Central Sensitization & Pain That Gets Worse

by Chelsea Henry

Pain can modify the way the nervous system works, making the body more sensitive to less stimulation, in a process called Central Sensitization. This happens mostly through changes in the brain and spinal cord, and means that little things hurt worse than they should, and that it takes longer for the pain to fade. We found this wonderful article, Central Sensitization in Chronic Pain by Paul Ingraham, which is a jargon-to-English translation of rock star pain researcher Clifford Woolf’s published paper.

As explained in the article, it is hard to know when a person is feeling more pain than they should, because we do not yet have a test we can run to show how much pain someone is feeling. That means that we only have our own experiences to go by, and without a defined “normal”, it is easy to not know that we are in more pain than we should be.

Central Sensitization is very well-documented and easy to create in lab settings. It also shows up so often as a complication of painful problems that some researchers think it might be a common denominator. It could be what puts the “chronic” in chronic pain.

Though we know that Central Sensitization exists, we do not yet know why it happens to some people and not others, and we do not have a good way to diagnose it. It could be a part of any case of chronic pain, but it is not clear how to separate the pain that comes from a problem in the tissue from the pain that comes from Central Sensitization.

When a person has Central Sensitization, it basically means they have a hyper-active warning system and the body is no longer giving useful, sensible pain signals. On a fundamental level, pain is about your brain’s assessment of safety: unsafe things hurt. Therefore we can treat Central Sensitization by being kind to our central nervous system. We can decrease stress and increase a feeling of safety and ease. Yoga, yoga therapy, massage, meditation, and mindfulness can all help create the felt experience of wellness the body needs in order to start turning off the alarms. Feeling safe and good, and having therapeutic experiences that are pleasant, easy, and reassuring, can go a long way in calming the nervous system and bringing the body back out of excessive pain.

Chronic Pain and the Hardest Pill to Swallow

by Chelsea Henry

Dr. Tracy Jackson spoke at TEDx Nashville about “The Hardest Pill to Swallow”, regarding chronic pain. We at HaLe’ feel inspired, because we see the evidence of the effectiveness of our holistic approach on the pain levels of our clients and students every day.

Chronic pain steals your mojo on every level. It is the #1 presenting complaint to doctors and top reason people are out of work, and yet US outcomes and treatment of chronic pain are among the worst in the developed world. We have a limited and flawed understanding of chronic pain, and we don’t want to accept what we do know.
Pain is a perception, and how do you prove it to doctors who are trained to diagnose and treat physical symptoms in the body? People with chronic pain go to 10 min doctor visits and present their case so that the doctor perceives their perception of their pain correctly. The worst that can happen is if the doctor thinks it is all in your head. But ALL pain is literally all in your head!

Think about a kid who doesn’t want to go to school because there is a test, or a monster under the bed. They get a tummy ache. They get a physical symptom based on an emotional issue. As adults, we deny that pain from mental stress manifests as pain in the body. But we cannot feel pain without a functioning brain. Chronic pain causes central sensitization, and our mood, sleep, and pain pathways all overlap. It all feels like pain in the body.

Americans are prescribed enough opioid pain pills for every person to take 3 pills a day for 42 days every year. The #1 cause of accidental death in the US is opioid overdose, which is more than car accidents. And yet no scientific study shows that opioids are effective for chronic pain after 6 months, and after that they start to change the body so that it feels more pain. They also mess with mood, sleep, immune function and sexual function. Chronic pain is not about a lack of pain pills. We are missing something.

Everything is connected in the body. You have to move regularly if you have chronic pain, it is the cornerstone of all effective treatment. It is significantly even more effective if that movement incorporates breathing and mindfulness techniques, like yoga. Some doctors ask how can that work if surgery and oxycontin don’t, but it has been proven to drastically reduce the pain experience by changing the way we think, breathe, and move. Harvard neuroscientists have shown that we can change the very structure of our brains and can reverse the changes caused by chronic pain by using the breath.

Pills and procedures do work for some people, but if they don’t work for you, you have to accept it and do something different. We can admit that stress and lifestyle choices contribute to and cause chronic pain at any age. We can hold ourselves accountable to seek out the longer, more durable path to real relief. We can advocate for more holistic functional rehabilitation resources (which have been thoroughly proven to work!) available to all of us, and teach that we can be active participants in our own healing and our own lives. The hardest pill to swallow is that there is no quick fix to chronic pain. But there is a fix!

Watch Dr. Tracy Jackson at TEDx Nashville

Lymphatic Massage Speeds Recovery from Surgery

from Adie Grey MacKenzie

The lymph system is both a producer of materials that help us heal and a septic system, and so supporting its function through lymphatic massage can speed our recovery from surgery. Lymphatic massage assists the body in moving inflammatory components back out of the system and it gooses our immune system function to help the healing process.

There is a cascade of events that allows us to heal. Part of that process is the inflammatory response, which is necessary for healing to happen when we disrupt the body through surgery. Inflammation also means there will be swelling localized to the surgical area, which slows the lymph system’s ability to do its job of moving wastes out and healthy components in. After surgery, it is also the lymph system that helps the body process all the materials that need to be moved out, including excess fluids given during surgery.

Lymphatic massage assists the function of the lymph system through all these processes. It also stimulates the parasympathetic nervous system, which is especially good in healing times because it allows our bodies to really rest in order to heal efficiently and effectively. This also has an analgesic effect because the parasympathetic nervous system calms our perception of pain. There is a whole interplay of physiological functions that lymphatic work supports, helping to heal from surgery, reduce post surgical pain and swelling, and speed return to function. It also helps avoid infection because it helps keep the immune system more fully functional.

Receiving lymphatic massage feels gentle and rhythmic, helping us to breathe more deeply and rest more fully, and is safer for tissues that are still healing after surgery. Even clients who have always thought they need deep and vigorous massage are surprised at how effective and soothing lymphatic massage is, with its relatively light touch. It is both satisfying and plenty deep enough to do profound work in supporting the healing process.

Now about those needles…

by Katherine Casey, LAc

If you have never had any experience with acupuncture before, you are probably concerned about the needles. This is understandable, because the only needles we are familiar with are hypodermic needles, which are hollow-bodied, and designed to either take something out of us (blood), or put something in us (medication). Neither experience is ever very pleasant!

Acupuncture needles are completely different from hypodermic needles. They are very thin, solid body (meaning, they aren’t hollow like hypodermic needles are), and they serve the purpose of delivering a message. They direct qi (that animating force that keeps us alive, pronounced “chi”) to do something, like “go over here and nourish the lungs because this body has a bad cold.”

Another concern people often have about acupuncture needles is whether or not they are reused. And the answer to this is an unequivocal and emphatic NO. Acupuncture needles arrive from the supplier in sterile packaging, and they are single use only, just like hypodermic needles. They are disposed of in a sharps container just like the ones found in doctors’ offices and hospitals. Acupuncture needles are never, ever reused.

What is Cupping Therapy?

by Katherine Casey, LAc

The history of cupping is documented in the medical histories of many parts of the world, including countries of Africa, Europe, the Middle East, as well as Asian countries. Cupping is the practice of applying specially designed cups to the skin using suction for the purpose of relieving muscle pain, reducing swelling, and increasing the circulation of blood and qi to an injured area. It can be used to assist in lymphatic drainage and in reducing cellulite. Cupping can also aid in alleviating digestive issues, such as constipation. Facial cupping can aid in the reduction of fine lines and facial puffiness.

Historically all kinds of items were used for cupping– animal horns, bamboo, stone, and sea shells are some of the materials used for cupping. Nowadays, in the modern clinic setting specially designed glass cups are used, as well as cups made of polycarbonate plastic or silicone, all of which can be easily cleaned after use.

How does it work? In order to answer this question let’s compare massage therapy and cupping. Massage therapy creates “positive pressure” by compressing tissue to relieve muscle tension. In constrast, cupping uses suction to create “negative pressure.” The suction action of cupping expands and opens up the layers of body tissue, allowing better circulation of blood and qi.

Cupping will often leave round marks, commonly referred to as bruises, though the marks are not true bruises, like those that occur from a compression injury. The marks gradually disappear a few days after treatment.

The Benefits of Mindfulness Practice

from Elmo Shade

The most common reasons people come to a Mindfulness Practice are

  1. Physical pain or chronic pain
  2. Emotional pain due to loss, death, or serious or potentially fatal diagnosis
  3. Inability to manage the day to day stressors of life

The benefits of mindfulness are known and well-documented. It reduces levels of stress, meaning the autonomic nervous system is not in fight, flight, or freeze mode. This then reduces both anxiety and depression, reduces fatigue and burnout, and reduces periods of restlessness. This leads to an increased ability to pay attention and concentrate and higher cognitive performance, particularly while learning. It enhances hormonal balance for women, and enhances the immune system of men and women.

Chronic pain, many of our physical ailments, and even diseases that we are experiencing are not actually illnesses or diseases. They are a result of the body system storing stress and pain that has never actually been released in a healthy manner. Mindfulness helps to reduce the discomfort of pain, both emotional and physical, and increases our capacity for compassion for ourselves and others.

Because Mindfulness Practice is about paying attention to physical, mental, emotional, and spiritual energies, it often leads to increased levels of energy. It can decrease fatigue and increase stamina. This higher energy level then brings increased movement. The American Psychiatric Association shows we spend 6-12 hours a day not moving, and this does not count the time we spend sleeping. Having the energy to move is a tremendous benefit.

Mindfulness Practice is evidence-based and proven to benefit quality of life through the reduction of physical pain, emotional pain, and chronic stress. Our collective stress levels are higher than they have ever been, especially for women, and that takes a toll on our health. We can bring ourselves back into balance through mindfulness.

The Benefits of Yoga at Any Age

from Nancy Kirkland

People derive different kinds of benefits from a yoga practice. Yoga and other eastern practices differ from most western forms of physical activity because you really have to incorporate the mind into the practice. With aerobic oriented activity like running or swimming, you can just let your mind drift off. With yoga, the mind focus brings a greater benefit in addition to the physical benefits of greater strength, flexibility, and balance. A lot of people sleep better, feel calmer, and breathe better. You don’t have to go in with the intention to get those benefits, they just result from doing a good yoga asana practice.

Yoga also helps people find what is challenging for them, be it physical, mental, or emotional, and helps find a way to address it. People often do yoga positions way too quickly. They will say their shoulder hurts, and I’ll say give it 6 months. Give pain time to resolve. Pain is a very good teacher and yoga is not a pain free practice. When people come to class with pain, they need to recognize that yoga is not an immediate cure all but that there are great benefits to a regular practice.

Yoga is a practice for people of all levels. HaLe’ has students ages 20 to 80, so don’t let fitness or age keep you away. Find a teacher that resonates with you and then stick with them. Don’t try for a lot of variety; go deeper instead of wider. Allow your class to become a community that develops over time. That’s a very supportive group to be in.

Also, don’t avoid props and don’t underestimate restorative yoga. Props like blocks, straps, and chairs make yoga much more accessible to people and allows them to achieve a comfortable practice with a properly aligned body. Restorative yoga is key to improving breath, awareness, and observations skills, even though a lot of people really resist it when they are new to yoga practice because they feel restless, want to exercise, and don’t see the value. It is an important part of a yoga practice; don’t ignore it.

A yoga practice, because it incorporates mind and body instead of being just body, comes with a lot of benefits. A good asana practice should be both convenient and enjoyable, and doing the yoga postures properly has different benefits for everyone. Most of all, though, don’t take it too seriously. It should also be fun.

 

Nancy Kirkland has 45 years of yoga practice and has been teaching yoga for 17 years.

Pelvic Health: No Where To Go But Inward

From Lynne Odom, PT, MOMT

Pelvic health has a huge effect on quality of life. Daily activities influence pelvic health in ways we may not be aware, like sitting postures, bathroom habits, etc. Learning what your pelvis holds and how it is interrelated to your anatomy can be very empowering. Gaining this knowledge helps increase awareness and appreciation for the pelvis and its important functions as the floor to the spine, connector of hips and pelvis, holder of organs and babies, etc.  Understanding what “normal” pelvic floor function is can be a starting point of awareness.

Dysfunction in pelvic health happens across the population, from pediatric to elderly, and can be affected by more things than having babies and aging. Improving pelvic function often helps with pain that is not responding to other therapies, especially low back pain, as well as bowel and bladder dysfunction, painful intercourse, and lumbar and spine dysfunction. The pelvic floor depends on the spine, abdomen, breath, and lower and upper extremity strength and function. Conditions such as low blood pressure and bowel and bladder issues may be directly related to pelvic dysfunction.

There are simple daily habits you can be aware of to bring better health to your pelvic area, including certain postures, bowel and bladder habits, and exercises. Histories of trauma, like sexual or physical trauma, pregnancy, birth, or surgery can all have an effect on pelvic health.

The most important starting place, though, is to learn to breathe into the pelvis. When you inhale, bring your breath all the way down to your vagina and/or perineum, and then fill the diaphragm, and then the chest. The pelvis is a body part you can’t see, and once you can be still enough to connect with it, there is an awareness that will open up. So be still, be with the breath, and breathe into the pelvis for pelvic health.

Fibromyalgia Symptom Relief through AIYA Yoga Therapy

Fibromyalgia symptoms cross physical and neurological boundaries, as do symptoms from traumatic accidents and surgeries that throw off the nervous system. There are many conditions that seem to affect the nervous system but that challenge Western medical diagnositics. The symptoms are real, even if they can seem mysterious and confounding to Western medicine. Assisted Integrated Yoga Asana (AIYA) Yoga Therapy is excellent at calming this family of symptoms.

The gentle assisted movement of AIYA Yoga Therapy, developed by Kristen Hubbard, brings relief to muscles and joints by moving through a range of motion and stretching as well as flushing of interstitial fluids. Sessions are done one on one on a thick mat on the floor, as the therapist takes you through a passive series of assisted stretches, other gentle movements, and working with the breath.

Kristen Hubbard has worked with fibromyalgia patients since 2011. Her treatments have a wonderful positive effect for fibromyalgia symptoms, and include a gentleness of process that makes sure all parts of the body are always supported and that there are no jarring or intense movements. This proficiency in effective treatment is informed by Kristen’s expertise in restorative yoga.

New clients should begin with a 1 hour initial treatment so that client and therapist can build trust and feel comfortable with each other. Depending on what the client needs, Kristen often recommends coming every other week for 4 or 5 treatments and then dropping down to more of a maintenance schedule. Since every body is unique, treatments also include discussion about self-care recommendations and some ideas for stretches at home in order to prolong the positive effects.

AIYA Yoga Therapy helps people with fibromyalgia symptoms get to a place where they are more comfortable in their bodies as they get to know their range of motion through safe movement free from fear of injury. They tend to have lessened pain days and less intensity of symptoms. The effects seem to last for several weeks before symptoms begin to return.

The Folk Art of Thai Massage

Thai Yoga collage

Thai Massage is a folk art, a healing art, and is a great complement to other healing therapies. It has its roots in both self-care and love and care of others, as inspired by the practice of Loving-Kindness, or Metta.

Practicing Thai Massage teaches a person how to ground and focus, how to center themselves, and helps create a sense of body-conciousness and body awareness.

Receiving Thai Massage helps drastically reduce stress levels in the body, and is a good treatment for neck pain, back pain, shoulder pain, and muscle soreness, as well as helping to open the joints.

Thai Massage is a branch of Thai medicine and medical theory, and is something that has been practiced by the indigenous people of Thailand for a long time. It started as a form of partner yoga, with its roots in self-massage. That is where the terms Thai Yoga Bodywork or Thai Yoga Massage come from.

There’s a system of self-care and self-massage techniques rooted in the whole Thai process because it starts with yourself. The techniques taught in classes are designed to mimic some of those original self-massage techniques, only they are modified to be done with a partner.

These partner techniques are especially fun for couples, parents, family members, and friends to learn and practice with each other. Once you have the training, you can easily do it together at home. It is also useful for fitness professionals like personal trainers, for massage therapists to broaden their skill base, and for yoga teachers to use with private clients.

Thai Massage is a wonderful practice to integrate into your lifestyle, with its benefits for giving, receiving, and sharing with others.

Ha.Le’ is pleased to offer an upcoming Thai Massage training workshop March 5th and 6th 2016 with Charlene Gaffney. More information here.
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