Holistic Pain Relief: Dr. Tick's Breakthrough Strategies to Manage and Eliminate Pain
312
Holistic Pain Relief: Dr. Tick's Breakthrough Strategies to Manage and Eliminate Pain
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Product Details
| ISBN-13: | 9781608682072 |
|---|---|
| Publisher: | New World Library |
| Publication date: | 10/01/2013 |
| Sold by: | Barnes & Noble |
| Format: | eBook |
| Pages: | 312 |
| File size: | 568 KB |
About the Author
Read an Excerpt
Holistic Pain Relief
Dr. Tick's Breakthrough Strategies to Manage and Eliminate Pain
By Heather Tick
New World Library
Copyright © 2013 Heather Tick, MDAll rights reserved.
ISBN: 978-1-60868-207-2
CHAPTER 1
PAIN, NATURE'S WAKE-UP CALL
The merest schoolgirl when she falls in love has Shakespeare or Keats to speak her mind for her, but let a sufferer try to describe a pain in his head to a doctor and language at once runs dry.
— Virginia Woolf, On Being Ill
For me, questions about pain and its treatment started during my first year of medical school at the University of Toronto. One day I noticed that I was experiencing a strange, nagging pain in my right shoulder. Like most of us who suddenly realize that Pain, the Intruder, has arrived on our doorstep, I fully expected it to go away on its own.
It was there the next day, and the day after. Although I tried to ignore it, that was impossible when I lifted my arm to reach overhead. I'd be jolted back to the reality that this pain wasn't going anywhere by itself. Instead, the pain was growing sharper, and if I maneuvered something heavy overhead, it felt even worse.
Over the course of three weeks, putting my arm behind me to pull on a sweater or coat became harder and harder, but I kept doing it to stretch the muscles and not lose the function. For the life of me, I couldn't remember what I'd done to cause this, so I continued to hope it would go away as silently as it had come.
I was still in my twenties with a pretty healthy diet and a regular exercise routine, so I told myself there was nothing to worry about. But then, a month passed, and I now had difficulty raising my arm above shoulder height. Finding a comfortable position to sleep proved trying. I was in pain when cooking meals that required extensive stirring and chopping. Carrying my schoolbooks hurt.
Finally, I accepted the inevitable: time to get some over-the-counter medications. Unfortunately (or fortunately, as I will explain), they disagreed with my stomach, so I had to stop them. The pain continued for another three months. Now, I had to limit my exercise to walking, because anything I did with my arms aggravated my painful shoulder. To compensate for the lack of sleep, I drank more coffee to stay awake in classes. A cloud of unhappiness settled over me. All I could think about was my shoulder; it dominated every daily activity. All I wanted was to get my life back and to forget about that shoulder.
As luck would have it, I was enrolled in an evening course on acupuncture, which was not part of the regular medical school curriculum. It was offered by a group of doctors who had established the Acupuncture Foundation of Canada to train physicians to use acupuncture techniques. I listened with fascination as one doctor lectured about theories of why it worked and why the Chinese had been using it for thousands of years. During another class, the lecturing physician described how painful sports injuries were treated using nothing more than a very thin needle containing no medication.
One evening, two doctors showed up to lecture. It was time to demonstrate what the instructor had been lecturing on for the past four weeks. They asked for volunteers to demonstrate on, and I quickly shot up my arm — my good arm. I walked up to the front of the room, wondering if little needles might be the answer to my problem. The doctors asked me questions about the location of my shoulder pain and had me move my head and arm this way and that. One of the doctors put some alcohol on a cotton ball and swabbed my skin in about six places around my shoulder. He then took a tiny needle and, with a quick tap, pushed it into the first freshly swabbed spot. I didn't feel anything but the pressure of the tap. He inserted five other needles with the same type of quick tap. Two of the needles stung slightly when inserted. I could feel the area around the needles grow warm, but they did not cause major discomfort. After ten minutes, he removed the needles. "That's it?" I thought.
I was sent home with homework: to continue treatments on myself every other day until symptoms abated. In a previous class we had learned how to insert the needles, so I was able to do acupuncture on myself using the same points that had been used in class. Within three days of my first treatment, all my symptoms had vanished. I could lift my arm pain-free, I could sleep through the night, and I could start light resistance exercises to strengthen my arm. It took another week until I regained the full range of motion in that arm.
And the best part? The problem didn't return.
Later that same year, my father developed neck and shoulder pain. His regular doctor recommended medication that proved ineffective after two weeks. The doctor had no other remedies to offer. I suggested that my father stop taking the ineffective pills, and I sent him to a chiropractor who included acupuncture in his treatments. My father was skeptical. He was convinced that the spinal adjustments would not work and ridiculed the idea that needles could remove pain. He went only to humor me. But with the combination of chiropractic care and acupuncture, my father recovered fully in six weeks. He was so impressed that he became a lifelong fan of both treatments. I found myself growing more and more fascinated by these practices that enhance the body's own ability to heal itself, with very little risk of side effects. I have been interested in pain management and alternative therapies ever since.
Throughout my practice, I have found it useful to return to the first principles: anatomy, physiology, and pathology. These are the basics that form the foundation of medicine, and the terms refer to the body structure, the science of how our bodies work, and what we know about how things go wrong. I am grateful that while I attended the University of Toronto Medical School my instructors spent a long time teaching these fundamentals. They gave me the tools to think about some of the basic mechanisms behind people's pain, the ways pain was commonly treated, and what happened when treatments failed. I became a family doctor and saw patients with lingering pain that often disabled them. Some of these people would not get better despite physical therapy, appointments with specialists, and the use of medications. For these unfortunate sufferers, I kept looking for answers. This led me farther and farther into the alternative fields of medicine: nutrition, massage therapy, craniosacral therapy, acupuncture, chiropractic, and others.
I became familiar with the term myofascial disorder. Myo means "muscle," and the fascia is the supporting tissue around the muscles. I had gone through my entire medical education, internship, and residency and had never heard the word until a few years after I started my practice. As I began to read more about it, it became apparent that this was a glaring omission: myofascial disorders are the most common cause of pain.
I read the early works of Janet Travell, MD, who was the grandmother of myofascial therapies in the United States and served as the physician for John F. Kennedy while he was in the White House. Then I read the references listed in her book and was astounded at the richness of this literature. I was introduced to the work of Dr. C. Chan Gunn, who developed coherent theories to explain the physiology of myofascial pain and its treatment. The writings of Janet Travell and Chan Gunn transformed my vision of healing, and the treatment developed by Dr. Gunn, called Gunn intramuscular stimulation, is the most effective tool I have found for myofascial pain. I learned that certain common and disabling types of chronic pain can go away with the right treatment. I have treated over five thousand new patients and seen the results. But while these techniques solved many of my own pain problems and those of my patients, over the years I have seen an increasing number of people with severe pain, complex and puzzling problems, and unexplained illness associated with their pain syndromes. We have a long way to go to tackle the challenges that face us.
Since I began to practice medicine in 1984, I have seen pain as a growing problem. There are an increasing number of sufferers, including younger people developing pain syndromes, and an increase in the severity and complexity of pain problems. I even have many teenagers in my practice now who have too much pain and disability to attend school. These are normal kids, including some high-level athletes, who want desperately to get on with their lives. Complicated procedures and sophisticated drugs have limited effects — their side effects are sometimes as much a burden as the original problem. What has never been adequately studied is the resulting loss of human potential — the gifts these people have been unable to develop that could have enriched our society. This is especially the case with very young sufferers.
Everyone knows what pain is. Most of us have known pain in our own bodies and have seen it in others. But when we really try to describe what pain is, we are often at a loss for words.
Pain itself does not have an emotional component. If you pinch yourself until it hurts, you are unlikely to react with happiness, anger, fear, or sadness. An emotional reaction usually occurs only when your pain seems to be incomprehensible or out of control, when you do not know how or when it will end.
There are words for pain in every language. There is no nation or culture that is spared the experience. Yet the experience of pain is a solitary one. Those who are living with pain pay in immediate suffering and by not being able to live their lives fully. Those in pain feel alone, isolated in their agony, and separated from their former lives and the lives of those around them. Pain sufferers may also feel the separation that comes with the judgments of others.
People in pain often do not "look" as though they are in pain. If they focus on their pain in conversation, or reveal their discomfort by their actions, they risk being labeled as "complainers" or "symptom magnifiers." Animals in pain instinctively seek privacy to lick their wounds. Similarly, there may be a natural instinct in people to seek comfort in withdrawal.
Pain is always a subjective experience. We have no ways to measure pain "objectively." There are charts, scales, body diagrams, and ratings, but none of them measure pain the way a thermometer measures a fever. In the end, the person in pain tells us about his pain. Patients with lingering pain almost universally have their experience of pain questioned, challenged, and disbelieved by health care practitioners and by friends and family. Most of these patients also say that the vocabulary available and the scorecards used in pain clinics do not help them convey the true experience of their pain.
Pain is complex. The issues involved spread out like the ripples from a pebble tossed into a pond. When these ripples become intermingled with the wave patterns of countless other pebbles, it becomes impossible to distinguish one pattern from the next. Chronic pain is like a fifty-thousand-piece jigsaw puzzle for which we have placed about five hundred pieces. We are not even sure what the big picture is. This is small comfort for those in pain. The good news is that, despite the lack of clarity in our vision, we have many useful interventions.
Acute pain is pain lasting a relatively short time and is usually injury related. Chronic pain is pain lasting longer than three months — or six months, depending on whose definition is used. But these are simplistic definitions of complex problems. In some cases, acute pain lasts more than six months because there has been neither an accurate diagnosis nor an appropriate treatment. In other cases, we are in the first month of a process which is already evolving into a chronic state. Nothing magical happens during the third or sixth month that makes the process different. Sometimes the pain is chronic pain from the beginning; we just didn't know. Other times, something does change in the way the body processes pain, but that may happen on day one, or day one hundred, or day three hundred. No expert can impose a timeline on Mother Nature.
The number of people who suffer from pain is staggering. That is why, in late 2000, the United States Congress passed a provision into law, signed by President Clinton, that declared the ten-year period beginning January 1, 2001, the Decade of Pain Control and Research. Countless studies have been undertaken to try to measure the effects of pain and the number of people affected. The definitions used and the variables measured are not identical from study to study, and so drawing information from them can be a little confusing. However, a decade later, the 2011 report of the Institute of Medicine, an organization in the United States that provides national advice on health issues, estimated that there were over 100 million Americans in pain. This figure did not include children in pain or any individuals in acute pain. There are a lot of people in pain. And this is not just an American problem. The International Association for the Study of Pain estimates that 20 percent of adults have moderate to severe chronic pain. Professor Harald Breivik, coeditor of Clinical Pain Management, has called chronic pain "one of the most underestimated health care problems in the world today, causing major consequences for the quality of life of the sufferer and a major burden on the health care system in the Western world."
Let us look at some of these statistics relating to costs. To begin with, pain has a cost to society, starting with costs for health care services, medication, surgery, and the complications that arise as a result of all those things. Then, there is the cost in lost productivity and absence from the workplace, which has impacts on industry but also on social service budgets and even tax revenues. The 2011 report by the Institute of Medicine estimated the annual cost of chronic pain in the United States at between $560 and $635 billion. The report called for a "culture change" in the medical system that treats pain.
In 2004 Americans spent $16.6 billion to relieve pain, most of it to purchase over-the-counter or prescription drugs. Pain is a problem for insurance companies too. The costs of high-tech procedures and surgeries like epidural injections, spinal cord stimulators and pumps, and spinal surgeries are rising each year. And what is worse is that we seem to be setting people up for other problems down the line. We are spending more and more and not getting people better.
When we look at the workplace, some costs of pain are easier to quantify than others. We can get the annual statistics for Workers' Compensation costs and lost workdays. What are harder to assess are the costs associated with people in pain who come to work but are unable to work at their full capacity, a phenomenon called "presenteeism."
A survey done by Gallup in 2011 found that nearly 47 percent of adults reported having a condition affecting the neck, the back, a lower limb, or another part of the body that caused recurring pain in the previous twelve months. Low-income Americans are even more likely to have chronic pain. Nearly 50 percent of all Americans seek care for pain each year.
No matter how you measure it, pain is a big problem: for the person in pain, for those providing treatment, for the insurer who is paying for treatment and time off work, for the employer waiting for an employee to return to work, for the kids who want their parent to play catch, and for other family members living with the person in pain. Unfortunately, conventional approaches to the treatment of pain often do not improve the situation.
Though most physicians would prefer to treat each patient as a unique case, many now adhere to practice guidelines — established signposts intended to shape the problem-solving path followed by physicians. Practice guidelines were originally designed as a sound basis for the minimum care a physician should offer but are now used as welcome assistance to the rushed physician who can spend only a few minutes with each patient.
Recent studies of patient-physician visits show that primary-care physicians in North America spend an average of 10.7 minutes with each patient. The doctors studied allowed the patient to speak for only eighteen seconds before they interrupted. This leaves very little time for nuanced communication and attention to the complexities that characterize most human conditions. There is barely time to decide which drug to prescribe before drawing the meeting to a close.
Physicians may also feel pressure to follow the standard-of-care practices — to do what most others in the community are doing. For example, prescribing the anti-inflammatory drug Vioxx was the standard of care for many years, even though evidence, little known to most doctors, indicated that it increased the risk of heart attack. Few doctors read the studies to learn about the drug's risk; instead, they simply looked at the information the drug reps handed them. When I presented information about this risk to a group of colleagues two years before Vioxx was pulled from the market, I was called an alarmist. Most of my colleagues continued prescribing the drug until it was no longer available. These are issues that I explore in greater detail in the pages that follow.
I have written this book as a patients' guide to understanding and managing chronic pain. Chronic pain is a growing problem, one that affects more people than before, with increasing severity; and now there are new types of pain that are unresponsive to conventional therapies. There is a growing body of scientific literature explaining the mechanisms of pain and how we experience it. But despite more research and knowledge, there are still patients with confusing collections of symptoms that defy explanation. For these people, chronic pain is just one piece of a complex puzzle that is the healthy human body.
(Continues...)
Excerpted from Holistic Pain Relief by Heather Tick. Copyright © 2013 Heather Tick, MD. Excerpted by permission of New World Library.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
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Table of Contents
Contents
Part I. Breaking New Ground,Chapter 1. Pain, Nature's Wake-Up Call,
Chapter 2. The Changing Times,
Chapter 3. A Visit with an Integrative Physician,
Part II. Pain Solutions,
Chapter 4. The Healing Diet: Lost Food Traditions,
Chapter 5. Resolve Stress and Dissolve Pain: The Mind-Body Solution,
Chapter 6. Healthy Habits,
Chapter 7. Dietary Supplements,
Chapter 8. Exercise,
Chapter 9. Prescription Drugs,
Chapter 10. Toxic Stew,
Part III. The Next Steps,
Chapter 11. Your Team,
Chapter 12. The Road to Recovery,
Acknowledgments,
Endnotes,
Glossary,
Resources,
Index,
About the Author,