Pain, Is it all in your mind?: Silje Endersen Reme at TEDxNHH
Vložit
- čas přidán 21. 11. 2012
- Silje Endresen Reme's talks about the common phenomenon of back pain; why some people develop chronic pain and disability while others don't, and what psychology has to do with it. Silje is a PhD. from Uni Health, Uni Research, Bergen & Harvard School of Public Health, Boston.
In the spirit of ideas worth spreading, TEDx is a program of local, self-organized events that bring people together to share a TED-like experience. At a TEDx event, TEDTalks video and live speakers combine to spark deep discussion and connection in a small group. These local, self-organized events are branded TEDx, where x = independently organized TED event. The TED Conference provides general guidance for the TEDx program, but individual TEDx events are self-organized.* (*Subject to certain rules and regulations) - Věda a technologie
Great talk! Reinforces Dr. John Sarno's theories and treatment modalities for chronic pain.
I'm surprised this talk hasn't been seen by more people because awareness of this concept is definitely growing at last. Having worked in the field of stress-induced chronic pain for the past 8 years, finally the studies mentioned here are coming to light and there is more openness than there was. The interest in the brain and the mind in chronic pain has meant that more studies are being published. As well as the studies mentioned in the talk there is also evidence of a strong link between chronic pain and adverse childhood experiences, which clearly shows that we need to look further than the area the pain is felt to find the answer. Great talk Silje.
I'm sure there are people that these studies help, but what about the individual who gets hit by a car and as a result has nerve damage...Not everyone sits in the same category that she's talking about...
I think most of pain is mental. Sometimes if I'm in pain and get distracted, I forget about the pain.
I realised I fear pain and avoid it. The problem with this is that i avoid life due to this.
actually i experience the worst pain about 4 years ago my guts got twisted or something ...and while i was waiting for the ambulance i though i could never control that with my mind when i got to the hospital they pump me full of drugs and i was so grateful there is a limit to what your body can take
Great presentation of an extremely complex (and fascinating) topic. Awareness of the psychosocial aspects of chronic pain is increasing in the medical community, although it is not even close to being routine for most healthcare professionals to screen and address this in most settings (at least here in Sweden). Patient awareness and acceptance is often a hurdle, but this is in part due to the emphasis on the biomedical model used in mainstream medicine. It is a challenge to convey this to many patients, without implying that their pain is “imagined”. I find that explaining the neurological and endocrinological changes that can occur with chronic pain to be more accepting to most sufferers - ie neural sensitisation and HPA axis response can be a good starting point before discussing other issues such as adverse childhood events and stress-related pain (thank you Georgie Oldfield for your excellent course!),. Although of course, we are all individuals and a “one size fits all” approach is seldom the best way. Offering flexible and holistic treatment plans, that include diet, sleep, physical activity and stress probably offer a good foundation.
I don't understand extrapolating from 1/3 of the sample to form the backbone of this theory of "pain is in the mind". No doubt psychosocial factors influence pain perception. However, researchers often fail to recognize how this approach is actively used by medicine and society to belittle persons in severe pain. Creating unattainable expectations and continuing derogatory assessments results in a self-fulfilling prophecy about the importance of psychosocial factors as patients are pushed into depression, anxiety, and isolation because their physical pain is dismissed as a secondary problem.
There are many nuances to this.
Are there doctors and social workers who don't yet fully understand what this actually means, yes there is - but that's why it's important to get social workers involved in more of the research.
Another nuance is miscommunication - where doctors/therapists etc., are saying one thing, but the patient is interpretating it another way...
If I talk to a colleague about how pain is biopsychosocial and can best be described simple as an output from the brain, my colleague will usually understand what it is I mean by it, but a patient might hear, "it's in my brain/head - they say it isn't real" - even thou that is in no way what's being said!
So we have to get better at explaining what it is we mean by it!
When we as professionals talk about pain as an 'illusion' it doesn't mean the same thing as it does to most people unfamiliar with the proffesions of physiotherapy, medicine and other health providers!
+GorillaGuerilla it's a chicken and egg thing. An underlying condition that is not obvious. Stress causes everything to tighten. Pain increases. Mild depression sets in. Stress is increased, etc... When the patient says that chronic pain isn't the main problem you have to understand that chronic pain is stigmatized.
Cerys InPain
I've dealt with nerve damage & chronic pain for 2 years now. Being in so much pain disables me from doing more activities with family & friends, makes it difficult to clean my own house, & takes more time out from pursuing my passion-music. The situation cultivates depression, thus making it an uphill battle to get relief. This talk may be true for some individuals who do not confront their psychosocial issues, but notice she completely excludes cases where someone has an injury or illness that will unavoidably manifest serious pain. This is cherry picking at it's worst, to the detriment of those of us who struggle with real pain & the battle against a medical system that seems designed to discredit us.
She even admitted she chose to focus on certain groups over others to bolster her study. This is madness.
YOU SUMMED THE MEDICAL PROFESSION UP PERFECTLY!MY EXPERIENCE AS WELL!
@@Gpacharlie FIVE YEARS LATER,IM SADLY STILL READING THE TRUTH!!NOTHING HAS CHANGED, AS YOU WELL ARE AWARE OF!THE DEFINITELY MININMIZE PAIN'S EFFECT ON THE MENTAL ASPECTS!THANKS FOR THIS COMMENT.
You mean like chronic long term, to the point of incapacitation, I feel like ive been shot through everyday, and sometimes opioids work, but when it starts to disintegrate you , your in trouble, someone dying on a daily basis, god help us. Mother in law you must be joking, those who have it have no family or proper home. This from a senior who has been slammed by life , work and the struggle itself. Wunderbar, show me the cure, beyond cutting the nerve and all while still having the drive to accomplish things.
Amazing stuff. But why so few views?!! This can potential help so many people!
Degenerative disc disease, bone on bone... also diagnosed with Multiple Sclerosis 12 years ago. MRI's of back and brain showing damage that cannot be fixed. I can pretty much detect if I have pain or otherwise. I wish more than anything I didn't have Multiple sclerosis, a chronic disease that affects the central nervous system, including the brain, spinal cord and optic nerves.
This video was back in 2012, I'm texting in December of 2018. SO much more information has come out about pain and how to address it. Pain is REAL...NOT imaginary! Those who suffer with it day to day know.
Definitely. Writing here in 2019. I am not trying to discourage anyone from going through cognitive based treatments for back pain. This will likely help a lot of people. I did my due diligence in this respect. I got in with a psychologist right after coming down with chronic pain. I remained optimistic that it would be manageable and even perhaps mostly go away, even after it had been there 24/7 for 3 months. For the next year I exercised, went to PT, did CBT, reduced my stress levels by a lot, and even took an anti-depressant to assist with avoiding depression / loss of hope. That work didn't go to waste... I do have way lower stress levels overall and I'm a lot healthier in my brain and body. Unfortunately the pain never went away though. I was diagnosed with hypermobility ehlers danlos and fibromyalgia. I really wish I did not have these conditions and I remain hopeful that things will get better, but that does not mean the pain is all in my head. My fascia and tendons struggle to hold my joints in place, causing spasms and tension. This happens in almost every joint when used. I'm still in PT, still in counseling, and still taking the anti-depressant. Sometimes pain that can't be explained physically does have a physical explanation that comes later. I hope for most reading this that their pain subsides or at least reduces a lot with treatment
Not imaginary. Neurological pathways formed over time!
I get what your saying. I wonder if these speakers experienced a car hitting them and suffered nerve damage... i wonder how there views on pain would be then...
She talks about pain that can not be explained by any obvious fysical causes. In your case this is obviously not the case.
I'm laying in bed with a bad back. I fell asleep and dreamt that I was getting out of bed. The pain woke me up and i am still in bed (???)
Walking helps relieve my back pain, sitting and lying down for too long makes it worse
@@mained5528 agree if I lie on my back it makes my lower back worse.💯💚✌
My god the best videos always have poor sound quality!
Holy shit, what a magnificent Ted Talk!
Fantastisk presentasjon. Du gjør meg stolt. :)
Takk for arbeidet og spredningen av dette budskapet/vitenskapen.
Very interesting! Backs up a lot of the ideas of Dr. Sarno. I'd be curious to hear her opinion on him.
I work in the field of vocational rehabilitation and from my observations this is very accurate. I believe the same trend pertains to MTBI's
You must ask the question for each pain, “Is the pain system correct or is it mistaken?” Chronic pain is a disease of the pain system where it’s no longer is protective. If the pain system is working there will be a bio mechanical issue, if it is not, the threat signal will be wrong and then chronic pain management will rely heavily on the affective-motivational defects in behaviour. Lorimer Moseley would appreciate your use of his spider story! Thank you!
My pain is gone by watching her
"Lyme disease AND co-infections, are now at epidemic levels, with a minimum estimate of 300,000 new cases a year in the U.S.A. alone. The saddest thing is, the MAJORITY do not know they are infected, while doctors misdiagnose them! Lower back pain is one the most common symptoms in untreated advanced Lyme. Lyme damages the synovial tissue in joints, and this doe NOT show on MRI's, CT scans, X-ray with contrast, and other diagnostics! Pain becomes a 24/7 issue with adanced Lyme nd co-infections, and the pain is real. You would hurt too, having spirochetes literally drilling their way through the body - they do not stay in the blood strream.
Lila Dove I heard recently that the minimum estimate is now up to 400,000 cases per year but the CDC is acting like Zika is such a huge problem (which it's not) and they continue to ignore Lyme 😡. I've had Lyme for more than 13 years and, of course, I was misdiagnosed for many years. It has destroyed my life and, at this point, I feel like my only hope is to eat healthier and maybe take some supplements that might "possibly" help. I see posts on Facebook almost every day/week about another Lyme suicide or other cause of death due to Lyme (and that's only the ones I hear about). Someone who I don't even know responded yesterday to a comment I made (in a non-Lyme group) with their "cure" for Lyme and I just ignored it. I was tempted to let them know that I don't want to hear about any more stupid cures but I didn't feel like getting into an argument. I swear sometimes I just wish I could go to sleep and not wake up. The only thing that keeps me going is my grandkids. I hope you're having a fairly pain free day 💚.
many countries don't have lime disease yet still have similar incidence of chronic back pain.
Wow. This would make a world of difference for doctors to check for. Darn, I’m in the yellow group.
Back pain in my head, nope herniated disc, ten years of it, finally since traction relieved pain, decided to stay stretched, three months later , completely over
Almost everyone has herniated discs though and experience no pain. There is a psychological factor to chronic pain. I’ve found relief from using these types of methods. But it really applies to people who live in fear/anxiety certain movements or psychical activities will bring on pain before you ever have the said pain.
@@bassman3212 tell you, ten years of shooting pain, two and half months traction, over completely, five years later, hit again, neglected stretching, this time four months intermittent traction, shooting pain’s went away, soreness gradually decreased, almost normal now, minor irritation
"A worker goes from healthy and relatively handsome" did she really say that? 😳
Pain and painful emotions are stored in the memory and are holographically retrieved to accentuate the present pain. In addition intense brain waves from ongoing issues and stressors add to these. Thus the resultant brain activity gives rise to pain.
"And the million dollar question. Is the pain all in the mind?
Yes of course where else could it be"
What was the point in saying this? Obviously it's in the brain. I am not going to walk to the shops to collect my pain - it's in my brain!
you clearly have never had a serious back injury (say a car hit you).
I'm guessing your not a specialist of anything to do with the body either...
@@dj.culture6590 maybe I have, maybe I haven't. The point stands that the pain is in the brain!
A recent publication ( doi:10.1007/s00586-013-2675-y ) had success in treating back pain with antibiotics against acne bacteria, which can invade the cartilage of the spine.
What questionnaires did you use to get info on their stress, depression, hopefulness, catastrophising etc ? Just wondering how I can incorporate this into clinical practice. Thanks
We're you able to to obtain a copy of them?
Hi Dr. Want to ask u. Does stree , aniexty depression trigger back pain ?
excellent - - - i like it alot
Of course - your worries, small and big - that you do not deal with - will show in your body, first as light symptoms as a mild headache and stomachache - then if not dealt with - it will most likely develop into more serious conditions. This is no news at all. However, a lot of people are not aware of this, so to them, this is big news. If people would consider how they feel more important than a lot of other stuff they find 'important' - the world would look quite different.
Very good stuff. I would add though, that the implication/statement that for most back pain, as an example, the medical field doesn't usually find viable causes, isn't exactly so. At least it's not so in the US. There are usually xrays and often MRIs and most adults, at least over 40, will show some spinal joint/disc degeneration. BUT the reason the treatments statistically have quite modest success is precisely what the presenter is discussing- the deviations found on imaging are often not the cause, or whole cause, of the pain. In the US, I'd say most doctors are not aligned with the research and understanding discussed here (yet) and many patients experience treatments, including surgeries, that don't relieve their pain. They should explore work like this, imo. Thanks for this research and talk!
The thing is, if you took out a major sample of the population and put them through X-Ray, MRI etc., you would find a group who by the conditions present should be in a lot of pain, but isn't...
+GorillaGuerilla True, but there is yet to be much in the way of good evidenced based studies. There is no shortage of people who could be studied, but no one is asking us.
is it just me or does anyone else suffer from just back pain. Before being hit by a speeding car my work- family were all great. I go to all these Psychologists and they ask all these questions to convince themselves that my pain has psychosocial elements....
I tell them my back only hurts when I overstress the injury but they just don't get it...fortunately, I have found that pain specialists see things a lot clearer (I've just had a spinal modulation device)...
Anyone who has experienced similar challenges to me please contact me.
Hello please help me i’m in a similar position
@@marijadejanova549 hey,
are you okay?
I honestly think all the smart ones should know this from experience by now :)
Might sounds crazy, but I can really block pain or even protect myself from flu of fever using this methode.
can't hear anything only when I turn everything off even electric. wtf.
Why is it so hard to concentrate?
...And SMART!
Duh it's in the brain!? Yes pain signals travel to the brain and we therefore "feel" it. I get it. I'm always in pain with failed back and bad knees and elbows from years of football abuse. I like horse racing and in the final stretch, my mind often wanders off my pain and I "forget" my pain for moments but it is not gone. Same thing when it is 2am and all is quiet and my pain gets worse because outside stimuli is muted so yes I get it! However, pain is at times horrible and i wake up when I roll over onto my back when I sleep and i happen to use a pain med called buprenorphine. I bought into the "in your mind and opiates make it worse" notion and tried for a whole year not being on medications but it did not work in the long run. Opioid medication has improved my function and quality of life and it sickens me when I read BS like Sarno's book that back pain is all in one's head-try my life for a day and meditate your way out of pain. Good luck!
"our experience of pain depends on how we interpret it" wow. What about really bad pain? like being burned? Is it really based mostly on fear?
Marianna Tsemekhman I am pretty sure this whole BS science is based on nothing, clarifies nothing and resolves nothing, a whole bunch of nothing science.
well said...
That pain is from structural damage. She is talking about when there is no structural damage then pain is purely neuroplastic.
The speaker is confusing correlation with causation, and also overstates the worth of CBT (which is what she's talking about), which meta-analysis shows is not effective for chronic pain. Chronic pain involves central sensitisation, mediated via the amygdala region of the brain, and is best approached via MDR, a method for switching off pain signalling permanently. There must be a twin focus of treatment, focussing on both direct and indirect triggers to pain signalling.
Christine Sutherland can a person stimulate the parasympathetic nervous system in order to alleviate or even cure pain, do you know? I've noticed if I do certain things, like diaphragmatic breathing, and, strangely, rubbing my lips, the pain in my right hip doesn't go away, but lessens almost to zero. Wierd but nice, as my pain has been 2 years long so far.
Volume is way too low
if its MY pain , its all in your mind ,!
Yeah terminal cancer pain is in the head sure. And it is no different to any other pain
PANTS!
Yes yes pAnTS
I've never seen pants fit on a woman better than those do on her...
Until you have damage to your spinal cord that is visible on an mri you shouldnt say its just in your mind. Ill bet this video dosent age well....
Attention technician. I almost cannot hear her voice. Her sound is very low.
U just did the right test and exams u could've saved that person from getting full blown thyroid issues! But why should u?! There's no money no profit in that u wait till the person get a full blown thyroid or get diabetic or even ca before u try to treat! Because u
She needs to speak up, Can't hear her.
I think it is all in their heads.
The Disconnect on this thesis is that just because "modern medicine" cannot find a "cause" or an "abnormal" image for pain, then it must be psychological. Would it occur to any "modern, scientific" doctor that maybe their modern medicine hasn't caught up to all the workings of our bodies? Basically, this could be the equivalent of the Flat Earth thesis...since we can only see so far, the earth looks flat, so we accept that that is the way things exist...discounting the possibility that processes are taking place in the nerves and / or brain that causes actually pain that our current technology cannot detect. - It always amazes me that physicians tend to conveniently forget that science and discovery move forward, making many of their past practices archaic and wrongheaded. - Bloodletting, anyone? (pass me the vioxx, please)
Thank God mine shows up all over on an MRI.
Incentivize back to work? Show them a photo of a big cardboard box under a freeway overpass.