Landau model to illustrate the process of learning and unlearning of nociplastic pain

TL;DR

This paper introduces a Landau model to illustrate the complex process of learning and unlearning nociplastic pain, emphasizing the role of personal history and biopsychosocial factors in pain perception and education.

Contribution

It presents a novel Landau model to clarify the dynamics of nociplastic pain learning and unlearning, aiding communication and understanding among clinicians and society.

Findings

Nociplastic pain is modeled as a first-order transition.

Perception depends on personal history and context.

Biopsychosocial loops influence pain perception and learning.

Abstract

Recent advances in the comprehension of the consolidation of nociplastic pain points to a complex nonconscious learnt process of threat perception. Neurobiological education is emerging as a promising approach to unlearn nociplastic pain supported by biopsychosocial tools (exposition to movement, mindfulness, sharing group format...). However this approach is still poorly known by clinisians and society in general forming a communication problem that, unfortunately, perpetuate the suffering of the patients. We propose a Landau model to describe the process of learning and unlearning nociplastic pain to help to clarify this complex situation and facilitate communication between different sectors of society. Nociplastic pain corresponds to a first order transition with attention more likely in the alert-protection state than in the trust-explore state. Two appealing results of the model are that the perception of the critical context depends on the personal history about the symptom and that biopsychosocial loops are formed when there are alarming learnt historic information about the symptom together with confused and contradictory expert information as in nocebo messages. Learning and unlearning in the model correspond to a change in control parameters able to weight more alert-protected state, trust-explore state or neutral state. This description makes clear why neurobiological education is the ground therapy from which others must be built to embody the pertinent, clear and trustful information.