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Pain as a Perceptual Experience

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Treatment of Chronic Pain by Integrative Approaches

Abstract

Human perception has been likened to a hologram. A hologram exists by converging two or more laser beams together, producing a three-dimensional vision that is very real, but doesn’t really exist. You can put your hand right through a hologram, yet it is quite visible and not disturbed by your hand. The more laser beams we add to the hologram, the richer the vision. This analogy is often used to address human perception. What our brain creates as a perception and how we project these perceptions onto the outside world are called qualia. The qualia we call our conscious experience of pain cannot be fully explained by neurophysiological events only. Some qualia, or perceptions, can be up to 90 % memory. Thus, our qualia are produced by a dynamic interaction between mind and brain and most likely through the mechanics of quantum physics.

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References

  1. Talbot M. The holographic universe. New York: HarperCollins; 1991.

    Google Scholar 

  2. Barnes J. Myofascial release: the missing link in traditional treatment. In: Davis C, editor. Complementary therapies in rehabilitation, evidence for efficacy in treatment, prevention, and wellness. 3rd ed. Thorofare: Slack In; 2009. p. 89–112.

    Google Scholar 

  3. Barnes JF. Myofascial release: the search for excellence-A comprehensive evaluatory and treatment approach. Paoli: Rehabilitation Services Inc; 1990.

    Google Scholar 

  4. Ray A, Zbik A. Cognitive behavioral therapies and beyond. In: Tollison CD, editor. Practical pain management. 3rd ed. Philadelphia: Lippincott Williams and Wilkins; 2002. p. 189–208.

    Google Scholar 

  5. Benini A. Pain as a biological phenomenon of consciousness. Praxis. 1998;87(7):224–8.

    CAS  PubMed  Google Scholar 

  6. Schwartz J, Begley S. The mind and the brain neuroplasticity and the power of mental force. New York: Harper Perennial; 2002. p. 372–7.

    Google Scholar 

  7. Gregory R. Brainy mind. BMJ. 1999;317:1693–5.

    Google Scholar 

  8. Satinover J. The quantum brain. New York: Wiley; 2001.

    Google Scholar 

  9. Schweinhardt P, Lee M, Tracey I. Imaging pain in patients: is it meaningful? Curr Opin Neurol. 2006;19:392–400.

    PubMed  Google Scholar 

  10. Songer D. Psychotherapeutic approaches in the treatment of pain. Psychiatry. 2005;2(5):19–24.

    PubMed Central  PubMed  Google Scholar 

  11. Doidge N. The brain that changes itself. New York: Penguin Books; 2007.

    Google Scholar 

  12. Stohler C, Kowalski C. Spatial and temporal summation of sensory and affective dimensions of deep somatic pain. Pain. 1999;79(2–3):165–73.

    CAS  PubMed  Google Scholar 

  13. Apkarian A, Bushnell M, Treede R-D, Zubieta J. Human brain mechanisms of pain perception and regulation in health and disease. Eur J Pain. 2005;9:463–84.

    PubMed  Google Scholar 

  14. Price D. Psychological mechanisms of pain and analgesia. Seattle: IASP Press; 1999.

    Google Scholar 

  15. Price D, Harkins S. The affective-motivational dimension of pain: a two-stage model. APS J. 1992;1:229–39.

    Google Scholar 

  16. Auvray M, Myin E, Spence C. The sensory-discriminative and affective-motivational aspects of pain. Neurosci Biobehav Rev. 2010;34(2):214–23.

    PubMed  Google Scholar 

  17. Gracely R. Affective dimensions of pain: how many and how measured? APS J. 1992;1:243–7.

    Google Scholar 

  18. Melzack R. Evolution of the neuromatrix theory of pain: the Prithvi Raj Lecture. Presented at the third world congress of World Institute of pain, Barcelona, Spain, 2004. Pain Pract. 2005;5(2):85–94.

    PubMed  Google Scholar 

  19. Melzack R. Pain – an overview. Acta Anaesthesiol Scand. 1999;43(9):880–4.

    CAS  PubMed  Google Scholar 

  20. Melzack R, Katz J. Pain assessment in adult patients. In: McMahon S, Koltzenburg M, editors. Wall and Melzack’s textbook of pain. 5th ed. Oxford: Elsevier Churchill Livingstone; 2006. p. 291–304.

    Google Scholar 

  21. Pesut B, McDonald H. Connecting philosophy and practice: implications of two philosophic approaches to pain for nurses’ expert clinical decision making. Nurs Philos. 2007;8(4):256–63.

    PubMed  Google Scholar 

  22. Sitges C, Garcia-Herrera M, Pericas M, et al. Abnormal brain processing of affective and sensory pain descriptors in chronic pain patients. J Affect Disord. 2007;104(1–3):73–82.

    PubMed  Google Scholar 

  23. Mialet J. From back pain to life-discontent: a holistic view of psychopathological contributions to pain. Ann Med Interne (Paris). 2003;154(4):219–26.

    Google Scholar 

  24. Bonica J. Neurophysiologic and pathologic aspects of acute and chronic pain. Arch Surg. 1977;112(6):750–61.

    CAS  PubMed  Google Scholar 

  25. Lippe P. An apologia in defense of pain medicine. Clin J Pain. 1998;14:189–90.

    CAS  PubMed  Google Scholar 

  26. Casey K, Tran T. Cortical mechanisms mediating acute and chronic pain in humans. In: Cervero F, Jensen T, editors. Handbook of clinical neurology. Boston: Elsevier; 2006. p. 159–77.

    Google Scholar 

  27. Voscopoulos C, Lema M. When does acute pain become chronic? Br J Anaesth. 2010;105 Suppl 1:i69–85.

    PubMed  Google Scholar 

  28. Rome H, Rome J. Limbically augmented pain syndrome (LAPS): kindling, corticolimbic sensitization, and convergence of affective and sensory systems in chronic pain disorders. Pain Med. 2000;1:7–23.

    PubMed  Google Scholar 

  29. Krämer H, Stenner C, Seddigh S, et al. Illusion of pain: pre-existing knowledge determines brain activation of ‘imagined allodynia. J Pain. 2008;9(6):543–51.

    PubMed  Google Scholar 

  30. Fontani G, Migliorini S, Benocci R, et al. Effect of mental imagery on the development of skilled motor actions. Percept Mot Skills. 2007;105(3 Pt 1):803–26.

    PubMed  Google Scholar 

  31. Sanders CW, Sadoski M, Bramson R, et al. Comparing the effects of physical practice and mental imagery rehearsal on learning basic surgical skills by medical students. Am J Obstet Gynecol. 2004;191(5):1811–4.

    PubMed  Google Scholar 

  32. Fitzgibbon B, Giumarra M, Georgiou-Karistianis N, et al. Shared pain: from empathy to synaesthesia. Neurosci Biobehav Rev. 2010;34(4):500–12.

    PubMed  Google Scholar 

  33. Meyer R, Ringkamp M, Campbell J, Raja S. Peripheral mechanisms of cutaneous nociception. In: McMahon S, Koltzenburg M, editors. Wall and Melzack’s textbook of pain. 5th ed. London: Elsevier; 2006. p. 3–34.

    Google Scholar 

  34. Julius D, McCloskey E. Cellular and molecular properties of primary afferent neurons. In: McMahon S, Koltzenburg M, editors. Wall and Melzack’s textbook of pain. 5th ed. London: Elsevier; 2006. p. 35–48.

    Google Scholar 

  35. Ji R, Kawasaki Y, Wen Y, Decostrel I. Possible role of spinal astrocytes in maintaining chronic pain sensitization: review of current evidence with focus on bFGF/JNK pathway. Neuron Glia Biol. 2006;2:259–69.

    PubMed Central  PubMed  Google Scholar 

  36. Hertz L, Hansson E. Roles of astrocytes an microglia in pain memory. In: DeLeo J, Sorkin L, Watkins L, editors. Immune and glial regulation of pain. Seattle: IASP Press; 2007. p. 21–41.

    Google Scholar 

  37. Woolf C. Pain: moving from symptom control toward mechanism specific pharmacological management. Ann Intern Med. 2004;140:441–51.

    PubMed  Google Scholar 

  38. Baron R. Mechanisms of disease: neuropathic pain – a clinical perspective. Nat Clin Pract Neurol. 2006;2(2):95–106.

    PubMed  Google Scholar 

  39. Basbaum A, Jessell T. The perception of pain. In: Kandel E et al., editors. Principles of neural science. 4th ed. New York: Oxford University Press; 2000. p. 472–91.

    Google Scholar 

  40. Fields H, Heinricher M, Mason P. Neurotransmitters in nociceptive modulating circuits. Annu Rev Neurosci. 1991;14:219–45.

    CAS  PubMed  Google Scholar 

  41. Kuner R. Central mechanisms of pathological pain. Nat Med. 2010;16(11):1258–66.

    CAS  PubMed  Google Scholar 

  42. Lee M, Mouraux A, Iannetti G. Characterizing the cortical activity through which pain emerges from nociception. J Neurosci. 2009;29(24):7909–16.

    CAS  PubMed  Google Scholar 

  43. Nicolelis M, Katz D, Krupa D. Potential circuit mechanisms underlying concurrent thalamic and cortical plasticity. Rev Neurosci. 1998;9(3):213–24.

    CAS  PubMed  Google Scholar 

  44. Varela F, Frenk S. The organ of form. J Soc Biol Struct. 1987;10(1):1073–83.

    Google Scholar 

  45. Myers T. Fascial fitness: training in the neuromyofascial web. Fitness J. 2011:36–43.

    Google Scholar 

  46. Myers T. Anatomy trains: myofascial meridians for manual and movement therapists. New York: Churchill Livingstone; 2009.

    Google Scholar 

  47. Scott J. Molecules that keep you in shape. New Sci. 1986;111:49–53.

    Google Scholar 

  48. Juhan D. Job’s body. Barrytown: Station Hill Press; 1987.

    Google Scholar 

  49. Travell J. Myofascia pain and dysfunction. Baltimore: Williams and Wilkins; 1983.

    Google Scholar 

  50. Hackett G, Hemwall G, Montgomery G. Ligament and tendon relaxation treated by prolotherapy. 5th ed. Oak Park: Beulah Land Press; 2002.

    Google Scholar 

  51. van Sterkenburg M, et al. The plantaris tendon and a potential role in mid-portion Achilles tendinopathy: an observational anatomical study. J Anat. 2011;218(3):336–41.

    PubMed Central  PubMed  Google Scholar 

  52. Sahin N, Oztürk A, Atici T. Foot mobility and plantar fascia elasticity with plantar fasciitis. Acta Orthop Traumatol Turc. 2010;44(5):385–91.

    PubMed  Google Scholar 

  53. Ball T. Structural integration-based fascial release efficacy in systemic lupus erythematosus (SLE): two case studies. J Bodyw Mov Ther. 2011;15(2):217–25.

    PubMed  Google Scholar 

  54. Prasarn ML, Oullette EA. Acute compartment syndrome of the upper extremity. J Am Acad Orthop Surg. 2011;19(1):49–58.

    PubMed  Google Scholar 

  55. Guimberteau J. Strolling under the skin. New York: Elsevier SAS; 2004.

    Google Scholar 

  56. Pert C. The molecules of emotion. New York: Touchstone; 1999.

    Google Scholar 

  57. Oschman J. Energy medicine: the scientific basis. New York: Churchill Livingstone; 2000.

    Google Scholar 

  58. Elkhodair S, et al. Single fascia iliaca compartment block for pain relief in patients with fractured neck of femur in the emergency department: a pilot study. Eur J Emerg Med. 2011;18:340–3.

    PubMed  Google Scholar 

  59. Kearns R, et al. Intrathecal opioid versus ultrasound guided fascia iliaca plane block for analgesia after primary hip arthroplasty: study protocol for a randomized, blinded, noninferiority controlled trial. Trials. 2011;21:12–51.

    Google Scholar 

  60. Kim HS, et al. Fascia iliaca compartment block reduces emergence agitation by providing effective analgesic properties in children. J Clin Anesth. 2011;23(2):119–23.

    PubMed  Google Scholar 

  61. Boström P, Karjalainen V. Epidural or fascial anesthesia for postoperative pain? Duodecim. 2011;127(3):281–3.

    PubMed  Google Scholar 

  62. Hoheisel U, Taguchi T, Treede RD, Mense S. Nociceptive input from the rat thoracolumbar fascia to lumbar dorsal horn neurones. Eur J Pain. 2011;15(8):810–5. Epub 2011 Feb 16.

    PubMed  Google Scholar 

  63. Craig K. Emotions and psychobiology. In: McMahon S, Koltzenburg M, editors. Wall and Melzack’s textbook of pain. 5th ed. Philadelphia: Elsevier Churchill Livingstone; 2006. p. 231–9.

    Google Scholar 

  64. Phillips HC, Hunter M. Headache in a psychophysical population. J Nerv Ment Dis. 1982;170:1–12.

    Google Scholar 

  65. Romano J, Turner J. Chronic pain and depression: does the evidence support a relationship? Psychol Bull. 1985;97:18–34.

    CAS  PubMed  Google Scholar 

  66. Aurelius M. The meditations of Marcus Aurelius. In: Eliot C, editor. Plato, Epictetus, Marcus Aurelius the Harvard Classics. New York: Collier & Son; 1937. p. 245–61.

    Google Scholar 

  67. Perlmutter D, Villoldo A. Power up your brain the neuroscience of enlightenment. Carlsbad: Hay House; 2011. p. 26–31.

    Google Scholar 

  68. Kusumi T, Nakamoto K, Koyasu M. Perceptual and cognitive characteristics of metaphorical pain language. Shinrigaku Kenkyu. 2010;80(6):467–75.

    PubMed  Google Scholar 

  69. Moroni C, Laurent B. Pain and cognition. Psychol Neuropsychiatr Vieil. 2006;4(1):21–30.

    PubMed  Google Scholar 

  70. Kirmayer L. Culture and the metaphoric mediation of pain. Transcult Psychiatry. 2008;45(2):318–38.

    PubMed  Google Scholar 

  71. Campbell C, France C, Robinson M, et al. Ethnic differences in the nociceptive flexion reflex (NFR). Pain. 2008;134(1–2):91–6.

    PubMed Central  PubMed  Google Scholar 

  72. Fillingham R. Sex differences in analgesic responses: evidence from experimental pain models. Eur J Anaesthesiol. 2002;26(suppl):16–24.

    Google Scholar 

  73. Gibson S, Farrell M. A review of age difference in the neurophysiology of nociception and the perceptual experience of pain. Clin J Pain. 2004;20(4):227–39.

    PubMed  Google Scholar 

  74. Turk D, Flor H. The cognitive-behavioral approach to pain management. In: McMahon S, Koltzenburg M, editors. Wall and Melzack’s textbook of pain. 5th ed. New York: Elsevier Churchill Livingstone; 2006. p. 339–48.

    Google Scholar 

  75. Rainville P, Hofbauer RK, Paus T, et al. Cerebral mechanisms of hypnotic induction and suggestion. J Cogn Neurosci. 1999;11(1):110–25.

    CAS  PubMed  Google Scholar 

  76. Malenka R, Nicoll R. Long-term potentiation – a decade of progress. Science. 1999;285:1870–4.

    CAS  PubMed  Google Scholar 

  77. Engert F, Bonhoeffer T. Dendritic spine changes associated with hippocampal long-term synaptic plasticity. Nature. 1999;399:66–70.

    CAS  PubMed  Google Scholar 

  78. Wagner A, Schacter D, Rotte M, et al. Building memories: remembering and forgetting of verbal experiences as predicted by brain activity. Science. 1998;281:1188–91.

    CAS  PubMed  Google Scholar 

  79. Brewer J. Making memories: brain activity that predicts how well visual experience will be remembered. Science. 1998;281:1185–7.

    CAS  PubMed  Google Scholar 

  80. Shi S, Hayashi Y, Petralia R, et al. Rapid spine delivery and redistribution of AMPA receptors after synaptic NMDA receptor activation. Science. 1999;284:1811–6.

    CAS  PubMed  Google Scholar 

  81. Damasio A. On some functions of the human prefrontal cortex. Ann N Y Acad Sci. 1995;769:241–51.

    CAS  PubMed  Google Scholar 

  82. Owen A, Herrod N, Menon D, et al. Redefining the functional organization of working memory processes with human lateral prefrontal cortex. Eur J Neurosci. 1999;11:567–74.

    CAS  PubMed  Google Scholar 

  83. D’Esposito M, Detre J, Alsop D, et al. The neural basis of the central executive system of working memory. Nature. 1995;378:279–81.

    PubMed  Google Scholar 

  84. Shapiro F. Eye movement desensitization and reprocessing. New York: Guilford Press; 1995.

    Google Scholar 

  85. Stowell H. Event related brain potentials and human pain: a first objective overview. Int J Psychophysiol. 1884;1(2):137–51.

    Google Scholar 

  86. Hellström C, Carlsson S. The long-lasting now: disorganization in subjective time in long-standing pain. Scand J Psychol. 1996;37(4):416–23.

    PubMed  Google Scholar 

  87. Lautenbacher S, Prager M, Rollman G. Pain additivity, diffuse noxious inhibitory controls, and attention: a functional measurement analysis. Somatosens Mot Res. 2007;24(4):189–201.

    PubMed  Google Scholar 

  88. van der Kolk B. The psychobiology of posttraumatic stress disorder. J Clin Psychiatry. 1997;58 Suppl 9:16–24.

    PubMed  Google Scholar 

  89. van der Kolk B, Fisler R. Childhood abuse and neglect and loss of self-regulation. Bull Menninger Clin. 1994;58(2):145–68.

    PubMed  Google Scholar 

  90. van der Kolk B, Greenberg M, Boyd H, et al. Inescapable shock, neurotransmitters, and addiction to trauma: toward a psychobiology of post-traumatic stress. Biol Psychiatry. 1985;20(3):314–25.

    PubMed  Google Scholar 

  91. van der Kolk B, Greenberg M, Orr S, et al. Endogenous opioids, stress induced analgesia, and posttraumatic stress disorder. Psychopharmacol Bull. 1989;25(3):417–21.

    PubMed  Google Scholar 

  92. van der Kolk B, Pelcovitz D, Roth S, et al. Dissociation, somatization, and affect dysregulation: the complexity of adaptation of trauma. Am J Psychiatry. 1996;153(7 Suppl):83–93.

    PubMed  Google Scholar 

  93. Rauch S. Neuroimaging and the neuroanatomy of PTSD. CNS Spectr. 1998;3 Suppl 2:31–3.

    Google Scholar 

  94. Shalev A, Peri T, Brandes D, Freedman S, Orr SP, Pitman RK. Auditory startle response in trauma survivors with PTSD: a prospective study. Am J Psychiatry. 2000;157:255–61.

    CAS  PubMed  Google Scholar 

  95. van der Kolk B. Psychological trauma. Washington: American Psychiatric Press; 1987.

    Google Scholar 

  96. Ramachandran V, Rogers-Ramachandran D. Phantom limbs and neural plasticity. Arch Neurol. 2000;57(3):317–20.

    CAS  PubMed  Google Scholar 

  97. Wade N. Beyond body experiences: phantom limbs, pain and the locus of sensation. Cortex. 2009;45(2):243–55.

    PubMed  Google Scholar 

  98. Kwan C, Diamant N, Mikula K, Davis K. Characteristics of rectal perception are altered in irritable bowel syndrome. Pain. 2005;113(1–2):160–71.

    PubMed  Google Scholar 

  99. Pain Giamberardino M, et al. Referred muscle pain and hyperalgesia from viscera. J Musculoskeletal Pain. 1999;7(1–2):61–9.

    Google Scholar 

  100. Silberstein S, et al. Neuropsychiatric aspects of primary headache disorders. In: Yudofsky S, Hales R, editors. Textbook of neuropsychiatry. 3rd ed. Washington: American Psychiatric Press; 1997. p. 381–412.

    Google Scholar 

  101. Burstein R, Strassman A. Peripheral and central sensitization during migraine. In: Devor M et al., editors. Proceedings of the 9th world congress on pain. Seattle: IASP Press; 2000. p. 589–602.

    Google Scholar 

  102. Post R, Weiss S, Smith M. Sensitization and kindling: implications for the evolving neural substrates of post-traumatic stress disorder. In: Friedman M, Charney D, Deutch A, editors. Neurobiological and clinical consequences of stress: from normal adaptation to post-traumatic stress disorder. Philadelphia: Lippincott-Raven; 1995. p. 203–24.

    Google Scholar 

  103. Weiss S, Post R. Caveats in the use of the kindling model of affective disorders. Toxicol Ind Health. 1994;10:421–7.

    CAS  PubMed  Google Scholar 

  104. Vecchiet L, Giamberardino M. Muscle pain, myofascial pain, and fibromyalgia: recent advances. J Musculoskeletal Pain. 1999;7(1–2).

    Google Scholar 

  105. Graven-Nielson T. Central hyperexcitability in fibromyalgia. J Musculoskeletal Pain. 1999;7(1–2):261–72.

    Google Scholar 

  106. Dohrenbusch R, Sodhi H, Lamprecht J, Genth E. Fibromyalgia as a disorder of perceptual organization? An analysis of acoustic stimulus processing in patients with widespread pain. Z Rheumatol. 1997;56(6):334–41.

    CAS  PubMed  Google Scholar 

  107. Spiegel H, Spiegel D. Trance and treatment: clinical uses of hypnosis. 2nd ed. Washington: American Psychiatric Publishing Inc; 2004.

    Google Scholar 

  108. Francis M. Mindfulness exercises may help chronic pain patients. In: Pain medicine network. Spring; 2011: p. 6–7.

    Google Scholar 

  109. Schneider J, Hofmann A, Rost C, Shapiro F. EMDR in the treatment of chronic phantom limb pain. Pain Med. 2008;9(1):76–82.

    PubMed  Google Scholar 

  110. Sumatani M, Miyachi S, Uematsu H, et al. Phantom limb pain originates from dysfunction of the primary motor cortex. Masui. 2010;59(11):1364–9.

    Google Scholar 

  111. Levy R, Deer T, Henderson J. Intracranial neurostimulation for pain control: a review. Pain Physician. 2010;13(2):157–65.

    PubMed  Google Scholar 

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Ray, A.L., Ullmann, R., Francis, M.C. (2015). Pain as a Perceptual Experience. In: Deer, T., Leong, M., Ray, A. (eds) Treatment of Chronic Pain by Integrative Approaches. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1821-8_1

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