Treating Pain with Integrative Health Care

from Janice Cathey

Two weeks ago we discussed Dr Jackson’s TED talk about the inadequacy of opioid drugs and surgery for addressing chronic pain. Last week we talked about Central Sensitization, a biological process where pain modifies the way the nervous system works, making things hurt worse than they should and pain last longer than it should.

As the health care field grows its understanding of where pain comes from and how we need to change our approach to treating it, it is our great honor to be care providers in relationship to individuals.  HaLe’ is grassroots, which means we are growing an innovative way, building from modern research and ancient modalities to better cope and deal with health issues.

Evidence shows that only 20% of medical issues can be 100% dealt with by the medical field. We have a great regard and respect for what surgery and medicines and other western medical practices can do for us, and want them available for ourselves, our families, and others. Yet there is so much more to health than what western medicine can fully treat.

What we do is collaborate and partner, drawing understanding of the body’s dynamic response that happens daily in our practice. Every time a person comes in and connects with their breath­­, when there is movement, when there is connection, then there is a dynamic response that happens. We are not bringing people a shallow patina of “feel better”; we are delivering a systematic method of health and well being that is accessible to every single person no matter what your age, medical history, or where you come from.

Integrative medicine is not a new way of treating health and wellness; it is an objective. It increases connectivity for an individual because that is what integration is. This is not about one system of the body, but about many systems working in unison for the betterment of whole health. There is a bottom up response coming from the patient as they demand care on a holistic level, and that broader scope is where the care paradigm begins to switch. We are here to provide support and create space for that to happen.

Health is a dynamic system of balance and counterbalance that is complex and interconnected. Every person should walk away feeling better than when they came in our door. Even when you aren’t feeling bad, there is still room to feel better and to engage in the processes of health.

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

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.

The Magic Muscle: the Psoas

from Kaaren Engel

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 AppleKatherine Casey, Acupuncturist: 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 BolsterJane House, Yoga Teacher:  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 herbsLiz Workman Mead, Ayurvedic & Nutritional Counselor:

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. OutdoorJanice Cathey, Bodyworker: 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.

Cooling, Receptive, Restorative Yoga

from Katie Noss

Restorative Yoga is a really great practice, especially in this day and age when most of us live with a lot of time pressure and stress. We all need to take a break, and in this yoga class, that’s what we do. We deeply relax and rest, fully supported with props, to create healing in the body.

Dedicate time for yourself to destress. Dedicate an hour. Dedicate more than hour. A lot of us feel like we don’t have the time, but this is a practice, and you just have to suit up and go. It is hard, so hard, to dedicate that hour for yourself, but you’ll see a lot of benefits. You will be glad you did it. If you are just running, hyper stressed, and super fast paced, if you don’t stop to relax, it can break down your physical body.

The benefits of Restorative Yoga far outweighs downtime at home. A lot of us can’t rest in our own home. So come to a beautiful space that is totally dedicated to healing, where there is nothing else going on except that. I have worked with people in class who had Parkinson’s and MS and other issues, and injuries are highly unlikely in Restorative Yoga because it is so gentle and supported. It can help take the edge off high blood pressure and really deepen the healing for other health issues, especially anything that is about too much heat (inflammation, pressure, etc) in the body. I personally had a sacrum injury and couldn’t lay flat on the floor. I just felt like I was stuck and I couldn’t move because I hurt so badly. That’s been gone ever since I started practicing 12, 13 years ago. Yoga offers these tools and you never stop learning. You never graduate from yoga; the benefits just continue to build.

Starting with Restorative Yoga, starting with my class, is a great place to start with yoga. A lot of us don’t even realize we aren’t relaxing until we come and do it. For some people they have to learn and practice. If you have a really fast paced high stress kind of life, this is a great yoga to start with because it is very gentle and soothing, not competitive at all. This is your own personal practice, and it is just about you, just you, showing up. There is nothing hard or forced, no pretzel poses. This is the opposite of that. It lays the foundations for more yoga practice, and all of us can use it; no matter what age or shape your body is in, injuries or surgeries, Restorative Yoga meets you wherever you’re at. Restorative Yoga is a cooling, receptive practice. It is not about doing, but about being.

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