Pain is often treatable but doctors, medical professionals, and patients don't understand the intricacies of chronic pain. Millions who suffer from pain become hopeless. With Aches and Gains, Dr. Paul Christo, a Johns Hopkins physician and leading pain specialist sheds new light on what it means to live with and overcome chronic pain. Dr. Christo shares celebrity interviews, including Naomi Judd, Lisa Swayze, Montel Williams, Ally Hilfiger, and Clay Walker, from his Sirius XM radio show Aches and Gains®, and stories from patients who have found a way to overcome the pain that once controlled their lives. Offering traditional, integrative, and innovative methods of easing pain, the book is a life-changing tool for anyone associated with pain including pain sufferers themselves, doctors, nurses, medical professionals, and caregivers.Features a foreword by renowned talk show host Montel Williams.
|Publisher:||Bull Publishing Company|
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About the Author
Dr. Paul Christo is one of America’s leading pain experts and hosts Aches and Gains®, the first national radio talk show dedicated to overcoming pain, stress reduction, and healthy living. Listed as a Top Doctor and in the top 1% for Pain Management by U.S. News & World Report, Dr. Christo is widely consulted by the media for his expertise in pain diagnosis and treatment.
Read an Excerpt
When Priya first walked into my office, she had come to the end of her rope. A young mother of two who had once led an extremely active life, she had been battling debilitating migraines since becoming pregnant with her first child. The pain would appear without warning, beginning in her eyes and the back of her neck. It moved up through the base of her skull, blurring her vision and causing her eyes to water. Finally, her entire head would be so crushed with pressure and pain that over-thecounter medications, such as aspirin or acetaminophen (Tylenol), did nothing.
Headaches are not unusual. It's estimated that 46% of adults across the world have an active headache disorder. But the pain Priya experienced went far beyond the typical tension headache. It caused nausea and vomiting, condemning her to lie in bed in a dark room for days at a time. Her husband would beg the children to stay quiet so Mommy could rest. In addition to interfering with their daily routine, the family found themselves canceling vacations and social engagements when Priya's migraines mercilessly incapacitated her for days.
Priya's doctors prescribed increasingly strong prescription pain pills, suppositories, and patches to try to manage these episodes. And while the medications enabled her to "sleep off" the migraine if she caught it early enough, they did little to nothing if she didn't catch it in time. Her days were haunted by the anxiety that a headache could appear at any time. Finally, her doctors resorted to injectable opioid painkillers and, in time, sent her to me.
The key to Priya's long-term relief came from an unlikely ally: Botox injections. Known primarily for its cosmetic abilities to minimize wrinkles, botulinum toxin (Botox) is actually a neurotoxin produced by the same bacteria that causes serious food poisoning. In small doses, Botox blocks the signals sent from nerves to muscles, preventing the muscles from contracting. New research now suggests that Botox may also reduce pain and inflammation by inhibiting neurotransmitters, which are the chemical messengers that transmit pain signals and sensitize the spinal cord to pain. Its utility for treating migraines was discovered when a number of the patients who were getting cosmetic treatments reported experiencing migraine relief as well.
I treated Priya by inserting a tiny needle into the muscles of her forehead, scalp, and along the back and sides of her head. I also gave her injections in the back of her neck and even above her shoulder blades. Research supports the efficacy of precise needle insertion sites, which target the muscles and trigger zones that are the sources of pain. Unlike muscle relaxants or injectable pain relievers, which focus on relieving pain after a headache has begun, Botox injections are used to prevent headaches. After regular treatment, Priya's headaches became less frequent and less intense. Although not yet medication free, Priya has regained a significant level of control over her migraines and, as a result, is living a richer, fuller life.
Understanding Headache Pain
Headaches can range from garden-variety tension type headaches to full-blown migraines. As I noted in Priya's story, an estimated 46% of adults across the world have an active headache disorder, and 99% of women and 93% of men experience headache pain in their lives.
Causes of Tension Type Headache (TTH) Pain
Everyday headaches known as tension type headaches (TTH) can be triggered by any number of common causes including, allergies, stress, fatigue, injury, illness, sun exposure, dehydration, or caffeine withdrawal, to name just a few. The pain from TTH is typically mild-to-moderate in intensity, on both sides of the head, and doesn't throb. Patients of mine who are experiencing TTH will say that they feel like a tight cap is on their heads or a tight band constricts their heads. Some even have nausea. Diagnostic testing (magnetic resonance imaging (MRI) or computed tomography (CT scan) is usually not needed for TTH.
Physicians currently believe that sensitization of pain receptors in the muscle or fascia around the head lead to these types of headaches. Pain receptors around blood vessels and tendons may also be sources of pain. If these pain receptors continue to send signals to the central nervous system, then chronic TTH develops. Similar to brain imaging studies in patients with chronic low back pain, one study in patients with chronic TTH showed a decrease in a certain type of brain tissue called gray matter in those areas of the brain involved with pain processing. This highlights the importance of treating TTH so that it doesn't become chronic.
Tension type headaches are often the normal reactions of the body to problems that the pain should prompt us to correct. A dehydration headache reminds you to drink more water. A person suffering from a cold or the flu will hopefully be driven by a mild headache to get much needed rest. Often, mild headaches can be remedied or prevented by getting adequate rest, drinking more liquids, and taking steps to reduce stress, tension, and anxiety in your life.
Causes of Migraine Headache Pain
Unlike everyday tension headaches, migraine and cluster headaches arise from spontaneous pain signals that serve no health-related purpose. People who suffer from these types of headaches on a regular basis are often born with sensitivity to certain stimuli. When present, those stimuli, such as light, sound, certain foods or food additives, can spark unbearable, throbbing, and usually one-sided pain.
Twelve percent of the U.S. population suffers from migraine headaches. An attack usually unfolds gradually over the course of hours to days, and most migraine sufferers (including myself) don't experience an aura, a strange sensation such as dizziness, ear-ringing, or flashes of light experienced before the headache. If left untreated, an attack will continue for several hours or even days. I suffer from episodic migraine headaches, which happen occasionally, whereas others experience chronic migraines, attacks occurring 15 days or more monthly for at least three months with headaches lasting four hours or more.
Migraines appear to be connected to hormones, since three times as many women experience them as men, most often during their childbearing years. Fortunately, women suffer less frequently after menopause, and migraines are relatively uncommon in children. We also believe that there is a genetic basis to migraines, but gene studies have not yet clarified which ones are actually linked to the disorder.
Migraine headaches begin at the "headache center" of the brain, a small area in the brainstem. This bundle of nerves is like a busy central traffic intersection between the brain and the body; nearly every neural signal from the brain to the body or from the body to the brain passes through it. When this part of the brainstem becomes overstimulated, it amplifies the effect of normal environmental stimuli. Sufferers suddenly feel as if someone turned up their hearing aids too high or forced them to wear night vision goggles in broad daylight, resulting in tremendous pain and nausea. Along with nausea and light sensitivity, many patients experience sound sensitivity.
Physicians used to believe that dilatation of blood vessels caused migraine headaches, but current research supports a process known as cortical spreading depression, a wave of electrical activity spreading across the brain, and specifically the cerebral cortex. This is thought to cause the aura of migraine, trigger a nerve of the face called the trigeminal nerve, and disrupt the natural barrier between brain tissue and blood. It's a complex process that leads to inflammation of the membranes enclosing the brain that are known as the meninges. This inflammation ultimately generates the headache. Nerve inflammation may intensify and prolong the migraine and may also sensitize nerves in a way that they "turn on" more easily, with greater force, and spontaneously. It's this sensitization in the brain that may explain why migraines worsen with coughing, bending, or quick head movements and may account for the throbbing quality of the pain.
Although not necessarily a source of migraine headaches, a condition known as occipital neuralgia can lead patients to feel one-sided head pain that's burning, deep, throbbing, and shooting, along with scalp tenderness to light touch. Patients can have symptoms that begin in the back of the head and travel to the top of the head (greater occipital nerve), or travel to the side of the head near the ear (lesser occipital nerve). There can be tenderness over the nerves, but not always. We believe that irritation or entrapment of the nerves may be the reason for occipital neuralgia, and many cases are related to whiplash injuries and head trauma. Certain patients report radiating pain up to the forehead or discomfort behind the eyes along with features of migraines. There certainly can be an overlap between this headache type and migraines. Occipital nerve blocks are shown to help patients with migraines as well as patients with the other primary headache disorders discussed in this chapter, TTH and cluster. I've had several referrals from neurologists to evaluate patients for nerve blocks with migraine-like headaches associated with occipital neuralgia. When nerve blocks are used for pain treatment and management, a local anesthetic medication is injected around a specific nerve in the body.
It is important to note that sinus headaches are often misdiagnosed. Many patients actually meet the diagnostic criteria for migraine. Sinus pain headache usually presents as a pressure-like sensation located on both sides of the head and behind the eyes. In addition, patients often have nasal congestion or obstruction with sinus headaches.
Causes of Cluster Headache Pain
Cluster headaches — so-called because of the group of headaches that attack closely together that most sufferers experience — involve similar areas of the brainstem as migraines, but cluster headaches also affect the nose, sinuses, and eyes. It's not clear what happens during the cluster attack, but it's thought that the hypothalamus, trigeminal nerve area, and nerve inflammation of a sinus deep inside the head may all contribute. Cluster headaches cause substantial disability and impair quality of life.
This headache type is classified among a group of headaches called the trigeminal autonomic cephalgias. The one-sided attacks can be vicious, making patients rock back and forth or pace relentlessly. The pain is on one side of the face — around or above the eye, or in the temporal region. The attacks can strike up to eight times per day, and usually last between 15 minutes to three hours. Compared to migraine headaches, this is short, but the excruciating nature of the cluster headache attack makes it seem like an eternity. Many times, cluster attacks continue every day for weeks before a period of remission. Patients may awaken in the middle of the night with severe pain, red and watery eyes and inflamed sinuses. This is due to the changes in the autonomic nervous system and specifically, the activation of the parasympathetic system and the blunting of the sympathetic system. Patients experience a droopy eyelid, small pupil size, tearing, and nasal congestion during the attacks. Cluster headache pain is not connected to any other medical problem: It's as if that burglar alarm has been triggered for no reason.
Thankfully, cluster headaches occur rarely, in less than 1% of the population. They affect men more than four times as often as women. There is some evidence that these headaches are inherited, and that cigarette smoking may be a risk factor for development.
No special testing is needed for diagnosis of cluster headaches (which is true for migraines as well). However, most doctors will order an MRI or CT scan of the brain when the diagnosis of cluster headache is first made. This excludes brain abnormalities that might be the source of the headache pain (tumors or aneurisms, for example). This is based on reports of patients thought to have cluster headaches, but who ended up having brain abnormalities instead. In contrast, an MRI is usually not needed for patients with classic migraine headaches or TTH.
Headache Pain and Triggers
Although it is unclear why some people experience migraines and cluster headaches and others do not, some factors have been shown to trigger symptoms in multiple patients. Stress, skipping meals, weather, sleep disturbances, perfumes, smoke, exercise, and even sexual activity can trigger headaches in some individuals. Alcohol consumption has been shown to increase the frequency and severity of migraine and cluster headaches: the darker the alcohol, the greater the chance of a problem. For instance, dark rum can trigger my own migraines (as will sleep loss, red wine, and sometimes stress). Caffeine, another common trigger, is a double-edged sword. A cup of coffee or large glass of soda can actually help get rid of a headache, but if you regularly drink more than one or two cups of coffee, tea or soda per day, you are at a higher risk of migraine, tension, or even chronic daily tension type headaches.
Stress is one of the most frequent triggers of both migraine and tension headaches, so managing stress is an important part of controlling headaches. If you suffer from headache pain, it makes sense to invest time in getting to know your triggers. Keeping track of other possible headache triggers in a journal and avoiding them can be a huge step toward conquering your headache pain.
When to Call Your Doctor about Headache Pain
Most headaches are very common and usually no cause for alarm. For example, I've had some patients worry that their headache may be caused by a brain tumor. Even though brain tumors can cause headaches, only a very small number of patients with headaches actually have brain tumors. However, there are some headaches that may require medical attention and serve as warning signs of possible serious disease:
* A "thunderclap" headache in which the pain comes suddenly and intensifies rapidly. This may reflect a bleed inside the brain called a subarachnoid hemorrhage.
* A "first headache," or a particular kind of headache experienced for the first time, particularly if you're over 40 years old. New headaches can suggest metastasis in a patient with cancer, encephalitis in a patient with Lyme disease, or an infection in a patient with HIV, for example.
* A headache that is unusually intense in comparison to the kind you usually get.
* A change in headache patterns (for example, awakening with a headache in the morning when you normally only get them at night).
These red flag symptoms do not necessarily indicate a severe health threat, but they should be checked out by your doctor and usually require a brain MRI or CT.
Treating and Preventing Headache Pain
If you suffer from headache pain, it is important to determine what kind of headaches you are experiencing and identify your triggers. Being able to discuss this with your physician will help your medical team find the right treatment for your headache pain. Depending on the type or severity of your headache, there are a variety of simple, effective treatments available.
Treating Tension Type Headache Pain
The typical tension type headache (TTH), can be treated with nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, acetaminophen (Tylenol), ibuprofen (Motrin), or even a cup of coffee. Ibuprofen (Motrin) leads to fewer side effects than other NSAIDs according to several studies. Some patients of mine have benefited from naproxen (Aleve) or diclofenac (Voltaren) as well. If these medicines don't help enough, then combining caffeine with acetaminophen or aspirin may be even more effective than taking a single drug alone. Adding caffeine can cause more side effects, though. These mainly consist of gastrointestinal upset.
A specific tricyclic antidepressant medication, amitriptyline (Elavil) can reduce the number and intensity of tension type headaches, and it even decreases tenderness of the muscles surrounding the head. Reducing this tenderness is important because it can prevent pain amplification from occurring in the spinal cord and brain. Other drugs in that family, nortriptyline (Pamelor) or protriptyline (Vivactil) are alternatives, but amitriptyline has the best evidence of efficacy. There are also many over-thecounter medications, such as decongestants or antihistamines that target sinus or allergy-related headaches.
Trigger point injections, injections of small amounts of local anesthetic into specific "tight" muscles in the scalp, jaw, and neck, can decrease tension type headache frequency as well as the need for medications.
Excerpted from "Aches and Gains"
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Table of Contents
Featured Celebrity Stories (listed in order of appearance in the book) xii
Foreword Montel Williams xiii
The Cost of Pain xv
The Experience of Pain xvi
Why I Wrote this Book xvii
Educating the Healers xx
Educating the Public xx
Why This Book? 1
Organization of the Book 2
General Strategies for Overcoming Pain 2
An Important Message About Caregiving 3
No One is Immune to Pain, but Together We Can Overcome It 4
What about the Opioid Epidemic? 4
Part I Understanding and Treating Your Pain
1 Headache Pain 7
Vignette-Headache Pain Priya 7
Understanding Headache Pain 8
Treating and Preventing Headache Pain 13
Hope for Headache Pain Relief 22
Suggested Further Reading 22
Other Resources to Explore 23
2 Joint and soft Tissue Pain 25
Vignette-Joint Pain Jennifer Grey Ty Warner 25
Understanding Joint Pain 26
Understanding Neck Pain 26
Treating Neck Pain 30
Understanding Low Back Pain 35
Treating Low Back Pain 39
Understanding Knee Pain 46
Treating Knee Pain 47
Vignette-Knee Pain Joe Montana 50
Understanding Shoulder Pain 51
Treating Shoulder Pain 52
Understanding Temporomandibular Joint Disorder (TMJ) 54
Vignette-TMJ Pain Yumiko 55
Treating Temporomandibular Joint Disorder (TMJ) 56
Hope for Joint and Soft Tissue Pain Relief 57
Suggested Further Reading 59
Other Resources to Explore 61
3 Arthritis Pain 63
Vignette-Arthritis Pain Kiki 63
Understanding Arthritis Pain 63
Understanding Osteoarthritis 63
Treating Osteoarthritis Pain 66
Understanding Rheumatoid Arthritis Pain 71
Treating Rheumatoid Arthritis 73
Understanding Gout 76
Treating Gout Pain 78
Hope for Arthritis Pain Relief 80
Suggested Further Reading 81
Other Resources to Explore 82
4 Neuropathic Pain 83
Understanding Neuropathic Pain 83
Treating Neuropathic Pain 85
Understanding Painful Diabetic Neuropathy 90
Vignette-Painful Diabetic Neuropath Jerry Mathers 90
Treating Painful Diabetic Neuropathy 91
Understanding Complex Regional Pain Syndrome 94
Treating Complex Regional Pain Syndrome 97
Understanding Trigeminal Neuralgia 101
Treating Trigeminal Neuralgia 102
Understanding Fibromyalgia 104
Treating Fibromyalgia Pain 107
Understanding Postherpetic Neuralgia (Persistent Shingles Pain) 109
Vignette-Postherpetic Neuralgia Donald 109
Treating Postherpetic Neuralgia (Persistent Shingles Pain) 113
Understanding Multiple Sclerosis 115
Vignette-Multiple Sclerosis Clay Walker 115
Treating Multiple Sclerosis Pain 116
Understanding Neurogenic Thoracic Outlet Syndrome 119
Treating Neurogenic Thoracic Outlet Syndrome 121
Hope for Neuropathic Pain Relief 122
Suggested Further Reading 123
Other Resources to Explore 125
5 Pelvic and Sexual Pain 127
Vignette-Sexual Pain Ellen 127
Understanding Pelvic and Sexual Pain 127
Treating Pelvic and Sexual Pain 132
Hope for Sexual Pain Relief 136
Suggested Further Reading 137
Other Resources to Explore 138
6 Infant Pain 139
Vignette-Infant Pain 139
Understanding Infant Pain 139
Vignette-Placenta previa Jan 140
Preventing and Treating Infant Pain 141
Hope for Infant Pain Relief 144
Suggested Further Reading 144
Other Resources to Explore 145
7 Sports Injury and Pain 147
Vignette-Sports Pain Michael McCrary 147
Understanding Sports Injury and Pain 148
Treating Sports Injury and Pain 152
Hope for Sports Injury and Pain Relief 156
Suggested Further Reading 156
Other Resources to Explore 157
8 Skeletal Pain 159
Vignette-Skeletal Pain After Injury Trevor 159
Understanding Skeletal Pain 159
Treating Skeletal Paul 161
Hope for Skeletal Pain Relief 166
Suggested Further Reading 167
Other Resources to Explore 167
9 Workplace Injury and Pain 169
Vignette-Work-Related Pain Mark Peel 169
Understanding Workplace Injury and Pain 170
Treating Carpal Tunnel and Other Work-Related Injuries and Pain 170
Hope for Workplace Injury and Pain Relief 173
Suggested Further Reading 173
Other Resources to Explore 174
10 Postsurgical Pain 175
Understanding Postsurgical Pain 175
Preventing a Lifetime of Pain after Surgery: Regional Anesthesia 176
Vignette-Regional Anesthesia and Pain James 178
Hope for Postsurgical Pain Relief 179
Suggested Further Reading 180
Other Resources to Explore 180
11 Disease-Related Pain 181
Immunizations and Pain Prevention 181
Understanding Sickle Cell Disease 182
Vignette-Sickle Cell Anemia Prodigy 182
Treating the Pain of Sickle Cell Disease 183
Understanding Lyme Disease 185
Diagnosing Lyme Disease 186
Pain and Lyme Disease 186
Vignette-Post-Treatment Lyme Disease Syndrome Sarah 187
Causes of Post-Treatment Lyme Disease Syndrome 188
Preventing and Treating Post-Treatment Lyme Disease Syndrome Pain 189
Vignette-Post-Treatment Lyme Disease Syndrome Ally Hilfiger 190
Hope for Disease-Related Pain Relief 192
Suggested Further Reading 193
Other Resources to Explore 194
12 Cancer Pain and Caregiving 195
Vignette-Cancer Pain Carla 195
Understanding Cancer Pain 195
Treating Cancer Pain 200
Caring for Those in Pain 206
Vignette-Cancer Pain and Caregiving Lisa Patrick Swayze 206
The Role of the Caregiver 208
Hope and Support for the Caregiver 209
Pain Control When Life Ends 210
Hope for Cancer Pain Relief 213
Suggested Further Reading 214
Other Resources to Explore 215
13 Autoimmune Pain: A Hidden Epidemic 217
Vignette-Autoimmune Pain Elvis Presley 217
Understanding Autoimmune Pain 218
Elvis Presley and Autoimmune Pain 218
Traumatic Brain Injury and Autoimmune Pain 220
President John F. Kennedy and Autoimmune Pain 223
Vignette-Autoimmune Pain John F. Kennedy 225
Hope for Autoimmune Pain Relief 226
Suggested Further Reading 228
Part II Medical Therapies for Pain: Traditional and Innovative
14 Pharmacological Therapies 231
Acetaminophen and NSAIDs 231
Tricyclic Antidepressants and Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) 233
Muscle Relaxants 235
Medical Marijuana: Uses and Controversy 242
Vignette-Medical Marijuana and Pain Montel Williams 243
Suggested Further Reading 248
Other Resources to Explore 249
15 Pain-Relieving Devices 251
Vignette-Spinal Cord Stimulation Stephen Noah 251
Understanding the Nervous System and Chronic Pain 252
Spinal Cord Stimulation (SCS) 253
Deep Brain Stimulation 257
Vignette-Deep Brain Stimulation Terry 257
Motor Cortex Stimulation 259
Vignette-Motor Cortex Stimulation Lee 261
Vagus Nerve Stimulation 262
Vignette-Vagus Nerve Stimulation Kyla 263
Transcutaneous Electrical Nerve Stimulation 265
Scrambler Therapy 265
Vignette-Scrambler Therapy: Colleen 267
Pain Pumps 268
Vignette-Pain Pump Graciela 270
Suggested Further Reading 272
Other Resources to Explore 273
16 Regenerative Biomedicine 275
Vignette-Prolotherapy Trenton 275
Platelet Rich Plasma Therapy 279
Vignette-PRP Therapy Jerome 280
Stem Cell Therapy 282
Vignette-Stem, Cell Therapy Derrick 284
On the Horizon: Nerve Restoration 289
Hope for Damaged Nerves and Pain Relief 293
Suggested Further Reading 294
Other Resources co Explore 295
Part III Integrative Therapies for Pain
17 Weight Control, Exercise, and Diet 299
Understanding Obesity, Pain, and Weight Control 299
Understanding Exercise and Pain 301
Vignette-Weight, Exercise, and Pain Katherine 302
Understanding Diet, Food, and Pain 303
Vignette-Food and Pain Tami 305
Other Sources of Information about Weight Control, Exercise, and Diet 306
Suggested Further Reading 307
Other Resources to Explore 307
18 Sleep, Stress, and Emotional Health 309
Understanding Sleep and Pain 309
Vignette-Sleep and Pain Fatima 311
Treating Sleep Problems 312
Understanding Stress and Pain 314
Understanding Emotional Health and Pain Prevention 317
Vignette-Emotional Health and Pain Carrie 319
Hope for Emotional Pain Relief 320
Suggested Further Reading 320
Other Resources to Explore 321
19 Mind-Body Techniques for Pain Relief 323
Understanding the Mind-Body Connection 323
Vignette-Biofeedback Clarissa 324
Cognitive Behavioral Therapy 328
Vignette-Cognitive Behavioral Therapy Neema 328
Vignette-Hypnosis Marco 334
Other Sources of Information about Mind-Body Techniques for Pain Relief 338
Suggested Further Reading 338
Other Resources to Explore 339
20 Alternative Medicine and Pain Relief 341
Holistic Medicine 342
Vignette-Holistic Medicine Naomi Judd 342
Herbal Remedies 344
Vignette-Acupuncture Lila 348
Other Sources of Information about Alternative Medicine and Pain Relief 352
Suggested Further Reading 353
21 Aromas, Music, and Pain Relief 355
Vignette-Aromatherapy Amanda Lana 356
Music Therapy 362
Vignette-Music Therapy Tim Janis 362
Vignette-Music Therapy Maria Kate 363
Vignette-Music Therapy Eliana and her mother 365
Other Sources of Information about Aromas, Music, and Pain Relief 366
Suggested Further Reading 367
Other Resources to Explore 368
22 Harnessing the Human Biofield 369
Healing with Touch and Energy 370
Chakra Healing 372
Vignette-Chakra Healing Ruby 372
Healing Touch 374
Vignette-Healing Touch Darla 375
The Japanese Healing Art of Jin Shin Jyutsu 377
Vignette-Jin Shin Jyutsu Elisabetta 377
Distance Healing 380
Vignette-Distance Healing Edina 381
Animal Therapy 383
Vignette-Animal Therapy Ted 384
Other Sources of Information about Harnessing the Human Biofield 386
Suggested Further Reading 386
Other Resources to Explore 387
23 Pain Relief through Movement 389
Vignette-Yoga Antonio 390
Pain Relief through Posture and Movement 394
Vignette-Feldenkrais Method Tabitha 395
Vignette-Egoscue Method Rod Susma 398
Vignette-Revolution in Motion Selena 399
Vignette-Gokhale Method Yeji 400
Other Sources of Information about Engaging the Body 403
Suggested Further Reading 403
Other Resources to Explore 405
24 Conclusion 407
Don't Wait 407
Reach Out for the Help You Need 408
Be Open 409
Don't Give Up 410
About the Author 441
Most Helpful Customer Reviews
If you or someone you know is in pain, this book is for you. Dr. Christo takes the "scary" medical jargon and makes it understandable. The celebrity and real life stories bring a name and face to pain conditions, diseases and procedures. He is very knowledgeable on a wide variety of conditions, symptoms and treatments. I felt like I was getting the advice of one of the top physicians in the country from the comfort of my living room. I highly recommend this book!