Is there a hierarchy of survival reflexes?
A hierarchy of survival reflexes for prioritising assessment and treatment in patients with pain of insidious onset is hypothesised. The hierarchy asserts that some systems are more vital than others and that the central nervous system (CNS) prioritises systems based on their significance to survival. The hypothesis suggests that dysfunction in more important systems will cause compensation in less important systems. This paper presents studies examining these effects for each system, arguing that each section of the hierarchy may have effects on other systems within the hierarchy. This concept is untested empirically, highly speculative and substantial research is required to validate the suggested hierarchical prioritisation by the CNS. Nonetheless, the hierarchy does provide a theoretical framework to use to exclude contributing systems in patients with pain of insidious onset.
Bowskill Clinic, 4 Duke Street, London W1U 3EL, United Kingdom. Electronic address: kieran@kieranmacphail.com.
Kieran
K
Macphail
D002490:Central Nervous System / Q000502:physiology*; D059350:Chronic Pain / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy*; D006309:Hearing / Q000502:physiology; D006801:Humans; D008954:Models, Biological; D009142:Musculoskeletal Physiological Phenomena; D009424:Nervous System Physiological Phenomena; D058748:Pain Perception / Q000502:physiology*; D012143:Respiratory Physiological Phenomena; D013284:Stomatognathic System / Q000502:physiology; D014781:Viscera / Q000502:physiology; D014785:Vision, Ocular / Q000502:physiology