The Naked Tales of a Studying Physio – Nociception

So I decided to take the plunge and return to study. It was an extremely difficult decision as I constantly questioned what the point was? I asked myself questions such as why am I doing it? Am I going to get anymore out of academia that I don’t get from reading myself or going on courses or engaging with others on social media? Will it give me anymore recognition? Why should extra letters be the thing that gives me that anyway? Will it progress my career? Will I earn anymore money? The questions went on. I hope that by the end of my post grad study I will have an answer for you.

 

Anyway that’s not the point of this blog. I want to take you on the journey with me.

Over the course of the year I will be posting bite size blogs about what I discover along the way. Will I be challenged? Will I think it was worthwhile? We shall see.

 

What’s up first – well I’m sure you guessed from the title. It’s a fascinating area is nociception. A lot of the bite size blog posts will be based on nociception. I am often confused by it as I hear many clinicians use it in contexts that don’t appear to make sense… to me. That’s not to say they are wrong, perhaps it’s because I don’t fully understand. As Lorimer Moseley has said the nervous system is wonderfully and fearfully complex. This is also true of nociception. Hence why I want to share what I learn with you and then add my thoughts to some of the frequent situations I encounter day-to-day.

 

So to give an IASP taxonomy definition of nociception:

 

Nociception*

The neural process of encoding noxious stimuli.

Note: Consequences of encoding may be autonomic (e. g. elevated blood pressure) or behavioral (motor withdrawal reflex or more complex nocifensive behavior). Pain sensation is not necessarily implied.

 

This definition then springs up another question. What exactly is noxious? I think it’s important to clarify noxious stimuli. Again if we look at the IASP taxonomy:

 

Noxious stimulus*

A stimulus that is damaging or threatens damage to normal tissues.

 

That’s pretty clear. The important aspect of this definition is ‘threatens damage to normal tissues.’ So it is not just tissue damage itself, it is the threat. This helps to explain a lot of the aches and pains we feel throughout the day.

 

Let’s choose a simple example, if we think about the ache in our shoulders that we feel after sitting for long periods at a computer screen, we often say that it feels tight? Is that really tightness in the muscle? If we think of the stimulus that threatens to damage normal tissues, it’s probably not likely to be tightness. Tightness is something we experience. It would make more sense that your clever nociceptive system is telling you to do something in order to reduce the potential threat of irritation to those tissues. Something called hypoxia which is a reduction of oxygen to your tissues (vital for their function) can occur when a blood vessel is compressed. So nociception is necessary here because of the threat of reduced blood flow to your tissues.

 

I intend to share more about nociception and nociceptors with you over the coming weeks, and of course if you think I’m way of course then be great to hear your thoughts.

 

Thanks for having a read

 

TNP

 

Reference

  1. Pain Taxonomy (2014). International Association for the study of Pain. Retrieved from iasp.org
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2 thoughts on “The Naked Tales of a Studying Physio – Nociception

  1. My question then is what defines nociception vs just normal sensation? Because in some situations something like light touch is perceived as a threat and others not, in fact just the opposite. So is nociception just sensation taken in context? or something different? Just curious what you think?

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    1. Hi Keith

      Thanks for your comment, it’s a great point! I’ll be attempting to discussing it in a later post. There’s a beautiful interplay that occurs in the nociceptive system. It is a highly adaptive monitoring system that is governed by an over arching entity – the brain.
      So in the case of biology nociceptive thresholds differ from human to human, this is something that has been acquired through our development. Those thresholds are constantly adapting depending on what the individual determines consciously or sub-consciously what the threshold should be. I would agree with you that it is contextual. Something perceived as more threatening threshold drops, something seen as less threatening threshold raises. Remember though this is not a single system occurrence at a single time. Monitoring is happening all the time and a hierarchy is placed on threat. i.e. sprained ankle alone = threat to tissues vs sprained ankle with bus bearing down on you = threat to life. Thresholds are modulated constantly.

      Hope that makes sense?

      Would love to hear what you think?

      Cheers

      Paul

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