A neural model for chronic pain and pain relief by extracorporeal shock wave treatment

Abstract

The paper develops a new theory of chronic pain and pain relief by extracorporeal shock wave treatment. Chronic pain without underlying anatomical disorder is looked at as a pathological control function of memory. Conditioned reXexes are considered to be engraved memory traces linking sensory input of aVerent signals with motor response of eVerent signals. This feature can be described by associative memory functions of the nervous system. Some conditioned reXexes may cause inappropriate or pathological reactions. Consequently, a circulus vitiosus of pain sensation and muscle and/or vessel contraction is generated when pain becomes chronic (pain spiral). The key feature is a dedicated engram responsible for a pathological (painful) reaction. The pain memory may be explained by the concept of a holographic memory model published by several authors. According to this model it is shown how nervous systems may generate and recall memory contents. The paper shows how extracorporeal shock wave treatment may reorganize pathologic memory traces, thus giving cause to real and permanent pain relief. In a generalized manner, the idea of associative memory functions may help in the understanding of conditioning as a learning process and explain extracorporeal shock wave application as an eYcient treatment concept for chronic pain. This concept may open the door for new treatment approaches to chronic pain and several other disorders of the nervous system.

Extracorporeal Shock Wave Therapy (ESWT) as a treatment for recurrent Neurogenic Heterotopic Ossification (NHO)

“…A number of studies in animals have shown that EWST results in changes in the expression of specific pain markers, such as substance P and calcitonin gene-related peptide (CGRP) in the spinal cord [35][36][37]. Wess [38] has suggested that EWST may disrupt the neural circuitry giving rise to chronic pain and thereby lead to pain relief.…”

Shock Waves in the Treatment of Post-Traumatic Myositis Ossificans

“…Some clinical studies have investigated the effects principally on AVN of the hip and they found a significant improvement in pain and in functionality without substantial changes of lesion on radiograph and MRI (Wang et al 2005. Therefore, these articles suggest that extracorporeal shock wave treatment may reorganize pathologic memory traces, thus, giving cause to real and permanent pain relief (Wess 2008).…”

Novel treatment of chronic perineal pain in a woman by extracorporeal shock wave therapy: A case report and published work review

“…The second mechanism involves the effect on neuroplasticity of the human pain memory and hence alternating the threshold of the pain memory and resetting the tolerance level as described by Wess . In a human neurological hologram, chronic pelvic pain may be represented by a reflex pattern between pain sensation and muscle contraction.…”

“…The second mechanism involves the effect on neuroplasticity of the human pain memory and hence alternating the threshold of the pain memory and resetting the tolerance level as described by Wess. 10 In a human neurological hologram, chronic pelvic pain may be represented by a reflex pattern between pain sensation and muscle contraction. The use of hyperstimulation shock wave may modulate the reflex cycle by introducing strong sensor input but weak motor output, thus erasing the old reflex pattern in chronic pelvic pain.…”