Pain part four: The importance of perception

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From Trauma Sensitive Mindfulness

“Through research on people living with osteoarthritis, Dr Tasha Stanton from the University of South Australia has discovered there are many surprising factors that influence pain, including the way a person perceives their own body.

‘If we give people [with osteoarthritis] pictures of their hand at different sizes and we say ‘please pick out which one best represents your hand’, they will choose the image that is significantly smaller.

‘That suggests that there is alteration in their perception of the size of their body part.

‘But it’s not limited to that—we also see problems with their perception of touch. They are not very good at localising where they are being touched and they are not very good at localising where that body part is located in space.’

Stanton says these tests suggest people with chronic pain process location-specific information differently. She hopes to use this new information to develop new treatments.

‘The tack I have taken has been saying: if we have these altered perceptions in people with pain, what if we actually target these perceptions directly?’

Working with people with knee osteoarthritis, Stanton and her team have devised a series of experimental ‘visual illusions’, in which patients wear video goggles while researchers feed them a ‘live video link’ of their knee.

Patients watch the video in real-time, unaware researchers are covertly changing what’s on the screen in front of them.

‘One of the more potent illusions that we use is called the stretch illusion. They are looking down at their knee and suddenly they see it start to elongate, as if the joint is stretching out and being tractioned.

‘At that exact same time, we give a slight pull on the calf muscle.

‘Both the visual and touch information is telling their brain, “Actually, your knee is stretching out big and long!” And for some people, they are getting pain relief with this type of illusion.’

According to Stanton, the research supports other evidence that suggests that information from one sense—like touch or vision—can modulate information that is coming from another sense.

‘Our brain takes information from all these different senses—from touch, from sound, from vision, from movement—it puts all these things together for us to create a perception or a feeling of our own body.

‘It makes sense, then, for treatments to embrace that multisensory nature.’

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