Inflammation and Pain – Integrative Rehabilitation

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The single most important factor in developing a treatment plan for pain is to first accurately diagnose its cause, and then create a comprehensive, integrated rehabilitation program.

Muscle painDr. Timmins: “I once worked in drug and alcohol intervention and rehabilitation with my brother, Bob Timmins, the founder of the Adolescent Substance Abuse Program. I administered biofeedback to adolescents enrolled in stress management programs, as well as adult patients in the chronic pain unit. Initially, I was reluctant to accept this position because I had no prior experience working with patients with chronic pain. However, when I realized that many of them were being treated with narcotics like morphine, I felt compelled to develop treatments that would help minimize their use of these addictive, toxic drugs while still providing effective pain relief.

We used various methods including biofeedback, visual imagery, muscle tensing, and relaxation, and breathing techniques. I worked with each patient to identify which of their senses they favored to enhance their ability to participate in the treatments. Some people are visual learners, others auditory or kinesthetic. Once we learned their preferred modes of learning, I was able to create personalized pain-control techniques. To my surprise and delight, the methods were quite successful. In many cases, these techniques helped patients significantly reduce or eliminate their need for pain medications.”

In treating inflammation and pain, doctors should select an approach that best meets the needs of the patient and has the fewest side effects. Most medications have toxic side effects that impose their own stress on the body. These should be avoided or limited whenever feasible. It really comes down to one’s tolerance for pain. Certain pain “killers” like morphine and hydrocodone can be highly addictive, thus becoming a source of chronic stress if used over time. In some cases, pain medications and anti-inflammatory prescription drugs may be the only viable option, especially when crisis intervention is necessary. However, over time they can become less effective and, worse yet, may undermine critical bodily functions.

The cumulative effect of toxic medications can damage the liver; sometimes this damage is irreversible. While certain drugs may be highly effective at alleviating the sensation of pain, they can actually impede the healing of the initial trauma by being a contributing source of stress on the liver and other organs, and by inhibiting the healing aspects of the inflammatory response.

In the interest of patients’ recovery and long-term health, doctors should modify their treatments to minimize the use of harmful drugs as soon as the pain becomes tolerable. During the course of “stepping down” their medications, physicians can introduce nontoxic therapies to take the edge off the transition.

Symptoms : chronic fatigue, fibromyalgia, depression, anxiety, insomnia, loss of appetite, short-term memory loss

A colleague of mine made the clinical observation that many of his patients with serious degenerative diseases had experienced head trauma, often very early in life. The correlation between head trauma and degenerative disease seemed like a stretch to me, so I categorized his theory as just that: an interesting theory. I didn’t think much about this again until I was treating Paula, a 36-year-old woman who was completely disabled as a result of chronic fatigue, fibromyalgia, depression, anxiety, insomnia, loss of appetite, short-term memory loss, and poor cognitive function.

Because of Paula’s memory and cognitive problems, I suspected that a head injury may be causing her illness. However, Paula was unable to remember any event involving significant head trauma. With her consent, I contacted her parents to determine whether they could recall such an incident.

In speaking with them, I learned about two major head traumas. Paula had been dropped on her head by a nurse shortly after being born. And, when she was four months old, she fell backwards in her highchair, hitting her head on a hard floor. She spent the next six months in a coma. Paula’s parents felt so guilty about the incident that they never discussed it with her.

When I learned about these events, I began to wonder whether my colleague could have been correct about the correlation between head trauma early in life and chronic illness later in life. Could the head trauma 36 years earlier be the cause of Paula’s chronic illness?

It is possible that Paula’s symptoms were related to chronic stress caused by head trauma and its effect on critical systems of her body when she was a baby. As with all degenerative illnesses, Paula’s health problems didn’t happen overnight. They were the result of cumulative stress that undermined her health over time. That the injuries she sustained as an infant set the stage for poor health is possible, making her more vulnerable to other health issues than most children and young adults. When I learned of her early history of head trauma, I decided to use the same treatment regimen that I would apply to someone with a concussion.

As part of her treatment, Paula received extensive bodywork and biofeedback to retrain her neural pathways and reestablish healthy control mechanisms linking her brain and critical body systems. After several months of treatment, Paula regained her mental, emotional, and physical health. Eventually, she was able to return to work full time and care for her family.

I believe that my colleague was on to something.”

 
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