Pain, the Tissues and the Nervous System: A conceptual model

Gifford, Louis

doi:10.1016/s0031-9406(05)65900-7

Cited by 125 publications

(52 citation statements)

References 48 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Many people with chronic pain become disabled, resulting in a loss of identity, difficulty coping and a reduction in quality of life (Maniadakis & Gray, 2000). It is recommended that interventions that empower patients and encourage self-management should be utilised (Gifford, 1998;Frost et al, 2004;Turk & McCarberg, 2005). Education is an important component of this empowerment approach to pain management (Gifford, 1998).…”

Section: Background and Contextmentioning

confidence: 99%

“…It is recommended that interventions that empower patients and encourage self-management should be utilised (Gifford, 1998;Frost et al, 2004;Turk & McCarberg, 2005). Education is an important component of this empowerment approach to pain management (Gifford, 1998). In principle, the better a person understands their condition, the better they will manage it.…”

Section: Background and Contextmentioning

confidence: 99%

See 1 more Smart Citation

A qualitative exploration of people's experiences of pain neurophysiological education for chronic pain: The importance of relevance for the individual

et al. 2016

View full text Add to dashboard Cite

Pain neurophysiology education (PNE) is a distinct form of patient education in pain management. The aims of this study were to explore the experience of PNE for people with chronic pain and to gain insight into their understanding of their pain after PNE.This was a qualitative study, based on Interpretive Phenomenology Analysis, using individual semi-structured interviews to collect data. We recruited a purposive sample of 10 adults with chronic musculoskeletal pain (men and women; mean age 48 years; with a mean pain duration of 9 years) who had recently completed PNE delivered as a single two-hour group session. The interview transcripts were analysed for emerging themes. We identified three themes: perceived relevance for the individual participant; perceived benefits for the individual participant; and evidence of reconceptualisation.An interlinking narrative was the importance of relevance. Eight participants viewed the session as relevant and reported benefits ranging from a better understanding of pain, improved ability to cope with the pain, and some suggested improved levels of physical activity. Four of these participants showed evidence of reconceptualisation, which we describe as partial and patchy. Two participants reported no benefit and did not perceive the material delivered within PNE to be relevant to themselves. Relevance to the individual needs of a person with chronic pain may be a key factor in the success of PNE, and this is a particular challenge when it is delivered in a group situation.

show abstract

Section: Background and Contextmentioning

confidence: 99%

Section: Background and Contextmentioning

confidence: 99%

A qualitative exploration of people's experiences of pain neurophysiological education for chronic pain: The importance of relevance for the individual

et al. 2016

View full text Add to dashboard Cite

show abstract

“…To facilitate understanding and implementation, Gifford (1998b) proposed the mature organism model (MOM). This model describes a cyclical process beginning with an input to the CNS (sampling), for example nocioception.…”

Section: The Mature Organism Modelmentioning

confidence: 99%

“…The output subsequently serves as a further input to the sampling loop. The MOM suggests that the CNS is continually sampling tissue health, the surrounding environment and itself, consciously and unconsciously, before scrutinising this input in the context of past experience, knowledge, beliefs, culture, past successful behaviour, past successful behaviour observed in others (Gifford, 1998b;Jones et al, 2002). This process of scrutiny before an output is generated is key and has the potential to create an environment for recovery or otherwise.…”

Section: The Mature Organism Modelmentioning

confidence: 99%

The central nervous system – An additional consideration in ‘rotator cuff tendinopathy’ and a potential basis for understanding response to loaded therapeutic exercise

et al. 2013

View full text Add to dashboard Cite

“…[1][2][3] 'Mechanisms-based classification' refers to the classification of clinical presentations of pain based on assumptions concerning the dominant underlying neurophysiological mechanisms responsible for its generation and/or maintenance. 4,5 It has been argued that mechanisms-based approaches may better explain observed variations in the nature and severity of many clinical presentations of musculoskeletal pain (e.g. low back (¡leg) pain, whiplash associated disorder): (i) where pain is reported in the absence of or disproportionate to any clearly identifiable pathology; (ii) where pain is reported to persist after the resolution of injury or pathology; (iii) where the severity of pain reported by patients with similar injuries and pathologies differs greatly; and paradoxically (iv) where pain does not exist despite evidence of injury or pathology.…”

mentioning

confidence: 99%

The reliability of clinical judgments and criteria associated with mechanisms-based classifications of pain in patients with low back pain disorders: a preliminary reliability study

Smart

Curley²,

Blake³

et al. 2010

Journal of Manual & Manipulative Therapy

View full text Add to dashboard Cite

Mechanisms-based classifications of pain have been advocated for their potential to aid understanding of clinical presentations of pain and improve clinical outcomes. However, the reliability of mechanisms-based classifications of pain and the clinical criteria upon which such classifications are based are not known. The purpose of this investigation was to assess the inter-and intra-examiner reliability of clinical judgments associated with: (i) mechanisms-based classifications of pain; and (ii) the identification and interpretation of individual symptoms and signs from a Delphi-derived expert consensus list of clinical criteria associated with mechanisms-based classifications of pain in patients with low back (¡leg) pain disorders. The interand intra-examiner reliability of an examination protocol performed by two physiotherapists on two separate cohorts of 40 patients was assessed. Data were analysed using kappa and percentage of agreement values. Inter-and intra-examiner agreement associated with clinicians' mechanisms-based classifications of low back (¡leg) pain was 'substantial' (kappa 50.77; 95% confidence interval (CI): 0.57-0.96; % agreement 587.5) and 'almost perfect' (kappa 50.96; 95% CI: 0.92-1.00; % agreement592.5), respectively. Sixty-eight and 95% of items on the clinical criteria checklist demonstrated clinically acceptable (kappa > 0.61 or % agreement > 80%) inter-and intra-examiner reliability, respectively. The results of this study provide preliminary evidence supporting the reliability of clinical judgments associated with mechanisms-based classifications of pain in patients with low back (¡leg) pain disorders. The reliability of mechanisms-based classifications of pain should be investigated using larger samples of patients and multiple independent examiners.

show abstract

Pain, the Tissues and the Nervous System: A conceptual model

Cited by 125 publications

References 48 publications

A qualitative exploration of people's experiences of pain neurophysiological education for chronic pain: The importance of relevance for the individual

A qualitative exploration of people's experiences of pain neurophysiological education for chronic pain: The importance of relevance for the individual

The central nervous system – An additional consideration in ‘rotator cuff tendinopathy’ and a potential basis for understanding response to loaded therapeutic exercise

The reliability of clinical judgments and criteria associated with mechanisms-based classifications of pain in patients with low back pain disorders: a preliminary reliability study

Contact Info

Product

Resources

About