Last year I was invited to wear my “Chiropractor in Marblehead, MA” hat to be on a panel to discuss pain management options to a group of psychotherapists who work primarily with the elderly population, those who often have chronic pain. Here is an excerpt from my talk about how looking at unexplained pain with “OTHER EYES” might help the healing process.
All doctors and those in the helping professions want to be able to treat the client’s pain and get good results. We depend on studies to help us develop clinical guidelines to determine when it is relevant to use conservative, complimentary or surgical interventions. In order to know the guidelines, research has to be done on subjects with pain.
My talk focuses on different types of back pain, theories about why someone may have back pain when it cannot be demonstrated on x-ray, MRI or CT scan. I will talk about my 29 years of experience as a chiropractor, a clinical nutritionist and intuitive healer.
The first study I would like to mention was published in the British Medical Journal in 2006. The subjects sampled all had back pain; one group had back pain from a know cause: spondylolithesis, stenosis, infection, osteoporosis, compression fracture, disc herniation and the other group had non-specific back pain – or pain without a clear origin. The conclusion: Of all the people who had back pain, 10% of all back pain has a known cause and while 90% of all back pain is non-specific or the cause not understood.
Another part of the study used 2 groups: one group with LBP and one group with no LB pain. Both groups had x-rays and both had MRI’s. The study was looking to see if there were more abnormalities on those with LBP. The conclusion: Many of the people with LBP showed absolutely no abnormalities on x-ray or MRI. They couldn’t find structurally what was wrong with those people.
Another study was published in the Spine Journal in 2010 done by Dr. Leonid Kalecman in Tel Aviv. This study had 2 groups, again one with LBP and one without LBP. Each got a CT scan. He wanted to know what was the prevalence of spinal degeneration (narrowing disc spaces, facet joint arthritis, stenosis, spondylosis) on a group of people whose average age was 52 years old. Of the 187 people scanned – 64% had disc narrowing, 65% had osteoarthritis, and 11% had spondlyosis –degenerative changes in the bones and disc. Conclusion: Degenerative features of the lumbar spine were extremely prevalent in this age group with or without back pain. The only degenerative feature that seems to associated with LPB was stenosis. Other degenerative changes seem to be UN-ASSOCIATED with LBP.
Where might this non-specific back pain be coming from in the 90% of the cases?
According to Dr. John Sarno, MD, professor of Clinical rehabilitation Medicine at NYU School of Medicine and author of the revolutionary books, “Mind over Back Pain and Healing Back Pain”, pain is a decoy or a red herring. He is the originator of the diagnosis, Tension Myositis syndrome (myositis meaning in the muscle) aka TMS. According to Dr. Sarno, TMS is a psychosomatic illness causing chronic back, neck, and limb pain which is not relieved by standard medical treatments. He includes other ailments, such as GI problems, and repetitive-strain injuries as part of the TMS diagnosis.
Dr. Sarno has successfully treated over ten thousand patients at the Rusk Institute by educating them that their real pain is of a psychological and emotional basis and their body is tricking them by causing their physical pain and symptoms. He states that the purpose of the pain to DIVERT the person’s attention away from repressed, undesirable emotions like anxiety and anger and his treatment is to educate his clients the way the bodymind work. Once they understand that the real issue is emotional, the pain serves no purpose. To reiterate, in order to prevent the conscious mind from becoming aware of the unpleasant emotions of anger and anxiety, these emotions become repressed or kept unconscious. The pain syndrome or TMS is a distraction from the real issues at hand!
In 2007, David Schechter (a medical doctor and former student and research assistant of Sarno) published a peer-reviewed study of TMS treatment showing a 54% success rate for chronic back pain. The average pain duration for the patients in this study was 9 years. In terms of statistical significance and success rate, the study outperformed similar studies of other psychological interventions for chronic back pain.
Another amazing answer to the question, where might this 90% of non-specific back pain be coming from, comes from the work of Dr. Candice Pert, an internationally recognized psychopharmacologist who recently held a professorship of physiology and biophysics at Georgetown University in Washington D.C. In the 1970’s Dr. Pert discovered the brain had opiate receptors – which explained why marathon runners got a “high.” She later wrote a life-changing book called “Molecules of Emotion.” In her book, she says, emotions run every system of your body. Emotions are the glue that holds your body and your mind together. Emotions hold your cells together. Emotions aren’t psychological, they are physiological and they are composed of molecules called neuropeptides and endorphins which bind to receptors on every cell of your body. Basically Dr. Pert is saying that YOUR BODY IS YOUR SUBCONSCIOUS MIND! In this way PAIN might be unexpressed or unresolved emotion trapped in the physical body.
Another explanation of where the 90% of non-specific low back may be coming from comes from the insights of a chiropractor named Dr. George Goodheart. In the 1960’s Dr. Goodheart discovered that there is a correlation between muscle strength, meridians and organ function and he mapped out the connections. What he figured out was if an organ is weak, the corresponding muscle will upon manual muscle testing, test weak. For our discussion, the adrenal gland, (the primary responder to stress, making adrenalin, cortisol), is mapped to the Sartorius muscle which connects the Anterior superior iliac spine (the knobby point on the front of the hip) to the medial knee. This muscle stabilizes the hip in the front. When someone has high stress and the adrenal gland gets tired or exhausted that muscle weakens and lets go, the hip will roll back and create structural stress and pain in the sacroiliac joint and low back.
What is the goal of a chiropractic adjustment? To remove the Nervous system interference in order that the body can heal itself. We believe the body is SELF-healing. I don’t treat pain or symptoms per se.
How does healing happen from a chiropractic perspective? Blockages known as subluxations interfere with the flow of the life force through the nervous system and give a person a range of physical symptoms: When I went to chiropractic school we talked about the bone moving out of place, pinching a nerve – like blowing a fuse – it trips up one area of the house. This is a small % of subluxations I treat.
Most subluxations effect whole areas of the nervous system, from the occiput to the tail bone because of the way stress patterns effect the body. If you think about your body when it gets stressed, what happens? It is a global event -a lot of your body is engaged. When someone is stressed, on a structural level the meningeal system, the covering over the nerves, stretch and torque the spinal cord causing subluxations that interfere with the nerve flow in regional areas.
HERE IS WHAT IS IMPORTANT. The spinal cord is the AT&T system of the body. Without it there would be no internal communication. We don’t want static on the line otherwise we don’t understand. These subluxations block the brains’ ability to witness the “bodymind” and therefore can’t “hear” the pain and therefore can’t do anything about it. We can’t change anything we are not aware of and that is equally as true of the brain as well.
I also call the spine the royal road to consciousness. The goal for me when I put my hands on someone’s spine is to find and remove the roadblocks, the subluxations, in order that the emotional and or biochemical conversation the bodymind is having in a subconscious way can NOW travel through the telephone wires of your nervous system up to the cortex and inform the brain exactly what it is feeling! As Dr. Pert says… the body is the subconscious mind and feelings are always wanting to find a way for expression and until that communication reaches the brain, there will be pain, tension, lack of ease in the body. Dr. Pert believes unexpressed emotions cause disease.
How many of you have had little children? Remember when they come in and grab your pant leg and say Mommy, mommy, mommy when you are in the middle of something…and until you give them your undivided attention they don’t stop. Pain is like that child. Until that brain can witness what is going on, that pain signal is going to keep firing. Open up the channels of the nervous system, the brain can witness itself and magically that pain will shift.
In my practice, most of my clients fall into this 90% non-specific back pain group. I love what Dr. Pert says because it explains why my clients may report having emotional releases – such as feeling anger, having intense dreams, or crying after a spinal alignment or during a Transformational Kinesiology session. It also explains why someone’s spine comes out of fight or flight posture right on the table as I am adjusting them. They feel more relaxed, the weight of the world can starts to melt. As they soften so does the pain. I know you have clients who come to see you who are in pain to such a degree that they have become the pain – there is nothing else but the pain. Chiropractic can help shift someone’s inner experience to this: I am me and I have pain rather than I am pain. Perspective is everything.
YOUR NUTRITION CHOICES CAN MAKE A BIG DIFFERENCE – As I mentioned, the weak adrenal glands can cause back pain because the muscle lets go. Poor diets contribute to adrenal gland function as well. Here are some guidelines for giving the adrenal gland everything it needs to function well.
I am going to outline the best “Stressed-out person’s diet”: Guidelines to help balance blood sugar, hormone levels and help with Adrenal fatigue, prevent ups and downs in energy and mood.
Eat every 2 hours. This relieves the adrenal glands from the job of maintaining normal blood sugar.
Always eat some kind of PROTEIN at every meal
Eat foods rich in Omega 3 fatty acids: like salmon, tuna, trout, herring, and mackerel. Like walnuts, flax seeds or chia seeds. Supplement with Omega – 3 Oil if you prefer. Omega 3’s help stabilize the mood.
Use monounsaturated fats like: extra virgin olive oil. Cook with Coconut oil and Butter or Ghee. Avoid transfats ; hydrogenated and partially hydrogenated oils which are in margarine, safflower, sunflower and corn oils. – oils that are used IN MOST CHIPS
Eat 7 or more servings of vegetables and fruits daily. Eat more vegetables than fruit.
Eat natural sources of protein rather than man-made like deli meats, “phoney baloney”
Eat more vegetable protein like lentils, chick peas and nut8.
Avoid dead and devitalized foods.
Essential vitamins for supporting the adrenal glands are Vitamins B6, B12 and folic acid.
THE ABSOLUTE KILLER of the adrenal gland’s ability to do its job is using NUTRASWEET, aspartame used in most diet foods and soda. It is sold as EQUAL, SPLENDA, SUCRALOSE. If your clients are diabetic they can use STEVIA.
About 25 years ago I had the privilege of preparing lunch for some guests at the spiritual home of a well-known meditation master. I remember looking down and realized that the diamond in my ring fell out and as you might well imagine I was quite distraught. Shortly after, my friend, a social worker, came in the kitchen and asked why I looked so upset and I told her what had happened. A BIG SMILE came to her face. She said FANTASTIC! “Don’t you know what good karma it is to lose something in the GURU’s house?” Now that’s what I call the ULTIMIATE REFRAME! Some pain is like the upset of that losing diamond. Our first instinct is that something is wrong. We think pain serves no purpose, it is random, it shouldn’t be like this, it makes us feel like a victim. I believe it is our job for those 90% for whom their pain has no obvious cause to consider reframing the PAIN. Perhaps pain can be a teacher to let it inform them that something is out of balance, something needs loving attention or maybe you are upset.
In my practice, I have treated many people who when their sense of themselves has shifted – when a person gets a divorce, loses a loved one, becomes a mother, loses a job, and one client who went from being a dental student to becoming a dentist in the clinic – all show up in my office with non-traumatic sacrum pain. Interestingly, the sacrum provides stability for the spine and gives them a foundation to sit on – and in these situations they each lost their center figuratively and structurally. Chiropractic helped them ground.
The last point I would like to consider here is the deep value of touch. I believe that being touched is a essential vitamin. Newborns cannot thrive without touch. We all need it. Touch helps to lower cortisol or stress hormones and when offered in a non-sexual way has a comforting and reassuring effect and can help reduce anxiety. The human touch can be a lifeline.
I think it would be so beneficial for the population you see, the elderly to consider creating some kind of team approach that includes therapy as well as chiropractic or other hands-on-healing modalities to support, deepen, nurture and give experiential understanding. I think would add such quality to their lives.
Thank you for your attention!