« SOAP Notes | Fingertips Home | Staying Well »

October 1, 2008

How Pain Works

We're learning about electric stimulation for the control of pain. To understand pain, a little bit of knowledge is necessary about how pain is transmitted though the nerves to the brain. I found a wonderful site that explains how pain works.

So for a lab assignment, we had a case scenario:
Assume the subject is 4 days post onset pain in their lower back and is referred for PT to relieve the pain. Select the appropriate stimulation parameters (mode, rate, pulse duration and amplitude), based upon your treatment goals, to carry out this procedure.

I won't go into details here, because that would require further explanation that is beyond the scope of this blog and may be beyond the scope of practice for massage therapists. However, following is a brief summary for what we used, why and the mechanism by which it reduces pain:

We chose interferential current for pain modulation because it activates sensory fibers to block transmission of pain. Sensory stimulation through e-stim uses the Gate Control Theory for pain control. Pain is transmitted through A-delta (fast, sharp pain) or C fibers (slow, burning pain) to inhibitory interneurons which send signals up to the brain via the spinal cord. Stimuli coming through A-beta fibers (pressure and touch) distract signals coming through the interneurons by shutting the gate on the pain signals coming into the spinal cord.

I include this explanation, because I believe it IS useful for massage therapists to understand how pain is transmitted through the central nervous system. Also, massage therapy is the oldest form of pain distraction known to man -- we directly stimulate the A-beta fibers through the simple act of touch. For more explanation about how the Gate Control Theory for Pain Control works, see the above link.

tags: massage massagetherapy wellness massage therapy bodywork health

Posted by linda at October 1, 2008 8:15 PM