AUTHOR=Valenzuela Belén 

TITLE=Landau model for illustrating the learning and unlearning process of nociplastic pain

JOURNAL=Frontiers in Pain Research

VOLUME=Volume 5 - 2024

YEAR=2024

URL=https://www.frontiersin.org/journals/pain-research/articles/10.3389/fpain.2024.1307532

DOI=10.3389/fpain.2024.1307532

ISSN=2673-561X

ABSTRACT=Recent advancements in understanding the consolidation of nociplastic pain point to a complex, non-conscious learned process of threat perception. Neurobiological pain education is emerging as a promising approach to unlearn nociplastic pain, supported by biopsychosocial tools such as exposure to movement, mindfulness, and group sharing formats. However, this approach is still not well-known among clinicians and society at large, creating a communication problem that unfortunately perpetuates the suffering of patients. We propose a Landau model to describe the learning and unlearning process of nociplastic pain, aiming to clarify this complex situation and facilitate communication across 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 personal history regarding the symptom and that biopsychosocial loops are formed when there is alarming learned historical information about the symptom, along with confused and contradictory expert information, as seen in nocebo messages. Learning and unlearning in the model correspond to a change in control parameters that can weight more the alert-protected state, trust-explore state, or neutral state. This description clarifies why neurobiological education is the ground therapy from which others must be built to embody the accesible, clear, and trustworthy information.