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Managing Pain without Meds

The Peak Affordability Lifestyle

If I were to summarize everything I have learned from Dr. Martenson and this community over the last few years into one statement, it would be “our future is unaffordable.” The mechanism by which our unaffordable future is realized - be it inflation, deflation, Peak Oil, resource scarcity, currency crisis, or overt corporate corruption - is largely irrelevant. The bottom line for each one of us and our families is that we can no longer expect the macro economy to provide for our needs. Our best chance at surviving the myriad of future predicaments facing us is to develop the capacity to provide for our own needs and to progressively achieve functional independence from the economy-at-large. I like to refer to this daunting process as “adapting the Peak Affordability lifestyle,” as it is really much more than just an agenda of preparations; it’s a way of life.

One particular personal need that is destined to become increasingly unaffordable, or even unavailable, is healthcare. The field of healthcare encompasses an infinite number of subjects and topics, but today I want to focus on one particular aspect of healthcare that people frequently feel helpless to address on their own: managing physical pain. Although physical pain complaints, such as low back pain, headaches, etc, are typically not life-threatening conditions, they nevertheless are perfectly capable of destroying a person’s life. This is an extremely unfortunate situation, because the majority of these pain complaints result from a simple misunderstanding about the nature of physical pain. 

My intention with this post is to provide the reader with an understanding of common pain complaints that will empower them to effectively deal with these disorders on their own, without the need of professional healthcare services. My wife and I run a small pain clinic in Houston, and the insights shared in this post are garnered from several decades of study and clinical experience. 

Don’t Kill The Messenger

The natural reaction for a person in the throes of a physical pain complaint is to identify their pain as the problem itself, and overlook the fact that the sensation of physical pain is merely a form of communication. As such, most people mistakingly turn to painkillers as a solution to these particular disorders. This approach never works, because by “killing the pain,” one is also blocking the very information that is needed to find an effective solution to it. 

The most effective use of painkillers is to promote sleep, as regular sleep is critical to the body’s healing process. When you are awake, however, you are best served by avoiding the use of painkillers. Pain is information, and the first step to finding a solution to your pain complaint is being open to the flow of this information.

Your Pain Has A Purpose

The purpose of pain is to protect an injured body tissue. While this statement seems dreadfully obvious, it is remarkably easy to overlook this fact when pain has seized control of your daily life. The mechanism by which pain acts to protect an injured tissue is a twofold process.

  1. The sensation of physical pain itself is an attempt to make you consciously aware of the injury; it is seeking your attention. At first, it may attempt to get your attention with a “whisper,” but this quickly escalates to a “roar” if you choose to ignore it. 
  2. It uses your conscious awareness of the injury to modify your behavior and physical activity in a way that prevents you from damaging the injured tissue further. 

A simple example of this process occurs when you sustain a cut on your foot. The pain associated with the cut both makes you aware of the injury and prevents you from walking on the foot so that the cut can heal. But in many cases, the injury is not as obvious as a simple cut. This is particularly true in pain complaints involving the neuromuscular system, such as low back pain, shoulder pain, hip pain, etc. The key to identifying the injury (or injuries) in these disorders lies in understanding how the presence of a particular pain modifies your normal bodily movement or physical activity.

Get To Know Your Pain

Early on in my study of the various manual therapies, I came across the remarkable story of Moshe Feldenkrais (D.Sc.). Dr. Feldenkrais worked as a physicist during World War II, and was the first European to earn a black belt in Judo after the war. Throughout his adult life, he was plagued by pain in a knee that he had injured playing soccer when he was younger. Several doctors he consulted advised that surgery was his only option, and that even with surgery, his chances of ever walking normally again were only 50/50. Frustrated with his lack of viable options, Moshe became determined to fix his knee himself. One day he surprised his colleagues by jumping up in the air and slapping his injured knee several times. All were astonished that he was apparently pain-free after so many years of suffering. Several months later, over libations, Moshe revealed to them how he had healed his knee; he personified his knee pain and made a real effort to ‘get to know it.’ Instead of trying to avoid his pain, like he had done for most of his adult life, he gave it his complete attention. “I soon as I had complete awareness in my knee joint” Moshe said, “I had no pain in it.”

Dr. Feldenkrais went on to write numerous books on his method of pain-relief, and his work became collectively known as The Feldenkrais Method of Somatic Education. While I would highly recommend becoming familiar with his work, the essential application of his method boils down to taking some time to understand your pain in greater detail. This process involves answering these two basic questions:

  • What activities, body movements, and body positions make the pain worse?
  • What activities, body movements, and body positions make the pain better?

Take some time to explore your pain. You will be amazed at how the simple act of giving physical pain your complete conscious attention, if only for a short period of time, can transform even the most unbearable pain into a kinesthetic sensation that is both tolerable and manageable.

Trigger Points And Referred Pain

While many in this community may be familiar with the term “trigger point” from an economic perspective, this term is also used to describe a very common, but relatively unknown, type of injury that occurs in muscle tissue. A myofascial trigger point is most simply described as a micro-spasm within a muscle. Trigger points occur when we place a demand on a muscle that it is unaccustomed to, or not “conditioned” to perform. As the muscular system takes most of the brunt, or “wear and tear,” of our daily life, trigger points are much more common than injuries to the joints, tendons, and bones.

One of the more fascinating aspects of trigger points is that they produce a type of physical pain known as referred pain. Referred pain simply means that the pain is experienced in a region of the body that does not contain the injury, or source of the pain. As you might expect, this phenomenon can create a great deal of confusion, as the actual injury is often not found where it appears to hurt. 

An example of trigger point referred pain is the common headache. A person experiencing pounding pain in their temples, is naturally going to conclude that the problem is systemic in nature. Maybe they think it’s caused by high blood pressure, a migraine attack, or if the pain persists long enough, they may even entertain the idea of a brain tumor. But, the most frequent cause of a pounding headache is referred pain from trigger points in the Trapezius muscle, that lies in the upper back and neck region of the body.

This begs the question, “Why would the pain from an injury in an upper back muscle be experienced in the head?” To answer this question we only need to examine how this referred pain causes you to modify your activity and movement. Most people, when faced with a pounding headache, are inclined to lay down for a while and immobilize their head. As the Trapezius muscle functions to move the head, immobilizing the head serves to allow this muscle group to rest, and prevents further aggravation of the trigger point(s) contained within it. 

Another fascinating aspect of the referred pain phenomenon involves phantom limb pain. It is quite common for people who have had an arm or leg removed because of traumatic injury or disease, to continue to experience pain in that limb. Quite often, this phantom limb pain is referred pain from trigger point activity in trunk or neck muscles, and responds very well to the appropriate Trigger Point Therapy protocol. 

What Should I Do?

So let’s say you find yourself in a situation where you or a loved one is incapacitated by physical pain, and no doctor or professional treatment is available to you. What do you do? My advice would be the following;

  • Before you get into that situation, educate yourself on Trigger Point Therapy. One excellent book that I would recommend is The Trigger Point Therapy Workbook: Your Self-Treatment Guide for Pain Relief, Second Edition by Clair Davies. You can also view parts of this book in Google Books
  • My wife, Dr. Laura Perry, and I also host a website where you can get information about trigger points and Trigger Point Therapy. You can visit our site at www.PainWhisperer.com. Additionally, for those interested in learning more about the practice of Trigger Point Therapy, you might want to take our free online introductory course in Clinical Trigger Point Therapy. While this course is geared towards the professional therapist, many nonprofessionals have found its content valuable.
  • And most importantly, don’t try to avoid your physical pain. Give it your complete attention and learn from it. Now if only we could get the politicians to adapt this approach to the “3 E” pain facing us all, the world could be a better place.

Thank you for reading this and I hope you find this information useful.

Best, JAG

P.S. Don’t tell my wife that I’m CaptainSheeple, LOL!


  

This What Should I Do? blog series is intended to surface knowledge and perspective useful to preparing for a future defined by Peak Oil.  The content is written by ChrisMartenson.com readers and is based in their own experiences in putting into practice many of the ideas exchanged on this site.  If there are topics you'd like to see featured here, or if you have interest in contributing a post in a relevant area of your expertise, please indicate so in our What Should I Do? series feedback forum.

If you have not yet seen the other articles in this series, you can find them here:

This series is a companion to this site's free What Should I Do? Guide, which provides guidance from Chris and the ChrisMartenson.com staff on specific strategies, products, and services that individuals should consider in their preparations.  

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Tycer's picture
Tycer
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Outstanding!

Thanks JAG

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The Quality Contributions keep coming, Thanks!

Truly appropriate.  Thanks for this quality piece.

Regards, Joanne.

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JAG Nice article.  I've

JAG

Nice article.  I've read about people with fibromyalgia having pain centered around trigger points.  Have you had success in relieving this?

Travlin 

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ao
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Feldenkrais,

Jeff,

I appreciate your effort to teach people to manage their own pain.  I'd like to offer some clarifications of what you wrote, however.  I happen to be a Feldenkrais practitioner trained under Mia Segal (and a number of others).  The Feldenkrais Method has very little to do with pain and everything to do with somatic awareness.  Also, the story about how Feldenkrais "cured" his pain is not quite accurate.  He essentially psychocybernetically took himself through all the various movements, positions, activities, etc. that caused him pain and developed motor strategies that were the most efficient and therefore, the least painful. 

Also, Janet Travell's work on trigger points (and subsequent evolutions of her work) is very effective for myofascial pain but not effective for pain arising from other somatic structures such as discs, joints, etc.

In addition, true phantom pain is not referred pain.  It is a very different phenomenon.

The PRRT (Pain Reflex Release Technology) work of John Iams is some of the most effective work on treating pain of nociceptive reflexogenic origin that I've seen after 32 years in the business and teaching in 40 different states and several universities.

The Total Motion Release work of Tom Dalonzo-Baker is another effective strategy for self treatment of musculoskeletal pain.

The McKenzie Approach is the most effective self treatment  single (not aggregtate) method I've seen for spinal pain of discogenic origin. 

But most importantly, where musculoskeletal pain is involved, treating function is the most effective way of treating pain.  Treating pain without treating function leads to a high rate of recidivism.

Also, a key thing to remember is that virtually all pain (except that of psychogenic origin) is secondary to one of only two factors, chemical irritation or mechanical deformation.  Pain of chemical origin is best treated chemically and pain of mechanical origin is best treated mechanically. 

A good (but overly expensive for what you get book) for explaining pain to the layperson is Explain Pain by David Butler.  Another neat little book (that unfortunately is out of print) is The Brilliant Function of Pain by Milton Ward.

Pain, unfortunately, is such a complex and misunderstood subject that even most health professionals seem or are poorly equipped to effectively resolve it.  Kudos for tackling such a tough subject.

 

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Article

Thanks, JAG.  This is a nice addition to this series.  Finding ways to be in good health is a neglected area -- but if you can stay off unnecessary meds and avoid unnecessarily invasive medical treatments you'll conserve a lot of resources.  And if you are not in decent health, preparing for your (own) future in other ways may be a waste of time.

A good generic resource for health is the book Eat, Move and Be Healthy by Paul Chek.  It discusses some of these methods and gives some simple exercises with diagrams.  My favorite part of his advice is that if the person giving you health advice is not in excellent shape, the advice is probably not worth very much.

I've also been favorably impressed with the Egoscue method for back pain.  Very simple and effective.  See www.egoscue.com and try the Get Help Now under the Method tab.  This was recently featured in Tim Ferris' "4-Hour Body", which is an interesting read because he turns himself into a human guinea pig and tries all sorts of medical and non-medical treatments and exercise and eating regimens.  (A lot of things in the "Don't try this at home" category, though.)

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Fibromyalgia and Trigger Point Therapy

Travlin wrote:

JAG

Nice article.  I've read about people with fibromyalgia having pain centered around trigger points.  Have you had success in relieving this?

Travlin 

Hi Travlin,

On the average, we see about 20 fibromyalgia patients/year in our practice. The majority of these patients have a component of their symptom presentation that is effectively treated with trigger point therapy protocols, but this component is usually a concurrent complaint that is clinically distinct from fibromyalgia. There is some overlap in the location of the tender points that clinically define fibromyalgia, and the location of common trigger points that contribute to various pain disorders, and some researchers consider the presence of trigger points to be an important factor in the severity of fibromyalgia symptoms. In our experience, we typically can help in the management of the fibromyalgia disorder, but a solution to this disorder is beyond the scope of trigger point therapy.

Best....Jeff

 

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Scope

Thanks for your contribution to this thread ao.

From reading your posts over the years, I have no doubt of your expertise in the healthcare field. And if you didn't live on the other side of the nation, I think we could engage in some excellent professional discourse over libations.  I had the idea of contacting you to do a joint post on this subject, but given the limited scope of this post, I thought your time would be better served elsewhere.

I recognize that their are many effective approaches to dealing with physical pain complaints, but I thought Trigger Point Therapy and the Feldenkrais Method the most applicable to the self-treatment scope of this post. 

Thanks for the book recommendations, I think I could probably get joyously lost for days in your personal library.

Best...Jeff

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peter31
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Post peak medicine

Nice article.  I don't have any special expertise in pain - I just whack it with pharmaceuticals, same as most other docs - but I am trying to create a framework which may help and encourage physicians to continue to offer healthcare in a post peak world:

www.postpeakmedicine.com

I created the website because I remember feeling very confused when I first learned about the economy and peak oil and wondering "what do I do now?" and this is my attempt to reach out to physicians in a similar position.

ao
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review

Dragline wrote:

A good generic resource for health is the book Eat, Move and Be Healthy by Paul Chek.  It discusses some of these methods and gives some simple exercises with diagrams.  My favorite part of his advice is that if the person giving you health advice is not in excellent shape, the advice is probably not worth very much.

I've also been favorably impressed with the Egoscue method for back pain.  Very simple and effective.  See www.egoscue.com and try the Get Help Now under the Method tab.  This was recently featured in Tim Ferris' "4-Hour Body", which is an interesting read because he turns himself into a human guinea pig and tries all sorts of medical and non-medical treatments and exercise and eating regimens.  (A lot of things in the "Don't try this at home" category, though.)

I concur with Paul Chek's book being a very good resource for overall health.  Some of the exercises may be a little bit daunting for some patients with pain and pathology, however.  He is very knowledgeable, especially considering that he is largely self taught, and I respect him for not only talking the talk but also for walking the walk. 

Egoscue is also self taught and makes some good points.  His method can be beneficial but he tends to hype it beyond its capabilities.  In my opinion, his method lacks biomechanical, neurophysiological, and pathological specificity and often fails to produce rapid short term results where some other methods would.  IIRC, he was on San Diego area TV and "treated" some patients.  None of them had their pain relieved in the short term.  John Iams was also on TV and obtained immediate results with pain relief.  Pete Egoscue certainly knows how to market his method though.  As an ex-Marine officer, he knows how to motivate people.  For better or worse (depending upon how you look at it), the public tends to believe most or all of what it hears with regards to marketing and doesn't have the knowledge and experiential base to critically evaluate what they see, hear, and feel.  If you have a lot of time and a lot of money, it's OK and relatively safe.  Otherwise, you may want to look elsewhere.  

 

 

frankgrill
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Acupuncture

Thanks for posting this thread.  Another great low-cost option for treating pain is acupuncture.  Community acupuncture is a new model in the acupuncture world that utilizes a low-cost, no-insurance business model.  It is also a decentralized network of practitioners that share information and help each other.  Treatments are based on a sliding scale of $15-35 and often times lower for those who can't afford it.  Check it out!

http://www.communityacupuncturenetwork.org/

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