There is an excellent tool that has been developed by the Neuro Orthopedic Institute (NOIgroup) that strives to give people a better understanding of the many factors involved in their pain. It is called the Protectometer. More information about the NOIgroup can be found at their website http://www.noigroup.com, but we will go through the basics below.
Please feel free to look at the previous posts regarding the topic of chronic pain if you would like more information on general concepts.
Let’s begin with a refresher on a definition of pain. Pain is defined in the literature as - An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.
In this context, pain can be understood as a defence mechanism or protector of our body, meant to alert us to an area or issue that requires attention or modification. For example, to move away from something too hot, or to remove our feet from the sharp stones underneath us.
The Protectometer, otherwise known as a “danger meter”, is an idea that can help to explain the many factors that may influence the pain experience. Referring to the definition of pain above, we know that the perception of danger in a body tissue or area can be enough on its own to create a pain response, under the right conditions.
Another way to visualize this is as a set of balance scales. With so many potential factors that can influence the positive and negative sides, it can be very difficult to decide which particular thing seemed to increase or decrease the painful symptoms. This helps to explain why sometimes it is very hard to pinpoint which one thing caused a problem when a combination of countless factors could be to blame. It can be very difficult to interpret all of the things that happen in a single day, let alone a week, or a month.
The scale can have a protective OR amplifying effect on symptoms. People who have more positives on their scale are likely to be more resilient, while people who have the deck stacked against them are likely to have more difficulty overall. The brain, nerves, and tissues, add up all of the different factors to decide what we feel and how much of it we feel in any particular moment. All physical activity, and all mental activity can play a role in adjusting the scales. All the things we do in a day, plus the things that are said, heard, thought, and believed, can make a difference. Even the environment we are in can play a role in what we feel.
Identifying the negative parts of the condition, environment, thoughts, activities, and feelings is an important step in determining what can change and how to go about it. This works in the reverse as well in that all of the positive things about feelings, activities, thoughts, environments, and support from others can help to balance the scales in our favour.
This is a dynamic and ever-changing balancing act between the positives and negatives in the body. While there can certainly be habits and a leaning in one direction based off of history, we know that the system is always capable of some measure of change.
So how do we tip the scales? We can add things to the positive aspect, or remove negative things from the other side. Now, not all of these things are changeable, but there are often a number of things that are. Everyone will have different things to consider and a different starting point, but that’s where we begin.
Please feel free to leave a comment or reach out to our office if you have any questions.
~ Trent, PT
· Moseley, G. L., & Butler, D. S. (2017). Explain pain supercharged: The clinician's manual.