#079

In this video, Doctor Andrea Furlan explains that there are 3 types of pain: nociplastic pain, neuropathic pain and nociplastic pain. Nociceptive pain includes acute injuries, inflammatory pain such as arthritis and fractures. Neuropathic pain include pain from neuropathy, neuralgia, radiculopathy, stroke, spinal cord injury, multiple sclerosis and shingles. Nociplastic pain includes fibromyalgia, complex regional pain syndrome (CRPS) and migraines.
She talks about how to distinguish them and the treatments that are used for each type of pain. For nociceptive pain the main treatment is ice, TENS, anti-inflammatory drugs, acetaminophen and opioids. For neuropathic pain the main treatment is antidepressants and anticonvulsant medications. For nociplastic pain the main treatment includes mind-body therapies.
00:00 Introduction
00:40 What Pain is
01:56 Nociceptive Pain
03:14 Neuropathic Pain
06:42 Nociplastic Pain
09:57 Treatment for Nociplastic Pain
Dr. Furlan is a pain specialist in Toronto Canada. She is a physiatrist (specialist in Physical Medicine & Rehabilitation). She holds a medical degree from the University of Sao Paulo and a Ph.D. degree from the University of Toronto. She has 30 years of experience helping people with chronic pain to get better quality of life.
To purchase any product mentioned by Dr. Furlan in these videos, check this link: www.amazon.com/shop/dr.andrea...
As an Amazon Associate, Dr. Furlan earns from qualifying purchases. If you purchase any product using the post above, you are helping Dr. Furlan to maintain this channel.
Subscribe to this channel: / drandreafurlan
#drAndreaFurlan #DrFurlan #DoctorFurlan
Let’s meet on Social Media:
Instagram: / dr.andrea.furlan
Twitter: / adfurlan
LinkedIn: / drandreafurlan
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ALERT: This video is not intended to replace medical advice. If you think you have a condition that is causing you pain, please consult with your doctor to get a diagnosis and a treatment plan for you. The intent of this video is only for educational purposes. If there is any emergency, go to the nearest emergency department or call an ambulance. CLOSED CAPTIONS in this video have not been professionally verified.
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[@jenjencannon3224]

Andrea... your work is amazing. We need you so much... especially right now when medical appointments are so hard to arrange. Your explanations are clear and bring light to subjects that are clouded with myths and incorrect assumptions. Thankyou sincerely.

[@DrAndreaFurlan]

That is very kind of you Jen.

[@mw5556]

אכן. הסרטונים מועברים בצורה ברורה לכל אחד. ערוץ מחכים גם בלי קשר להתמודדות עם כאב. אין ספק רופאה מיוחדת ואיכפתית. תודה רבה

[@teresa985]

@@DrAndreaFurlan Doc what does it mean if top of my head has burning sensation that comes & goes ? Once in a while for 2-3 mins i get headache while im having burning sensation.

[@minervavillar645]

Your patients are very lucky for having you as their specialist,keep it up dra furlan.

[@DrAndreaFurlan]

Thank you Minerva!

[@kemilamccall7595]

I'm really enjoying your videos. You are a great teacher and you are very calming and caring. You give me hope that can one day live pain free.

[@DrAndreaFurlan]

Thank you for watching the video and writing this comment. Please share this video with your friends. I have lots of videos about chronic pain on my channel kzbin.info And don't forget to turn on the notifications 🔔

[@rachaelsun7798]

Our best educator thank you so much Dr. Furlan

[@DrAndreaFurlan]

Wow, thank you

[@divine1562]

Dr Andrea you're truly an angel and I feel lucky to have found your channel. Thanks a ton..🥺❤️

[@DrAndreaFurlan]

You are so welcome! Have you seen my website already? www.doctorandreafurlan.com/ I hope you like it.

[@shantilawrence7143]

Thank you Dr Andrea Furlan for your needful advice God bless you abundantly.

[@farhanaaktershifa8269]

I watched some other videos but none of them could make me clear about the terms. You described excellently and those examples were very helpful. Thanks!

[@lecramitiok]

Amazing work, Dr. Furlan! I am a registered physiotherapist in Vancouver and I’m enjoying your videos so much. I deal with a huge chronic pain population and I will start sharing some your videos for educational purposes in my practice. Proud Brazilian here 🇧🇷. Keep up the good work!

[@DrAndreaFurlan]

Fico feliz em poder ajudar

[@DrTavares]

Thank you Dr. Furlan! Excellent information!

[@DrAndreaFurlan]

Glad you enjoyed it!

[@sbson6458]

Thank you Dr. for explaining in simple terms for easy understanding.

[@patriciaishiko8560]

Que orgulho ver um trabalho tão lindo como o dessa médica!!! Desejo ainda mais sucesso na sua caminhada, Dra!!!!

[@DrAndreaFurlan]

Obrigada Patricia.

[@ngbeehong8172]

Thank you Dr. Andrea for sharing and explaining abt the 3 types of pains . Frm here we learn something new ,God bless you and your family❤🌹🌹🌹

[@DrAndreaFurlan]

You are so welcome!

[@mariateresamoco850]

Muito interessante Dra. ANDREA. Vou partilhar sim. Estou numa de Pregabalina e Morfina. Triste e incomodada. No inicio do video a Dra. fala que há pessoas que não sentem dor e vivem menos. Alertou-me, minha neta de 12 anos em criança fui testemunha de casos extranhos com ela. Como vivem longe de mim e raramente os vejo, vou hoje mesmo esclarecer esse assunto. Obrigada. Deus a abençoe.

[@ellagreen1110]

I appreciate your videos and to if you could the exercise for arthritis with hip pain. Thank you

[@myrachurchman5013]

Thank you so much for this explanation of different types of pain.

[@DrAndreaFurlan]

You're most welcome!

[@anandtiwari52]

Your every clip is precise and precious. Thnx.

[@DrAndreaFurlan]

Thank you for watching the video and writing this comment. Please share this video with your friends. I have lots of videos about chronic pain on my channel kzbin.info And don't forget to turn on the notifications 🔔

[@anandtiwari52]

@@DrAndreaFurlan Already have done M'am. THNX.

[@fongyoutubefong1745]

Thank you

[@helgapage5713]

Thank you so much Dr. Andrea.

[@DrAndreaFurlan]

Thanks for watching!

[@robbpowell194]

You are speaking my language. This is so valuable. Thank you

[@DrAndreaFurlan]

Understanding these differences is key to get the correct treatment.

[@stephengoh5456]

Fantastic. Love it. Thank you!

[@DrAndreaFurlan]

Glad you enjoyed it!

[@ushaindukuri9675]

Excellent service

[@DrAndreaFurlan]

That is great to hear. Please share this video with your friends. I have lots of videos about chronic pain on my channel kzbin.info And don't forget to turn on the notifications 🔔

[@feliciadavis5979]

Thank you so much, Andrea, for a very clear presentation. I liked very much how you used the analogy of the security system in the house. Very insightful and clear. Thank you!

[@DrAndreaFurlan]

You're very welcome!

[@drjoydevmondal9639]

Thanks for your excellent lectures about pain .THANKS.

[@DrAndreaFurlan]

Glad you like them!

[@suewright1299]

Extremely interesting Dr Andrea, very very thanks indeed for a great video and a great deal of information

[@DrAndreaFurlan]

Glad it was helpful!

[@sudhabhatt7300]

Dr.Andrea I love the way you explain about three types of pain it helps in day today life thank you mem

[@DrAndreaFurlan]

Glad it was helpful!

[@perlavelardo3123]

From Buenos Aires. Thank you, very clear your explanation.

[@DrAndreaFurlan]

Hi Perla, I spent my honeymoon in Buenos Aires and Bariloche. Beautiful cities.

[@perlavelardo3123]

@@DrAndreaFurlan yes. I live in Buenos Aires. I m a doctor too. 40 years in muy profession. Bariloche is my prefer city to rest during my vacation time Thanks for your remembers

[@wellingtonsboots4074]

Thank you Dr Furlan this was helpful

[@DrAndreaFurlan]

Glad it was helpful!

[@manigehnezami4816]

Dr . Andrea you are a good teacher and good Dr I really ❤ your advise .God bless you 🙏.

[@DrAndreaFurlan]

Glad it was helpful!

[@dennisonchoke5460]

Dr Andrea.. your doing a good job.

[@DrAndreaFurlan]

Thank you for this comment. Have you seen my website yet? All of my videos are organized by topics and you can download all handouts, worksheets and booklets that I made. You will need to sign up for a membership to access all of my materials. It is FREE to become a member. Check it out: www.doctorandreafurlan.com And please remember that I do not give individual medical advice via email, social media or website. My channel and my website are for educational purposes only. For any individual medical advice, please talk to your doctor.

[@Iamnosey]

Thank you for the educational videos and your work as a pain doctor. The pain is real 💔

[@DrAndreaFurlan]

You are so welcome!

[@vidavirginia2199]

Thank you so much for all your help 👏🏼

[@DrAndreaFurlan]

You're so welcome!

[@krishnanclips]

Watching your videos here in India is a "must-do" for me. They are already helping me immensely (esp. the frozen shoulder exercises).

[@antamarndi6693]

Thank you mam for information of types of pain.

[@DrAndreaFurlan]

It's my pleasure

[@nephetsmil]

She is not only beautiful but very intellegent being..kudos to her..and no offense intended.

[@DrAndreaFurlan]

Thank you for watching the video and writing this comment. Please share this video with your friends. I have lots of videos about chronic pain on my channel kzbin.info And don't forget to turn on the notifications 🔔

[@AyHatun35]

Thank you 🌷

[@ajaymane482]

One of the best session explained in simple manner to avoid medicines

[@ajaymane482]

Thankyou so much doctor

[@DrAndreaFurlan]

Thank you for watching the video and writing this comment. Please share this video with your friends. I have lots of videos about chronic pain on my channel kzbin.info And don't forget to turn on the notifications 🔔

[@aparnalondhe6442]

Hello Dr, thank you for the information. God bless

[@DrAndreaFurlan]

Thank you for watching and for writing this comment. God bless you too. Consider subscribing to this channel. I have lots of videos that you might find useful.

[@Yotay597]

You are amazing , thank you so much ❤❤❤❤❤❤❤❤❤

[@charlynnmullin38]

Thank you❤️

[@DrAndreaFurlan]

You’re welcome 😊

[@veenaparmar8760]

Good morning Excellent well done very well explained everything.Really 💖 touching information .

[@DrAndreaFurlan]

So nice of you

[@flordelizamabilin4368]

Wow clearly explained! Thank you.👏

[@DrAndreaFurlan]

You're welcome 😊

[@sujalsujal8062]

Informative video Ma'am 👍

[@DrAndreaFurlan]

That is great to hear. Please share this video with your friends. I have lots of videos about chronic pain on my channel kzbin.info And don't forget to turn on the notifications 🔔

[@RunPJs]

This is brilliant. Only thing missing is whether nociplastic pain has similar pain symptoms as neuropathic pain. I hope so!

[@benardettenaluyima693]

Thank you so much for the teaching

[@DrAndreaFurlan]

You are very welcome

[@benardettenaluyima693]

Love you too

[@varshas8745]

Best education video, in detail keep going 👍👍🙏

[@DrAndreaFurlan]

So nice of you

[@T0neXIII]

Than you again!

[@DrAndreaFurlan]

Welcome

[@rajeevpaswan1933]

Thank you ma'am very nice information❤🙏🙏

[@DrAndreaFurlan]

Most welcome 😊

[@brigsalim4841]

beautifuly explained. congratulation

[@DrAndreaFurlan]

Thank you for watching the video and writing this comment. Please share this video with your friends. I have lots of videos about chronic pain on my channel kzbin.info And don't forget to turn on the notifications 🔔 on youTube. so you get notified when I post new videos. And please remember, I do not give individual medical advice via social media or email.

[@PhysioTeachsenthilkumar]

Good one possible speak some more about nociplastic with added depth TQ Dr

[@kimduong232]

Thanks many Dr Andrea ❤️❤️❤️❤️❤️🇦🇺

[@DrAndreaFurlan]

Thank you for watching the video and writing this comment. Please share this video with your friends. I have lots of videos about chronic pain on my channel kzbin.info And don't forget to turn on the notifications 🔔

[@rsesoltani1647]

Dear doctor,thankyou for thissubj etyouteaching

[@DrAndreaFurlan]

Thank you for watching the video and writing this comment. Please share this video with your friends. I have lots of videos about chronic pain on my channel kzbin.info And don't forget to turn on the notifications 🔔

[@HealthOO7]

Dr Andrea, this presentation is one of the best I ever came across on the topic of pain Physiology. Can you please do a video on Bunions? Kindly suggest the best treatment for Bunions ( just started).

[@DrAndreaFurlan]

I'm glad to hear that.

[@dr.vigneshkumarphdphysioth6585]

Excellent madam about neuropathic nociceptive & nociplastic pain ...great awareness to drs to identify ...and good sharing about evidence based information & treatment .1) education 2) physical activity 3) meditation and cognitive therapy 4) reassurance plays a key role i have been treating many patients with nociplasic ..yes fear avoidance behaviour is a major issue need to educate and restore back functionally ...great

[@DrAndreaFurlan]

Thank you Vignesh!

[@roxie8700]

I've had chronic pain since 2001 after having radiation for Colon Cancer. The beam went through my lower spine to reach my tumor. My back feels like it is going to break at waist everyday of my life. And no one knows what to do except pain medication like Dilaudid or Morphine. Nothing really shows up on a MRI or CT. How a person's mind control pain, I can't imagine that working?

[@DrAndreaFurlan]

It is possible Chloe. Stay tuned, I'll post more videos about that. Please talk to your doctor about it.

[@roxie8700]

@@DrAndreaFurlan thanks for your reply. My doctor gives me the prescriptions for pain medication. I, on my own, have reduced it to what is absolutely necessary but the pain never goes away completely. I still need Dilaudid daily or I would never be able to get out of bed, I would cry all day in pain. "I" stopped the "pops" and Fentanyl and all other major drug. I've used heat,TENS, PT, Massage, Pain Management Specialist, but nothing helps the bone/spine and surrounding nerves....nothing!

[@smohan6457]

Hi madam, namaste good to see you...

[@DrAndreaFurlan]

So nice of you

[@Leozaminelli]

Dr. Encontrei seu canal no KZbin por acaso, estou com uma hérnia de disco na l4-l5 comprimindo a raiz do nervo ciático e saco Dural, uma dor na perna esquerda quase que insuportável, gostaria de saber da Dr, hérnias de disco são eliminadas pelo organismo mesmo? Ou só com cirurgia, desde já agradeço

[@DrAndreaFurlan]

Oi Leonardo. Que bocm que voce gosta do canal.

[@sanelprtenjaca9147]

What kind of pain is chronic muscle tmj pain (dull aching) developed after stress?

[@DrAndreaFurlan]

Hi Sanel, it is hard to say without getting a lot of more details and need to do a complete physical exam.

[@lunam7249]

your grinding your teeth when you sleep

[@franciswarnock8977]

I've been seeing pain mgmt doctors for over 20 years for chronic pain from disc prolapse and resultant spinal fusions and not one would know anything about what you are talking about. Currently on Pregabalin, Duloxetine and Tramadol or would be debilitated otherwise. I wish I could see you or one of the very few like you that know about this condition, and would perform an in depth exam and analysis and come up with a treatment plan. Very frustrating.

[@sv-luciafed7168]

Thank you Dr. Andrea! What kind of pain can be attributed to glossalgia? This happened many years ago after stress. Tongue burns as if scalded with boiling water There are no external signs of tongue disease. There is no pain when eating. from stress the pain intensifies.

[@DrAndreaFurlan]

That is a very interesting question. It can be one of the 3 or all 3 combined. The only way to know is by doing an extensive medical history and physical exam. I usually take 90 min or more to do them.

[@paulacraig8252]

Would it be in neuropathic?

[@sv-luciafed7168]

@@DrAndreaFurlan Examination by a dentist did not reveal any external signs of the disease. When I was taking antidepressants, the pain on my tongue completely disappeared a few months after I started taking it. When I stopped taking it, the pain returned. Probably because of anxiety, or for some other reason.

[@judyrobas5123]

You always.look so nice doctor! 😀

[@DrAndreaFurlan]

Thank you! 😃

[@marieradi-nahas767]

Dr. Furlan. What are your thoughts on a nerve block or cortisone injection to treat sciatica and to treat the tingling in the leg, ankle and foot as a result of three herniated discs? It is a know fact that cortisone injections can only be administered once as repeat treatments with cortisone can damage the soft tissues. Would appreciate knowing your thoughts around this issue. Thank you.

[@DrAndreaFurlan]

I already recorded a video about cortisone injections, and I think it will be released in the next few weeks. Stay tuned!

[@marieradi-nahas767]

Thank you. I always looks forward to your very informative videos.

[@DrAndreaFurlan]

I just released a video about cortisone injections kzbin.info/www/bejne/i6mreGSmoruqsM0

[@dr.amitabhamukherjee3601]

Andrea, could you shed some light on the role of PTNS/TTNS in the management of nociplastic pain, in my case CPPS (chronic pelvic pain)/chronic non-bacterial (type 3) prostatitis? Does it help at all? If it does, what's the treatment protocol in terms of duration and periodicity of stimulation, frequency/intensity modes and length of treatment? Will appreciate your honest opinion. I am a doctor-sufferer myself. Finding it difficult to handle the flare-ups at my age (60). Thanks.

[@evridikikolovou9804]

Hi my dear mrs andrea for me if i am nice inside i haven't pain am full of energy love from frozen lesvos you are the best

[@DrAndreaFurlan]

Wonderful

[@maryhamilton6843]

Where would you say fibromyalgia pain come from and treatment❓

[@DrAndreaFurlan]

Hi Mary, I have another video about fibromyalgia, and another video that explains why some people have it and others don't.

[@j.mcconnell5260]

March 2021 Oxford Union said 42% of women with fibromyalgia also have a Tarlov cyst. This number has been rising rapidly last few years.

[@DrAndreaFurlan]

That sounds to me like fake medical information. Can you send me the reference to the scientific study?

[@j.mcconnell5260]

@@DrAndreaFurlan no sweat. Pub med. NIH. "High prevelence of perineural cyst in patients showing signs of fibromyalgia chronic fatigue syndrome" I've seen these numbers rapidly rising last couple of years. I don't know if doctors will ever be allowed to know the MRI technique to detect them. I could give you that technique, however the good folks at the internet scrubbed the the reference where I obtained it. T1 weighted low intensity cerebral spinal fluid T2 weighted high intensity the lesion will have the same intensity of cerebral spinal fluid. See I'm a patient I don't care for keeping this hidden.

[@j.mcconnell5260]

@@DrAndreaFurlan Maybe NIH wording is more ambiguous implying misdiagnosis. Okay I'll imply the opposite and more . Type two menengele diverticuli in the sacrum causes fibromyalgia 100%. This all powerful cyst is often found with autism ADHD MS chiari malformation parkinson's Alzheimers Williams syndrome cystic hygroma increasingly Lyme in Canada even. Many more nuerological conditiones. The cyst is expert at being hidden. Perhaps it's place in the sun is coming?

[@j.mcconnell5260]

@@DrAndreaFurlan please check out fibromyalgia planners videos. Some reason many have kids ASD themselves ADHD. I don't think their struggles should be easily dismissed. Good see the old way was the bad way. I'm not advocating the surgery excision. Epidural steroid injections keep me pain free. It has to be the correct two procedures though.

[@j.mcconnell5260]

@@DrAndreaFurlan drug resistant epilepsy 68% improvement after minimumly invasive Tarlov cyst surgery. NIH.

[@terapeut8703]

Good morning my my nice freind..lovely day

[@DrAndreaFurlan]

Thanks for visiting

[@terapeut8703]

@@DrAndreaFurlan you are my teacher I respekt so much

[@mikecain6947]

Is nociplastic pain the same as what used to be called central pain?

[@DrAndreaFurlan]

Nociplastic pain is caused by many different mechanisms. One of them is central sensitization.

[@mikecain6947]

@@DrAndreaFurlan thank you.

[@kindese973]

I’m DX with neuropathy a year ago. I’ve lived the past year with ups and downs. Sometimes I’m able to go on with my day as if nothing happened, other days I have muscle weakness or balance issues with the next day I’m feeling good. Some days I walk 10K steps while others 2K. What should I do?

[@sonderl1ng]

What if my nociplastic pain always worsens, when i think about it? Because of it, i can't meditate and do exercise. I need to distract myself as much as possible. It's been 1.5 years and i don't see how i can treat it

[@DrAndreaFurlan]

There are many ways to get rid of nociplastic pain.

[@terapeut8703]

Whate about lung rehabilitation after Covid 19

[@DrAndreaFurlan]

Thank you for your comment and suggestion. This topic is outside of the scope of this youtube channel. In my channel I talk about issues of chronic pain, diagnoses, causes, treatment and exercises for chronic pain.

[@terapeut8703]

@@DrAndreaFurlan ok andear but every body taking about it me Na wrong methode of treatment i pelive and trust in you♥️❤

[@deswaramadan341]

Terimkasih Dok untuk penjelasannya.. Sya nyeri pasca stroke..nyeri.perih dan panas seperti terbakar.. Apakah seiring waktu keluhan ini bisa hilang atau berkurang Dok..help me Dok..central post stroke pain..???

[@DrAndreaFurlan]

Thank you for your comment. That is a good question/suggestion for a future video. I have in my list to do a video about central post stroke pain. Thank you Deswa.

[@deswaramadan341]

@@DrAndreaFurlan Ok thaks you Doc

[@drkishormullachery]

🙏

[@DrAndreaFurlan]

Thanks

[@user-bl4eu2ih6h]

👍👍👍

[@DrAndreaFurlan]

Thank you for watching the video and writing this comment. Please share this video with your friends. I have lots of videos about chronic pain on my channel kzbin.info And don't forget to turn on the notifications 🔔

[@olumla7715]

🙏🏻💙💐

[@DrAndreaFurlan]

Thank you for watching the video and writing this comment. Please share this video with your friends. I have lots of videos about chronic pain on my channel kzbin.info And don't forget to turn on the notifications 🔔

[@furkanatmaca5809]

Neuropatnic pain ===>>¿ Karpal Tünel Sendromu ve boyun fıtığı başlangıcı tanısı aldım. Grubu bu olmalı.

[@DrAndreaFurlan]

Hi Furkan, sorry to hear that. I hope you get better soon.

[@furkanatmaca5809]

@@DrAndreaFurlan 🤨🧐😓🙈🙉💫💣💥💯🙅‍♂️💁‍♂️🤷‍♂️👨‍🔬👨‍🦯🤸‍♂️🤸‍♂️🧘‍♂️🤾‍♂️🏊‍♂️🏋️‍♂️🚴‍♂️🏂

[@marypaite4880]

Doctor,could you please tell me the best diet,exercises for hypothyrodism??

[@DrAndreaFurlan]

Hi Mary, I already have another video for hypothyroidism.

[@marcosrodriguespro]

Great video but state that it is very simple To retrain the brain is a gross oversimplification of a very complex system 😓 Terminology matters and we all must be careful With the words we use. Hope this was just a brain fart :-)

[@DrAndreaFurlan]

Hi Marcos, your point is well taken. The process to retrain the brain is like doing physiotherapy for the body. I tell my patients that it is like "physiotherapy for the brain". There are many exercises, and the patient has to practice, practice and practice. I'm writing a mini-course on how to retrain the brain for chronic pain. Stay tuned.

[@paulacraig8252]

So basically you're saying that chronic pain isn't real pain.

[@DrAndreaFurlan]

Unfortuntately many people make that wrong interpretation. All 3 kinds of pain are true and very real.

[@agribiovn]

Thanks ! @UCXnFys9ZXBE0uyDhKHUi-dA.

[@DrAndreaFurlan]

You are welcome

[@abicranberry4608]

You had me till you described nociplastic pain. Like seriously why don’t you just say it’s the patients fault.

[@DrAndreaFurlan]

Hi Abi, I don’t believe it is the person’s fault. Nociplastic pain is a biological phenomenon that happens in all human beings. It is just the way the pain system is designed.

[@AightRS]

Your incapability to understand the human body is not relevant here. My god.

[@ferdabasak6806]

Thank you

[@DrAndreaFurlan]

You're welcome