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

In Your Words… No longer prone to falling

by Barbara Y.

For my entire life, I’ve been somewhat clumsy. I tripped over things, ran into corners and fell often. As a kid, this wasn’t so bad but as an adult it became more problematic. As a result, I’ve needed a good bit of bodywork, having done various types of massage with many different therapists for over 20 years.  I always thought it was just me, something in my personality that made me prone to falling. However, all this changed when I had the great fortune to meet Will Ravenel at HaLe’.

Not only has Will, through Rolf Therapy and Myofascial Release, balanced the structure of my body so I’m more grounded with better posture, I haven’t had a bad fall since working with him (knock on wood). Rolf Therapy was something I’d always heard about with curiosity but kept putting off. I’m forever grateful to Janice Cathey for suggesting this form of bodywork, as it’s been perfect for me. I’ve heard others talk about their Rolf therapists with mixed reviews. I have only glowing praise for Will. He is not only extremely knowledgeable about the human body, he’s a kind and generous person. He takes time to explain the work, giving exercises and advice on maintaining good posture. Will has helped me understand how integrated we are physiologically and how to maintain a balanced and grounded way of moving through the world.

Lymphatic Massage Speeds Recovery from Surgery

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.

The Magic Muscle: the Psoas

The psoas (pronounced so-az) is the one muscle that attaches the upper body to the lower body. It allows locomotion by allowing you to lift your legs to actually walk. It is the filet mignon of the body, the tenderloin, and is actually very delicate. It needs to be treated with sensitivity, so that it becomes juicy and full and soft. When it is juicy, you walk like a dancer, with legs that just swing from your body.

It is also the emotional core of the body, holding massive amounts of emotional information. It is where we hold birth and childhood trauma, or any other trauma, because it is directly a part of our flight or fight response. This makes sense because you are either running or curling into a ball, which are both primarily psoas reactions. When you’ve been traumatized and just want to curl up, that is the psoas acting as a protector, and when you release that, you can stand up straight, face the world, and approach it with ease.  It can also hold good stuff if you create that. A relaxed and juicy psoas leads to full body orgasms that flow through your whole body.

One of the best things you can do for your psoas is Constructive Rest Pose, where you lie on your back with your knees bent and feet parallel to each other at the width of your hip sockets, about 12-16″ away from your buttocks. You can also put your feet up on a chair. This pose allows the psoas to drop and lengthen. A fetal curl also allows it to soften and relax. These simple relaxations are so important. They not only change the body physically, but you can feel yourself moving more deeply into the floor. Your sympathetic nervous system gets a break and the body gets soft, bringing us a treasure trove for the body, mind, and spirit.

You can also work with balls to soften and hydrate the feet, standing up and pressing and releasing the foot onto a ball. This hydrates the tissues all the way up to the psoas, which is why we do a lot of it in class.

The psoas is fascinating because everything lands there, all your emotional issues, everything, and it works best when it is soft and relaxed. We can play with it, approaching it with a childlike curiosity of how things move. And when the psoas is juicy, we will all walk like dancers, with an easy flow.

Health Tips for Jet Lag and Travel

The keys to taking care of your body while traveling are hydration, combating insomnia, and body comfort. We’ve asked some of our expert team how to best support the body through travel. Here is what they said:

Acupuncture AppleAcupuncture: These three acupressure points will help support your body through jet lag and travel weariness:

Stomach 36: Stretch legs out in front of you and place a pillow under your knees. Place the fingers of your right hand directly under the left kneecap. Just under the little finger, about a thumb’s distance from the shin bone you will find a little hollow place. That is S 36. Apply gentle even pressure for about a couple minutes and repeat on the other side.

Xin Bao 6: Find the wrist crease on the palm side of the left hand. Measure 2 thumb widths from the crease. The point is located between the tendons. Apply gentle pressure with the tip of the thumb for a minute or so. Repeat on the other side.

Ren 6: Lie comfortably on your back. Place the first 3 fingers of your left hand directly below your navel. With your right hand, place your index finger directly below your navel right next to your 3rd finger. Massage this point for a couple of minutes.

 

Woman On Yoga BolsterYoga and Therapeutic Movement:  When you come back from a trip, remember that there are 2 parts to a really good yoga practice: the physical, and what I call telling the truth. Physically, prioritize getting sleep, listen to your body, and allow a couple of days on either side of the trip to settle back in and recalibrate before you go back to your usual schedule.

A yoga posture that is especially helpful is a gentle forward fold, where you stand with your sitting bones on the wall, walk your feet forward 12-18 inches from the wall, and then bend forward. This has elements of child’s pose as you lay along your thighs, allowing you to breathe into your back a bit. Also helpful are gentle twists, inversions, downward dog, and cat-cow for spinal releasing.

For the second part, Telling the Truth, find a person that can hear you and is present for you where you are. Have a conversation about your trip and anything that shifted, or realizations, or experiences. Trips can often rearrange us a little and it is very grounding to connect with your people when you come back.

 

Various spices and herbsAyurveda & Nutrition:

Take Ashwaganda, which is a rejuvenate and helps with the way travel throws off the body’s biochemistry. Take it the night before and then while traveling, especially to help sleep. (available at HaLe’)

Take Triphala, which helps fix constipation, assists with detoxification, and regulates the bowels. (available at HaLe’)

Drink lots of water, and in summer, put things in the water like cucumber or mint to help cool your body.

Do dry massage: take a dry washcloth before you get in the bath and start at your ankles, brushing up toward the heart to get circulation going. This is especially good for when you’ve been sitting a long time.

 

zen stones jy wooden banch on the beach near sea. OutdoorBodywork: Biochemical processes don’t move as fast as we can travel, so the body needs support in catching up.

Help reset your sleep cycle with exposure to natural sun for at least 20 min. Using a natural sleep aid such as melatonin can also help.

Balance the hips and release the neck and shoulders because those can get compacted during travel.

We need to stay more hydrated than usual. Coconut water and bottled spring water are especially good. 

Diet-wise, eat bananas and maybe some nuts. Avoid fatty foods, spicy foods, dairy, and caffeine.

Take an epsom salt bath with a little lavender or something in it that rejuvenates to help with travel weariness. 

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.

Behavioral Health for Mind, Body, and Spirit Care

from Janice Glasscock, LCSW

Behavioral health care and mental health care focus on thought processes and emotions, on personal narrative, and helping the mind communicate with the brain. This allows us to better understand our own stories and feelings so that we can make better decisions and act towards healing.

Behavioral and mental health care is especially useful for people in situations that feel stuck, full of loss or fear, and/or during large transitions. These situations can include an unhealthy pattern in a relationship, moving into new parenthood, and launching children from home. They can also be about dealing with a life threatening health condition or diagnosis, stage of life transitions like aging or health concerns, work place or work relationship concerns, or the loss of a significant relationship.

Approximately 67% of people with behavioral or mental health concerns do not receive treatment, and these concerns account for about half of disability days from work. Depression is the #1 condition currently affecting health care costs right now, and it has a global and pervasive impact on health issues and conditions.

We can improve our overall sense of well-being, health, and quality of life by paying attention to our behavioral and mental health as a part of our mind, body, and spirit interplay. This means paying attention to our thinking and cognitive processes, and to our decisions and actions. Strong behavioral and mental health helps with:

  • positive, effective work and personal relationships
  • good life choices and lifestyle development
  • physical health/well-being
  • handling natural ups and downs of life, and coping during life crises
  • self-discovery and personal growth

Psychotherapy as treatment for behavioral and mental health concerns is an evidence-based way to reduce depression and anxiety and more effectively cope and problem solve. It has long-lasting benefits, and helps to address chronic low and high levels of stress that are on-going contributors to compromised health and well-being.

Within a positive, safe, and constructive relationship with a professional, psychotherapy helps identify and better understand cognitive sources of unease, and to change/broaden thinking about both the problems of daily living and the catastrophic, all-consuming psychological and emotional crises from which we need recovery. It is a great modality to help us take action on the paths of healing.

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.