Self-Help

Last Sunday, three St. Louis area massage therapists met to watch a video recording of Peter O'Sullivan's keynote address at the 2017 San Diego Pain Summit. The subject of O'Sullivan's address was A Paradigm Shift in Understanding and Managing Low Back Pain.

I love massage. I’m passionate about it. I think it has many benefits and a lot of unrealized potential. I think it’s so awesome that I see no need to exaggerate or make unsupported claims. I am also committed to client-centered practice and part of that commitment is providing honest, accurate information.

The world of weight loss is, unfortunately, full of misleading, exaggerated, and completely bogus claims. There’s a large population that struggles with weight and it’s an easy population to exploit for profit. As a result, fraud is rampant in the weight-loss industry. Unfortunately, predatory misinformation offering false promises of easy weight loss has spilled over to include massage.

I hate to disappoint anyone but there is no evidence to support the claim that massage will cause you to lose weight.

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.

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 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

If I could make only one recommendation to individuals living with chronic pain, it would be to read the book Explain Pain by David Butler and Lorimer Moseley.

Directed at both clinicians who work with chronic pain patients and patients who live with chronic pain, Explain Pain shows how the discoveries of modern pain science can be put to practical use. Written in understandable language with a touch of lighthearted humor, Butler and Moseley take a complex subject and make it possible for the average person to understand and use. One client remarked that she thought it would be hard to read and was delighted that she did not find it difficult at all. 

Graded exposure can be a useful technique for persons living with chronic pain. Graded exposure is a method of finding movement that is pain-free and building on that. The idea is to break the brain's association between a particular movement and pain.

Got back pain? Call us!

Low back pain is one of the leading causes of disability in the United States. Everyone knows someone who suffers from back pain and most Americans will suffer from it some time in their life.  In spite of its prevalence, successful treatment of low back pain remains elusive. No one has consistently good statistics in the treatment of low back pain.

What can we offer you?

We cannot promise results. However, we can promise this:

Low back pain is one of the most common and persistent pain problems, affecting millions of people. Besides working hands-on with clients, I try to help them understand how pain works and to find ways they can continue to help themselves at home.

Cory Blickenstaff is a physical therapist in Vancouver, WA. My clients have found his videos on "edgework" and "novel movements" to be helpful and enjoyable.

"Edgework" is finding the point in a movement where it begins to transition from easy and comfortable to slightly guarded or painful. Movements should be done slowly, watching carefully for the first sign of holding the breath, muscular tension, or pain. The movement presented in the video is one possible movement. Other movements can be used as "edgework" using the same approach.

"Novel movements" are movements that are a little different from the way we normally move. As Cory says, they are movements about which the brain has not yet formed an opinion. By practicing novel movements, we can try to find movements that are not painful and break the association between movement and pain.