The Pain Neuromatrix
Pain is a complex multidimensional experience that involves biological, psychological and sociological factors that vary to different degrees in terms of how much they each contribute to a person’s unique pain scenario.
Some people may experience musculoskeletal pain that is heavily driven by messaging from their tissues (sensory input or nociception-often called ‘mechanical’ pain), while others may experience pain that is modulated heavily by stress, emotions, or beliefs. In fact, some sources report that up to 1/3 of individuals with depression experience musculoskeletal pain only and do not feel sad.
It is important that we remember each person’s pain is real and unique and that we take the time to listen to their story. Many times the drivers of the pain come out in their story rather than a bunch of complicated orthopedic tests. I can’t tell you how many times I have been working with a patient and on their third or fourth visit they say something like, ‘I just remembered my pain began about the time my kids left for college’ or ‘when I lost my job’. If we are too focused on muscles, fascia or whatever other tissue, we often miss what is happening to the whole person.
Health should always be examined through a biopsychosocial lens. Let’s not forget this.