Video and Transcript: Treating Pain with Grid Localization

Hi, everyone! Dr. Orit Hickman here from Pain Science Physical Therapy.

I wanted to do another video on how to treat your sensory system. So, in one of my previous videos, I talked about that one of the things that happens with persistent pain is that your sensory system and your motor system are not communicating well with each other. And, a lot of times, how that presents is you might notice things like you drop things, you have difficulty with movement, [and] your endurance isn’t great, so you can’t walk for long periods of time. Right? These are all examples of your motor system not functioning properly. But, when you’ve had persistent pain, it’s a lot of times occurring because your sensory system is not functioning properly either. I have-I’ve done two videos so far on how to treat the sensory system. Check those out. One’s Small Object Identification, and one is Graphesthesia. 

This activity that we’re going to do is something called Grid Localization. So, I’ve got a printed grid out. It’s got the numbers one through nine on it. And, what I would do with a patient is… Let’s say that patient is having back pain. I would actually draw the grid out on their back. And then, I would say to them, “Ok. Here’s where one, two, three, four, five, six, seven, eight, nine exists on your back.” I would give them the grid. So, I’d be-the patient’s holding the grid. And, as I am tapping on different locations on their back, they have to tell me where am I-where am I-where am I touching. And, they would be like, “Oh, ya. You’re touching one, five, seven, three, six, nine.” Where they have to actually figure out where on my back-where on their back I have touched. And so, this activity can be done anywhere on the human body. So, if you’ve got pain on the right shoulder, for example, somebody would draw a grid on your right shoulder. They would tap out where one, two, three, four, five, six, seven, eight, nine exists on the shoulder. And then, they would tap/touch different locations in the grid. And, you have to figure out where did they touch! 

This is a challenging activity by the way. This is not easy to do. So, I don’t want you to be frustrated if you do it and you go, “I can’t figure out where they are at!” Have them move the grid to a location where you’re not experiencing persistent pain. Have them try there for a period of time till you get the hang of it. And then, have them slowly move back to the location that you are having pain. 

This is done for a few different reasons. It’s done for pain relief, but it’s primarily-the first thing is addressing this cortical smudging in the brain. So, we’re trying to affect the sensory system and improve how the sensory system is functioning. Once that system is functioning better, your alarm system is not as reactive. So, pain levels tend to go down over time. But, that’s not necessarily the first thing that you’re going to experience. Usually, patients will say things like, “My endurance is better. I can walk for longer periods of time” or “ I can do more activities [like] lifting up overhead. I can-you know-have my arms up overhead doing my hair for longer periods of time.” So, your function is typically going to-typically going to improve well before your pain levels improve. 

Hope this helps. Definitely make it-write any comments below. Give me a thumbs-up if you thought this was a great video and subscribe to the YouTube channel to learn more about how to treat persistent pain. Have a great day!