Alberta Pain Conference 2020 – what’s new in pain

Dr. Tasha Stanton – targeting pain from many angles and the importance of language, sensory modulation, and brain trickery.

Dr. Stanton also mentioned the complexity of the Flight Fright Freeze response.

The context of your environment contributes to pain – measuring the nociceptive withdrawal response/reflex can tell us about the level of threat and how pain is affected. We have a dynamic system that updates based on available information for that person, in that environment, in that society. The balance of information, these cues affect pain.

Research with laser zaps and different stimuli show very interesting results. A person smelling a soothing smell will experience less pain than the person immersed in a toxic smell, like a fart.

Words can alter the pain experience. If we hear words with danger cues, then pain increases. What we are told about our body influences pain. (Reminds me of how easily a doctor can cause a side effect with the choice of their words).

Things hurt more when they aren’t sure they are safe. Every clinical encounter is an opportunity to add or decrease the danger response. Be careful about the message you give a patient when you, as a clinician, report on things like X-rays. For instance, there are so many people with osteoarthritis who have no pain. (Same with MRI’s of the back). Imaging doesn’t determine your outcome. Doesn’t always correlate with pain levels.

Imbue safety cues rather than danger cues. We are BIOPLASTIC – love that.

Your body continues to adapt even you are ageing.

Exercise is so important. Do not give danger cues that movement is bad. Evidence supports that movement can hurt initially, but then will get better. Tissue adapts through loading. Slowly increase your effort. Check out the links Pacing and Gentle Exercise which is important in managing chronic pain.

Also look at how you speak about your own body, even when it’s what you say about yourself. Don’t talk about your “bad” body.

She shared research that proved information from one sensor can change the pain experience. It even causes physical changes, like reduction in the swelling of the knee. What you see can change what you feel. You can change your perception by looking at something differently – your brain accepting that change can occur through strong sensory input.

Increasing your confidence, perceived strength, and decreasing fear, all lead to decreases in pain intensity. How well you feel your body is equipped to do tasks influences your pain and function.

She shared fascinating research sharing illusions used to decrease a burning mouth by using colour to create the illusion of pain reduction. Using mediated reality, they use mirrors to flip a patient’s reality to work on patients with phantom limb pain. Moving the remaining limb in the mirror can feel as if the phantom limb is moving and can reduce pain.

Sound information has strong links to feeling and movement. Stiff joints make a lot of noise. They did research pairing sound with pressure on their back. Using loud awful noise, the patient’s pain increased. When the sound was soothing and whooshing, the pain was less.

You can look up studies on The influence of auditory cues on bodily and movement perception.

Using brain trickery can be used to help pain. Priming the brain can shape your expectations. Effective priming can influence what we can achieve.

If we understand these influencers of pain, we can change the way people experience pain. Our words matter.

Thank you


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