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(Understand &) Explain
                 Pain


 Lorimer Moseley
 NHMRC Senior Research Fellow
 Prince of Wales Medical Research Institute, Sydney, Australia


 Senior Fellow
 The GAMFI project
 University of Oxford, UK

                                                                  © GL Moseley
                                                        www.BodyInMind.com.au
Nociception is neither sufficient
        nor necessary for pain



                                  © GL Moseley
                        www.BodyInMind.com.au
The relationship between
nociception and pain is variable



                                  © GL Moseley
                        www.BodyInMind.com.au
Pain
       Tissue
       danger




       pain



                Take action –
                remove danger
                                          © GL Moseley
                                www.BodyInMind.com.au
© GL Moseley
www.BodyInMind.com.au
Complex reasoning
 mechanisms based on
  experience, context,
environment…MEANING




                    © GL Moseley
          www.BodyInMind.com.au
Complex reasoning
p ain    mechanisms based on
          experience, context,
        environment…MEANING




                            © GL Moseley
                  www.BodyInMind.com.au
Complex reasoning
 mechanisms based on
  experience, context,
environment…MEANING

     “How dangerous
      is this really?”




                    © GL Moseley
          www.BodyInMind.com.au
Pain does not provide an accurate
indication of tissue state –

It makes us take action to promote
our well-being (get out of danger!)


                                    © GL Moseley
                          www.BodyInMind.com.au
Every represented byte can modulate




                                  Pain



        ‘Basic’ protective responses


                     Motor system
                   Immune system
                 Autonomic system
                             © GL Moseley
                   www.BodyInMind.com.au
Every represented byte can modulate




                                  Pain



        ‘Basic’ protective responses


                     Motor system
                   Immune system
                 Autonomic system
                             © GL Moseley
                   www.BodyInMind.com.au
Every represented byte can modulate




                                  Pain



        ‘Basic’ protective responses


                     Motor system
                   Immune system
                 Autonomic system
                             © GL Moseley
                   www.BodyInMind.com.au
Every represented byte can modulate




                                  Pain



        ‘Basic’ protective responses


                     Motor system
                   Immune system
                 Autonomic system
                             © GL Moseley
                   www.BodyInMind.com.au
Every represented byte can modulate




                                  Pain



        ‘Basic’ protective responses


                     Motor system
                   Immune system
                 Autonomic system
                             © GL Moseley
                   www.BodyInMind.com.au
multi-system
   outputs

“How dangerous
 is this really?”




                              © GL Moseley
                    www.BodyInMind.com.au
Every represented byte can modulate

Sum evaluative inputs = “It is not as dangerous as that”




                                                      Pain



                           ‘Basic’ protective responses


                                         Motor system
                                       Immune system
                                     Autonomic system
                                                 © GL Moseley
                                       www.BodyInMind.com.au
Every represented byte can modulate

  Sum evaluative inputs = “It is not as dangerous as that”




                                                        Pain



                             ‘Basic’ protective responses


                                           Motor system
                                         Immune system
                                       Autonomic system
                                                   © GL Moseley
Descending inhibition                    www.BodyInMind.com.au
Every represented byte can modulate

  Sum evaluative inputs = “It is not as dangerous as that”




                                                        Pain



                             ‘Basic’ protective responses


                                           Motor system
                                         Immune system
                                       Autonomic system
                                                   © GL Moseley
Descending inhibition                    www.BodyInMind.com.au
Every represented byte can modulate

  Sum evaluative inputs = “It is not as dangerous as that”




                                                        Pain



                             ‘Basic’ protective responses


                                           Motor system
                                         Immune system
                                       Autonomic system
                                                   © GL Moseley
Descending inhibition                    www.BodyInMind.com.au
Every represented byte can modulate

Sum evaluative inputs = “It is more dangerous that that”




                                                      Pain



                           ‘Basic’ protective responses


                                         Motor system
                                       Immune system
                                     Autonomic system
                                                 © GL Moseley
                                       www.BodyInMind.com.au
Every represented byte can modulate

  Sum evaluative inputs = “It is more dangerous that that”




                                                        Pain



                             ‘Basic’ protective responses


                                           Motor system
                                         Immune system
                                       Autonomic system
                                                   © GL Moseley
Descending facilitation                  www.BodyInMind.com.au
Every represented byte can modulate

  Sum evaluative inputs = “It is more dangerous that that”




                                                        Pain



                             ‘Basic’ protective responses


                                           Motor system
                                         Immune system
                                       Autonomic system
                                                   © GL Moseley
Descending facilitation                  www.BodyInMind.com.au
Every represented byte can modulate

  Sum evaluative inputs = “It is more dangerous that that”




                                                        Pain



                             ‘Basic’ protective responses


                                           Motor system
                                         Immune system
                                       Autonomic system
                                                   © GL Moseley
Descending facilitation                  www.BodyInMind.com.au
Thanks



Lorimer Moseley
NHMRC Senior Research Fellow
Prince of Wales Medical Research Institute, Sydney, Australia


Senior Fellow
The GAMFI project
University of Oxford, UK

                                                                 © GL Moseley
                                                       www.BodyInMind.com.au

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How dangerous is this really?

  • 1. (Understand &) Explain Pain Lorimer Moseley NHMRC Senior Research Fellow Prince of Wales Medical Research Institute, Sydney, Australia Senior Fellow The GAMFI project University of Oxford, UK © GL Moseley www.BodyInMind.com.au
  • 2. Nociception is neither sufficient nor necessary for pain © GL Moseley www.BodyInMind.com.au
  • 3. The relationship between nociception and pain is variable © GL Moseley www.BodyInMind.com.au
  • 4. Pain Tissue danger pain Take action – remove danger © GL Moseley www.BodyInMind.com.au
  • 6. Complex reasoning mechanisms based on experience, context, environment…MEANING © GL Moseley www.BodyInMind.com.au
  • 7. Complex reasoning p ain mechanisms based on experience, context, environment…MEANING © GL Moseley www.BodyInMind.com.au
  • 8. Complex reasoning mechanisms based on experience, context, environment…MEANING “How dangerous is this really?” © GL Moseley www.BodyInMind.com.au
  • 9. Pain does not provide an accurate indication of tissue state – It makes us take action to promote our well-being (get out of danger!) © GL Moseley www.BodyInMind.com.au
  • 10. Every represented byte can modulate Pain ‘Basic’ protective responses Motor system Immune system Autonomic system © GL Moseley www.BodyInMind.com.au
  • 11. Every represented byte can modulate Pain ‘Basic’ protective responses Motor system Immune system Autonomic system © GL Moseley www.BodyInMind.com.au
  • 12. Every represented byte can modulate Pain ‘Basic’ protective responses Motor system Immune system Autonomic system © GL Moseley www.BodyInMind.com.au
  • 13. Every represented byte can modulate Pain ‘Basic’ protective responses Motor system Immune system Autonomic system © GL Moseley www.BodyInMind.com.au
  • 14. Every represented byte can modulate Pain ‘Basic’ protective responses Motor system Immune system Autonomic system © GL Moseley www.BodyInMind.com.au
  • 15. multi-system outputs “How dangerous is this really?” © GL Moseley www.BodyInMind.com.au
  • 16. Every represented byte can modulate Sum evaluative inputs = “It is not as dangerous as that” Pain ‘Basic’ protective responses Motor system Immune system Autonomic system © GL Moseley www.BodyInMind.com.au
  • 17. Every represented byte can modulate Sum evaluative inputs = “It is not as dangerous as that” Pain ‘Basic’ protective responses Motor system Immune system Autonomic system © GL Moseley Descending inhibition www.BodyInMind.com.au
  • 18. Every represented byte can modulate Sum evaluative inputs = “It is not as dangerous as that” Pain ‘Basic’ protective responses Motor system Immune system Autonomic system © GL Moseley Descending inhibition www.BodyInMind.com.au
  • 19. Every represented byte can modulate Sum evaluative inputs = “It is not as dangerous as that” Pain ‘Basic’ protective responses Motor system Immune system Autonomic system © GL Moseley Descending inhibition www.BodyInMind.com.au
  • 20. Every represented byte can modulate Sum evaluative inputs = “It is more dangerous that that” Pain ‘Basic’ protective responses Motor system Immune system Autonomic system © GL Moseley www.BodyInMind.com.au
  • 21. Every represented byte can modulate Sum evaluative inputs = “It is more dangerous that that” Pain ‘Basic’ protective responses Motor system Immune system Autonomic system © GL Moseley Descending facilitation www.BodyInMind.com.au
  • 22. Every represented byte can modulate Sum evaluative inputs = “It is more dangerous that that” Pain ‘Basic’ protective responses Motor system Immune system Autonomic system © GL Moseley Descending facilitation www.BodyInMind.com.au
  • 23. Every represented byte can modulate Sum evaluative inputs = “It is more dangerous that that” Pain ‘Basic’ protective responses Motor system Immune system Autonomic system © GL Moseley Descending facilitation www.BodyInMind.com.au
  • 24. Thanks Lorimer Moseley NHMRC Senior Research Fellow Prince of Wales Medical Research Institute, Sydney, Australia Senior Fellow The GAMFI project University of Oxford, UK © GL Moseley www.BodyInMind.com.au