Pain Neuromatrix and the Physiotherapy Patient
The body–self neuromatrix is a term used to describe the interconnected maze of nerves that carry the painful stimulus to all the different areas of the brain such as the central cortex, thalamus and limbic system that are involved in perceiving, reacting to and regulating pain. (Keefe, Abernethy & Campbell 2005, Melzack 2005, 2001, 1999, Moseley 2003)
Essentially three different areas of information feed into the neuromatrix. 1. Sensory information from our physical body (skin, muscle, organs etc). 2. Cognitive information from past experiences, memory, mood, anxiety, and attention. 3. Emotional information from the limbic system and homeostatic information (Melzack 2005)
The neuromatrix generates the following three functions a. Perception of pain b. Action plan c. Stress-regulation instructions (Melzack 2005)
All these attributes form what is termed the neurosignature of pain. Each person has their own unique neurosignatures which are determined partly by genetics and partly by environmental experiences. (Melzack 2005, 2001, 1999)
Another characteristic of the neuromatrix is that it forms a continuous loop that supplies a steady stream of feedback of awareness and action to each area. (Melzack 2005, 2001, 1999)
The presence of memory in the neuromatrix also allows us to feed-forward or anticipate pain, this helps us avoid danger.(Melzack 2005)
The neuromatrix helps explain hyperalgesia or why the experience of pain sometimes seems out of proportion with the physical injury. Your frame of mind at the time of injury, memory of past experiences and general health influence the neurosignature and therefore the experience of pain. (Melzack 2005, 2001, 1999)
The neuromatrix can also help us explain abnormal pain reactions. Allodynia is pain that arises from a normally non-painful stimulus. When the neuromatrix is active for a prolonged period of time, as in times of stress, the threshold stimulus needed to produce pain is
Essentially three different areas of information feed into the neuromatrix. 1. Sensory information from our physical body (skin, muscle, organs etc). 2. Cognitive information from past experiences, memory, mood, anxiety, and attention. 3. Emotional information from the limbic system and homeostatic information (Melzack 2005)
The neuromatrix generates the following three functions a. Perception of pain b. Action plan c. Stress-regulation instructions (Melzack 2005)
All these attributes form what is termed the neurosignature of pain. Each person has their own unique neurosignatures which are determined partly by genetics and partly by environmental experiences. (Melzack 2005, 2001, 1999)
Another characteristic of the neuromatrix is that it forms a continuous loop that supplies a steady stream of feedback of awareness and action to each area. (Melzack 2005, 2001, 1999)
The presence of memory in the neuromatrix also allows us to feed-forward or anticipate pain, this helps us avoid danger.(Melzack 2005)
The neuromatrix helps explain hyperalgesia or why the experience of pain sometimes seems out of proportion with the physical injury. Your frame of mind at the time of injury, memory of past experiences and general health influence the neurosignature and therefore the experience of pain. (Melzack 2005, 2001, 1999)
The neuromatrix can also help us explain abnormal pain reactions. Allodynia is pain that arises from a normally non-painful stimulus. When the neuromatrix is active for a prolonged period of time, as in times of stress, the threshold stimulus needed to produce pain is
References: Melzack R 2001, ‘Pain and the neuromatrix in the brain’, Journal of Dental Education, vol. 65, no.12, pp. 1378-1382.