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【更多资讯】打开世脊联公众平台，点右上角查看历史记录  澳洲疼痛学家Lorimer Moseley用动画片的形式告诉你疼痛的机制。 驯兽之路 Tame the Beast 是时候重新认识顽固性疼痛了 It’s time to rethink persistent pain Once upon a time, all the lands were fraught with persistent pain.So widespread was this affliction that one in four people experienced it. The pain lasted more than 3 months. It shadowed their daily lives… held them back from everyday activities … and the interventions they tried proved useless…“Hey, pain! Go away! We’ve tried it all But still you stay! Moving less, Taking pills, Knives and needles.I can't stand it any more ! But the pain remains like a loyal companion.The peoples’ hopes faded and they became resigned to living with the pain – only now, the pain was a beast!  在很久以前，人们就已经意识到顽固性疼痛的存在，并且有了一种说法:世界上1/4的人一生中都会经历疼痛，这种疼痛会持续超过3个月以上，严重影响人们的生活，让人无法从事日常活动。尝试任何的治疗均以无效告终。“Hey,疼痛，你离开我吧！我们尝试了这么多方法怎么你还在？不管是吃药、开刀还是针刺，我们还是痛。我们再也忍受不了！忍受不了了！！”但疼痛依旧在，忠诚的不离不弃。人们无法战胜疼痛，就不得不与疼痛一起生活了，于是疼痛慢慢长成为了一只野兽。 Then, along came a group of researchers, of which I am one. “Back off, big fella!” I’m Professor Lorimer Moseley and I’m a pain scientist.Pain scientists are starting to think differently about pain and its causes. And we’re making exciting discoveries…Like how the way you think about your pain can change the way it feels. Over the next few minutes, I’ll help you to understand your pain. Understanding is important because it can change how much things hurt and how much your body can do… And can help you to tame the beast.  现在，许多团队都在研究它，而我也是其中的一个。（退后，大家伙），我是Prof Lorimer Moseley,一名研究疼痛的科学家。疼痛科学家对疼痛以及它的形成有着不一样的观点。对疼痛的研究有了新的发现。比如，人们对待疼痛的态度不一样能影响对疼痛的主观感觉。在接下来的几分钟，我会帮助你更加了解你的疼痛，读懂疼痛是非常重要的。因为这决定着疼痛对你的伤害有多大，伴随疼痛，你的身体还能做多少活动。而这将会帮助您驯化疼痛这只猛兽。  First, trust me about this.Pain is not an accurate measure of tissue health. Pain is a protector. By making unpleasant feelings, your brain changes your behaviour – so you can avoid injury or your tissues can heal. Sometimes pain is not helpful – like phantom limb pain. You don’t expect a missing limb to ache. But it does and the pain is very real.So how do we explain this? Pain is a warning signal from your brain that depends on credible evidence to say your body needs protecting. Sometimes it’s too protective and you get unnecessary warning signals. Pain scientists now understand that there are many ways our nervous system ends up producing unnecessary warning signals. Take conditioning for example.Think of Pavlov’s dog… Every time food was offered, Pavlov rang a bell. Of course, the dog would salivate seeing the food. This went on for a while. Eventually the dog was conditioned to salivate for the bell alone.   首先，相信我说的这一点，疼痛并不是衡量身体健康的准确指标，疼痛是一种保护机制，当遭遇不好的感觉刺激时，大脑会让身体做出相应的保护措施，从而让我们免受损伤，让组织得以修复，但有时疼痛也是有害的，比如幻肢痛。虽然那条腿不在了，但是人体还是能感觉那里痛，而且痛起来非常地真实。怎么解释这种现象呢？疼痛是来自大脑的一种警告信号，基于可靠的信息来作为判断，来保护你的身体，但有时候疼痛又过度保护了，以至于让你产生过多不必要的警告信号，现在疼痛科学家相信，人体的神经系统存在多种通路，让机体产生各种不必要的警告信号，拿条件反射来说，巴普洛夫给狗做过一个实验，每次给狗喂食物时都摇响铃铛，当然狗因为食物而垂涎，以这种方式维持了一段时间之后。最终，狗就条件反射地对摇响铃铛做出了垂涎的反应。  Conditioning is just one of the ways your body learns pain. And the longer your nervous system produces pain, the better it gets at producing it. Your body learns pain.So what feeds this beast? Let’s look at how pain works… In your body’s tissues, there are specific neurones, which normally only respond to harmful stimuli. – whether mechanical, chemical or thermal. When they are activated, they send a warning signal to your spinal cord, which can in turn send a signal to your brain. This activity in neurones is called ‘nociception’ and it’s happening all the time. But iit only sometimes results in pain. Most of the time, the brain protects you with other things like movement. Once the warning signal reaches the brain, the brain makes sense of it based on the information arriving and the vast amount already stored. If there’s reason to think protection is required, then your brain makes pain.One of our amazing discoveries is that you can have pain without any physical stimuli. Thoughts and places might activate the warning signals. And the pain feels exactly the same. But it’s not just your brain - your spinal cord also learns how to generate unnecessary warning signals.So how do you know when your nervous system is learning pain? You may notice your pain spreads or comes on without warning. Your body feels odd and it’s hard to move properly. Your pain changes quickly with your mood and small annoyances can set it off. Old injuries start to hurt again. You’re more sensitive to stimuli. And the longer the pain goes on, the more all of this occurs.  条件反射只是人体学习疼痛的其中一种方式，你的神经系统产生的疼痛的时间越长，就像在给电池充电一样，你的身体正在学习疼痛，那是什么饲养了这些猛兽？让我们看看疼痛是怎么产生的，我们的身体表面有很多特定的神经元，它们感知一切对身体有害的信号，无论是机械性的、化学性的以及温热的刺激，当这些神经元被刺激激活时，它们会将警告信号传入脊髓，经过转化再上传至大脑，这个过程称为痛觉感知。这种过程无时无刻不再发生，但只有在某一些时候才真正产生疼痛，而大多数时候大脑会做出其他反应，例如动作的产生。当外界刺激产生警告信号传入大脑时，大脑会将这种信号与以往储存的信号进行对比，当大脑认为这种信号是有害的，需要启动保护机制时，大脑就会产生疼痛。一项令人惊讶的研究结果是：人体并不需要实实在在的刺激就可以产生疼痛，内心的想法与所处的环境都可以产生警告信号，而大脑所产生的疼痛则感觉是实实在在的，不只是大脑，脊髓也会学习如何产生不必要的警告信号，那如何知道我们的神经系统在学习疼痛呢，你可能会发现你的疼痛在到处蔓延，你会感觉身体很奇怪而不能很好的活动，你的疼痛会随着你的心情的变化而变化。再小的噪音都有可能引发症状，以前的旧患又重新痛起来了，对外界的刺激很敏感，而随着疼痛持续，这些情况会出现的更频繁。  The old way we understood pain left many sufferers feeling like no one believed it was real. Or that for it to hurt so bad, there must be a tissue problem. But we now know how persistent pain happens.So how can you tame the beast?Pain is a very personal thing. There’s no one size fits all solution. And while you probably have well thought out coping strategies, it’s time to take a new approach to dealing with and reducing your pain – one that focuses on retraining your pain system. This might mean testing yourself physically and moving more than you normally would. Being honest about your current attitudes and beliefs can also help. As can asking your health professional new questions.How do I know if my pain system is being over protective?How can I retrain my pain system to be less protective?How do I know if I’m safe to move?So be brave and have hope! Because – it is possible to tame the beast!  以往我们对待疼痛的看法很难理解这种现象，而且会留下严重后果，让患者觉得没有人相信自己，或者会认为这么严重的疼痛一定是有严重的组织损伤，但现在我们知道了顽固性疼痛是如何产生的了，那我们如何驯化疼痛这只猛兽呢？疼痛是一件非常私人的事情，没有任何一种方法可以解决所有的疼痛，尽管你原来可能接受着各种各样的治疗手段，但现在是时候尝试一种新的方式管理疼痛了，其中一项就是重新训练你的疼痛系统，这会让你重新认识你的身体机能，让你活动的比平常更多，从而让你相信自己可以做到，另外，也可以向你的医师问不一样的问题，比如，我怎么知道我的疼痛系统是不是过度保护了呢？我要如何训练才能让我的疼痛系统不那么过度保护？我如何知道我可以安全的运动？所以勇敢一点，还要充满希望。因为我们是有希望驯化疼痛这只猛兽的。 【新朋友】点击标题下方蓝字“世界脊柱健康联盟”快速关注 |
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