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Pathways to healing: Holistic MD Says, 'Change Starts at the Grassroots'.

Heather Tick, MD, is a family physician who's developed special skills for dealing with chronic myofascial pain. Her recently published book, Holistic Pain Relief, offers a comprehensive review of ways to prevent and/or deal with chronic pain.

Tick's interest in natural healing started early. Even as a child, she was unusually aware of the importance of natural food. "I remember my friends would encourage me to bake with cake mixes. I would say, oh, no, there are too many chemicals in that mix."

Tick trained as an MD at the University of Toronto, but her medical training didn't include "natural" methods of healing. "I took my first acupuncture course while I was still a medical student, but it was not part of the curriculum," she says. "During that period I experienced shoulder pain that lingered for many months--but during the acupuncture course it disappeared with a few simple treatments. That impressed me so much. I had tried many conventional methods without any relief, but acupuncture stimulated something in my body that allowed it to heal itself."

When she started practicing as a family medicine doctor, Tick found that the most challenging cases involved chronic pain, often myofascial pain. "Myofascial pain refers to pain that affects both muscles and the fascia, the connective tissue that runs throughout our body," Tick said. "It is the commonest cause of pain. Even when we talk about other common causes of pain, like arthritis or postsurgical pain, they frequently include a component of myofascial pain. When you relieve the myofascial problem, often the other issues become more manageable."

Tick continued taking courses through the Acupuncture Foundation of Canada, and she learned about the pioneering work of C. Chan Gunn, MD, who developed a way to relieve myofascial pain called Gunn Intramuscular Stimulation (IMS). It uses the same thin, flexible needles used in acupuncture, but in a very different way. The treatment involves "dry needling" of affected areas of the body. The needle sites can be at the epicenter of taut, tender muscle bands, or they can be near areas where a nerve may have become irritated and supersensitive. This treatment helps the area to relax, helps the nerve to function normally again, and initiates the natural healing process.

Integrative Pain Clinics in Toronto, Arizona, and Seattle

Tick incorporated these methods into her practice, and eventually started an integrative pain clinic in Toronto. The staff included chiropractors, massage therapists, kinesiologists, naturopaths, physical therapists, a psychiatrist, and practitioners of healing touch and Reiki. Everyone learned from each other. "When you look at how change happens in medicine, it often manifests at the fringes, the grassroots, not at big institutions," Tick says. For example, initially she charged very low fees for the innovative Gunn IMS methods--something that would have been difficult at a less flexible organization. "As it became obvious that these methods were actually making a big difference for people, then I was able to charge more appropriately for my time. I wouldn't have had the freedom to go through that process at a big institution."

In 2007 Tick was invited to found the Family Medicine Integrative Pain Clinic at the University of Arizona, Tucson. The University of Arizona Health Plan wanted to explore, and pay for, new approaches for treating pain in Medicaid patients. "They were tired of paying for six surgeries on the same patient without seeing significant improvement. They had heard about my work, and they knew they needed a different approach," Tick says. "During my work in Arizona, I was able to demonstrate that my patients had fewer high-priced interventions, and good clinical results. There was a cost savings, even though the insurer was paying for unusual services that generally they would not have covered."

In 2012 the chief of pain medicine at the University of Washington Medical School invited Tick to move to university's Center for Pain Relief, an anesthesiology-based Pain clinic. She sees about 10 new patients every week at the center, and the rest of her clinical calendar is made up of return visits, many of them for Gunn IMS.

However, a significant portion of her time at the Center for Pain Relief is reserved for teaching and research. Each year the clinic trains six "pain fellows," who are graduate anesthesiologists or physical medicine rehab doctors, training to be the pain specialists of the future. Tick is responsible for showing them the physical examination methods used to recognize myofascial pain and the special needling techniques of Gunn IMS. She also emphasizes nutrition, appropriate use of nutraceuticals, and reducing inflammation. "The reception at the university has been excellent," she says. "My department is very open-minded and focused on results. People who may have been skeptical when I first arrived now recognize that I get good results, and they refer patients to me enthusiastically."

New Book on Holistic Pain Relief In November 2013, Tick published Holistic Pain Relief, a 300-page book with chapters that include:

* Pain, Nature's Wake-Up Call

* The Changing Times

* A Visit with an Integrated Physician

* The Healing Diet: Lost Food Traditions

* Resolve Stress and Dissolve Pain: The Mind-Body Solution

* Healthy Habits

* Dietary Supplements

* Exercise

* Prescription Drugs

* Toxic Stew

* Your Team

* The Road to Recovery

Townsend Letter readers are already familiar with many of the methods that Tick discusses in this book. What makes it unusual, and very much worth reading, is the holistic attitude that examines interrelationships among diet, immune response, exercise, dietary supplements, and mind-body methods.

For example, think about sleep, something that affects so many aspects of our health. Ask Tick how we can develop better sleep habits, and she talks first about ways to corral your worries. We see a lot of worriers. I ask them, is worrying helping you get what you want? OK, if worry is something you need to do, then pick one hour out of every day, one specific time, and schedule that as your worrying time. The rest of the day, if worries arise, you just tell them this is not their time."

Then Tick goes on to talk about the environment in which we sleep: it's important to have total darkness. It's important to have a minimum of electronics, preferably none, in the room where we're sleeping. "If you can, turn off your Wi-Fi before you go to sleep," she says. "We know there are effects, and some people are very sensitive. Just because you weren't sensitive last year, that may have changed, you may be sensitive now."

When you wake up early, use that time for relaxation, she suggests. Don't immediately turn on a light or open the computer. "Just lie there and say, 'Even though I may not la I I asleep again, I'll use this time to rest my body and my brain.' When you do breathing meditation, you oxygenate your body, and you also activate the relaxation response and balance your sympathetic-parasympathetic system."

Tick, MD Practical Advice on Green Drinks

Towards the end of my conversation with Tick, she reemphasized the importance of a healthful diet. I confessed that as soon as we ended our phone call, I planned to eat a chocolate bar, to summon up energy for the second half of the day. "That's fine," she responded, "as long as it has 700/0 or more cocoa. That counts as health food. As soon as we're finished talking I'm going to make greens juice, and after that I also plan to indulge in a 70% chocolate bar that's sitting on the counter."

Personally, I haven't been preparing green drinks because they seemed so complicated, and I didn't know which juicer to buy, and there would be so much equipment to wash afterwards.

Tick was full of practical tips. "I use a masticating juicer, made by Omega, which doesn't heat the greens; it just slowly crushes everything." she said. "It doesn't take much space on my kitchen counter, and it's easy to clean. I have parsley, cilantro, celery, cucumber, ginger, kale, and collard greens waiting. I will add a carrot just for a bit of sweetness. It is the most refreshing thing; it is like instant energy."

She added that cilantro is an especially powerful chelating agent that can remove heavy metals from the body. "When we eat greens, we don't digest the cell walls," she added. "When we juice greens, then we can access enzymes and minerals stored within the cell."

Who could resist that? As soon as our phone call ended, I started shopping for a juicer.


Heather Tick's website:

Tick H. Holistic Pain Relief: Dr. Tick's Breakthrough Strategies to Manage and Eliminate Pain. New World Library; 2013.

For more information about Chan Gunn and the Institute for the Study and Treatment of Pain:

Elaine Zablocki has been a freelance health-care journalist for more than 20 years. She was the editor of Alternative Medicine Business News and CHRF News Files. She writes regularly for many health-care publications.
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Title Annotation:Heather Tick, MD
Author:Zablocki, Elaine
Publication:Townsend Letter
Geographic Code:1USA
Date:Apr 1, 2014
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