| T O P I C R E V I E W |
| khamira |
Posted - 08/12/2004 : 11:54:07
Dear members, I am a 28 yr old female, physician by profession. Before my injury I had finished 8 months of my residency training in Internal Medicine at a prestigious University hospital after which I have been on leave of absence. I need advice from you. Plz help me.
About 4 months ago I was carrying an extremely heavy trash bag. I was dragging the bag on the floor (to dump it to the dumpster outside my apartment) while bent on my right side when suddenly I felt severe shooting stabbing pain in my lower back(on right side) shooting through my right buttock, right groin & posterior to right thigh. For the next 4 weeks I saw my primary care physician, orthopedic doctor, sports medicine doc and went through the usual conservative management of limited activity, pain meds and physical therapy along with lumbar Xrays, rheumatological work-up which was all negative. I continued to suffer from severe pain so an MRI was obtained one month after injury which did not reveal any disc herniation.
Thereafter,I saw a Neurologist who injected my low back with Botox seven weeks after injury. I was advised by him to continue NSAIDs and limited activity. I continued to suffer from deep burning pain in my right buttock with severe tightness/stiffness in my posterior Right thigh down to calf, relieving only on lying down on my back. 11 weeks after injury a Bone Scan was obtained which too was negative.
I saw a pain/anesthesia speacialist 5 weeks ago who gave a theory that at the time I picked up trash my L5-S1 disk herniated and by the time MRI was done it went back however it had done the damage of inflamming my right sciatic nerve which still in not healed. He ordered EMG studies however the neurologist did not do the needle prick of muscles. He just tested the nerve velocity which was 40 % reduced at L5 to S1 level on my right side. Clinically I still have my knee jerk and ankle jerk intact. The pain specialist injected me with epidural steroid 3 weeks ago with slight alleviation of my pain.
He also performed mylogram/epidurogram which showed scar tissue in my epidural space L3 down.
Initially I drove my car to get to my appointments etc, then stopped and started and then stopped driving again. Even daily activities are impossible for me now.
I came across John Sarno's books 2 weeks ago. I need you to advice me if you think its TMS, coz' being a typical orthodox doctor myself, its hard to swallow for me. This is the first time in my life that I have suffered BACKPAIN and SCIATICA and I am having it continously for 4 months since my injury. In the past never had any back or shoulder or neck pain. I havent had any of the TMS equivalents except HEART-BURN. My pain doesnt move around to other body parts. Yes I have been under trememdous stress because of my marriage, my profession and my own personality.
I request all members of this forum to help me understand what's going on and if it is TMS what should I do. Plz help me . May God bless you.
Khamira |
| 20 L A T E S T R E P L I E S (Newest First) |
| khamira |
Posted - 08/18/2004 : 16:18:16
Hey Strider, thats a wonderful suggestion. that is exactly what i am realizing . that there might have been several other repressed angers and issues that brought on tms in the first place but the tms pain in itself is causing so much frustration anger and depression. and that i guess adds on to the vicious cycle.
when i was studying -all my life-especially as a medical student i thought LEARNING is tough especially memorization of core knowledge. however the biggest lesson of life now i have learnt is that ITS EVEN MORE TOUGH TO UNLEARN WHAT ONE HAS LEARNED THROUGH THE YEARS...to unlearn the concrete BELIEFS ingrained into my mind about PHYSICAL CAUSES of pain through my professional training , further strengthened by the string of PHYSICIANS I saw. To UNLEARN the specific BEHAIVIOUR PATTERNS I myself PROGRAMMED my self into doing.
Thats where the anti-TMS strategy comes into play..that is UNLEARN the CONDITIONED RESPONSES.
So now I have to learn how to unlearn. I so appreciate your input Strider...
Thanks and all the best. |
| Stryder |
Posted - 08/18/2004 : 14:34:43
Hi Khamira,
Here is something you may want to try to deal with the pain in addition to your working through your TMS issues. When I was in excessive pain prior to learning it was TMS, I spent a lot of time (many weeks) flat on my back in bed rest. Some time the pain even at rest was very bad. I was fighting the pain, and that was feeding my anger about the pain, a vicious circle.
So, try this. Eventually you must _ignore_ the pain, but until you can do that try _accepting_ the pain. Don't fight the pain, say in your mind, "I'm in pain right now, its pretty bad, but that's just my brain telling me I have pain. That's ok brain, I'm not going to fight it, I know you are causing me the pain...". The goal here is to try to stop being angry about the pain. It doesnt do much for addressing the other things you are angry about, but you'll just have to deal with those as part of your TMS treatment.
Hope this helps. Take care, -Stryder. |
| khamira |
Posted - 08/18/2004 : 11:46:18
Thankyou so much res for your sharing your experience and encouragement. I am now working hard to really deeply believe its TMS and doing all I can to fight it hard.
I wish you GOODLUCK too and remember you had it before and you were able to fight it off like you mentioned. so you can and you will do it again. Keep reading page 82 of Dr Sarno's Healing back pain.
All the best. |
| res |
Posted - 08/17/2004 : 08:14:57
I am a physical therapist and had sciatica following a difficult delivery. I too had a negetive MRI. Overcoming the medical training is extremely difficult. I was trained in all the back cures and dangers of having sciatica. I was terrified I would need surgery and I had seen all the bad results as I had worked in orthopedics for 4 years. I was depressed and scared. I had to put aside what I learned about the back and believe. Not easy, but it worked after several months. I saw a TMS doctor and it helped to have someone confirm the diagnosis. I have stayed pain free for a couple of years. Now, however, I am battling a new area that I also had a problem with 9 years ago, before I learned of TMS. I know it is TMS, but I am once again battling that medical training and the idea of all nerve pain is a disc. I am now working on taking my own advice.
Good luck-you can do it! |
| khamira |
Posted - 08/13/2004 : 21:12:49
Dear All,
I would pay my thanks to ALL members of this forum and especially All those who replied my post and helped me understand and face the reality.
I guess no one would understand this better than TMS personalities THE CONSTANT YEARNING WITHIN TO BE APPROVED AND VALIDATED.... I guess I had concluded within that it is TMS and yet I doubted my own conclusion....
You have helped me get rid of this internal conflict and stand up against TMS. Its going to be a tough battle, I know. But I guess the hardest part was to ADMIT that IT IS TMS....lets see what follows.
Thankyou very much,
Khamira |
| FarmerEd |
Posted - 08/13/2004 : 19:17:34
In MBP page 91 Dr Sarno says, "Here is a situation I see over and over with TMS: Physical incidents, like the hit from behind accident, a slip or fall, doing phyiscal work, engaging in a sport, and repetitive work motions are used by the brain as excuses to start up TMS. They are triggers, not causes, and must be identified as such. We have incredible healing mechanisms that have evolved over millions of years. No matter how severe, injuries heal. Continuing pain is always the signal TMS has begun. Consider that a fracture of the largest bone in the body, the femur(thigh bone), takes only six weeks to heal and will be stronger at thefracture sight than it was before the break."
I believe once our, "internal reservoir of rage is full to the brim", as Texasrunner described it, our mind starts to look for a distraction to focus our attention on so these repressed emotions don't surface. If the mind has a recent injury to use as a trigger to begin the chronic pain of TMS I believe it will take advantage of this event since it already has your attention. If this is not available, I think it will fabricate an incident, like Dave's example of bending over for a pencil starting the pain.
Dr. Sarno also mentions that many of his patients describe hearing a pop when the pain started although no physical injury can be found. So I believe TMS can start either way. If a recent injury is available to focus the TMS process on the mind may use it, if none is avaiable it will produce a convincing event. |
| tennis tom |
Posted - 08/13/2004 : 10:44:57
In my case I went to a "tms" doc who said the pain in my butt was arthitis and not "tms" with the previso that he specialized in backs and not butts. I wanted him to tell me that it was TMS. I got in my car, drove 100 miles and the pain went from my butt to my neck. It stayed in that area for exactly one week. I had a dormant injury in my neck from six months earlier when I passed out on the bathroom floor from my ulcer and was down a few pints of blood. In the hospital I didn't worry about the wrenched neck and said to myself "Don't let it becaome a potential TMS site." It was uncomfortable for a week, but I played through it. After a week it went away and the pain returned to my butt. The perfect example to me of moving pain. It firmed my belief in TMS. I still have pain in my butt but think about it more TMS'ly. I'm on the tennis court 4 hours a day, 6 days a week, walk 45 minutes several times a week, swim 30 minutes, and could drive cross country and back with no sitting pain. I still have my limp but it's improving. I can run backwards faster then forward with no pain. tMS is a tricky thing, a result, I felieve, of an imperfect wiring system, connected to the primitive part of our brain. |
| Suzanne |
Posted - 08/13/2004 : 10:24:04
quote:
Originally posted by Dave
quote:
Originally posted by bernard lewis
Pain is caused in first instance because of a real physical injury.
This is not true. An attack of pain can be pure TMS that is simulating an injury. When somebody "throws their back out" bending over to pick up a pencil, do you really think they have injured themselves through such a benign activity?
I completely agree with Dave. This can't be true at all.
"The injury may have been there yor years but there is one day that it gets worse and the the pain attack occurs."
I my case, my TMS is NOT my back. Not my leg, hip, neck, etc. It's also not a place I've ever used or could possibly have injured. In fact, these is no injury. The muscle that spasms is in my pelvic floor area. The "injury" that set it off was a very long power-walk. I never did this activity prior. It didn't hurt the day after, but 4 days later. Only one out of 7 specialists said "maybe you pulled your piriformis muscle that day", but it would've been healed by now. He also said it would've hurt the following day, or that night.
But prior to seeing any doctors at all, I couldn't think of any reason for this sudden pain and the only thing I could associate it with was that intense miles-long power walk. (which I took to go clear my head while visiting my grandparents who were both dying in front of me, not from old age, but cancer and emphysema)
TMS chose a great spot. I "hurt myself" doing that power walk.
I had a CT scan, which showed a dense fuzzy mass in my left buttock area. The technician reported this to my specialist as not a growth, but a muscle spasm caught in action. To be sure, I was sent for an MRI. No mass. Another MRI followed for my lower spine, and L5-S1 showed slight degeneration, normal for a 38 year old.
Many top NYC specialists have run numerous tests on me and nothing ever comes up, except upon examination, there is obvious spasms in my pelvic region. Every neurological test came back normal. I'd seen approx. 11 specialists before going to Dr. Sarno.
Now, if TMS is not the reason for my severe pain, and some injury was (and the nervous system "calibrates", the brain changes chemistry to lower the pain, intensify it, etc.), why would MY pain, the severe muscle spasms of the levator ani and/or piriformis, which then triggers off other muscles in the area, all GO AWAY 100% when I go on a vacation? I do the same things while away as I do at home. When I go on vacations, my pain ceases to exist. At home, I can barely sit. I'm in spasm now. If I were to get on a plane to Hawaii today, the pain would take a hiatus until I return home.
That backs up Dr. Sarno's theories more than I can say. Only I know I'm on vacation. My *mind* knows, NOT my muscles or any body part. A true injury wouldn't go away just because I go away.
I go away — from whatever it is that is causing the TMS in my daily life and thoughts — the pain goes away. On vacation, I don't think about daily pressures, stress and other things that would cause anxiety. I probably also don't even unconsciously think of anything that bothers be because I'm too distracted by my relaxing, enjoyable time away. The pain distraction is overtaken by the enjoyment distraction. My theory. |
| JohnD |
Posted - 08/13/2004 : 09:03:33
" Pain is caused in first instance because of a real physical injury"
Logically, there is no evidence to back up this claim. I prefer to keep an open minded view that TMS can show up after a real injury or could just show up on its own. |
| Dave |
Posted - 08/13/2004 : 08:51:56
quote:
Originally posted by bernard lewis
Pain is caused in first instance because of a real physical injury.
This is not true. An attack of pain can be pure TMS that is simulating an injury. When somebody "throws their back out" bending over to pick up a pencil, do you really think they have injured themselves through such a benign activity? |
| bernard lewis |
Posted - 08/13/2004 : 08:05:42
After having suffered for several years, from whatever you want to call it, but I call back pain, I have arrived to the following conclussión. Pain is caused in first instance because of a real physical injury. The injury may have been there yor years but there is one day that it gets worse and the the pain attack occurs.
Other times you may have no attacks but a pain that comes and goes.
Some months later the injury may heal or at least may improve, however the effects of the first attack persist, usually with changes, but the area of the first bout of pain is involved. The reason is explained in many book about neurology: there are chemical mechanism that pepetuate the pain, even if the physical cause has disapeared. It seems however that although the pain persists it can be 'calibrated' by the central nervous system. Other than pure nervous system effects there are mechanical effects, that by the way are almost ignored by Sarno. One can find easily tremendous muscle contractures on people with chronic back pain. While contracture is there the muscle will hurt.
Probably DrSarno treatment may help to break the neurological cycle that perpetuates the pain because, probably, once the brain ceases to pay atention to an area there are true neurological changes in that area. Neurologist know that the nerve topology and chemical reactions change constantly to adapt to new conditions so it may happen also with back pain.
Which is very difficult to swallow in Sarno theories is that so many physical changes found on people do not cause pain.
|
| Texasrunner |
Posted - 08/13/2004 : 07:25:10
Khamria- Probably the most difficult aspect of dealing with TMS is accepting on the deepest level, that the pain is not a signal that something PHYSICAL is wrong, but that it is a signal that your internal reservoir of rage is full to the brim. This must be especially hard for a trained physician, because like everyone, you have been taught over and over to recognize pain as a signal of some physical problem. Our first response is "what else could it be? That's the conditioning. And it continues daily, because all you have to do is pick up a book or magazine, and you'll see reinforcement in the form of articles or opinions about various physical causes of pain thatcin reality are most likely TMS. Once you experience some success with dealing with the pain psychologically, you will begin to build confidence. Ultimately, I think one day you'll look back on this...I'd expect you to become somewhat of an expert, and to treat your patients with the knowledge that some of their complaints could be TMS. |
| FarmerEd |
Posted - 08/12/2004 : 20:10:35
Hello Khamira,
I believe TMS is very opportunistic. You could have very well initially hurt your back by straining a muscle, but I don't think that is the cause of the continuing pain. By your own account you are in a very stressful time in your life, trying to impress others and make a name for yourself. These pressures enrage the unconscious mind. Your mind has been seeking desperately to find something to distract your attention from these repressed feelings and keep them from surfacing. Your back injury gave your mind the perfect opportunity to focus your attention by continuing the pain in a chronic form even though the initial injury has long since healed.
Reading your posts gives me the impression this pain has your complete attention and has become the focus of your life. As far as your mind is concerned it is "mission accomplished" and it will keep up this diversion as long as necessary.
I remember in the "Wizard of Oz" when Dorthy and friends confronted the Wizard and were terrified by the spectacle put on for them. The spectacle was supposed to keep their attention off the truth. I think this is what TMS does. It is indeed terrifying, but it is also designed to keep your attention off "the man behind the screen". Our unconscious mind is "the man behind the screen", weak, narcisstic, dependent and irrational. By focusing on it the need for the terrifying display put on by TMS becomes unnecessary and as Dave said it begins to fade away over time.
|
| Dave |
Posted - 08/12/2004 : 17:56:59
quote:
Originally posted by khamira
Dear Susie, Lisa, Dave and Steve,
I really appreciate your replies and suggestions. Your posts have made me realize what I am running away from...harsh reality. Your posts have made me do something I have been avoiding by hiding behind my pain....REFLECT.
I remember reading Sarno stating something like this that when the person realizes his emotional pain in disguise of physical pain then a person would say its better to have emotional pain than physical. But has any of you been in a situation where even confronting the reality of having to deal with the stress/problems/pressures/consequences actually freaks you out? And isnt the society more receptive and sympathetic when you tell them you are having physical pain? How many people actually sympathize when we tell them I am crushed with stress or that I am depressed...
Your posts have given me the notion that its allright to be an emotional human being..its ok to feel stressed out ...that i dont need to prove through an MRI/EMG or another test that I AM IN PAIN. So what that my pain is not physical...so what that I was not able to cope with certain stressful situations....and last but not the least that i am not alone. Thankyou and please keep giving me suggestions.
Khamira
Based on this message I think you have a very good handle on the TMS concept. I don't think there's much more advice to give. I think you will find that there are lots of emotions beneath the surface, and once you stop to allow yourself to feel them, without worrying about repercussions, I think the pain will fade on its own.
Some TMS personalities need to "be" something. "Be good" or "Be perfect" or "Be liked" or "Be appreciated" or "Be acknowledged" ... I think it's important to learn how to just "BE". |
| Susie |
Posted - 08/12/2004 : 17:22:00
I just want to add that I have suffered tms equivalent symptoms for years and was totally unaware of what the cause was. How lucky you are to discover this so young and how lucky your patients will be. When you work through this process and have positive results, you will have a totally new insight to help your patients with. You will have access to so many more sufferers than most of us would. You will recognize , as so many of us have, that so many suffer from tms in varing degrees. Possibly something positive along with your cure will come out of your pain. |
| khamira |
Posted - 08/12/2004 : 16:53:33
Dear Susie, Lisa, Dave and Steve,
I really appreciate your replies and suggestions. Your posts have made me realize what I am running away from...harsh reality. Your posts have made me do something I have been avoiding by hiding behind my pain....REFLECT.
I remember reading Sarno stating something like this that when the person realizes his emotional pain in disguise of physical pain then a person would say its better to have emotional pain than physical. But has any of you been in a situation where even confronting the reality of having to deal with the stress/problems/pressures/consequences actually freaks you out? And isnt the society more receptive and sympathetic when you tell them you are having physical pain? How many people actually sympathize when we tell them I am crushed with stress or that I am depressed...
Your posts have given me the notion that its allright to be an emotional human being..its ok to feel stressed out ...that i dont need to prove through an MRI/EMG or another test that I AM IN PAIN. So what that my pain is not physical...so what that I was not able to cope with certain stressful situations....and last but not the least that i am not alone. Thankyou and please keep giving me suggestions.
Khamira |
| lisa |
Posted - 08/12/2004 : 15:36:47
Also for figuring if a problem is psychogenic or physical (and resolving it if it's psychogenic) I recommend a couple books see this thread
http://www.tmshelp.com/forum/topic.asp?TOPIC_ID=156
They are more scientifically based. The psychogenic part of my problem isn't the major part but I found these useful for that part.
You don't have to believe all of what Sarno writes (or even most of it) to benefit from a mind/body approach. I know he makes a big point that you have to believe it but that's simply not true.
|
| Dave |
Posted - 08/12/2004 : 15:34:00
quote:
Originally posted by khamira
About 4 months ago I was carrying an extremely heavy trash bag. I was dragging the bag on the floor (to dump it to the dumpster outside my apartment) while bent on my right side when suddenly I felt severe shooting stabbing pain in my lower back(on right side) shooting through my right buttock, right groin & posterior to right thigh.
This is very typical of an acute TMS attack.
quote:
...an MRI was obtained one month after injury which did not reveal any disc herniation.
That's good, although even if it did it would not alter the TMS diagnosis.
quote:
...I saw a I saw a pain/anesthesia speacialist 5 weeks ago who gave a theory that at the time I picked up trash my L5-S1 disk herniated and by the time MRI was done it went back however it had done the damage of inflamming my right sciatic nerve which still in not healed.
Wow, that's a creative theory! I think it's total B.S.
Your situation is very typical of TMS. Think about the timing of this attack. You are at a critical point in your young career; it must be a very difficult time for you. There are so many potential sources of repressed emotions. There is a tremendous amount of pressure on you, feelings of self-doubt, harsh self-judgements, etc. So many emotions that you cannot feel -- dare not feel -- or the consequences can be career-threatening. Your mind chose a way out: an acute TMS attack -- a convenient distraction for you to focus on -- a socially acceptable way to escape from your stressful life.
Say this is not TMS; say you injured yourself lifting that trash. Surely, that is a possibility. However, if that were the case, it would certainly have healed by now. As a physician you know, our bodies are remarkable machines.
So, either this is an acute injury made chronic by TMS, or (more likely) an outright attack of TMS. I think you should read Dr. Sarno (I recommend Healing Back Pain) and focus on your personality, on your emotions surrounding your residency, on all the possible psychological issues going on with your life. Forget about the pain; this is TMS.
For you, it's going to be difficult. You need to forget all those diagnoses that your colleagues made. You need to accept that the mind can and does play a primary role in the initiation of real, physical symptoms. This might go against much of your training, but it is an essential step to getting better.
The keys to getting better now are:
(1) Reputiate any structural explanation for your pain. There is no disc abnormality, no nerve damage. The pain is due to chemical changes initiated by the brain to serve as a distraction.
(2) Ignore the pain. This is hard to do, but try your best to resume normal activities. Take pain killers if you need them, but get back to your life. Start slowly, don't try to do too much. When you are aware of the pain, tell yourself that you understand this "trick" that your brain is playing on you.
(3) Think psychological. Write a list of all the possible sources of stress in your life. Explore them in detail. Try hard to feel those emotions. Accept that the pressures of your life, and your personality are in serious conflict with the child inside you that doesn't want to deal with it all.
(4) Don't fear injury. You will not hurt yourself by doing things that cause pain. You cannot do any permanent damage to your spine or nerves. The pain is a process initiated by your brain.
As you read Dr. Sarno, you may be tempted to look for inconsistencies with your own situation. Don't fall into that trap. Dr. Sarno is well meaning, but his books can be frustrating if taken literally. TMS is different in everyone; the cause of TMS is different in everyone. There is no magic bullet; just acceptance of the diagnosis, and focus on the emotional work.
Good luck! |
| Steve |
Posted - 08/12/2004 : 14:47:17
Khamira - I too had an incident (falling down several stairs) in late 2002 that triggered excrutiating lower back pain and sciatica for the first time in my life. The pain did not move around and i was CONVINCED something was structurally wrong and several doctors' diagnoses supported this belief. Sitting was the hardest thing for me. Four months later the back pain quickly and completely faded into oblivion, not coincidentally, along with a very painful emotional episode in my life. Now I know absolutely nothing was wrong with my back. You should strongly consider that you have very possibly been felled by TMS. |
| lisa |
Posted - 08/12/2004 : 14:36:39
I can think of four possibilities:
1) psychogenic problems (one part of TMS theory)
2) central nervous system sentization (the other part of TMS theory)
3) the sudden exertion caused a trigger point to form in your low back. that's easy to fix yourself, see the trigger point therapy workbook by Davis
4) chemical radiculopathy which can cause abnormal EMG with a normal MRI, there's a bunch of medical articles summarized and referenced on this page http://www.chirogeek.com/000_Sciatica_General_Infor.htm
look towards the bottom of the page.
As a scientist, I can understand your concern about Sarno's books. It's pretty clear that he has not done a through objective review of the literature and that his ability to do good experimental design in his clinal studies is quite weak. However there is something to the idea of central nervous system senstization in chronic pain states which is the one of the main underlying idea to the theory as far as I understand. Here's some references from medical literature from the people treating me.They gave me Sarno's books but they don't really push the Sarno's psychology theories (since I have a 18mm herniation), more the neurobiology of chronic pain states. I think most of the refennces are about central sentization but I'm not quite sure as I've only read a fraction of them and I am only a scientist not a doctor. Butler in particular is a good overview.
-Ahissar, E., Vaadia, E., Ahissar, M., Bergman, H., Arieli, A., & Abeles, M. (1992) Dependence of cortical plasticity on corelated activity of single neurons and on behavioral context. Science 257: 1412-1415.
-Breig, A. (1978) Adverse Mechanical Tension in the Central Nervous System Almquist and Wiskell: Stockholm.
-Buomonano, D.V., & Merzenich, M.M. (1998) Cortical plasticity: From synapses to maps. Ann Rev Neurosci 21: 149-186.
-Butler, David, (2000) The Sensitive Nervous System Noigroup Publications PO Box 41 Unley DC, 5061, Australia.
-Engert, F., Bonhoeffer, T. (1999) Dendritic spine changes associated with hippocampal long-term synaptic plasticity. Nature 399: 66-70.
-Gifford, L. (1995): Fluid movement may partially account for the behavior of symptoms associated with nociception in disc injury and disease. In: Shacklock M (ed) Moving in on Pain. Butterworth-Heinemann, Sydney. 32-40.
-Gifford, L., Butler, D.(1997) The Integration of Pain Sciences into Clinical Practice. J. of Hand Therapy, 86-95.
-Kabat, Herman (1980) Low Back Pain And Sciatica from Prolapsed Cervical Discs in 1980 Warren H. Green, Inc. St. Louis, Missouri, USA. (1-314-991-1335)
-Kobayashi, S. (1974) "Tract Pain Syndrome" Associated with Chronic Cervical Disc Herniation. Hawaii Med J, 33: #10 376-381.
-Kornberg, C., McCarthy, T. (1992) The Effect of Neural Stretching Technique on Sympathetic Outflow to the Lower Limbs. JOSPT; Vol 16, #6.
- Melzack, Ronald. (1999) From the gate to the neuromatrix. IASP Pain Supplement 6 S121 – S126
-Rijntjes M, Dettmers C, Buchel C, Kiebel S, Frackowiak RSJ & Weiller C (1999) A blueprint for movement: functional and anatomical representations in the human motor system. J of Neuroscience, 19(18):8043-8048.
-Sluka, K. (1996): Pain Mechanisms Involved in Musculoskeletal Disorders. JOSPT, October 24(4):240-254.
-Tinazzi, M., Fiaschi, A., Rosso, T., Faccioli, F., Grosslercher, J., Aglioti, SM. (2000) Neuroplastic Changes Related to Pain Occur at Multiple Levels of the Human Somatosensory System: A Somatosensory-Evoked Potentials Study in Patients with Cervical Radicular Pain. J Neuroscience: 20(24):9277-9283.
-Woolf, CJ (1994): The Dorsal horn: State-dependent sensory processing and the generation of pain.
In Wall, PD and Melzack, R (eds) Textbook of Pain, Churchill Livingstone, Edinburgh, 101-112.
I hope you find a solution to your problem, whatever it may turn out to be. |
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