Medical Journeys

Archive for the ‘Pain Management’ Category

Humanity is unfortunately no stranger to pain. Regardless of where you live in the world, the socio-economic status you hold or your perceived level of happiness, you can be guaranteed that without fail you will experience some degree of pain in your physical body at some time during your lifetime.

What is Pain?
Pain comes in many forms, the most obvious being physical pain, in which a person experiences feelings of discomfort or hurt within the body. Not all physical pain is bad, nor is it necessarily associated with illness; ask any woman who has been through the birthing process, or a child proudly showing off their new tooth. Similarly, the pains felt when you break your arm, cut your finger or haul yourself out of bed after doing 200 sit-ups the previous day are all normal and healthy messages. Your body in its automatic self-preservation mode is alerting you to the fact that it has experienced trauma – just in case you hadn’t noticed!

Chronic Pain
However, some physical pain can become chronic. Chronic pain is pain that continues day in, day out, without any signs that the problem is resolving itself! Do you know what I’m referring to? It may have at its roots a long-term or presently incurable illness, or may have been brought about by injury or even a former operation. Some chronic pain may not even have an evident source; however its existence is keenly felt.

People who live with chronic pain will often testify that it affects their quality of life. It can physically prevent them from being able to participate in various activities of normal life, which then often leads to feelings of helplessness or even depression. For some, there seems to be no escape from the endless state of pain.

Chronic Pain Management for a Better Life
If the feelings I have just described sound familiar as a sufferer of chronic pain, I am sure that you would welcome any reasonable solution to help alleviate – and potentially remove – your symptoms. Some sufferers are willing to try any manner of pills, remedies and therapies in the hope of finding relief. They often turn to medication or even surgery in their quest for chronic pain management, but somewhere in the subconscious mind, the pain is still very real. It is clear that an alternative method of chronic pain management is needed.

Pain Relief Hypnosis
I recommend that you consider pain relief hypnotherapy. It has been clinically documented that pain relief hypnosis works. In a report published in 2001, The British Psychological Society found that “…hypnotic procedures are effective in the management and relief of both acute and chronic pain and in assisting in the alleviation of pain, discomfort and distress due to medical and dental procedures and childbirth”.

Without getting too anatomical, let me explain that pain signals are sent via your nerves through your body and into your brain. As a pain relief hypnotherapist, I utilise the techniques of Hypnosis and NLP to change the way in which those pain signals are processed by the brain. As an outcome, the pain you perceive or feel will either be greatly reduced or controlled. How is this possible? Put simply, when you are in a relaxed state, your body is calmer – and when your body is calmer, the pain you feel is lessened.

Pain relief hypnosis offers a distraction from the pain you are feeling by allowing you to experience an altered state of mind. It is a very natural and non-invasive method of healing for both body and mind. There are many benefits to undergoing pain relief hypnotherapy; perhaps one of the most attractive – other than the relief experienced, of course – is that hypnosis offers a healing option which is non-medication based and therefore not habit-forming.

Do not wait… Find Relief from Chronic Pain Today
Now, before you undergo any pain relief hypnotherapy, it is very important that you first seek to determine the cause of the pain with your medical doctor. Armed with this knowledge, I will be able to treat the direct source of the problem, and work at successfully bringing some relief to you. A pain relief hypnotherapist will be able to give you that relief you so desperately need!

If you suffer from nerve or spinal injuries, lupus, lower back pain, rheumatoid arthritis, Crohn’s disease, joint pain including osteoarthritis, fibromyalgia, irritable bowel syndrome, migraines or similar ailments, please don’t hesitate to contact your pain relief hypnotherapist today. You don’t know what you are missing out on! You’ll be kicking yourself knowing that there was a simple remedy!

You deserve a better quality of life. You deserve to enjoy all of the things that make life worth living – great relationships, sunshine, good health and the anticipation of each new day – without having to endure persistent and relentless chronic pain.

Author: Georgina Hoehmann
Article Source: EzineArticles.com
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Do these situations sound familiar to you?

• Sharon has had fibromyalgia for many years, although it was just recently diagnosed. Some days, it’s all she can do to get out of bed
• Joe was in an auto accident last year. The doctors say his injuries have healed, but his neck and back still hurt every day.
• Lois lives with arthritis. The pain in her joints comes and goes, but even on a good day it takes at least an hour before her hands and shoulders can move somewhat comfortably.

Chronic pain has been described as a "silent epidemic". The American Academy of Pain Management gives the following statistics: An estimated 50 million Americans live with chronic pain caused by disease, disorder or accident. An additional 25 million people suffer acute pain resulting from surgery or accident.Approximately two thirds of these individuals in pain have been living with this pain for more than five years. The most common types of pain include arthritis, lower back, bone/joint pain, muscle pain and fibromyalgia.

Living with chronic pain can consume a lot of energy we would ordinarily use for pleasurable activities. Patients tend to get depressed, anxious, and withdrawn. Little by little they give up activities that have become too difficult, and they experience isolation as a result. The impact on family and other loved ones is also significant.

Often patients living with chronic pain feel that there is no help for them. They’ve usually been to several doctors, followed recommendations, and used different types of medications. Some of the medications may have worked well but had intolerable side effects; some of the medications may not have worked at all. Eventually patients start to feel that they "just have to live with it".

How we live with chronic pain is what makes all the difference. As we learn more about how our brains and bodies work, we find that the degree of pain felt, and the amount of tissue or other body damage, does not necessarily correlate. Does this mean that our pain is all in our heads? No! What it means is that our brains, so amazingly complex, may learn to over-respond to pain, and / or that our minds, the parts of us that think our thoughts, may have learned to think about our pain in ways that aren’t productive.

What has been learned can be un-learned, and what we think that is incorrect can be changed. And the good news is that there are many ways to do this.

So what can help? First, cover all the medical bases. Then move on to the cognitive / behavioral / emotional areas. Remember, our bodies and our brains are connected, and they always work together!

• See a medical pain professional. Assuming that your condition has been diagnosed and is being treated properly from a physical angle, the next step should be to consult with a medical doctor who specializes in working with chronic pain. These physicians have many years of training in all sorts of ways to treat your pain. They will have good recommendations to make that go beyond taking narcotics.
• After you have covered all the medical bases, the next step is your thought processes and emotional reaction to pain. Don’t believe this is important? Think about a time when you were having fun and were completely immersed in the experience, and happened to get hurt. You may not have even noticed the pain until later. Our experience of pain (or anything else) is largely determined by how we focus on it. This is where a therapist trained in management of chronic pain can help.

How can a therapist help your chronic pain?

• You can learn how to distract your brain from pain, and to respond to it differently, through tools like hypnosis and guided imagery.
• You can learn to relax your body much more thoroughly with specific exercises. Relaxation training helps ease tense muscles, and can improve your sleep.
• You can learn to notice your thoughts, the "endless chatter" that we all have, and where they are negative and non-productive, you can learn to change them. Remember the "little engine that could"? It’s a very powerful tool!
• Where pain is the result of a trauma, like an auto accident, or where the pain itself has become traumatic, you can be helped to move past and recover from that trauma, which may itself result in a reduction of felt pain.

Chronic pain can come from many causes, and sometimes the underlying cause cannot be completely treated. The resulting pain is not something that "you just have to live with it". There are many tools that can help improve various aspects of the pain.

The key is look for professionals who know how to work with chronic pain. Ask your doctor for a referral. Or try looking online in your area, under "pain management" or "chronic pain". Just be sure to check out anyone you find online, to make sure they are a qualified professional.

Remember Sharon, Joe and Lois from our examples at the beginning? Feeling better and functioning more are definite improvements, even if they aren’t completely pain free. You may have to live with chronic pain, but you can live better and enjoy life more.

Author: Deborah Tucker
Article Source: EzineArticles.com
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In a mountain cave that has been lodged in darkness for eons, a lone lighted match can dislodge the darkness in an instant, just as the accumulated ignorance of ages can be dispersed by an enlightened yogi with the illuminated torch of wisdom. There are those who have been painfully dragging their bodies around all day long and want freedom from pain in their consciousness. Realization comes with a price; it is giving the time necessary to their development. These words I am bringing to you come from the teachings of a great master, a yogi from India to help us alleviate pain and suffering. The delusion of pain and suffering is the greatest curse on the soul. You might be okay today, but how do you know you will not be a victim tomorrow or some day? It is wise to try to remove its causes as long as there are any probabilities of pain or suffering in the future. The three aspects causing man’s suffering are wrong actions, delusion and mass karma.

Identification of the flesh comes from delusion. From the earliest stages of life the little child imagines that he and his body are one. See him cry when you pinch him, then soothe his hand and observe how he likes it. By pampering the body, bodily identification increases. When you love your body too much, you become overly vulnerable and sensitive making yourself suffer any time your body is uncomfortable. Because you have been taught to suffer you depend to much on bodily comfort for pleasure. The need for all types of comforts is the main cause of pain. That is why we are told by the wise men and saints not to be attached to anything that causes you to be unhappy or dissatisfied due to its absence. When bland or plain food is offered, don’t yearn for your preferred dishes. One must become divinely indifferent. For example, if you drop on the floor a wonderful plate of food you were going to eat, how should you react? You can spend a lot of time cleaning something but if you accidentally drop it in the mud you might start laughing. When you can have that kind of detachment you will become more pain free. Be more detached.

The link between your bodily suffering and you is simply mental. Our consciousness of pain is mental or physical and is born of feeling and ego. The truth is that if you teach yourself to live in the body without thinking of it as yourself you will have far less suffering. When you go to sleep at night after a hard days work and your body is sore and you are dead tired, you fall asleep into unconsciousness yet your body feels no pain. It’s the same as going to the dentist to fill a cavity. When you are given an anesthetic to kill the pain, you have disconnected your mind from the sensation of pain. However, being hurt in a dream is the imagination of pain and being hit by a blunt instrument is the feeling of pain. Physical pain is caused by feeling coming from a sensation and imaginary pain is born of imagination. The two of them are formed in the mind. Dreaming of pain hurts us mentally in the same degree as physical pain hurts us in the awakened state. That is why a detached mind does not feel any pain and that is why sleep is a blessing. What ever your troubles are it does not matter because when you are sleeping you are free from them. You must learn during your waking hours how to be consciously free. You can’t know the sweetness of sugar if you haven’t tasted it; if you have not used the total capability of the mind, you can not grasp its astonishing power.

Mental power is the best anesthesia against pain. You will see that the pain will be significantly lessened if the mind refuses to recognize it. If you become tough within you will develop more strength of mind. When pain comes say to yourself, “it doesn’t bother me,” just care for it, but don’t suffer from it. Remember, the more you care for and love your body and are excessively concerned about it, the less power the mind will have to redeem itself. Your imagination heightens your suffering and feeling sorry for yourself or worrying won’t lessen your pain but greatly increases it. Some people let themselves be swung back and forth by the pendulum of emotion and moods. It is very difficult for those who allow themselves to be swung backward and forward with these emotions to understand the steadfastness of those who are even-minded and in a state of mental poise.

There are some people in whom feeling is prevalent and therefore suffer more either in the cold or hot weather where even-minded mentalities do not. Pain and pleasure are the results of an extended and continuous psychological habit. Physical pleasure or pain are both accompanied by sensations from the body but are not caused from these sensations.

They are formed by belief and feeling and psychological habits originate from hereditary and environmental effects and are transmitted from generation to generation. Mankind has been bequeathed the mentality of pain from erring ancestors. Just as our older civilizations thought the world to be flat, modern man inherited a belief in pain from his predecessors. Unfortunately they were not educated in psychology as to the development of the psychological illness of belief in pain.

The mother of all mental sorrow and pain originates for sensitiveness. Unpleasant sensations that are physical in nature are for example stepping on a nail which causes the belief of being painful and it is the same as an unpleasant thought of the death of a loved one or the loss of an important possession, it causes sadness. Mental sorrows can give more misery than agonizing physical sensations. Instead of getting excited be impartial for identification or sympathy causes pain. The mentally sensitive are always worried by suggestions of a cold night or a hot day. To sympathize or acknowledge the sorrow-making sensitiveness in anyone is wrong because it amplifies the illusion of misery and pain deceiving the mind and senses.

The yogi masters tell us it is written in the Gita that in place of giving into the impulses of heat and cold, we can by mental control be trained to endure them gradually, like using less heat and not being frightened of the out-of-doors. Our bodies and minds should be made pain-proof.

Those who want to expand their consciousness must learn the art of remaining even-minded while observing their mental and physical changes and should try to practice the technique of “titiksha” (endurance) that is practiced by the yogi masters. Even a little practice of this art can help strengthen your mind. Now watch and analyze yourself whenever you are feeling the following: When you experience extreme cold, a fever, extreme heat or a miserable head cold focus on the nasal passages; when experiencing a sad state of mind or while having a cut or a wound observe it as a lessening sensation but do not try to disregard it; when you are feeling very happy possessing something that was longed for, try to remain totally impartial.

Learning the above will teach endurance and detachment and while watching what is going on with an academic view should help you neutralize agitated sensations. The average person soon learns that the mind can not control the mind, but the yogi masters know different, that by the method of visualization, will power and imagination the yogi can soften the brightness of the senses of touch, sight, hearing, smell and taste at any time he doesn’t want to be troubled by them.

In order to shut off worry, imagination and mental restlessness put these steps into practice, concentrate on one positive thought at a time, use will-power to eliminate unwanted negative thoughts, become even-minded during all conditions and change the emotions of love and hate to self-control.

We must learn to observe our bodily changes academically but not with indifference. Bodily pain, like a pinprick is produced as a helpful warning sensation intended to pinpoint information to the brain that the pin pricked skin needs attention or repair.

THOUGHTS FOR CONQUERING PAIN

When pain arrives in your body through disease or injury, heat or cold, keep these suggestions in mind:

A. Pain was not designed to torture you or be your enemy but a friend to warn you of physical trouble. Do not give into the mind and allow it to be identified with your body’s pain; for it is relatively limited and short-lived, endure it.
B. Pain is manufactured by your mind.
C. Do not dwell on the sensations of pain, keep calm and divert your mind into absorbing thoughts or work.
D. You must associate yourself with strong-willed people, so you may steal their magnetism. The company of sick people can make you sickness-conscious through wrong magnetic-vibrations, which should be conquered. Those who wish to become successful should mix with successful people; the company of successful people is a great antidote for failure.
E. If you are sorrowful remember that sorrow is not conquered by more sorrow, but by joyfulness.

To learn the secrets of the yogi masters read the book “Autobiography of a Yogi” by Paramahansa Yogananda, where most questions are answered. For those of you who are extremely worried about things or are habitual worriers make a note of this next paragraph and read it daily.

Give all your worries to God. It is your funeral when you are worried all arranged by yourself. Don’t be buried alive by your worries. Why be miserable and die every day from your anxieties? What ever you are experiencing, ill health, sorrow, poverty, be reminded there are people on this earth suffering a thousand times more than you. Do not imagine yourself to be so ill-fated, doing that will bring sure defeat and close out the omnipresent guidance of God that is always looking to help you.

Author: Gary Zalben
Article Source: EzineArticles.com
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There are many individuals that suffer from pain on a consistent basis. There are some that suffer from medical conditions that result in discomfort. The others suffer as a result of an injury that they sustained, or surgery that they had to undergo for one reason or another. Many of these people wish to indulge in natural pain relief.

Those that suffer from one form of pain or another know and understand that pills are simply a “band aid” for the discomfort that they experience. This is why so many seek natural pain relief options. These options provide an individual with the ability to truly overcome the obstacles that result in pain.

If you are interested in engaging in a natural pain relief option, it is critical to carefully consider the cause of your pain, as well as your unique medical history. You should discuss your desire to participate in this type of treatment with your doctor. A medical professional should stand behind your decision to seek relief “outside the pill”.

Many individuals do not realize that natural pain relief can result in many complications. Every treatment carries some sort of risk and/or complication. This is one of the main reasons that it is advised that you seek approval from your doctor when considering natural pain relief. They will be able to determine as to whether or not the treatment is safe for you.

One of the first methods of natural pain relief that many individuals participate in is that of stress management. Many medical professionals have established that stress is a factor that can actually magnify our perception of the pain that we are experiencing. The mind is a powerful organ when it comes to our experiences with pain.

When we experience pain, many things happen in our body. If we are experiencing high levels of stress, these things are intensified. This includes the muscles becoming stiff and rigid, our bodies working hard to interrupt the pain, and our minds either objecting to the pain, or buckling under the pain. This is why stress management is an effective natural pain relief method.

Stress management as a natural pain relief method can be performed by engaging in an assortment of relaxation techniques. This includes practicing yoga, visualization techniques, and even receiving a massage. Many may even elect to join a support group, or Tai Chi.

The next form of natural pain relief for those who wish to avoid the complications of taking medicine is exercise. There are a number of people who have discovered that pain actually increases when they fail to move and workout the body. Inactivity leads to degeneration. Degeneration leads to pain.

Individuals who fail to work out can experience problems like weak muscles that degenerate quickly, failure in bone density, complications with the heart and other organs, as well as depression as a result of suppressed mood-enhancing hormones and substances in the body. Many simply do not know and understand the impact of exercise on the body. It has many positive attributes when it comes to pain relief and health in general.

While exercise is an excellent natural pain relief method, it is important to inquire as to which exercises are best for you and the specific pain that you suffer from. You should discuss this with your doctor. They will be able to provide you with an effective exercise regime to compliment your condition.

Many people do not consider it, but indulging in a proper diet is a natural pain relief method. Not only does a proper diet help you lose weight and maintain a healthy weight level, but it can also provide the body with the necessary vitamins and nutrients that can help the body fight infections, build the bones, and maintain muscle mass.

The ingredients that can help an individual experience less pain include high levels of protein, various types of vitamins, foods that contain omega-3, foods that contain high levels of saturated fat, minerals, and hormones. Foods that contain antioxidants are also essential in the natural relief of pain in the body.

Many medical professionals have determined that a whole food raw organic diet is one of the best types of diets that an individual who experiences pain can benefit from. Individuals who consume foods that were cultivated with many chemicals can actually experience more severe levels of pain. Foods that are cooked often lose a portion of the nutritional value. This can have a negative impact on pain levels as well.

Many who experience discomfort can achieve natural pain relief by engaging in physical therapy. When an individual engages in this type of natural pain relief, they learn to effectively care for themselves and to appropriately participate in activities that they once found to be extremely difficult. This can be a very rewarding experience for many.

Individuals indulging in this type of natural pain relief can learn steps that will help them to build strength in their body. They learn who they are, and how they work. They also acquire a new sense of mobility that can improve their overall quality of life. This can be a very rewarding experience for many who are trapped under the obstacle of pain in their life.

Aromatherapy is another form of natural pain relief for many. Individuals who use aromatherapy implement the use of different kinds of essential oils in order to produce an effect in the body. Though used for many different things, pain relief is a main motive for many different people. It has been established that these aromas have an effect on the receptors that control the amount of pain that we experience.

As you can see, there are many different kinds of natural pain relief options for people. These options vary from the use of aromatherapy to the use of physical therapy. While these methods are appropriate for every single person who experiences pain, most will have a particular preference when it comes to them personally. If you wish to experience natural pain relief, the options listed here will put you on track.

Author: V.K. Rajagopalan
Article Source: EzineArticles.com
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Are you currently suffering from some type of chronic pain? Well, you are not alone.
It is estimated that:

50 million Americans live with chronic pain each year (American Pain Foundation)
33 million Americans have at least 1 of 100 forms of arthritis and nearly 90% of people over 40 have beginning signs of arthritis (Journal of Rheumatology, 16)
1 out of 3 Americans each month lose more than 20 hours of sleep due to pain (American Alliance of Cancer Pain Initiatives)
Pain is the second leading medical cause of work absenteeism (American Pain Society)
60% of men and women experience pain every day (American Alliance of Cancer Pain Initiatives)
50% of elderly living in the community experience pain while 71%-83% of institutionalized elderly suffer from some form of pain. (Pain, 1997)
Women are less likely to receive treatment for pain than men (Law/Medical Ethics, 2001)

Chronic pain is a subjective experience, affecting each person in a unique way. There are as many different causes as there are types of pain. Also, each person responds to pain differently. Some have a higher physiological threshold for tolerating pain. Some have a naturally more relaxed body or a way of breathing deeply that may dampen some of the painful sensations. Personal attitudes, beliefs, behaviors, and the attitudes and responses of healthcare providers and loved ones can either help to alleviate or actually exacerbate the actual pain.

In the 1980′s, The American Academy of Pain Management (AAPM) was formed to facilitate dialogue among physicians, counselors, educators, administrators and patients. That organization, still very active today, represents a powerful professional resource, providing cutting edge research on the most effective methods for treating and alleviating pain. But this organization focuses mainly on professionals and clinicians.

The American Pain Foundation (APF), established in 1997, now has a membership of over 80,000 people living with pain, their caregivers, and healthcare personnel. This foundation was established to improve the quality of life for patients suffering from pain, sometimes daily, and to advocate for public awareness, information, education and research into this elusive medical condition that affects so many of us.

In 2004, the APF created a Military/Veterans Pain Initiative to help veterans, those active in the military, and their families to cope with the pain that many of them live with daily. This initiative provides educational materials and peer to peer support to reduce the sense of isolation and to improve the quality of their lives.

The APF offers a toll free, pain information center hotline and personalized email responses from staff. The free online support community, PainAid, gives current information for patients to determine the best pain care and connect with others struggling with their own pain. The APF site also offers a Pain Resource Locator, a database of local resources and organizations as well current pain-related clinical research trials.

If you are suffering from pain, regardless of the cause or the severity, you do not have to suffer in fear and isolation. This organization has been created to help you, or someone you know who is suffering from chronic pain, to find the best way to cope with the pain, alleviate the pain, and get back to living an enjoyable life.

Author: Erica Goodstone, Ph.D.
Article Source: EzineArticles.com
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Achieve pain control through diet, not painkillers.

Pain is not a disease, but often a result or a symptom of disease.

Pain is a subjective experience – the perception of pain varies with individuals. Pain is often difficult to describe, but you know it when it strikes you. Nobody is immune from pain throughout lifespan. Some learn to accept pain as part of the unpleasant side of life, while others fight pain tooth and nail.

Your diet plays a significant role on pain control.

Pain is often connected with diet, given that it is related to disease, which may be a result of a poor diet. You reap what you sow, and you become what you eat.

Fortunately, foods not only can prevent pain but also effectively fight pain.

Research findings have shown that foods work against pain, even acute and chronic pain. Research studies have also shown how and why foods work against pain.

Foods have nutrients (not junk foods), which can work miracles in the human body against disease and pain.

At the site of injury, nutrients can reduce further damage done to cells and tissues. In addition, appropriate nutrients can cool your body’s inflammatory response to the injury inflicted. Furthermore, they provide analgesia on pain nerves, thereby instrumental in alleviating, if not suppressing, the pain. Finally, good nutrients from foods may enhance your brain’s chemicals to reduce pain sensitivity.

Different types of pain require different types of foods or nutrients for optimum pain control. For example, if you have arthritis, you need to use diet to stop the joint damage as well as to suppress the pain caused by the damage. If you have cancer pain, you may want to use foods to control the disease progress, thereby minimizing the resultant pain.

Research has shown that certain foods have certain food nutrients for different kinds of pain. For example, brown rice (not bleached white rice, which is partially depleted of its nutrients) soothe your digestive tract. Ginger has been used by the Chinese for thousands of years to cure migraine and headaches. Cranberry can alleviate pain due to bladder infections. Vitamin B6 enhances your brain’s resistance to pain or its pain sensitivity.

Therefore, it is important to choose pain-free foods as your staple foods to avoid pain in the first place.

Pain-free foods are foods that do not cause any pain or allergy leading to pain. They include rice, green vegetables, colored vegetables (with the exception of tomatoes). They are all safe for consumption in any amount.

Then, you should add other foods that may ease your pain, that is, foods that improve your blood flow to prevent inflammation or stagnation; or avoid foods that tend to cause blockage in your blood vessels. All dairy products and foods rich in animal protein are not friendly to blood flow. Foods rich in fiber help your body remove unwanted fats and cholesterol, which may cause blockage and inflammation. It is also important that you eliminate any food that causes allergy and reaction in your body.

If intake of foods is inadequate in pain control, you may consider taking supplements of herbs, extracts, and vitamins to enhance your pain control.

Author: Stephen Lau
Article Source: EzineArticles.com
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We’re all familiar with experiencing some type of physical pain in our lives. Go to your medicine cabinet and look at how many medications you stock to alleviate pain. Makers of pain relief medications (over-the-counter) even go so far as to create medications that target specific types of pain. It’s obvious that we’ll do whatever it takes to avoid pain, but what about when our choices are limited?

If you’ve ever been in the hospital, you may have been asked how severe is the pain you’re experiencing on a scale of 1 to 10. This is no time to be a hero. You should know that the level of pain will be the deciding factor on the type of pain medication or other pain reducing procedures used to help you. Too many people, who aren’t drug seeking, try and brave the pain because we have a cultural myth about being a hero and pain (even if the hero is only in our own heads).

It’s important to tackle pain because it is extremely intrusive in our lives. It interferes with our quality of life, our day-to-day responsibilities, clouds our thinking and disrupts our body’s ability to function properly. Pain is not a universal experience. The type of pain you’re experiencing is dependent on your illness or injury. Muscular skeletal pain differs greatly from never pain, both in experience and treatment. Just as there isn’t one type of pain, pain treatments are tailored to the type of pain you’re experiencing. Don’t assume that the medication a family member took for migraines will help you following surgery.

The other differentiating factor is when pain is a major symptom of the disease as in Fibromyalgia and when it is a byproduct of treatment, like following surgery. Believe it or not doctors prescribe medications other than analgesics and narcotics to relieve pain. Some types of pain are best treated by anti-depressants. This is the time when speaking with your doctor or your pharmacist can help you understand the treatment and how it alleviates pain.

Along with the countless number of pharmaceuticals on the market, some are choosing to tackle their pain with alternative treatments. Acupuncture has become a more mainstream treatment for pain. Increasingly acupuncture is being recognized by insurance companies and reimbursement is available. The type of treatment you choose for pain is up to you. However you choose to reduce or eliminate pain, be sure that you do it safely and with guidance. This is no time to self-medicate (with alcohol or illegal drugs), that won’t eradicate the pain, only mask if for a short period of time.

The problem with pain is that there is no test that shows the veracity of your pain. It is an experience your doctor has to believe. It’s a personal experience so having a good rapport with your medical provider goes a long way when fighting pain. Understand that pain can’t always be eradicated so looking for other techniques like acupuncture or meditation and visualization can aid in improving your quality of life.

Pain is real; don’t allow others to discount your experience. You may decide to seek a consult with a pain specialist. Palliative care physicians are well versed in pain relief. We’re accustomed to seeing palliative care physicians work in hospice with the dying, but they are increasing being referred patients with long standing, uncontrollable pain. Always ask “what next” as long as you’re experiencing pain that is consuming or intruding in your life.

Author: Greg Katz
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For many decades we have been using electricity to control pain. Actually we could go back several centuries to the oft repeated use of electric eels for gout pain. The patient would put the painful part in a bucket of eels and obtain pain relief from the shock of the eels. This is our first recorded use of electricity for pain control. It does not matter whether the pain is chronic or acute as the process of sensory input for the pain sensation is practically identical. Historically tens units have been used outside the clinic for the patient to wear and adjust during their daily activities to accommodate the pain being felt. If the pain is very severe, acute onset, or the patient has moments when the pain intensity is too great for them to bear, then interferential is used in the clinical setting. In rare situations a dorsal column stimulator (DCS) will be used and in the most severe a deep brain stimulator (DBS) will be used. I’ll explain each of these farther along in this email.

Physiology:

Pain is symptomatic of a problem somewhere in your body. The pain signal triggers your brain to respond to the harmful stimulus, such as touching a hot pan, by rapidly withdrawing your hand. If the hand was harmed, tissue damaged, then a new process is started by the brain to make sure there is no infectious agents such as bacteria, germs etc. in the body where the pain was experienced. The brain will signal the release of T-cells ( natural antibiotics ) to the site and will precede the t – cells with histamines so they can break through the capillaries to the area the bacteria is and kill it. The brain will cause many physiological and biological changes with the latter two being a small part of the process.

The pain stimulus is sent to the spinal column to go to the brain. It is an electrical signal that imbalances certain nerves and the resulting actions by the nerves insure the pain message is received so no further harm is done. All of this is good until the message going to the brain is continuous or more frequent than is needed and unnecessary. It is at this point when the message is constant that the patient has a problem. Now the issue is not protecting the body but preventing further harm by the constant pain message which limits the patient’s abilities to be functional. The pain impulse becomes an inhibitor to health. One comment you will hear often is the pain ” is all in your head”. Very accurate statement as all pain is in the head as that is where it is perceived so nothing new here. The danger of it not being in your head is most evident in a patient with diabetic neuropathy or other diseases where the sensory input is lost. That patient may have a cut, or burn to their foot/legs, and never know about it until infection has set in. The impairment of the sensory input to the patient’s brain results in far more serious injury often resulting in systemic infection, amputation or in some cases death. For those patients the lack of pain being in their “head” can be tragic.

How Electrical Signals To The Body Work:

With chronic pain the nerves that are transmitting the pain signal are activated by minimal input. When the pain nerve going to the spinal cord is stimulated a message is sent and the spinal cord can only accept and transmit a limited number of messages to the brain. The messages to the brain come in from different types of nerves referred to as “A”, “B”, “C” fibers. These fibers carry different messages such as pressure, heat etc. so the fibers have different duties (jobs) to keep the brain informed of what our body is experiencing. Because there are more nerve fibers coming to the spine than there are pathways to the brain then some messages do not get transmitted. When that message is the pain message from the C fiber, then if not transmitted, obviously there can be no pain.

If not in the brain then no pain.

With electricity for the chronic pain patient we use devices to stimulate the “non pain” fibers.

For visualization I like to compare this process to the old fashion telephone system where you had an operator who physically routed phone calls to their destination. The operator might only have access to 10 outgoing lines so when there were 20 calls coming into the central system the operator had to decide which of the 10 were most important and allow them through while letting the other 10 know to wait or call back when less busy. This is similar to the process our spine goes through on deciding what messages are allowed or not allowed.

In order to prioritize non pain messages so the spinal cord will transmit that message, rather than the pain message, we use electricity to stimulate the non-pain fibers. The electrical impulse stimulates ( causing physical/chemical changes ) to the nerve fibers and therefore the input from the non pain fibers are transmitted and the pain message is not. When using electrical inputs the patient experiences non pain sensations since that sensation is what is being transmitted to the brain for our perception. The pain signal goes away or is never transmitted therefore no pain.

At this point a word of clarification on the “blocking” of the pain message. Naturally one would assume that by blocking the impulse the patient runs risk of real injury yet it would not be perceived. That is not the case with controlled electrical input from a device. The amount of electrical stimulus in the painful area is produced based upon the existing level of pain at the time the electrical stimulus is set up. If the electrical stimulus is too great then that stimulus itself will cause the patient to have pain. The patient would react by simply saying that the electricity is now painful so the level of the intensity would be lowered so the patient experiences no pain. If after the electrical stimulus is set up and the patient now has a new injury then the pain stimulus from the new injury will override the existing settings and the new painful stimulus will override and the new injury will be just that, a more powerful stimulus that is transmitted to the brain and the patient knows of a new injury and the body reacts accordingly. This is most common in the use of electrical devices for athletes. A football player wearing a unit during a game who has suffered a “hip pointer” or “sprained ankle” would still feel any new injury or stimulus such as re-injuring the ankle. The pain from the new injury is perceived, not overridden by the electrical device.

Devices to Stop The Pain Message

Listed below are the type electrical devices normally used to stop chronic pain:

1. TENS ( Transcutaneous Electrical Nerve Stimulator ) – A small portable device worn by the patient operating from generally a 9 volt battery. Device is worn constantly, or when pain present, and can be worn 24/7 if necessary. Characterized electrically by having range of 1 – 150 pulses per second ( PPS) of electricity. PPS simply means the machine comes off and on 150 times a second. Tens have no carryover pain relief which means if the unit is turned off then the pain immediately returns. TENS are covered by most insurance companies, including Medicare.

2. Interferential Unit ( IF/IFC) – Somewhat larger than a tens unit and uses electricity from a plug in AC adaptor. The pulses per second are 8,000 – 8,150. The greater pulses per second mean an Interferential Unit can not be worn or used for any extended time period if using a battery system but needs to be plugged in to the wall. Interferential has considerable carryover pain relief and often after a 20 -30 minute treatment the pain will not return for hours/ days or weeks. Interferential is covered by some insurance companies when billed as durable medical equipment ( DME) but is regarded by Medicare as experimental.

3. Dorsal Column Stimulator ( DCS) – An external device power source that usually uses radio waves to transmit power to the receiver which is connected to wires embedded on each side of the spinal column. This is an implant requiring surgical intervention. The stimulus often results in immediate pain relief with some carryover in certain patients. Normally the surgery has to be preapproved by the insurance company and external devices have failed prior to the authorization of the implantation of a DCS.

4. Deep Brain Simulator ( DBS) – Similar to the DCS except the wires are placed into the brain. Implant done generally by a neurosurgeon and often a last resort type treatment for patients who potentially suicidal due to the severity of their chronic pain.

Author: Bob G Johnson
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Melzack defined the Neuromatrix of pain as “pain is a multidimensional experience produced by characteristic ‘neurosignature’ patterns of nerve impulses generated by a widely distributed neural network-the ‘body-self neuromatrix’-in the brain (3).”

Anyone still there? Wow, that does sound like something right out of the movie the Matrix with big fancy words like “multidimensional” “neurosignature” “neural network” are we still talking about physiology today or in 2050? The above quote was actually from 2001, so coming up on seven years ago now, but you would be hard pressed to find a ton of acceptance to the theory (although momentum for it gaining steam).

But how does this relate to me? I just want to perform at a higher level?

A brief tangent about pain -

The old school view of pain was that when you stuff that hot cream cheese puff from the Chin Young buffet in your cake hole, the signal travels from your tongue into the pain center in your brain. The hunt was on as scientist spent years trying to find this elusive, Bigfoot like creature in the brain. Let’s try the cortex, maybe that is it? Nope. Thalamus? Not it again (10). On the search went, but to no avail (9). The thought was that once we find the pain center, we can cut it out, ablate it, drug it and bammmm-o, no more pain. While this fantasy sounds awesome, it is just that—a fantasy as physiology is not quite that simple. We now know that there is no pain center. Drat, so much for the trying the easy stuff first. We know that pain does live in the brain, but it is multidimensial (there is that word again); most likely stored away in the nooks and crinkles just like a squirrel hiding nuts for the winter in your lawn.

Pain is produced when the brain perceives that danger to body tissues exists and that action is required as a survival response. Back to our friend at the buffet with the hot cheese puff in his mouth. What happens next? He either tries to dump the said cheese puff on to the plate in a very non conspicuous way (can you give me a “good luck buddy” shout), or add some cold water perhaps. Either way, it is highly unlikely he will sit there as it smolders into his tongue and pollutes the room with the smell of burning flesh. Pain is an action signal-do something!

The brain and the nervous system control ALL muscle movements. When pain occurs it inhibits the nervous system as a protective mechanism. Remember that the body only cares about survival and does not give a hairy rat’s butt about performance. If I injure my elbow, my nervous system will start to shut down the muscles around that joint as a protective mechanism to try to prevent further damage (ala arthrokinetic reflex).

The Neurosignature
Pain is a specific interpretation of the brain, or as Melzack calls it a “neurosignature” (no that is not how Neo from the Matrix signs his name, that would be the neosignature). This neurosignature is dependent on many imputs (multidimensional). The main inputs into the brain are proprioceptive, visual, and vestibular. Remember that proprioception is the body’s 3D map of itself and allows you (ok your friend) to touch their nose with their eyes closed when they get pulled over by the Smokey along the road. Everyone is familiar with vision, as we are highly visual creatures (some would argue males more so than females, but I won’t go there). Vestibular refers to the function of the inner ear and balance. With every step we take (yes even with every breath you take for all you Police fans), the brain is receiving inputs from each of these systems and combines them to form a neurosignature. I hear some academics in the back shouting “where is the data” so here you go.

Phantom Limb Pain
Many times those who have lost a limb, will complain of pain coming from their lost limb! At first blush, the thought “they must be insane” runs through my head, but several studies have shown this to be true in very sane people; and the pain is real (5). How can this happen? So the very same inputs that provide the brain with signals interpreted as pain, can run amok in the brain and actually produce pain!(4) So it is not just a one way system, as the brain it seems can produce pain that feels like it was coming from the lost limb-kind of like working for a double agent. Imagine you are a super top secret agent (inputs from the body) hired by Emilio the Shark (the brain) to get info on those sneaky Russians (lost limb). Yeah those Russians are sneaky, so watch out Pavel, But you then learn that Emilio the Shark has sold you out and is just creating information for the Russians! Dang it. So the brain appears to create pain from the lost limb.

The pain can many times be induced by a conflict between visual feedback and proprioceptive representations of the amputated limb (8). If this is true, it should be fixed by reversing this and presenting a “working limb” to the brain, right? By using a mirror box, you can create an image (from the good limb) to appear where the lost limb would normally be in space. This can “trick” the brain into believing there is a limb there, and many times the pain will diminish (1).

Placebo Effect
Everyone has heard of the placebo effect by now. While there are many different flavors of it, it is believed that the brain (and perhaps the spinal cord) play a key role! Obvious I know. Pain depends on both biological and psychological factors (2). Matre et al. (2) did an experiment where they heated up a small patch of skin on volunteers (always read the fine print) and the only difference was that one group was told that this special magnet (which was not even a magnet, just a lump of iron to look like a magnet) would reduce the pain. Sure as heck, it did just as predicted with the placebo group reporting less pain! Other studies have shown similar results (6), and it is common place to include a placebo group in almost any experiment.

Seriously man, how does ANY of this help me?

Ok, so we know that changing the inputs to the brain via proprioception, visual, and even vestibular inputs can alter the perception of pain. Even the context of the event (placebo effect) can even alter it (7). So how goes this help you increase performance?

Pain and Performance
Pain becomes a huge priority in the body and if you are not sure, then ask anyone in pain! Remember that we are a survival based organism and while pain works great to keep us alive at certain times, if you are dealing with pain you will not have peak performance. Still don’t believe me? Go out and run your fastest 100 meters. Now have Emilio the Shark kick you square in the nut sack and try it again. I can guarantee your second performance will not be as stellar.

Just as in the mirror box example, we can alter the brain’s perception of pain via proprioceptive, visual, and vestibular input! Injury is a big event and it carries a pretty hefty neurosignature. I worked with a client that had sprained his left ankle pretty bad at a fun house and we used these principals. I first had him do a specific Z Health joint mobitity drill (proprioceptive input), with his eyes up and to the right (visual input) and in his case also with his head rotated to the right and up (vestibular input); and within a few motions we were able to get his pain from a 6/7 on a 1-10 scale to less than a 1. We just gave the brain the correct inputs to alter its perception of pain.

Amazing.

Conclusion (aka read this part for sure)

In conclusion, from out good buddy Melzack (who also had help from Patrick Wall) defined the Neuromatrix of pain as “pain is a multidimensional experience produced by characteristic ‘neurosignature’ patterns of nerve impulses generated by a widely distributed neural network-the ‘body-self neuromatrix’-in the brain (3).” Definitely a mouth of futuristic Matrix-like words, but we know that pain lives in the brain and it can be modified by changing proprioceptive, visual, and vestibular inputs. Decreasing pain will have you on the fast track to enhanced performance!

References
1. Chan BL, R Witt, AP Charrow, et al. Mirror therapy for phantom limb pain. N Engl J Med. . 2007; 357(21):2206-7.
2. Matre D, KL Casey, S Knardahl. Placebo-induced changes in spinal cord pain processing. J Neurosci. . 2006; 26(2):559-63.
3. Melzack R. Pain and the neuromatrix in the brain. J Dent Educ. . 2001; 65(12):1378-82.
4. Melzack R. From the gate to the neuromatrix. Pain. . 1999; Suppl 6:S121-6.
5. Melzack R. Labat lecture. Phantom limbs. Reg Anesth. . 1989; 14(5):208-11.
6. Oken BS. Placebo effects: clinical aspects and neurobiology. Brain. . 2008.
7. Quevedo AS, RC Coghill. Attentional modulation of spatial integration of pain: evidence for dynamic spatial tuning. J Neurosci. . 2007; 27(43):11635-40.
8. Ramachandran VS, D Rogers-Ramachandran. Synaesthesia in phantom limbs induced with mirrors. Proc Biol Sci. . 1996; 263(1369):377-86.
9. Shaw KA, VK Srikanth, JL Fryer, L Blizzard, T Dwyer, AJ Venn. Dual energy X-ray absorptiometry body composition and aging in a population-based older cohort. Int J Obes (Lond). . 2007; 31(2):279-84.
10. Spiegel EA, HT Wycis. Present status of stereoencephalotomies for pain relief. Confin Neurol. . 1966; 27(1):7-17.

Author: Mike T Nelson
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Although pain affects more than 76 million Americans, it can be an isolating experience. According to the American Pain Foundation, pain is a critical, biological warning sign to the body when something. Pain can signal injury, such as touching a hot oven, or an underlying disease or infection, such as cancer or shingles. Pain is classified as acute or chronic. Acute pain usually follows surgery or injury and resolves as the body heals itself. Pain is diagnosed as chronic when it persists after healing has taken place.

Failure to treat acute pain promptly and appropriately can contribute to the development of chronic pain syndromes. In such cases, pain signals remain active in the nervous system for weeks, months or even years. In addition, pain can lead to other health problems, causing damage to the body. If untreated, chronic pain can weaken the immune system, decrease the quality of life, create feelings of anger and depression, lead to a deterioration of relationships, and result in a loss of independence.

Many people wrongly assume they have to live with pain – that it is an inevitable part of their disease or condition, or a natural part of growing older. The fact is most pain can be relieved with proper pain management.

Pain should be assessed thoroughly and treated early and aggressively. Early treatment is the best way to minimize the suffering and disability often associated with under-treated pain.

It’s important to become your own best advocate as you navigate the road to pain relief and reclaim your life. The earlier you seek treatment, the better. Following are some helpful things to keep in mind from the American Pain Foundation:

In the search for a healthcare provider who will help you reach your goals of pain relief and management, you may have been told, “Nothing more can be done to ease your pain,” or “You’ll just have to live with it.” If this is your situation, take the time to find a healthcare provider who has the education, skills and willingness to work with you to manage pain. Don’t be afraid to speak up. Only you know the extent of your pain and how it affects your quality of life.

Consider starting a pain notebook, a tool to help you keep a record of pain. The notebook should include when the pain occurs, for how long, the level of pain, and its impact on day-to-day life. Keeping track of what things make your pain better or worse will help your healthcare team find the best ways to treat pain.

Knowledge is power. There are a variety of drug and non-drug therapies (e.g., physical therapy, yoga, meditation) available to effectively control pain. These are typically used in combination. Ask your healthcare provider about ways to relax and cope with pain. Pain can feel worse if you are stressed, depressed or anxious. Be an informed consumer and learn all you can about pain and pain management options.

As you work with your healthcare provider, set realistic goals for things you most want to do. Do you want to achieve better sleep? Begin exercising or return work? Begin with the easiest goals first. Set realistic goals for pain relief. Persistent pain tends not to disappear. Look for a provider who will work with you to get you to the point where you can “live life again.”

Prior to appointments, write down questions you have and let your provider know if there is something you don’t understand. Also, bring along a relative or close friend to provide support and to help take notes and remember what was said. Sometimes, it’s easy to forget or misunderstand what was explained during doctor’s appointments. Having someone else there to process the information can be a great boost to your appointments.

During initial appointments, share with your provider what over-the-counter medications, vitamins and supplements you take, at what does and how often. Also, be honest about personal health habits, such as smoking, alcohol use, etc., which can interfere with some pain treatments and increase pain levels.

Finally, find out about support groups and educational programs in your area or online. Also seek the support and encouragement of friends and family members when you need them. They can provide the incentive you need to not give up in your quest for pain relief. And remember, there will be both good and bad days. Give yourself some grace as you traverse the road to pain relief.

Author: Susan Knapp
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