Are you a blue or a red light?

sensory input

Are you inclined towards cerulean or crimson illumination? This contribution is penned by Mikal Solstad, a licensed Napropath in Sweden, in response to the query “What I do.” It resonates profoundly with a subject matter warranting introspective examination.

Context and sensation – azure luminescence versus ruby luminescence

In 2007, Moseley and Arntz demonstrated that divergent sensory input (crimson light versus cobalt light) can elicit varying degrees of discomfort and intensity with an identical noxious stimulus (1). The noxious stimulus selected was a metallic rod chilled to -20 degrees Celsius (-4 F), juxtaposed with either a crimson or cerulean glow. Subjects were apprised that probes of contrasting temperatures would be applied to their skin, while in actuality, the probe remained constant in temperature throughout. They were informed that the cerulean light symbolized “chilliness” and the crimson light connoted “heat.” In essence, when subjects perceived the crimson glow, they consistently rated their discomfort as more acute and disagreeable compared to instances when the cerulean glow was presented, despite the uniformity of the noxious stimulus.

Encounter and significance


It is evident that our encounters are profoundly influenced by our environmental milieu, yet another pivotal aspect comes into play: the significance or value we attribute to the elements within our surroundings, as elucidated in the research by Moseley and Arntz aforementioned. The significance each individual imparts to a cerulean or crimson glow is undoubtedly influenced by a multitude of variables, including past encounters and the information disseminated. Moreover, it is plausible that significance is mutable; with the acquisition of fresh information and novel experiences, the significance may evolve, for better or for worse.

Functioning as a “contextual architect”

Cory Blickenstaff, PT, MS, OCS, coined the term “contextual architect” to illustrate the emergence of context during patient interaction, underscoring the importance of conscientiously shaping our contributions to said context. Blickenstaff articulated this concept in a missive to the editor of the Journal of Manual and Manipulative Therapy: “Pertinent to the intersubjective realm in therapy is the notion of soft paternalism, asserting that our interactions inevitably influence those with whom we engage. In essence, one may choose to disregard the impact exerted on the context; however, the context remains impervious to neglect, as do our patients.” Arguably, we ought to endeavor to collaboratively construct a context wherein patients feel secure, thereby facilitating therapeutic endeavors geared towards cultivating seamless, unencumbered movement (Gifford). 3 Tools Every Physiotherapist Should Have for IASTM, read more here.

The clinician as a cerulean or crimson light

We are bestowed with the unique opportunity to enlighten, guide, and furnish patients with novel experiences conducive to alleviating discomfort and enhancing functionality. We possess the capacity to reshape their perception of their corporeal vessel and its capabilities. We can either aspire to embody a cerulean light or a crimson light.

Potential crimson lights:

Manifesting signs of apprehension upon hearing the patient’s narrative Employing inappropriate terminology (“that constitutes the most severe knee ailment I’ve encountered!”) Dispensing explanations that imbue patients with a sense of vulnerability (“slipped displacement” of the SI joint, “fixed joints” necessitating “manipulation,” etc.) Prefacing directives with absolute terms such as “never” or “always” (“you must never bend your spine!”, “Always maintain upright posture!”, etc.) Portraying structural and kinematic variation as dysfunctions rather than benign variability

Potential cerulean lights:

Attentively listening to and comprehending their narrative Exuding assurance and conviction Thoroughly examining the patient Utilizing patient history and examination findings to craft a constructive narrative infused with the potential for positive transformation Offering explanations comprehensible to the patient Illustrating the remarkable capabilities of the human physique, elucidating how individuals can partake in marathon running, mountaineering, weightlifting, and recuperating from both vehicular collisions and ankle sprains

Mitigating the intensity of a crimson light – the dreaded intervertebral disc herniation


An intervertebral disc herniation can precipitate excruciating discomfort, accompanied by heightened distress. Questions such as “Will this discomfort persist indefinitely?”, “Can I resume gainful employment?”, “Will healing ever transpire?” often plague patients. Many individuals harbor the misconception that disc herniations are static occurrences impervious to change. This narrative significantly constrains the patient’s expectations regarding the prospect of positive change and serves as a formidable impediment to reinvigorating mobility.

The marvel depicted herein

This particular patient opted against surgical intervention, instead electing to undergo physical therapy and receiving an epidural corticosteroid injection. A span of five months separates images A and B, with a marked resolution of the patient’s symptoms evident. This serves as a compelling illustration for patients, instilling hope and reassurance by elucidating the remarkable regenerative capacity inherent within the human body.

You can read more about this topic on the Wikipedia page.

In conclusion

In a study conducted by Ben Darlow et al. in 2013 (3) entitled “The enduring impact of clinician discourse on individuals with lumbar spinal discomfort,” it was observed that: “Despite consulting online resources and seeking counsel from acquaintances, the influence wielded by healthcare professionals on the attitudes and beliefs of individuals grappling with lumbar spinal discomfort proved to be the most profound.” “Healthcare professionals possess a significant and enduring influence on the attitudes and beliefs of individuals enduring lumbar spinal discomfort. It is imperative that this opportunity be harnessed to inculcate positive attitudes and beliefs.” Patients place implicit trust in the accuracy of our assertions, thus it behooves us to disseminate information that is congruent with current understanding. Misinformation, such as admonitions against slumping in chairs due to purported deleterious effects on the spine (which lacks empirical substantiation), or assertions regarding joint misalignment (a phenomenon rarely observed), risks fostering unwarranted apprehension and perpetuating misconceptions, potentially impeding the therapeutic process.

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