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I ended up on crutches for about fifteen months with my ankle looking like this the entire time. Michael Nicholas: Studies done elsewhere have reported change in brain activity after these sorts of interventions, when people start moving again, the symptoms settle, then changes have been seen along the measures like FMRIs. And it appears that the longer those changes are present, the more severe they become and the harder it is to intervene. Prof Michael Cousins [email protected] Management Research Institute Royal North Shore Hospital St Leonards NSW 2065 A/Prof Michael Nicholas [email protected] Pain Management Program Royal North Shore Hospital St Leonards NSW 2065 Pain Management Research Institute ADAPT Pain Management Program Australian Reflex Sympathetic Dystrophy Support Group National Institute of Neurological Disorders and Stroke (USA) Complex Regional Pain Syndrome Fact Sheet Mayo Health Insite Chronic pain Better Health Channel Pain management ^ top Everyone with RSD/CRPS should go to which is the best website and used by doctors as well as patients all over the world.Dr Maryanne Demasi: Now this looks really painful, was it as painful as it looks? NARRATION: Like Laura, Ketamine drips, epidurals and spinal nerve blocks failed to relieve Kates pain. NARRATION: Its also a mental training exercise intended to undo the neuro-plastic changes in the brain caused by years of persistent pain. NARRATION: This brain rewiring is now thought to be a major contributor to Complex Regional Pain Syndrome. To Laura: Has Laura considered a morphine pump implant?NARRATION: Functional MRIs have shown that chronic pain actually causes changes in the wiring of the brain, This ability to change is known as neuro-plasticity.The brain continues to send pain messages long after the injury has healed.

This over stimulation of the central nervous system is a hallmark of chronic pain. Michael Cousins: Chronic pain is really very different from acute pain.So he decided that he couldn't put up with this pain any longer and he hoped that by taking the leg off he'd get rid of all the pain.But it doesn't fix the problem because there are major changes that occur in the spinal cord and also in the brain. Kates pain began with a minor injury during a netball game.Laura Black: Ah, the worst ones can be hours and hours. Laura Black: I was hiking with some friends and it was just sort of basic teenage clumsiness I guess, I fell over a rock. But the pain persisted for months even though her injury had healed. Dr Maryanne Demasi: What did the doctor say to you? It feels like somebody's got a red hot corkscrew and they're they're twisting it through my bones. Nerve fibres in the spinal cord release neurotransmitters that send messages to thalamus in the brain. The thalamus triggers other areas of the brain and returns messages to nerve cells in order to diminish pain signals. You know I've gone from sort of you know a very happy person, I knew what I wanted to do with my life, to somebody who's trapped inside. Dr Maryanne Demasi: Pain is essential for survival. Now if I wave my hand over this flame, it hurts and the pain warns me to stop.

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On the other hand chronic pain or persistent pain as I prefer to call it, is bad pain.

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