Pain and the Brain

Take a look into our current understanding of the function of the human brain and some of the important diseases that cause nervous system dysfunction. On this edition, Allan Basbaum, UCSF department of anatomy, explores pain and the brain. Recorded on 05/31/2007. [10/2007] [Show ID: 13074]
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[@DrMazzarella]

I have taken over 120 CME courses in pain management, have two diplomates in pain and a certification in pain associated with traumatic stress. This provided a completely new insight into pain, which was not covered in any of my previous learning. A great example of why continuing education is need for pain management and a great presentation.

[@longlakeshore]

Excellent lecture. As a long term chronic myofacial pain patient, I take issue with the concept of "allodynia". My chronic pain IS pain, not allodyniia, and the only thing that controls it are powerful prescription narcotics. Labeling it "allodynia" is a dangerous and misleading drift into semantics which is happening, IMHO, because medical professionals and anatomists can't accept the fact that tissues heal but sometimes nerve fibers keep sending pain signals anyway. PAIN IS REAL.

[@phwaleed]

Dr. Allan is brilliant...and we need more of his medical presentations.

[@chrissad1]

Thanks for the video Allen! I am a Physical Therapist in South Africa that has been using different techniques and equipment to treat pain, but my success rate with patients' is really directly link to cognitive behavioral therapy and trying to change the patient's perception of their condition. If the patient doesn't perceive their pain as a threat anymore, the amount of pain, muscle spasm and activity avoidance are significantly reduced

[@longlakeshore]

@Drazion203: Pain docs do NOT always start with narcotics (and yes, I know opiates are narcotics... that's no great revelation u kno... certainly not worth all caps). As I have already explained, my pain doc tried a dozen antidepressants & anti-seizure meds over a nine month period b4 prescribing opiate painkillers, and was very reluctant to do so. My pain management physicians saved my life then and continue to do so. I am very thankful for their good work.

[@tracipatterson2725]

Thank you for this video. I was diagnosed with CRPS and lived with the condition for 6+ years. The traditional treatments of blocks and even SCS did nothing but progress my condition. In 2013 I found someone that worked with hypnosis, cell memory, the Limbic system, etc., and I was able to get into remission. I now treat chronic pain patients with "Hypnosis Combined Therapy" with remarkable outcomes.

[@elliediaz6667]

Hi Traci: I've been suffering from rotator cuff, cervical and lower back pain for years. At this point it has affected my sleep and causing more severe pain elsewhere due to muscle contraction. Can you give me your therapyst's contact information to see if I can find someone in the Orlando, FL area who practices that modality. Thank's in advance for your help. :-) Ellie

[@tracipatterson2725]

+Ellie Diaz Hello. I received you message/comment. Right now there are 2 of us treating Chronic Pain patients with the combination I mentioned. Unfortunately, neither of us are in FL. The gentleman that treated me is semi-retired, and my office is in CA. Here is my website: www.AdvancedPathways.com. I personally have added in additional modalities too. Please feel free to contact me for a free consultation. ~ Traci Patterson, CH, CI

[@christineferreira5365]

Traci Patterson if u ever read this pls leave a way to msg u privately

[@tracipatterson2725]

There was a request on how to contact me. My email is: [e-mail] Website: AdvancedPathways.com Phone: [phone] Hope this helps. Traci Patterson

[@reg8297]

Traci Patterson Hi Tracy can I ask you is it Annie hoppers dvds you use to help others I have chronic nerve pain

[@manthasagittarius1]

He is really good. This is a keeper for the lecture set I collect for my students.

[@cynthiamorton5835]

Allan's explanation in "Pain in the Brain" wonderfully helps comfort the mind by revealing we conflicted by these radical sensors don't just create or have control of the horrible onset of these complicated multiple symptoms of pain.They have found the truth and research WILL bring a cure... I pray

[@Thomes-Maisling]

This guy's a good lecturer. I get chronic neuralgia, so this is really useful info to me.

[@longlakeshore]

I agree, there is SOME truth in Dr Basbaum's lecture. Added it to my favorites long ago. I disagree with him labeling pain as allodynia just because pain is caused by a stimulus which normally would not cause pain. What gets lost in translation is that allodynia IS pain and that a "normal" stimulus causes pain. It's still pain. It still hurts like hell and, in my case, requires powerful opiates to relieve. Pain is pain. Don't call it something else.

[@persephoneluv]

i am finally understanding whats happening to my body

[@jamesfhermans]

A very good lecture and well worth watching for the description of pain pathology. Just a pity about his misguided view that acupuncture is a placebo. Acupuncture has been shown to be effective over placebo through the recent work by Vickers et al., Acupuncture for Chronic Pain Individual Patient Data Meta-analysis... Arch Intern Med. 2012;172(19):1444-1453. doi:10.1001/archinternmed.2012.3654

[@alfred576]

Hi Dr. Allan, I loved your presentation on pain because my pain has been increasing since cervical spine surgery in Aug 2023. Probably my brain is re-inforcing my sensation of pain because I have become consumed with it. I have to find a way to re-program my brain. Thank you.

[@aymanelhefnawi]

great information thanks

[@umuse]

Perfectly right. Pain that is felt _ no matter where it originates and how convoluted the pathways that are involved and no matter where its awareness is manifested is REAL! It is reality, that can supersede all others!

[@Bitachon]

12+ years ago...wow

[@longlakeshore]

To have pain is to have certainty. To hear about pain is to have doubt.

[@AnnieCoomes]

This is a great video that helps to explain how Cranial sacral therapy helps people with chronic pain. We work with the brain, limbic system and neurochemical anatomy Thank you

[@gorillaguerillaDK]

Annie Coomes No! You create Placebos....

[@chuckypud]

i can't see what your problem is lls, pain is pain and different types of pain require different names . allodynia is pain from normal stimulus , like you might get pain from wind on your face i imagine like trigeminal neuralgia. he says this is the most serious type of pain so doesn't offend you in my opinion if anything he gives your problems more respect. i suffer from chronic back pain and this really has opened my eyes as id been focused on my discs and never gave my brain any thought

[@RiderForge]

The brain is what decides whether or not something is interpreted as pain and it can be manipulated. Your example is anecdotal and your relief can easily be the result of placebo. Expecting a treatment to work is enough to make it work.

[@longlakeshore]

You're the one who is confused, as is Dr. Basbaum at 6:22 when he presents a slide saying pain is a subjective experience, not a stimulus. It IS a stimulus. Proof? A temporary block of my facial nerve (CVII) w/marcaine gives me complete pain relief for ~3 hours till the local wears off. Surgical damage to this nerve has left me in severe chronic pain for the last 26 years. Whatever the damage was/is, CVII continues to send pain signals to my brain. Were it affective, the block wouldn't work.

[@umuse]

If you tried hypnosis, assuming you respond to it and you are willing to forego your present medication, you would perhaps know a bit more about it.

[@longlakeshore]

A good pain management clinic with good pain management physicians, nurses and counselors. Find one and let them diagnose and treat your pain.

[@swhatley13111]

Suffered with RSDS for over 20 years, have begged doctors to just take my foot off.

[@tracipatterson2725]

The problem is studies have shown that phantom limb pain would be a very high probability with amputation. Traditional treatments do not work effectively for most RSD/CRPS patients. This is where working with other methods to reset the pain loop, decrease stress, decrease anxiety, etc... come into play.

[@swhatley13111]

Thanks for responding - I honestly do not think doctors care.

[@waxogen]

Dear Sir, Hi, I have been in pain for over 25 years and have been taking 18 mg of morphine four times a day. I think the cause is because I spent overtime in the Sarcophagus of Chernobyl's blown out reactor # 4 I made three trips to Chernobyl and received doses of radiation each time. My entire body is in much pain even though I am taking all this morphine. My weight was 155 lbs. during my first trip and am now 106 lbs. I am 80 years old, What are my chances of getting this virus? Can you help me? thx

[@Riversleigh1]

thanks, I am trying to understand psychological pain for my patients and I am interested in how they self medicate with tobacco, alcohol, THC or any other addiction. If chronic pain has an emotional component then certainly mental pain is as real. I would appreciate any tips in making the connection between the two. Any books or references to follow up.

[@marielieful]

Riversleigh1 thats the problem that doctors believe that when we complain about pain they cant detect they automatically believe is all mental pain. I dont use alcohol or thc I do smoke ciggs... fibromyalgia, interstitial cystitis and Vulvodynia is horrible and is not all in the head

[@gorillaguerillaDK]

The Raw Reality Of IC Videos p Pain IS "in the head" - it's an output, not an input! The thing is, you need to understand what "in the head" means, and what it doesn't mean! All pain is biopsychosocial, that means how you experience pain isn't just about how tissue react, and in chronic pain conditions, it is even more clear that it's not just signals from the tissue! This doesn't mean that you're "mentally ill"! If you want to understand what pain is, I recommend reading David Butler and Lorimer Moseley's book Explain Pain

[@Onesimus747]

pain medicine has come leaps and bounds since i jumped in the pool. apprx 2001. i have had 3-5 great doctors. the science of "centralization" of chronic intractable pain has really come to the point pain free hours everyday for severe patients are possible. the problem is insertion of the DEA into medicine and doctors that have a "bias" against a class of analgesics. if you have this bias and plan on being a physician go into research. the doctors with this bias create more suffering that pain relief and the clause first do no harm is not upheld.

[@CariLemme]

Yes they do! I have met too many sadistic, self-righteous a-holes marauding about as physicians in their white coats doing harm to already miserable people all day every day. Too bad Hippocratic Oath isn't law

[@neatstuff8200]

This information about medication is so old, 5 years. January 1st 2014 started a so-called taper and I would say half of all pain patients I've been eliminated in the genocide so far. I hope this person is not one of them.

[@longlakeshore]

So many questions. What kind of chronic pain do you have? How long have you had it? Do you have a diagnosis from a medical doctor? Have you seen a pain management physician? Without more information I have no idea what will help you.

[@RiderForge]

you're confused. allodynia is defined as pain caused by non-painful stimuli. don't get too hung up on the sun burn example; it was simply used because the idea is familiar to many people. calling something allodynia does not make it "fake," it just means that something hurts and the cause is a stimulus or movement or whatever that should not be painful. someone with arthritis is describing allodynia; it hurts when i move my hands.

[@apexxxx10]

*What about the internationally used PAIN SCALE 1-10? Bangkok-Johnny*

[@longlakeshore]

Your conclusions are in error. I didn't "expect" the C7 block to work because I didn't know in advance which nerves were being blocked! When one of several, separate temporary blocks gave full pain relief I was informed AFTER THE FACT that it was a facial nerve block. Poof goes your placebo theory. Poof goes your antecdotal claim.

[@DJxSGGxNeo]

What about such pain like anxiety attacks or some kind of attack which forces my body and mind to separate Depersonalization? I have episodes where the pain is unreal, worse than having a broken body part. It's all over my body and my thoughts hurt. What is this?

[@tousifk3138]

I didn't hear the speach, what do you think about depersonalization, do you curse it, do you run away from it, do you give it a scary name, ur brain is fired up, stay with it the depersonalization, broken fracture pain is all like a baby pain, but the pain ur telling is bad really bad, it's still ok coz u still have episodes, u have to meet a pain psychologists , don't fight ur pain, also stress will screw up. what is this? It's a pain produced by ur brain

[@DJxSGGxNeo]

@@tousifk3138 Thanks for your reply, I have it some what under control these days, when it comes on I am able to minimize how it feels. But when it first happened to me, no one believed me, and I didn't care if they did or not, it was so harsh that I just wanted help, since it would paralyze me and prevent me from doing anything functional. I used to panic and have anxiety attacks that would occur with it, though I have been able to over come those. It's crazy how such a thing exist, the worst pain ever and there is not much known about it.

[@longlakeshore]

If allodynia is pain from normal stimulus, what about pain from NO stimulus? I know plenty of people with arthritis (Basbaum's example) who have constant pain in their hands WITHOUT moving their hands. I'm a chronic pain patient from infection and surgical nerve damage to a cranial nerve. With no stimulus whatsoever I am in constant pain so severe only powerful opiates work. I fear that labeling pain as something else will make everyone think it's not pain.

[@philisbramlett6890]

Where can I become a a patient ? I'm educated but,I am dismissed like a piece of trash following an MVA that devastated my body, my career, my family , my reputation etc. Pain has consumed & crippled my body & my mind and I'm riddled with guilt because I allowed it . Can you help me. My life has value and meaning . I share with my loved ones and those even less fortunate than myself because serving them is what my goal was since the beginning . Please help ? Pain is always there. I know I could be so much more without it . Once you are labeled with it you become a list of other diagnosis just to cover their misunderstanding of pain !

[@umuse]

You are damn well right, I really dont know chronic pain. Well you can say you have at least tried it. But really I think there is some semblance of truth in here. May be not to the extent as depicted. Is your medication being administered relatively targeted? This possibility has been explored in the video too?

[@mamaalik12]

wish i had the oppertinuty to be taught by ppl like this, all our lecturers do is.. powerpoint format :/

[@longlakeshore]

Sunburn allodynia at 11:50? Bull. I've had sunburn that hurt like hell all night long with no touch, clothing or air movement at all.

[@ThePhantomLash]

@longlakeshore Have you heard of Bruno Groening ?? Or Immunics with Bayard Barnes ? Get on !!

[@ampswithfans]

Doctor, PhD or MD? Makes really no diffence, right? You get what you get, unfortunately. I have brain lesions, too many to count, and spinal cord insults. My PCP, the gutless wonder at the time, prescribed Vicodin for severe chronic Neuropathic PAIN !

[@Guillermo_Carratero]

44:05 Excuse me good doctor sir, but Piet Mondria(a)n was a Dutch painter ;-)

[@jimijackson]

great presentation :) *claps*

[@frilansspion]

is that the voice of kermit doing the intro??

[@seriouslymatsteele]

Run for the hills!!

[@MrZawdin]

There is a newer updated version of this talk on the channel, check it out!

[@cynthiaenrico962]

Hello THello uteustyriuaataytstdydudiutustu

[@RiderForge]

Allan, you are the f**king man.

[@faanross]

Can a placebo be effective even if the patient does not believe it will?

[@brandonzarnoth4495]

+brahfaanicus yes! For example, the phantom limb pain. Although the patient knows it is only a reflection, his sub-concious mind does not. His brain fires as if it is indeed his phantom limb superimposed once again.

[@gorillaguerillaDK]

brahfaanicus If the patient has seen it work on others, then it doesn't neccesarily means they have to believe it works, but it still can.....

[@043justdoit]

technically then 'painful stimuli' doesn't exist. The deep brain stimulation seems similar to electroconvulsive shock

[@persephoneluv]

help me what has helped your pain?

[@longlakeshore]

@ThePhantomLash Yes I've heard of Bruno Groening (can you hear me groaning?) and Barnes. IMO he's just another faith healer who offers no real solutions for real physical pain.

[@cittaslowclub8338]

no ibuprofen Paracetamol YES 1 a day okay. Please help I have concentration and motivation problems. Long fibers in hands help you to relax when you shake it after a burn but why? Are there other things released besides Endorphins? Student asks " Why do some people like pain? " I like pain but it is not sexual. My Oxytocin is low and so is my dopamine. The pain makes everything alright. I also don't have any drug problems. My doctor subscribed me strong opiates for sleeping problems. It didn't work. one time I took an overdose. it still didn't work. So I stopped. And it also wasn't addictive. I think that if you like physical pain, your emotional pain is anger 💢.DHT’s affect on the brain is about five times larger than testosterone’s. It not only unleashes aggression, but also increases dopamine, which makes the aggression feel good. (Page 84)

[@skibitom]

Endorphins are our human drug.

[@SelfishNeuron]

Tell me where does it hurt? In my mind of course! *lol*

[@anialiandr]

Placebo is a magic word for all they dont understand but have the power to denigrate. Where is self-criticism? Well as a professor you set the rules. This is why we need the old professors to die for the upcoming PhD to take over

[@gorillaguerillaDK]

F*** the pain away.....

[@marielieful]

Pain is not a perception.... omg this is why we all suffering and alot of people are going to commit suicide.

[@cartmansuperstar]

?