I came across this interesting video on Sacral Musings. The basic premise is that pain is not the reality of a situation – it is the efferent modulating response to protect the human organism from stimulus that may be harmful. Watch the video and then read on…
As a student at the Canadian Academy of Osteopathy this concept is often highlighted by Vice Principal Brandon Stevens when he says: pain is born at the dorsal horn but it isn’t pain until it reaches the brain. What we have is a situation where afferent stimulus is assigned meaning in the cerebrum based on past experiences with the stimulus and then the efferent response reflects the meaning that has been assigned to the stimulus (as is evidenced in Mr. Moseley’s explanation of being bitten by the snake). From this it can be inferred that the job of pain is simply protective as it is not indicative of the reality of the stimulus.
What might this mean for an Osteopathic Operator? Stimulus that has created pain for a patient in the past will create efferent responses that will likely be dominated by the sympathetic nervous system. If an Operator does not monitor ALL barriers (including mental – these are palpable in the body and are displayed through efferent responses) then treatment will not have the intended goals. Some pain/discomfort is entirely social – a good example would be the removal of clothing for treatment is not a comfortable thing for most Canadians so I leave my patients fully clothed to avoid the discomfort that may get in the way of an effective treatment. Patients present with different life stories and those will alter the way that an Operator is able to effectively touch them which is one of the reasons that reliance on technique is problematic – if my patient has had an issue with the way their neck has been handled in the past I can not just use standard cervical “techniques”, I will have to understand how else I might effectively use the principles of Osteopathic treatment to work with the mechanics of this individual patient’s cervical spine without scaring them to a point that I am unable to treat them. Every Operator will approach this from different angles and that is fine as long as the patient is provided with effective results.
The principles of Osteopathy provide the necessary tools to help people as long as they are adhered to. Remember that a person is a single unit of mind, body, and spirit. The mind will influence how the body can be approached. The mind will influence how the body functions. Treating the body and monitoring how the afferent stimulus the Operator is providing is influencing efferent responses has the ability to alter parts of the function of the brain. Treatment is adding a new story to the patient’s memory bank that will now be considered when afferent stimulus arrives – treat gently, appeal to physiology and the desired results will occur.
As a closing remark I will point out that pain is not taught as a guiding principle in Osteopathy. Altering pain is not the goal of treatment – altering function is. When function is appropriate pain goes away.