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pain frustration

Chronic Pain – Healing with Release

Healing with release is based on the fundamental idea, backed by research, that stress, tension and trauma are both psychological and physical. Twentieth-century science is moving forward to a better understanding of the body’s deterioration. Hans Selye recognized that physiological disease could arise from psychological causes, such as stress (Somatic viewpoint). The pathology of chronic pain is associated with numerous losses such as a decline in physical fitness, disturbance of sleep, strained relationships, loss of energy and fatigue. Social isolation, loneliness and anger are often evident in people suffering from chronic pain. These negative emotions exacerbate pain and increase suffering. An estimated 33 to 35 million U.S. adults are likely to experience depression at some point during their lives.  

In 2011 in USA alone hundred million Americans suffer with chronic pain and the cost of lost wages translated to $ 600 billion due to employees with chronic pain calling in sick because of a pain–related condition such as:

  • Headache—$14 billion, only $1 billion of which consists of health care costs (Hu et al., 1999), partly because most people with migraine stop seeking medical care for the condition (Silberstein, 2010)
  • Arthritis—$189 billion, less than half ($81 billion) of which is for health care costs (Yelin et al., 2007)
  • Spine problems—$2,500 average in incremental medical costs (Martin et al., 2008); and low back problems—$30 billion (Soni, 2010) Opioid pain medication use presents serious risks, including overdose and opioid use disorder
  • Between 1999 and 2015, more than 183,000 people in USA died from overdoses related to opioids.

By having a flexible spine with strong hips and thighs, the human body is ideally designed for movement such as walking, running, squatting, and claiming- throwing objects and swimming.  Unfortunately, during the course of a person’s life, the sensory-motor nervous system continually responds to daily stresses and traumas with specific muscular reflexes. These reflexes, triggered repeatedly, create habitual muscular contractions which cannot be relaxed–at least not voluntarily.

If stressed, traumatized, overused and repetitively used muscles are required to continue to work, the muscle begins to tighten. Once this happens the contraction of the muscle constricts the blood vessels. This reduction of blood flow reduces the oxygen to the tissue. Once a tissue is oxygen deprived, it will shut down and tighten more. This creates a negative pattern of tension, oxygen deprivation, and more tension that ultimately results in rigid muscle tone. This results in one’s postural misalignment and muscular asymmetry with symptoms such as:

  • Chronically hard, tight muscles
  • Chronic tightness or chronic inflammation of a tendon(tendinosis)
  • Chronic joint tension or chronic inflammation
  • Limited range of motion in a joint
  • Impingement of a nerve resulting in numbness or a tingling sensation
  • Compression of a disc resulting in neck or back pain
  • Muscle weakness in one area especially if the muscle feels tight
  • Consistent muscle cramping
  • Joint instability while performing daily tasks
  • Recurring muscle strain or injury to the same muscles

Muscles needed to perform regular, daily tasks (such as sitting and standing) are what we call “functional muscles”.  It is more important in daily life to have functional muscles than it is to have big, hard muscles.  Functional muscles require more endurance than pure strength.  The focus of restoring to maintain a healthy body is to increase the endurance of those muscles which are needed to function throughout the day.

The exercises which safely activate a natural reflex mechanism calming down the nervous system which releases muscular tension are based on restoring blood flow and oxygen to tissue.

Muscular tension release can be done by manual pressure that is applied to the most superficial layer of tissue where dysfunction appears (pain, tension or rigidity). Once the tight tissue is stimulated, blood flow to the area increases and the tight tissue will become suppler. This allows the therapist to access the next layer of tissue without applying excessive pressure.  This pattern is repeated until all layers of dysfunctional tissue are restored and the tight, rigid tissue is replaced with supple and mobile tissue.  Supple and mobile tissue will be free of pain and have a greater range of motion.

The ability to release muscular tension independently one must learn how to align their body and mind while experiencing an alert but relax state of awareness. The SykorovaSynchro Method℠ is a phenomenal educational tool with positive impacts to patients mentally, physically and emotionally and has three stages/ progressive levels:

  1. To balance function of sensory-motor cortex via sensory stimulation mental imagery (sometimes called visualization, guided imagery), progressive muscular relaxation and control breathing. Result is relaxed but alert state of awareness.
  2. To enhance sensory integration/ awareness of somatic movement (movement regulated by feeling, mental imagery, sensation). Result is ability to perform somatic/ intuitive movement.
  3. Ability to perform conscious exercises – via mental imagery, sensation. Positive result is in neuro muscular conditioning/ function – postural improvement, balance, coordination, flexibility and agility.

Research has shown that when we imagine an experience, we often have similar mental and physical responses to those we have when the event actually happens. For example, if one recalls an upsetting or frightening experience, she/he may feel their heart beating faster, may begin to sweat, and hands may become cold and clammy.

In life it is very important to minimize the negative effects and maximize the healthy, healing aspects of the mind–body connection. Each person has a unique capacity for getting better, healthier, achieving peak performance and recovering from injury.

The mind-body connection means that one can learn to use his/her thoughts to positively influence the body’s physical responses, to create abilities to be aware of their own thoughts and actions in the present, without judging them self.

Physical activity has the potential to be not just an activity of the body, but a whole body-mind-spirit system. Exercise can create a unique, beneficial mental state; and the positive mental state can enhance the benefit of exercise as a part of muscular release tension plan, which reinforces the perception that exercise is just an out of body experience.  We have to remember, that our bodies are made to feel good and has abilities to heal.

A unique water exercise program based and structured on those principles will teach you to release tension, increase mobility and build endurance in muscles, tendons and joints. Those physical exercises are performed with an intense focus to utilize four principles such as breathing, proper form, control and concentration.

  • Exercise is performed with controlled breathing that utilizes full inhalations and full exhalations that follow a specific number of counts or rhythm. The goal is to learn how to breathe at a pace of 6 breaths a minute, about 3 or 4 seconds inhaling and 6 or 7 seconds exhaling. Once we have the slow, deep breathing accomplished, we don’t have to worry about counting and imagine breathing out any tension in the body or thoughts that get in the way of comfort and relaxation. The benefit of the water environment is tremendous. Hydraulic pressure increases human vital capacity in shoulder depth immersion 7x more than air, which promotes deep breathing and natural relaxation.
  • Exercise is performed with proper form or in precision. Quality of movement counts more than quantity in a mind-body exercise. Precision requires mental control. The mind has to be wholly focused on the purpose of the exercises as you perform them. The sensation of water on the skin is enhancing biofeedback’s, which helps with proper form greatly.
  • Neuromuscular exercise always involves the control and balance of your own body-weight. In water exercise we have interplay between gravity and buoyancy, weight and weightlessness. Control of the body can become challenging and at the same time very beneficial for overall success. By implementing movement patterns in a variety of directions, we stimulate and enhance balance, coordination, and flexibility, and inspire the neuromuscular system to become more expansive and creative. Moving in different speeds is an aspect of our physical capabilities that must be practiced in order to maintain a sense of health and well-being.
  • Releasing Movement is performed with intense concentration on yourself, in the present moment. The mind-body exerciser is focusing on his/her body rather than on the instructor, or on other participants. One should never be day dreaming about other things. The point-of-focus in a self- sensing exercise will differ from most other forms of physical exercise. One should be thinking about stabilizing, or anchoring, the area of the body that is NOT in motion. This is contrary to the usual Western method of trying to isolate the muscles that we perceive to be performing the movement.

Working as a health-fitness professional for the past 30 years, I am sensitive to the overall health of students/clients, and I continue to put research developments into practice. The focus in fitness these days for “Active Aging”, “Athletic Recovery”, “Chronic Pain Management”, “Healing with Release” are functional exercises – exercises that simultaneously use multiple muscles and joints to improve muscular endurance, overall strength, coordination, balance, posture and agility – to get a challenging, effective and fun full-body functional workout as well as prepare the body for every day, real world activities.

Join Dr. Sykorova Pritz for her upcoming webinar, Pain-Free Movement Techniques.


Reprinted with permission from Dr. Maria Sykorova Pritz and the Aquatic Exercise Association (AEA). The AEA is the leading educational agency in water fitness and is reaching health-fitness professionals in aquatic field. This article first appeared in the August/September 2018 issue of their AKWA magazine. 


Dr. Maria Sykorova Pritz Ed.D earned her doctorate in education (specialty in Physical Education and Sports) from University Comenius in Bratislava, Slovakia. Maria is an ATRI faculty member, member of AEA Research Council, author of health fitness articles and FLS CE class, presenter for national and international fitness conferences. In her 32 years of professional career Maria is combining academic knowledge with hands on experience in functional fitness, pain management via land based and aquatic fitness. Maria’s unique training method (SykorovaSynchro Method℠) involves integration of multidisplinery techniques to achieve overall health and optimized performance. Maria is an ATRI faculty member, member of the AEA Research Committee, FLS continuing education developer, author and presenter.

Resources:

  1. BURDENKO I, MILLER J. (2001) Defying Gravity. www.Burdenko.com.
  2. GREGOR T., SYKOROVA PRITZ M.: (2008) Pain management and psychophysical     conditioning through water exercise. Revue Mediciny v praxi, Bratislava, MAURO Slovakia s.r.o. Rocnik 6, cislo 1, 2008, s.29, 30, 38 ISSN 1336-202X
  3. Discovery writers. (2013): Mind – Body Exercise Connection. Discovery Fit &Health; http://health.howstuffworks.com/wellness/diet-fitness/information/mind-body-exercise-connection.htm
  4. INSTITUTE of MEDICINE (2011): Relieving Pain in America. A Blueprint for Transforming Prevention, Care, Education, and Research
  5. JOHNSON, L.S.(2009):”Therapist’s Guide to Posttraumatic Stress Disorder Intervention”, Academic Press is an imprint of Elsevier, San Diego, California, USA.Page146-148, ISBN:978-0-12-374851-5
  6. RAMSEY L. (2018): As America fights opioid addiction, the healthcare system is failing people who live with chronic pain: http://www.businessinsider.com/people-with-chronic-pain-during-opioid-crisis-2018-1
  7. SYKOROVA PRITZ, M. (2007):” The effect of water exercise on selected aspects of overall health on a fibromyalgia population”. Aquatic Fitness Research Journal, October 2007, Volume 4, Issue 2, Nokomis, Florida, USA: Aquatic Exercise Association. page. 6-13
  8. SYKOROVA PRITZ, M. (2018):” Healing with Release” AKWA: Volume 32, No 2;  Brunswick GA. USA; Aquatic Exercise Association, page 31-33,ISSN: 1536-5549
  9. STOLNICK, D.:  (2000-2008) Looking for joint pain relief. Vilage Inc.
  10. VAN HOUDENHOVE, B, – EGLE, U, – LUYTEN, P. (2005): “The role of life stress in fibromyalgia”, Curr Rheumatol Rep. 2005 Oct; 7(5):365-70.
  11. THEARMAN, B.H.: (2007) Simple solutions to Chronic Pain. New Habringer Publication, Inc. ISBN-13: 978-1-57224-482-5.

NOTE: To learn more about SykorovaSynchro Method, it is recommended that you take the course “Application of Water Exercise for Health Fitness Professionals Specializing in Pain Management.” to increase your knowledge and skills.  For more information, log on to www.FitnessLearningSystems.com.

 

Surgery word cloud

Can I Avoid Surgery?

Did the title of this article capture your attention?  It should because surgery, no matter how big or small, is serious business. The type of surgery this article is speaking to is orthopedic surgery. This means surgery due to pain, disease, and dysfunction in your muscles, tendons, ligaments, bones, and joints.

Maybe you, or someone you care about, have been told that surgery is necessary.  You have done what the doctor suggested.  You tried Physical Therapy.  You went beyond that, and tried massage, acupuncture, chiropractic, drugs, and other alternative interventions. Why would avoiding a surgery even come into your mind? You are in pain, the doctor said you need it and that should be the end of the discussion right?

It’s a tough decision with uncertain consequences. Second and third opinions are recommended.

There might be several reasons why you want to avoid it; the thought of someone going in and “cutting you” (surgery is really a controlled injury), the risks associated with being put under anesthesia, the long recovery time and disruption to your life routine post surgery, you know someone that had surgery and months later are still not feeling much better, or they may be suffering complications from the surgery itself.

You have doubts.

Maybe you have read the recent research that concluded that a very common surgical procedure on knees actually showed more long term harm than good. (1)

Have you read the research that shows that there are many individuals with a diagnosable orthopedic disease that don’t report pain?  And there is research that shows that some report pain and nothing can be found wrong that directly explains the pain. (2) (3)

Maybe you will need the surgery. But is there one more conservative non-surgical alternative that you haven’t tried yet?

There is… Exercise.

But wait, you already did exercises at the physical therapy clinic. Even the chiropractor gave you some stretches and rubber bands to tug on and that didn’t work.

Here is the problem. All exercise is not created equal. What may work for one person doesn’t work for another.  Why is that?

Because every pain situation, just like people, is unique.

Pain is a word. When you choose to use the word pain to describe a sensation in your body you are clearly elevating the level of concern you have for the sensation.

Pain is not a thing like a brick, cat, glove, or car. Pain is the brain’s conclusion about all of the information it is receiving and processing from within the body moment-to-moment.

If you are considering surgery because you are experiencing a sensation that you choose to use the word pain to describe, then in a sense you are having surgery to remove the pain right? Which is weird because pain isn’t a thing to be removed, as it is simply a word chosen to describe a subjective conclusion based on bodily information. So a surgeon doesn’t remove pain with a scalpel, they remove the body part that they think is causing the pain. Sometimes this works great. Sometimes it doesn’t. See previous references.

What the surgeon is doing, what the drugs are doing, what the spinal manipulations are doing, are changing, or at least trying to change, the information that the body is producing to see if changing the information that way will lead to a new conclusion of the brain.

Change the information and possibly change the conclusion.

Back to the exercise thing.

What is exercise? It is stimulation to, and of, the body that changes the information within it. Sometimes those changes are short term and sometimes they can be of a longer term.

But you tried exercise in physical therapy and with the chiropractor and it didn’t help.

As stated earlier not all exercise is equal. Often exercises are just given to work on the area of the body that hurts. This might not be the best way to change the information. Exercise has very specific influences on the body depending on HOW you do it. The old adage “Just Do It” is painfully inaccurate advice. We need to know the quantity but also need to know the quality of your experience with different exercises.

Pain is a subjective experience that, at least right now, does not have an objective measurement like temperature, pressure, and distance. Your pain is totally unique to you and cannot be experienced by anyone else. Pain has a component of quality associated with it. It certainly can have a cause like when you break a bone, cut of your skin, tear a muscle, or sprain a ligament. But sometimes the cause is not so clear-cut.

So what am I proposing? What could be the thing that you haven’t tried yet?

A different approach. A totally different strategy. A more precise HOW.

I am talking about exercise that is highly catered and highly specific to your unique body.

Your body has its own unique history, a unique genetic profile, a unique combination of diseases and dysfunction, all of which confluence towards a unique problem. This requires a completely unique solution. A completely unique HOW.

This unique strategy and HOW is based on some simple concepts.

  1. All physical exercise uses the Muscular System in some form or another.
  2. The Muscular System receives and produces information form the nervous system.
  3. Muscles control you in three primary ways:
    • By contracting to maintain your joint positions,
    • By contracting to change your joint positions by lengthening,
    • By contracting to change your joint positions by shortening.
  4. Your body is a system that by definition means that all of the body parts are interconnected, interacting, and interdependent.
  5. A system’s control over information, and the stability of that information, can be assessed by perturbing it – by knocking it off course a bit – to see if it can make the necessary course corrections in order to stay in control.
  6. You should be the center of attention – not the exercise. You should not be made to conform to the exercise – the exercise should be made to conform to you.

If number 4 is true then it stands to reason that any part of your body’s information generation and processing can affect any other part’s information.  You may good at contraction shortening but are not so good at contraction lengthening.

If number 5 is true then a good way to see if you actually have control and assess the information control is my assessing your ability to do number 3.

Given the fact that your body is completely unique from any other body, this means that any strategy and HOW must be created to explore your unique information control system and any influences between parts. See number 6.

This is what Muscle System Specialists are trained to do. To systematically explore your information control by assessing your muscles’ ability to hold joint positions and change joint positions via lengthening or shortening contractions. This tells us about the quality of you information generation and processing.

The challenge is to find those places and conditions. You have roughly 600+ muscles and are capable of being in a dizzying array of positions and motions.

It’s okay – we have a process to explore your unique body’s abilities and start discovering the solutions it needs in order to change its control, to change the quality of information within it that just might lead to a change a reduction in pain.

Can you avoid surgery? Maybe. You have to decide if it’s worth some time and effort to exhaust conservative non-surgical options. Always speak with your doctors regarding this important decision.


Greg Mack is a gold-certified ACE Medical Exercise Specialist and an ACE Certified Personal Trainer. He is the founder and CEO of the corporation Fitness Opportunities. Inc. dba as Physicians Fitness and Exercise Professional Education. He is also a founding partner in the Muscle System Consortia. Greg has operated out of chiropractic clinics, outpatient physical therapy clinics, a community hospital, large gyms, and health clubs, as well operating private studios. His experience in working in such diverse venues enhanced his awareness of the wide gulf that exists between the medical community and fitness facilities, particularly for those individuals trying to recover from, and manage, a diagnosed disease. 

Charlie Rowe, CMSS joined Physicians Fitness in the fall of 2007 after spending 9 years as the Senior Personal Trainer at Oak Hill Country Club in Rochester, New York. He has also worked within an outpatient Physical Therapy Clinic coordinating care with the Physical Therapist since joining Physicians Fitness. Charlie has earned the Cooper Clinic’s Certified Personal Trainer, the NSCA’s Certified Strength and Conditioning Specialist, the American College of Sports Medicine Certified Health Fitness Specialist, Resistance Training Specialist Master Level, and American Council on Exercise Certified Orthopedic Exercise Specialist Certifications. 

References

  • Thorlund, J., et al, Arthroscopic surgery for degenerative knee: systematic review and meta-analysis of benefits and harms, BMJ 2015;350:h2747 doi: 10.1136/bmj.h2747
  • Ave Marie, L., Why Most People Are Wrong About Injuries and Pain – SimpliFaster Blog, 12/24/2018
  • Brinjikji, W., et al, Systematic Literature Review of Imaging Features of Spinal Degeneration in Asymptomatic Populations, Apr 2015 www.ajnr.org
Back pain

Exercise Not Helping Your Back Pain? It’s Not you, It’s Your Strategy! | Part 2

This is part 2 in a series. Click here to read part 1.

In Part 1 of this series, we discussed the dilemma of back pain that persists despite your persistent efforts to solve the problem.  You’ve been prescribed medication, exercise, and a myriad of methods to “stretch” and “loosen” your muscles, but no avail. You must be a lost cause . . . right?

Maybe not.

It’s not your effort that’s lacking; perhaps it’s your strategy of solving the problem that’s in need of some tweaking.

In Part 1 we established that the body operates as a system:  an interconnected, interactinginterdependent set of parts designed to achieve a goal– and in the case of the human body, the goal is production of high-quality movement for the sake of survival.  Part of its genius, in my opinion, is in its sophisticated setup for communication within itself: the body is one continuous, cohesive system with a built-in mechanism that allows for every part to be aware of, and work with, the other parts to achieve the goal of operating efficiently.  The human body is a truly amazing system!

Every body movement is a whole-body task that requires an internal, whole-body solution.  Your muscles are an interconnected, interacting, interdependent system, constantly communicating back and forth, working together to create and control movement. All of your muscles are involved in one way or another in any bodily event.

Conversely, an issue with low-quality muscle function in any area of your system has the inherent potential to affect the performance quality—and your brain’s conclusion about how you feel–  in any other area of your system.

 Let’s apply this Systems Approach to form a new strategy to address your back pain.

Solving Your Body’s Problems Using the Systems Approach

The fact that your back is where you feel muscle pain and tightness doesn’t necessarily mean your back itself is the problem.  The standard Western medicine approach subscribes to the philosophy of “Local pain means a local problem, which requires a local solution”, but this isn’t always the case.

Imagine you start your car in the morning, and the “check engine” light pops up.  What’s wrong with your car?  Is the “check engine” light itself the problem?  No– the “check engine” light is an indicator, a safety mechanism built into your car’s system to alert you of a problem somewhere in the car’s system that needs to be addressed.

Likewise, pain you experience with movement is simply an indicator that there’s low-quality function somewhere in your muscle system . . . but not necessarily at the specific location you feel the pain.  The pain is just symptom, the downstream result of poor quality.  The pain itself is not the problem to be solved; the low-quality control is the problem!  Instead of focusing directly on the part where you feel pain, my work focus is on the quality of your position control.  Any area of the body with low-quality muscular control can contribute to a problem with movement, pain, tightness, or discomfort you are experiencing in any other area of their body.

While the work of a Certified Muscle System Specialist™ and the work of a physical therapist may look similar, the philosophy and thought process differ greatly.  Physical therapy generally focuses on a patient’s complaint of pain or tightness, and as a result the therapy is almost always performed on or around the area of the patient’s pain. The physical therapy approach often subscribes to the philosophy of “local problem, local solution” we discussed earlier.

The same goes for massage therapy, stretching, chiropractic, pain medication, and other traditional options for treatment of muscle pain and tightness.  The “local problem, local solution” approach focuses on the pain instead of on the quality of your muscle function as a cohesive, dynamic system.  Chasing “the pain” is rarely an effective problem-solving method. This is the reason why using generic protocols and pre-packaged plans to “treat back pain” are not effective.  This is also why “strengthen your core” isn’t always the panacea for back pain we’re led to believe.

So . . . you’ve completed physical therapy, diligently taken your medication, foam rolled the “tight” area every day . . . but your “check engine” light is still on.  So, how can you understand what your system needs to turn it off?

Find a “systems mechanic” for your muscle system.

Work with a practitioner who is able to look under the hood, run a battery of diagnostics, find areas of low-quality function throughout your muscle system, and prescribe a system-wide plan to remedy the problem and put into place an ongoing maintenance process (like getting regular oil changes and maintenance on your car) so you can keep your system running at its optimal operating potential.

This is the role of a Certified Muscle System Specialist™– we’re muscle system mechanics!  As we help you improve control throughout your system, we can elicit a significant, positive effect on how your entire body feels and moves. Our clients are often surprised that improving muscle control in an area can lessen pain they were experiencing at a different location of their body!

So the next time you’re feeling muscle pain and tightness—or any change in the quality of how your muscles move and feel– remember that the whole is greater than the sum of its parts.  The strategy you’re using to take care of your system matters!

About the Certified Muscle System Specialist™

If you’re interested in learning more about how a Certified Muscle System Specialist™ can help you move better, feel better, and live better, click here.

To find a Certified Muscle System Specialist™ near you, see our list of practitioners throughout the U.S. and Canada.

If you’re a fitness practitioner who is interested in learning more about how to become a Certified Muscle System Specialist™, visit us at www.exerciseproed.com.

Originally published on Physicians Fitness. Republished with permission.


Jessica Cahen, M.S., CMSS, ACE-CMES, RTS is a Course Facilitator for Exercise Professional Education, a rapidly-growing Continuing Education company for exercise professionals, offering the Certified Muscle System Specialist™ course as well as custom-tailored CEC courses for groups upon request.

Jessica holds a Masters Degree in Clinical Exercise Physiology and the Certified Muscle System Specialist™ designation.  She has also earned the distinction of being one of only a handful of ACE Certified Medical Exercise Specialists in the Midwest.  She practices as a Certified Muscle System Specialist™ at Physicians Fitness in Columbus, OH.

Back pain

Chronic Pain

Hey! Did you know that all pain is all in your head?  It doesn’t mean you don’t have real pain when something to cause pain happens, or that chronic pain is not real.  Feelings of pain are very real and are initiated by the brain for a very important basic reason…to keep you safe.

The study of the neuroscience of pain has changed considerably in the past 10 years.  It is now believed that the sensation of pain is a necessary function that warns the body of potential pain or of actual injury.  The process starts with the nociceptor detecting a potentially painful stimulus from the skin or an internal organ. Neurotransmitters (chemical messengers) transmit the signals through the nervous system and spinal cord to the brain. In essence, how the brain processes the signals causes an appropriate or inappropriate pain response.

One example is a child falling and skinning his knees.  He gets up and continues to play as if nothing happened.  Then another child or adult reacts to the blood running down his legs, he looks, his brain responds differently to the neurological stimulus, and suddenly there is pain.  Initially the brain did not register the experience as painful, however the next time the child falls, he will probably immediately register the skinned knees as painful. Experience plays a role in the pain response.

The pain response can also be overridden by the brain in circumstances that are life threatening.  For example, a soldier who runs to safety with a serious gun-shot wound. The brain, due to past experience, can conversely register the event as much more painful or life threatening than necessary. For example, someone who was bitten by a poisonous snake may brush it off as being scratched by a stick, until they realize they have a life-threatening injury. But the next time they get scratched by a stick, they may respond as if they were bitten by a poisonous snake.

According to Elliot Krane in his Ted Talk “The Mystery of Chronic Pain,” after an injury or surgery, the nervous system can sometimes get what is going on wrong.  Approximately ten percent of the time, the nerves and glial cells (play a vital role in modulation, amplification, and distortion of sensory experiences) that interact in the pain response develop into a feedback loop that can become distorted. This altered feedback can make chronic pain become its own disease.

Dr. Maria Sykorova-Pritz in her course “Application of Water Exercise for Pain Management” describes how chronic pain is not simple, but very complicated.  The body, mind, emotions, and behavior can become entwined in the chronic pain cycle. Pain medication is often prescribed for chronic pain. Rampant prescription of pain medication is believed to play a large role in the opioid epidemic in the United States.  Although pain medication is often prescribed for chronic pain, it does nothing to unravel the combination of physical, emotional, and behavioral factors that are now believed to cause chronic pain.

There is growing evidence that chronic pain is caused by multiple factors including cognitive, physiological, and behavioral factors. If you are working with clients or interacting with a family member with chronic pain, it is important to understand that it is not just simply a physiological response to pain. It is important to effectively influence a client’s attitude, cultural background and belief system-which influences social norms and perceived behavioral control.  To achieve the highest positive health/fitness results among the chronic pain population, it is important to know and understand your client as a whole person.

As we start to look for alternative ways to deal with chronic pain and its aftermath, a combination of physical therapy/exercise and emotional/behavioral counseling is emerging as the tools of choice.  Using the practice of yoga and water therapy/exercise to relieve and even cure chronic pain are proving to be viable and more effective alternatives than pain medication. Statistics from the Institute of Medicine indicate that more than 100 million Americans suffer with chronic pain, thus creating a viable niche for those wishing to work with clients with chronic pain. Now that more is known about chronic pain, its potential causes, the chronic pain cycle, and how to treat it effectively, education is key to working with this population in need.  Proper treatment and compassion for chronic pain sufferers can help end the opioid crisis and help people beat chronic pain to live pain free lives without addiction and suffering.

For more information about the psychology and treatment of chronic pain management, see Dr. Maria Sykorova-Pritz’s continuing education course “Application of Water Exercise for Pain Management.


Compiled by June Chewning. June M. Chewning BS, MA has been in the fitness industry since 1978 serving as a physical education teacher, group fitness instructor, personal trainer, gym owner, master trainer, adjunct college professor, curriculum formatter and developer, and education consultant. She is the education specialist at Fitness Learning Systems, a continuing education company.

References

Fibromyalgia signs

Four Tips for Proactively Managing Your Chronic Pain with your Healthcare Provider

If you suffer from chronic pain or fibromyalgia, it’s time to get proactive when it comes to your health. When I was dealing with my chronic back and neck pain and fibromyalgia that occurred from a car accident in 2006 I took everything my doctors said as gospel, but after years of listening and following their instructions, my pain was still not improving. That is until I started to take things in to my own hands.

carolestavely2

How Do I Know If This Is Good For Me? Advice From an Enlightened Chronic Pain Sufferer

One of the most significant lessons I learned on my path toward overcoming chronic pain was making the distinction between discomfort and pain. Quite often, discomfort precedes and might even be necessary to improve soft tissue conditions. This is something I really wish I had understood and embraced early in the development of my chronic pain disorder.