Module Two: Natural Physical Methods.

There are many physical approaches to pain relief. Included in this group are Acupuncture, Chiropractic, Exercise and Stretching, Massage Therapy, and Physical Therapy. This is not an all-inclusive list by any means. Other physical approaches include Cranialsacral Therapy, Meditation and Relaxation Techniques, Osteopathy, Yoga and others. To adequately and fully discuss each of these approaches would require much more room than is available in this book. The information for each of these subjects can easily fill multiple books and in fact does. There are many excellent books available which cover and discuss these approaches in-depth. I highly recommend that you read and study those topics here which interest you. In regard to pain relief, by themselves and as part of an overall pain relief program; all of these approaches have outstanding benefits the should not be ignored.

Because of the limits of space, these physical approaches will only be introduced to you in the same manner as the other sections of this book.

Acupuncture

Acupuncture had its origins in China and has been practiced for over five thousand years. This unique health approach is based on the belief that health is determined by balancing "Qi" (also called Chi). Qi is believed to be the vital energy of all life. Acupuncturist believe that qi circulates in the body along twelve "major" energy pathways which they call "meridians." These meridians are linked to major organs and organ systems. Within these meridians are literally thousands of "acupuncture points" that are utilized by acupuncturists to balance and effect the flow of qi. It is believed that qi energy flow becomes unbalanced with disease states and other maladies. To effect and improve health, accupuncturist's manipulate qi through the use of acupuncture needles and non-needle applications to the acupuncture points. Acupuncture needles are thin, specialized needles which are inserted under the skin into these acupuncture points. It has been documented that acupuncture can relieve and decrease pain and help in a variety of health conditions. Pain is an area that acupuncture has proven to be very successful in relieving. It appears that acupuncture stimulates the release of endorphins and enkaphalins, which are the body's natural pain relieving substances (see Section One: Pain mechanisms and pathways).

Conditions in which acupuncture can be used include addictions, arthritis, asthma, bronchitis, cough, fever, fibromyalgia, headaches, inflammation (joints, muscle and skin), itching, joint pain, menstrual pain, mental disorders, migraine headaches, muscle pain, muscle spasms, neuralgia, pain syndromes, pleurisy, rheumatism, sciatica and tennis elbow. Please note that I have focused more on pain related conditions here. Acupuncture, especially in traditional eastern medicine, is used to treat most diseases and conditions including the common cold, duodenal ulcer, Meniere's disease, myopia, sinusitis, stroke and its related symptoms, etc.

Precautions: Potential for skin reactions from the needles can occur, but is considered rare.

Chiropractic

Chiropractic is a natural, drug free approach to health care that is based on the body's innate, built-in ability to heal itself. This "innate" intelligence within the body is basic to our capability to heal ourselves from a variety of everyday stresses, maladies and health problems. Chiropractic utilizes "adjustments" of the spine and joints to influence the nervous system, and through this, the body's innate intelligence and various natural defense mechanisms for healing. The chiropractic adjustment is performed by the hands or using specialized adjusting instruments and actually "moves and manipulates" the spine. This is very important because the spinal column and spinal cord coordinates and controls the functions of all the systems in the body. Misalignments of the spine, called "subluxations" of the spine by chiropractors, creates blockages and nerve interference which in turn cause pain and reduce the body's normal capacity for healing. Chiropractic adjustments return the spine to normal alignment which essential for optimum health and function.

Conditions in which chiropractic can be used include arthritis, asthma, back pain, fibromyalgia, frozen shoulder, headaches, inflammation (joints, muscle and skin), joint pain (both in the spine and extremities), low back pain, menstrual pain, migraine headaches, muscle pain, muscle spasms, neck pain, neuralgia, pain syndromes, pleurisy, rheumatism, sciatica and scoliosis. ***please note that I have focused more on pain related conditions here. Chiropractic can be used to treat a variety of diseases and conditions including addictions, bedwetting, constipation, gynecological disorders, otitis media, tinnitus, etc..

Precautions: Potential for muscular reactions, such as muscle spasm, can occur occasionally following a chiropractic adjustment. Chiropractic adjustments are contraindicated with bone tumors, fractures, certain types of cancer and severe osteoporosis.

Exercise and Stretching

It has been understood for ages that movement of the body has inherent health benefits. This basic concept has been greatly expanded as our knowledge of the body has grown; especially in regard to physical function, the mind/body connection and the body's basic health needs. There are multiple positive benefits to exercising and stretching the body. These encompass all aspects of our being; including the physical, mental, emotional and spiritual.

Exercise and stretching from the perspective of achieving pain relief must go beyond the general concepts of basic working out or performing a few toe touches each day. At this level, we consider exercise and stretching from a "therapeutic" aspect. Therapeutic exercise and stretching is based on the ultimate goal of achieving symptom-free movement and function. When we say "therapeutic," we are describing a program that is designed to facilitate a return to health as well as resolve the pain issues involved. It is an integrated program with multiple levels; from beginning basic movements that progressively increase to a person's end tolerance and capability. A therapeutic exercise and stretching program increases range of motion, flexibility, joint motion, muscle tone, muscle loading capacity and other variables. By positively impacting these components, we can in turn decrease and resolve pain, facilitate general health and impact a disease process.

Typically, therapeutic exercise and stretching programs are prepared and set up by a health care professional who monitors your progress. If your pain is from a disease process or other health condition, it becomes critical that you have the expertise of a professional to design, monitor and alter your program as needed. This is especially important in regard to symptoms and pain syndromes. An inappropriate program may not only make your pain worse but may cause your disease or condition to progress. I put in these warnings simply because I have seen the unfortunate results of poorly designed therapeutic programs.

Conditions in which exercise and stretching can be used include arthritis, back pain, fibromyalgia, frozen shoulder, headaches, joint pain (both in the spine and extremities), low back pain, menstrual pain, migraine headaches, muscle pain, muscle spasms, neck pain, neuralgia, pain syndromes, rheumatism, sciatica, sprain, strains and scoliosis. ***Please note that I have focused more on pain related conditions here. Exercise and stretching can be used to treat a variety of diseases and conditions including depression and other mental disorders, neurological disorders, pregnancy, pulmonary conditions, respiratory conditions, stress relief, stroke rehabilitation, vascular disorders and weight control.

Precautions: Potential for muscular reactions, such as muscle spasm or inflammation, can occur if exercise and/or stretching is performed too aggressively or advanced to quickly. Exercise and stretching can be contraindicated with certain diseases and conditions. Please consult a health care professional for information in this regard.

Massage Therapy

Massage has been used in some form for literally thousands of years. The "laying on of hands," especially by rubbing, has been a traditional form of healing used by many cultures. Massage was used by the ancient Greeks and Romans as a principle means of healing as well as pain relief.

There a variety of massage therapy versions, from basic gentle stroking to shiatsu (pressure pointing). All have value through touch and muscle manipulation. Certainly, pain relief is at the forefront of this value from a therapeutic standpoint. Massage therapy can have many positive effects beyond that of pain relief, including as a stress reliever, for circulation problems, depression, etc.

Conditions in which massage can be used include anxiety, arthritis, back pain, bronchial congestion, cancer, circulation problems, colds, congestion, depression, fibromyalgia, frozen shoulder, headaches, heart disorders, high blood pressure, hyperactivity, insomnia, joint pain (both in the spine and extremities), low back pain, menstrual pain, migraine headaches, muscle pain, muscle spasms, neck pain, neuralgia, pain syndromes, rheumatism, sciatica, sinusitis, sprain, strains, stress and tension. ***Please note that massage can have a positive impact on many diseases and conditions. Including a variety of mental disorders, neurological disorders, pregnancy, pulmonary conditions, respiratory conditions and vascular disorders.

Precautions: Massage is contraindicated with skin eruptions (boils, rashes, scabies, etc..), bruises, varicose veins, fever, inflamed joints, tumors, undiagnosed lumps, thrombosis and phlebitis (unless under a doctor's supervision).

Physical Therapy

Physical therapy is a general term which is used to describe a number of approaches to pain relief, rehabilitation and general health. Within this group we are interested in a number of physical modalities including ice (cryotherapy), heat (dry and moist types). hydrotherapy (water therapy -- i.e. jacuzzi), electrical muscle stimulation, tens, traction and ultrasound. A brief description of each of these follows.

Ice (cryotherapy): This therapy utilizes cold as a therapeutic approach. By placing cold over the involved area, we can sedate nerves, reduce muscular spasms, reduce inflammation and decrease pain. Icing types include cold/ice packs, frozen water and immersion therapy in ice water.

Heat: There are two type of heat that are typically used. The first is dry heat, such as is obtained from a heating pad. The other type is moist heat which can be obtained from a moist hot pack or heat-moistened towel. By placing heat over the involved area, we decrease muscle spasms, reduce muscle tightness and decrease pain.

Hydrotherapy: This is basically water therapy and can involve heated or cold water. An example of the heated type would be a jacuzzi. The cold water version typically is a cold bath. Both of these types can also be done through a shower. These therapies can be used to effect a localized area or for full body therapy. The effects of these therapies are the same as those listed for ice and heat.

Electrical Muscle Stimulation: These modalities are machine based with pads placed over the involved areas of the body; typically soft tissue (muscle). These machines put an electrical current at therapeutic levels into the soft tissue to stimulate a response, i.e. on a muscle will cause that muscle to contract at a prescribed rate or at a constant contraction. The point of this therapy is to cause the muscle to contract, then relax. This type of therapy is to reduce and decrease muscular spasm, hypertonicity and spasm, decrease inflammation and reduce soft tissue adhesions. These machines are also used in a rehabilitative capacity to work weakened or atrophied muscles.

Tens (aka: Transcutaneous electrical nerve stimulation): This therapy also involves applying an electrical current to affected nerves, only at a micro level. Tens machines are used for pain control by causing nerve conduction to be blocked and reducing nerve irritation. It is believed that Tens units also stimulate the production of endorphins, the body's natural painkillers.

Traction: There are two types of traction -- intermittent and constant. These types of therapies can be performed on specialized machines or by hand. The purpose of this therapy is stretch effect muscles and soft tissue, reducing muscle spasms, hypertonicity and tightness. It is also used to open up spinal units to take pressure of the intervertebral discs and spinal nerves.

Ultrasound: This machine-based therapy takes an electrical current and translates it through a sound-head with a specialized crystal which turns the current into mechanical sound waves. This soundhead is used over the affected areas, utilizing a coupling agent to transmit the sound waves through the skin. It is used to reduce inflammation, muscular spasms, muscle tightness, pain relief, organization of new scar tissue, breakdown of old scar tissue and adhesions.

Each of these physical therapy modalities has excellent value for pain relief and in addressing a variety of conditions. They can be applied as both home based therapy and as an in-office therapeutic approach by health care professionals. I have found them to be an excellent adjunct to my treatment programs for their pain relieving capabilities.

Precautions: For those modalities which are machine based and of a commercial grade, it is imperative that their application be performed by a qualified health care professional who is trained in their operation and clinical uses. These machines can burn tissue, cause inflammatory responses, cause muscular spasms, cause frostbite and cause and increase pain. Always use caution when using physical therapy modalities and make sure you fully understand their application and usage.

Section III

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