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How Can I Diagnose My Pain Like a Pain Specialist?

This excerpt is taken from an episode of the "Tell Me About Your Pain" podcast. You can listen to the full episode below, or on Apple Podcasts, Spotify, and Google Podcasts


In this episode, Alan talks to Howard Schubiner, one of the pioneers of mind-body medicine. Dr. Schubiner has developed a unique protocol to help patients determine whether their pain is caused by their brains, or by a structural problem in their bodies. Dr. Schubiner shares some of his landmark techniques (such as provocative testing) geared toward diagnosing pain. Then Alan and Dr. Schubiner talk about how you can use these techniques to help figure out the cause of your own pain.

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Alan and Dr. Howard Schubiner on properly diagnosing pain.

Alan: You know, when I had really bad back pain, I saw a lot of different physicians, physical therapists, and chiropractors, and I remember there was a physical therapist she's like the head of physical therapy at a really prestigious facility, and she looked at my MRI slides and she said: "oh my goodness did you like fall off a third-story balcony or something?" This is terrifying to hear, you know?

Dr. Schubiner: Yea, and frankly, it just makes me mad that the data we are referring to that most people have abnormalities on their MRIs is not new. It's been around since the 90s. 

Alan: Yea. it's just not so widely known yet. So that's one of the things that I thought you could potentially help our listeners with today is whether someone has back pain, neck pain, headaches, or mouth pain. Suppose they're diagnosed with trigeminal neuralgia or herniated discs. What guidelines do you think you would be able to help provide so that people can make that determination on their own?

Dr. Schubiner: I think most of the time, people actually can do that. First of all, have they been diagnosed with a specific diagnosis, a neural circuit disorder such as fibromyalgia and irritable bowel syndrome. 

Alan: Just to interject for a sec for those of you listening, Howard referred to it as "neural circuit pain," Howard and I both used to refer to this condition as "neural pathway pain." Then Howard started calling at neural circuit pain, and I started referring to it as "neuroplastic pain," and when the boulder study comes out, it's going to be referred to as "centralized pain," so we like to keep things simple. They're all different names for the same syndrome.

Dr. Schubiner: If someone has been given a specific diagnosis by definition precludes having a structural problem, then it's neural circuit pain right there fibromyalgia, irritable bowel syndrome, tension headaches, migraine headaches, POTS,  burning mouth syndrome, small fiber neuropathy, there's a whole bunch of these, for example, you have tooth pain, and you go to the dentist, then you go to five dentists,  and they can't find anything well if they've ruled out a disease problem by looking and not finding it then by definition that's going to be a neuroplastic problem.

[this is an excerpt only - for the full episode, listen to the podcast above]

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