Hello and welcome.
I'm so glad you're here.
You may have come upon this clip because you've heard the term neuroplastic pain or tension myositis symptom or nociplastic pain and you're curious if this could apply to you so you're in the right place.
We're going to break it down in two different videos talking about symptoms,
Patterns,
Characteristics that increase the likelihood that your pain has a neuroplastic component.
So as I speak it might be helpful to have a pen and paper nearby so you can jot down the things that resonate that are true for you.
In the neuroplastic community,
We call this building and evidence checklist.
And so this can be helpful for you when you start to doubt that you have neuroplastic pain.
It's also something that is helpful when you go to a provider to explain why you think that you have this type of pain.
So before we jump in,
I want to put out there that we cannot say you have neuroplastic pain if you haven't had a thorough medical workup.
So even if you came to me with all the symptoms and patterns of neuroplastic pain,
If you hadn't had a thorough medical workup,
We would not even start to turn over that leaf of investigation until we can make sure that there's not a fracture,
A ligament tear,
An infection,
A tumor,
Etc.
So that is always step number one.
Neuroplastic pain is a diagnosis of exclusion,
Meaning we have to exclude the fact that there's no structural issue first.
So that's step one.
Now let's talk about the characteristics of pain itself that are consistent with neuroplastic pain.
So if your symptoms started around a really stressful period of time or right after a big stressor,
So I've seen plenty of patients with symptoms that have flared right after a wedding or when they're planning a wedding.
Even though this sounds really fun and exciting,
There's a lot of stress involved in this,
Right?
Another common thing is during relationship changes,
So divorce,
During breakups.
And then something that I probably see the most commonly is when people are in a relationship.
A work environment that is extremely stressful and demanding,
Because that's Every day of the week,
They're going into an environment where they feel stressed.
And that puts a lot of taxation on the nervous system.
So thinking back to when did my Pane start.
What was happening right before,
What was happening around that time,
Right after.
Is a key.
Part of the diagnosis.
The next piece we'll talk about is symptoms that persist after an injury is healed.
So most injuries will heal on their own or with some intervention.
The body is resilient.
It knows how to heal.
If everything looks like it has healed properly,
Yet the pain persists,
That is a really common sign of neuroplastic pain.
So the brain has learned this pain pattern because there was an injury,
But now the injury is healed and the brain is kind of stuck in this learned pain pattern.
The next symptom we'll look at is.
.
.
Symptoms that move,
Travel,
Or shift over time.
The other piece of this is if the quality of the pain changes,
Meaning like it started off really like dull,
Now it feels fiery and burny,
Sometimes it feels sharp.
So if the quality of the pain is changing over time,
And that can be within the span of the day or within a span of weeks to months,
Or the location is shifting over time.
And again,
Same time frame,
Over a day,
Over weeks to months.
This is consistent with neuroplastic pain because if I had a tumor in my shoulder,
And there was a structural reason for my pain.
It's unlikely that I would start to feel pain over on the other side.
The pain is going to stay where the structural injury is.
But with neuroplastic pain.
That pain signal isn't always 100% perfect and kind of creating the same pain signal every single time.
And so there might be a little bit of variation where,
Oh,
I feel it more over here.
Now I feel it more over here,
Right?
Same thing with the quality of the pain.
If I have a structural reason for pain,
Shoulder pain,
If I have a tumor in my shoulder,
The quality of the pain is likely going to stay the same unless the injury changes.
Meaning,
You know,
I had a tumor and now the tumor isn't now impinging on a nerve,
So now I have nerve pain rather than kind of more of that pressure structural pain.
But usually with structural injury,
Unless the injury is progressing and getting worse,
The quality of the pain isn't going to change very much.
Okay.
The next thing we look for is symptoms occur in different body parts at the same time.
So there are a few diagnoses where we can have multiple symptoms and multiple parts of the body and multiple organ systems,
But it's very rare.
And again,
This is why we have to have a medical workup to exclude these things.
So multiple sclerosis could be a reason why you're having multiple symptoms all at once,
Like weakness,
Bladder symptoms,
Headaches,
But there aren't a lot of disease processes that are going to hit you all at once.
But if you're having wrist pain and knee pain and migraines and bladder pain and all of these things happening simultaneously.
It's less likely that that is a part of one disease process or that you're just injuring multiple parts of your body at the same time.
The more unifying and likely explanation is that your nervous system is perceiving threat and it's sending out a lot of warning signals.
Through all these different pain sensations or all these different symptoms simultaneously.
The next one we'll look at are having symptoms on both sides of the body.
So it's unlikely that you're going to have pain in both shoulders from an injury,
Right?
If you're going to injure something,
It's usually unilateral or one-sided.
So if you're having knee pain on both sides,
Shoulder pain on both sides.
Ankle pain on both sides.
Less likely that that's due to a structural problem and more likely that that is due to a neuroplastic issue.
Another pattern we see is symptoms that fluctuate throughout the day.
If I have a tumor in my shoulder,
That tumor is going to be pressing on the surrounding tissues all the time.
I'm going to have pain all the time because the tumor is not going anywhere.
When you have neuroplastic pain,
If you're feeling more stressed or more tired,
Sometimes the pain can get worse.
Or if you're enjoying something or in a state of flow and your brain is really not paying attention to the pain,
Then the pain can decrease.
And along those lines,
Symptoms that decrease when you're engaged in something distracting or very absorbing,
You're watching your favorite TV show,
You're absorbed in a hobby,
You're really enjoying yourself and you're just like,
It's been 25 minutes and I haven't really noticed that the pain is there.
That is a big indicator that you could have neuroplastic pain.
Symptoms worsen when you feel stressed or in a stressful situation or worse after going through a stressful experience.
Symptoms are triggered by seemingly unrelated things.
An example of this is you smell something and you get a migraine.
In neuroplastic pain,
We call this predictive coding.
It's a learned association,
Like Pavlov and his dogs,
Learning that when the bell rings,
That means food.
Therefore,
My body is getting ready by drooling.
The brain has learned when I smell this,
A headache comes on.
This is a brain process,
Not a structural one.
We don't have an explanation physiologically or anatomically why smelling a certain scent would create a headache.
But when we study how the brain predicts threat,
We can clearly see why the brain is creating that loop.
I had a client who had pelvic pain,
Lower back pain,
And he had learned somehow along the way through experience that sitting on a chair that was wooden or hard was safe.
But sitting on a chair that was cushiony or sitting on the side of a bed was unsafe and would create pain.
So anatomically,
Structurally,
It doesn't make sense that sitting on something really hard would not precipitate pain.
And sitting on something with a little bit more cushion and comfort would but that was what his brain has learned.
His brain learned that sitting on something hard was supportive and was not going to cause pain and sitting on something comfortable would.
