158 - Phillip Snell, DC - Assessing different aspects of the nervous system
Sep 20, 2024
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Phillip Snell, a doctor of chiropractic, dives deep into the fascinating world of the nervous system and its impact on movement and pain management. The conversation spans various assessment methods, shedding light on the neurocentric approach and its relevance for clinicians. They discuss the complexities of chronic neck and shoulder pain, along with practical treatment methodologies. Snell also emphasizes the connection between stress management and breathing techniques, providing valuable insights for improving patient outcomes.
The dual assessment of the nervous system encompasses both the psychological factors affecting pain perception and the physiological structures involved.
Integrating a systematic approach in treating pain includes identifying nociception sources while empowering patients through education and personalized intervention strategies.
Applying the biopsychosocial model to pain management recognizes the importance of psychological and social factors in understanding and treating chronic pain.
Deep dives
Understanding the Nervous System's Role in Pain
The nervous system plays a critical role in how individuals experience pain, with a focus on examining it from both a macroscopic and microscopic perspective. A macroscopic view involves understanding the psychological factors associated with pain, such as how a patient's mindset can influence their perception of discomfort. Meanwhile, the microscopic perspective looks into the physiological and neurological structures, including the spinal cord and peripheral nerves, that contribute to pain sensations. This dual approach helps clinicians better evaluate and address the complex nature of pain in patients.
Contextualizing Neurological Assessments
In clinical practice, assessing a patient's nervous system should be an integral part of neurological exams, providing context for the evaluation of their pain. By situating nervous system evaluations within the broader neurological context, practitioners can better understand how various aspects of the nervous system interact with pain experiences. The dialogue emphasizes the sequential approach from larger to smaller structures in neurological assessments, allowing for a more comprehensive evaluation of the patient's condition. This method helps clinicians identify primary sources of pain and tailor appropriate interventions.
An Integrated Approach to Pain Management
A systematic approach to treating pain involves first identifying the source of nociception and then integrating symptom modification and functional improvement strategies into a patient’s treatment plan. This includes conducting a thorough examination to understand the patient's pain history, movement mechanics, and lifestyle factors that contribute to their condition. By providing patients with agency through education and a home exercise program, practitioners can help mitigate pain while addressing underlying functional issues. This multifaceted strategy not only alleviates discomfort but empowers patients to take control of their recovery.
The Biopsychosocial Model in Practice
Incorporating the biopsychosocial (BPS) model into clinical practice enhances the understanding of chronic pain management beyond just physical symptoms. Acknowledging the psychological and social aspects of pain can provide critical insights into a patient's condition, emphasizing that chronic pain often has a multidimensional origin. Suggestions for navigating BPS concepts involve using sensitive language and maintaining a compassionate tone while discussing pain with patients, which can ease the integration of neurological and psychosocial factors into their treatment. This encourages a more holistic view rather than relegating pain solely to psychological origins.
Epigenetic Factors and Pain Experience
Epigenetic factors, including stress, sleep patterns, diet, and lifestyle choices, significantly influence an individual's pain experience and recovery process. A comprehensive evaluation of these four epigenetic 'buckets' helps clinicians contextualize a patient's pain within a broader lifestyle framework, identifying potential areas for improvement. Strategies could include implementing stress management techniques or encouraging healthier dietary habits, which are crucial for long-term pain management. By understanding how these factors interrelate with the nervous system, practitioners can create more effective, personalized treatment plans for their patients.
