CEPCO – Centre Epaule Coude

It’s in your head!

A patient would not dare raising his arm even though his shoulder surgery went perfectly well? An amputated limb hurts horribly?

Your brain is probably playing tricks on you! After orthopedic surgery (e.g: following shoulder dislocation) most people resume activities and sports and perform just as well as before their injury. “But some patients don’t do as well and continue to be afraid despite the fact that their shoulder is stable, examinations and imaging results are all normal, ligaments are perfectly well attached and the surgical procedure was a success …” Dr. Hoffmeyer, Chief of Service of orthopedics at the Geneva University Hospitals, says. “They do not necessarily have pain, they are just skeptical about using their arms and wonder whether or not they will ever be able to.” More than 20% of patients continue to fear the worst. This inspired Dr. Hoffmeyer and orthopedic surgeon Dr. Cunningham to work with Dr. Haller, neuroradiologist, to determine whether or not something was wrong. And there, bingo! When these patients were shown videos of movements likely to dislocate the shoulder, the MRI showed significant cerebral reorganization, with over activation of the zones that regulate emotions such as fear.
The brain is also at the forefront of “phantom pains” following amputation. In such instances, one of the solutions consists of tricking the brain, using a simple mirror or virtual reality, as shown by this exciting report of 36.9˚. In the case of nerve damage causing unsustainable neuropathic pain, the implantation of a neuro-stimulation system can improve the lives of 60 to 70% of patients; yet, it does not cure the causes of suffering but filters or simply blocks the arrival of these signals to the brain. And there are more secrets to be discovered from these exciting findings …
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