Dermoneuromodulation: The neuromatrix model of pain

I've written extensively about Melzack's Neuromatrix model of pain, here (on a wikipage), and elsewhere in this blog, most recently here.
The main story is to realize, to grok, to wrap one's head around the fact that pain is an output of the brain, not an input. Details are still arriving.

Here is a picture of the updated model.

What we want is to accomplish the following:

DECREASE PAIN OUTPUT, IMPROVE MOVEMENT OUTPUT,
WHICH IN TURN, MAY AFFECT STRESS OUPUT POSITIVELY

Or, this is good too:

PAIN EDUCATION CAN HELP PATIENT FEEL THEY HAVE LOCUS OF CONTROL,
WHICH MAY REDUCE THEIR STRESS LEVEL

Overall, what we REALLY hope we can do (with manual therapy), is this: 

ADDITION OF CONTEXT-APPROPRIATE MANUAL THERAPY, CONSISTENT WITH PAIN EDUCATION

We want our contact to be congruent with our education about the neuromatrix and pain. We want our contact to help, not hinder, the process of resolution of pain and movement impairment DUE to "pain".  We want it to help reduce bad stress, but maybe the patient needs to use their own positive "stress response" (from their own locus of control) to get themselves free from pain. We want to augment the teaching we did (the magnifying glass in the diagram). 


It's best if our physically applied input is kind, light, warm, non-nociceptive, steady. Skin stretching is not a bad way to proceed. If someone has fierce allodynia, you might try a mirror box and a soft sable makeup brush, applied to the skin on the opposite side, or an adjacent part of the somatosensory representation. Give their brain time to figure out the input and respond. Sometimes this means light contact over a longer period of time, not more pressure, or faster pressure. 

Melzack R; Pain and the Neuromatrix in the Brain

1. Dermoneuromodulation (diagram, gearing up)

2. Dermoneuromodulation: Where it came from

3. Dermoneuromodulation: Ruffini sensory endings and dorsolateral prefrontal cortex

4. Dermoneuromodulation: Neurodynamics, tunnel syndromes, cutaneous nerves.

6. Dermoneuromodulation: Ascending pathways