Pain Management

Using pain science to make a difference in your life.

Posted on: Sat, 09/06/2014 - 2:58am By: Alice

People come to my office for a variety of reasons. Some come to relax and that’s great. I think if we all got a massage about once every three weeks, the world would be a kinder, gentler place. People would probably be nicer to each other, to their spouse and their kids, and maybe be a little more patient to the guy who cut them off on the highway without realizing it because his mind was on something else or he didn't see you in his blind spot. Massage for relaxation, to "downregulate the sympathetic nervous system" (tech talk for chill out,) for the pure enjoyment of it, is a fine reason to get massage. 

Others come because they’re athletes or musicians or have other reasons for wanting to keep themselves in top shape. They appreciate having a body that’s well-tuned, not held back by unnecessary tension or bothersome pain.

I see a fair number of pregnant ladies,. It seems a lot of massage therapists don't do prenatal massage. I welcome mothers-to-be. I love nurturing women during this special time of their life and enjoy helping to relieve the temporary discomfort that often accompanies pregnancy.

Shifting away from nociception and mesodermalism and towards "yesciception," neurocentrism, and pain science.

Posted on: Mon, 04/28/2014 - 8:12pm By: Alice

Most of us were brought up, professionally, with an idea of "deep tissue" and the need to "break up adhesions," "stretch fascia," and generally "fix" the meat and bones. Along the way, some of us discovered pain science, neuromatrix theory, and the realization that it is the nervous system that creates tension, creates the sensation of pain, and it is through the nervous system that one corrects it. We came to understand that manual therapy works not by mechanically altering muscle, facia, posture, etc., but by influencing the nervous system.

Modern pain science has found that the more the nervous system is subjected to nociception, the more sensitive it becomes. Therefore, we avoid creating pain.

Pain Questionnaire Answers

Posted on: Mon, 04/21/2014 - 5:33pm By: Alice

About a week ago I put up a pain questionnaire.  


As promised, we're providing the answers, courtesy of Zac Cupples, PT.

Zac 
Cupples, a physical therapist in Plainfield, IL, had such great answers to these 
questions that I asked him if I could borrow them and he agreed. A few sentences were edited out for brevity and to keep it where we non-PT folks can understand. Read his unedited answers and the rest of his article on pain education here. Also highly recommended is his series on the book Explain Pain. If you haven't read it, this is a great chapter-by-chapter summary. If you have, it's a great review.

Thanks, Zac! 

And now for the answers:

“The best way to treat chronic pain is to prevent it.”

 

Pain receptors convey the pain message to your brain: FALSE

How Well Do You Know Pain Science?

Posted on: Thu, 04/10/2014 - 10:51am By: Alice

How well do you understand how pain works? Answer these questions and find out. We'll publish the answers after the pain education class this Saturday.

Pain Neuroscience Questionnaire

True or False?

1 When part of your body is injured, special pain receptors convey the pain message to your brain.

2 Pain only occurs when you are injured.

3 The timing and intensity of pain matches the timing and number of signals in danger messages.

4 Nerves have to connect a body part to the brain in order for that part to be in pain.

5 In chronic pain, the central nervous system becomes more sensitive to danger messages from tissues.

6 The body tells the brain when it is in pain.

7 The brain can send messages down your spinal cord that can increase the danger messages going up the spinal cord.

8 Nerves can adapt by increasing their resting level of excitement.

9 Chronic pain means an injury hasn’t healed properly.

10 Receptors on nerves work by opening ion channels (sensors) in the wall of the nerve

Pain Education Class, 4/12/14: Registration is now open

Posted on: Thu, 01/16/2014 - 11:25pm By: Alice

Chronic pain is epidemic. It is estimated that 25% of American adults live with chronic pain and the costs in terms of medical expense and lost productivity run into billions of dollars every year. It is impossible to calculate the cost in terms effect on the quality of so many people's lives. 

We are excited to be offering a two hour pain education class at Forest Park Community College on Saturday, April 12, 2014. The class, Explaining Pain: Help Manage Chronic Pain, is for anyone who lives with chronic pain, anyone who lives or works with individuals with chronic pain, or anyone who wants to better understand chronic pain. Professionals, non-professionals, people with pain or people without pain are all welcome.

This two hour lecture will introduce you to what modern pain science has learned about chronic pain and ways that may help you manage it more effectively. The class will be based on the book Explain Pain by Butler and Moseley. 

Gentle Treatment for TMJ Dysfunction

Posted on: Sun, 09/15/2013 - 3:28pm By: Alice

When people say, “I have TMJ,” they usually mean that they have temporomandibular joint dysfunction, a condition that can cause jaw pain that can be difficult to treat. Chewing may be painful and it can lead to headaches and neck, shoulder, and upper back pain. They may experience popping, clicking, and shifting when they open and close their jaw and their mouth may even get stuck in an open position if they yawn or open their mouth too far.

Notes from Skepticamp, 9/14/13: A Skeptical Look at Back Pain

Posted on: Thu, 09/12/2013 - 3:01pm By: Alice

These are notes from a presentation given at the Skeptical Society of St. Louis Skepticamp on Saturday, September 14, 2013. Links to some of the resources and studies mentioned during the presentation, as well as additional links that may be of interest, are provided for those who would like to look at them.

 

A Skeptical Look at Back Pain: Notes from Skepticamp 2013

In 1995 I was working at St. Mary’s hospital when I heard about this study which examined 98 people who had no low back pain (LBP) and found that a large percentage had herniated discs. ("asymptomatic" means without symptoms i.e. no pain)

 http://www.nejm.org/doi/full/10.1056/NEJM199407143310201

            98 asymptomatic individuals ages 20 – 80

            36% normal discs at all levels

            52% bulging disc at at least 1 level

            38% abnormal at more than one level

            Findings similar in men & women

            Abnormalities increased with age

Herniated Discs, MRIs, and Low Back Pain: Part 1

Posted on: Fri, 09/06/2013 - 1:55am By: Alice

 

"Did you hear about the study of the MRIs and herniated discs?" It was 1995, I was working at St. Mary's Hospital, and one of my fellow massage therapists had news about a surprising piece of research. In those days before the internet it was difficult for us to get information about studies of interest to us massage therapists. A juicy tidbit like this was cause for excitement.

A Massage Therapist's Guide to SomaSimple

Posted on: Sun, 05/19/2013 - 4:34am By: Alice

The SomaSimple forums are one of the best resources available for any manual therapist working with clients with chronic pain. However, massage therapists who find their way to the SomaSimple site are often overwhelmed at first by the enormity of the material, intimidated by the level of discussion, and confused about where to start. Having been through that and survived, I'd like to help make it easier for those curious massage therapists who come behind me. Why? Because I think that what SomaSimple has to offer is of enormous value and can't be found anywhere else. It is one of the best resources I've found for learning about current pain science and how to apply it in your practice.

What is SomaSimple?

SomaSimple is a website of forums and archived material for science-minded manual therapists. The majority of members are physical therapists (called physiotherapists outside of the U.S.). Other professions are also represented: osteopaths, chiropractors, massage therapists, yoga instructors, personal trainers, coaches. What they have in common is an interest in pain science and science relevant to manual therapists.

Interview with Massage Talk Radio

Posted on: Wed, 05/08/2013 - 10:36pm By: Alice

On Monday, May 6, Kathryn Merrow interviewed me for 30 minutes for Massage Talk Radio. We had a lot of fun. She asked about how I got into massage, about my training and experience, and how I've evolved to incorporate the various things I've learned over the years into my practice. We talked about how my understanding of trigger points has changed and I was particularly happy to speak about what I've learned about pain science in recent years. I appreciated the opportunity to tell my fellow massage therapists that even though learning something new that contradicts what we've believed to be true can be uncomfortable at first, it does not have to be threatening and, in fact, when we embrace understanding how the body actually works, it's exciting and liberating.

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