaires.
 
Ariel said:
It's really only as boring as you make it! I think this is somewhat of a misconception. Although I agree that many went about it in a very boring (and dogmatic) fashion. There are still some fun and interesting topics!

As for the psychologists, perhaps we should replace them with analytic philosophers. We'd get better questionnaires.
Click to expand...

Yep, true, still some fun stuff, and although I walked away with a philosophy degree thirty years ago assuming it would never prove relevant or helpful, it’s recently proved quite useful when playing expertise top trumps on anything from AI ethics to VR.
 
TiredSam said:
According to the helpful friend when we suffer pain our brain retains a memory of it, or something, so in future pain is also influenced by memories of past pain, I think.
Click to expand...

Yer, well, it does doesn't it?

I remember pains - or I guess my brain does.
I remember how awful the dentist's drill is if the injection wasn't big enough so yes next time my pain is influenced by that. Although I am not sure the actual sensation is different even if the painfulness is. Sometimes it is less and sometimes more - depending on what happened before, I think.

But that would tell us nothing about abnormal or 'inappropriate' pain in so-called fibromyalgia because the normal state of affairs does not explain an abnormal state of affairs. I don't have fibromyalgia but I have had a few pains - sciatica, renal colic, dislocation.

I am pretty sure nobody knows enough about the neurology to have a usefully predictive theory of mechanism so I don't think there is anything more to it than what we know from ordinary life though.
 
Does it tho?

It remembers that there was pain, that it didn't like it, how bad it was etc.

But that isn't the same as remembering the pain, itself.

I can remember that in 1982 I was forced to see Star Trek The motion picture, but not remember much about it, let alone be able to experience it happening now purely reliving it.

Poorly explained but my point is it is possible to remember that something happened but not be in the moment it happened, or much else, and if something can't be remembered beyond it's bare existence is that enough to influence future behaviour?

Other than in the case of cliffs lol
 
Wonko said:
But that isn't the same as remembering the pain, itself.
Click to expand...

I remember the pains themselves. I have a very clear memory of my renal colic and of a certain type of headache I used to get, the dentist's drill... I remember them in the same way that I remember images of buildings or birds or a Schubert song. People differ in how much they recall, I think, but I suspect we remember pains as much as we remember anything.
 
Thanks for the replies.

JemPD said:
I cant be sure but i think that is what the 'central sensitisation' theory is based on?
Click to expand...
It may well be, but there's only so much cutting-edge science I can keep up with so I haven't bothered paying any attention to central sensitisation theory, I just look at the names of those involved and use a simple heuristic to decide how much of my time to dedicate to it.

I thought that although most people remember that they had pain, they aren't very good at really remembering what the actual pain felt like. At least that's the reason I heard as to why anyone ever has another baby after the first one.

Over my 8 years of ME I have had fewer and fewer headaches, going from about 150 headache days a year in the first 2 years, down to about 25 a year for the last 2-3 years. If my headaches were informed by previous headaches I should be having more and more and they should be getting worse and worse, but strangely the opposite seems to be the case, even though I've never read "Explain Pain" or followed the advice therein. In fact avoiding the advice to avoid avoidance behaviour has worked well for me. I guess I must be an anomaly.
 
I also think that these experts don't know what they're talking about and also think there is little evidence just a belief and desire to appear to know when there is very little that we really do know about the brain in general.

When someone puts their hand on an extremely hot surface for the first time the brain apparently isn't even involved. Or at least not the higher functioning part that is 'neuro-plastic'.

We experience pain and we remember. And avoid it. Because there are physical consequences to not remembering.

There are degrees and types of pain but the brainiacs that blather on about this don't bother teasing anything apart it's all holistic woo -- everything's related and catagories are broad and very, very vague.

Lots of people experience pain and then contextualise it in a way that diffuses any sort of panic / hypervigilance / catastrophising, otherwise how do children get siblings.

And this sort of reasoning that is used by this lot is always othering IMO. It would never happen that any researcher in this belief system would ever succumb to their pain in the way being characterised.

These people IMO just don't think very hard. To me it's just very lazy thinking and not very clever or nuanced or in the end useful to anyone but themselves for making a career out of nonsense that can't be either proved or refuted.
 
Remembering pain doesn't mean the experience will be worse the next time. If it's a time limited pain like periods, childbirth, migraines, dental procedures, etc. knowing that however awful it is, it will stop within minutes, hours or a few days can make it more bearable and less traumatic. I think pain of unknown origin or unknown duration is much harder to deal with.
 
I seem to be a really spectacular failure in this department?

About 10 days ago I accidentally found a way to relieve the muscle pain I've had for years, and within four or five days I couldn't remember what it was like to have it.

The pain came back again this evening. I'd forgotten to top the potassium up so the effects wore off, and my brain's telling me that it's a completely new and worrying experience. (I've had this muscle pain since 1976.)

Same with discomfort. After enduring a couple of days of uncomfortably hot summer days and nights, I'm convinced that I will never again feel too cold for comfort. Ever. In fact it was all an illusion, I've never really been cold.

Until I'm scraping frost off the windscreen, of course, at which point no ambient temperature could possibly be too warm for me.
 
About 10-15 years ago I used to be very familiar with Butler and Mosley theories and the book “explain pain“. They’re famous in the physical therapy (physiotherapy) world in Australia, the UK and the USA.

One of the things that I remember was in their book was explaining the push/crash cycle in the context of pain and the importance of pacing – although I don’t think they actually call it pacing …they just say stay within your limits. They also spent a lot of time on the dangers of catastrophizing. The book uses cartooning for accessibility. They also make use of mirror therapy.

My memory so poor nowadays that that’s about all I can remember. I spent about five years working with a physical therapist who practiced their methodologies. Some of their stuff ranges into the biopsychological realm which turned me off.

@TiredSam, my memory is that their work concentrated on neuromuscular pain and not on headaches, but perhaps they’ve taken it into that area, also.

If you’re interested you can easily find both of them and their groups on the Internet.
 
Last edited:
TiredSam said:
According to the helpful friend when we suffer pain our brain retains a memory of it, or something, so in future pain is also influenced by memories of past pain
Click to expand...

Perhaps my retained memories of past roast duck dinners and hearing ducks at the park explain my extreme aversion to quackery and quacks in the present.


Edit: the fact that Amazon is quoting over A$240 for a 130 page spiral-bound book (or $35 for the ebook) also sets off my quack-meter.
 
Last edited:
TiredSam said:
According to the helpful friend when we suffer pain our brain retains a memory of it, or something, so in future pain is also influenced by memories of past pain, I think. My wife remembers learning this during her training as a nurse too.
Click to expand...

Of course it is, but this is a good thing. That memory is an important feedback loop that actually prevents unnecessary pain signals - it provides both a means of calibration and a means of conscious interpretation, for it prevents the brain from incorrectly identifying other signals as pain.
This feedback loop can go wrong - but that requires demonstrable brain pathology, such as injury or a serious tumor.
 
You must log in or register to reply here.
Back
Top Bottom