Nerve pain? Dr. Weiss.. .

[Guest guest]

HI nne.

Hon seeing you mention Dr.Weiss I have this article by him and how can those nerves (neurons) be normal again & thought it might be beneficial to someone . Clipped from long 'great' article on pelvic pain and excess nerve involvement! such as those with 10X's the nerve bundles with vestibulitis. (Which are also found in Crohns disease). I hope the link's still hot I've had it a long time.

http://www.jmweissmd.com/article.htm

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"From a practical standpoint, the question arises: How can these altered or sensitized neurons become normal again?

We have methods to eradicate myofascial trigger points, but how do we treat sensitized nerves?

Gracely et al.10 suggest that altered central processing cannot be sustained without ongoing input from a painful focus. In their study, when an anesthetic block was administered to a painful point near the elbow, the chronic pain in the distal arm and hand subsided. Koltzenburg et al.11 have stated that "central sensitization cannot be perpetuated by central processes alone."

They suggest that, when nociceptor activity is blocked or reduced below a critical level, the central processing mechanism quickly reverts to normal.

Cohen12 has also indicated that ongoing remote but related nociceptors can maintain neuropathic pain. In a study with Arryo,13 their patient’s knee pain was not significantly helped until the ipsilateral dysfunctional SI joint was treated.

The success of blocking painful input to the spinal cord to allow altered central processing to return to normal is described by Bach et al.,14 who reported that pain memories in phantom limbs appeared less common when an anesthetic block created a pain-free interval between the onset of pain and the amputation. Bonica15 found that closely spaced anesthetic blocks yielded pain relief of progressively greater duration and magnitude. This indicates that the block allowed the sensitized nerves a stimulation-free period in which to recover.

Therefore, effective therapy must be widespread and comprehensive to identify and correct any ongoing painful input that originates anywhere in the receptive fields. Therapy must be directed at eradicating all noxious stimuli transmitted to the sacral spinal cord from, for example, the skin, viscera, myofascial trigger points, or abnormal body mechanics, to allow a stimulation-free period. General factors should also be treated, as these disrupt normal pain modulation: e.g., hormonal and nutritional abnormalities and sleep disturbances.

Chronic stress, a contributor to neural sensitivity and increased symptoms, must also be addressed. Psychotherapy can play an important role in identifying old traumas that sustain muscle hypertonus. In addition to deep-seated psychological problems, day-to-day stress can create or increase muscle tension and decrease the pain threshold. Therefore, the daily practice of a stress-reduction technique is essential to lower the overall muscle tension and keep it below a symptomatic level.

The failure to use a broad therapeutic approach to search out and eradicate all incoming noxious stimuli that maintain nerve sensitization will result in continued or recurrent pain. Therefore, it follows that the successful treatment approach must be holistic and comprehensive.

10. Gracely RH, Lynch SA, GJ. Painful neuropathy: Altered central processing maintained dynamically by peripheral input. Pain 1992;51:175-194.

11. Koltzenburg MK, Torebjork HE, Wahren LK. Nociceptor modulated central sensitization causes mechanical hyperalgesia in acute chenrogenic and chronic neuropathic pain. Brain 1994;117:579-591.

12. Cohen ML. Comment on Gracely et al. Painful neuropathy: Altered central processing maintained dynamically by peripheral input. Pain 1992;51:194.

13. Cohen ML, Arryo TF. Comment on Hopkins and Charters. An unusual case of causalgia relevance to recent hypothesis on mechanisms of causalgia. (Pain 1989;37:93-95) Pain 1990;40:354-355.

14. Bach S, Noreng MF, Tjellden NV. Phantom limb pain in amputees during the first 12 months following limb amputation, after preoperative lumbar epidural blockage. Pain 1988;33:297-307.

15. Bonica JJ Causalgia and other reflex sympathetic dystrophies. in Bonica JJ The management of pain, Vol. 1, 2nd ed, Philadelphia: Lea and Febiger, 1990, pp. 220-256.