What’s the Big Deal if I Crack My Own Spine? – Stop Everyday Pain

What’s the Big Deal if I Crack My Own Spine? – Stop Everyday Pain

Is this you when your back feels stiff?  Looking for relief from stiffness or pain by twisting it out?  Hoping for that crack that feels like what you get from your chiropractor?  It’s not the same.  It’s more dangerous to do this yourself and you should learn about why this is.

 

Read more from the original post and early book excerpt by following the link below: “When the jammed-up joints are properly released, then the hyper-mobile joints – the ones that are cracking all the time – should not feel the need to do so much of the work anymore”

It might be that you’re noticing cracks and pops with regular daily movement or you are making your joints do this repeatedly throughout the day in the hopes for relief from pressure.  In both cases you should learn more about what’s really going on, so you make informed choices…

Source: What’s the Big Deal if I Crack My Own Spine? – Stop Everyday Pain

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Your Pain is Not Because You’re “Fat”

Your Pain is Not Because You’re “Fat”

What do I know about the struggle to lose weight? Not much and I don’t pretend to. That is a genetic “crap shoot” that I came out on the lucky side of.

What I DO know is that pain does not happen to overweight people alone.

The other thing I know and hear about more often than I should, is how doctors of all specialties commonly and unabashedly display extreme prejudice against people who are overweight.  Numerous patients of mine tell me similar stories about reaching out for help with their pain and being met with a host of physician encounters that leave them feeling judged and ashamed.  So many doctors are quick to blame the weight and slow to investigate past the fat.

Anyone in this day and age knows about the correlation between obesity and disease and mortality.  I’ll go out on a limb here and suggest that the majority of overweight patients know that it’s not ideal to be on the heavy side.  The last thing they need to hear is that everything wrong with them is because of their weight. First of all, that’s just not always true and more importantly, blaming their weight is certainly not something they need a doctor’s help doing.

When has fat-shaming ever helped anyone make positive lasting change? Being judged by careless strangers is one thing but by your own healthcare provider is quite another and shouldn’t be allowed.

If someone has been steadily on the heavy side for the majority of their lifetime and there hasn’t been a sudden recent change in weight, then the skeleton – while perhaps stressed in ways that lighter people aren’t – has had years to adapt.  Our bodies are pretty amazing that way and given years to slowly get used to something, we just do.  The likelihood that suddenly the weight is the main problem is unlikely for this sort of scenario.
I see plenty of lean and “fit” looking people who just wake up one day in pain and have no idea why.  We don’t say to those people: “Well it’s obviously because you’re too skinny.  Come back and see me when you’ve gained some weight.”

Here’s another problematic drawing of parallels that seems to happen quite a bit…

Any sized woman who experiences a 9 month gain of pregnancy weight should never be compared with someone who is chronically overweight.  It is completely different. Not only do most overweight people not gain that quickly but they also aren’t experiencing the unique destabilizing and mechanically disorienting effects of massive hormonal and blood volume changes.

If weight is legitimately suspected as the cause for pain, then the last thing you should do as a doc is dismiss the patient with a sweeping prescription for exercise and calorie restriction when the more likely chronic weight-related risk is cardiovascular.  If anything, this person needs to have a heart health check first.

When a patient feels alienated from their physician due to the shame over their weight, it creates a dangerous  barrier to receiving true healthcare solutions.

I hear first-hand from patients that they will simply not return for care when they feel unfairly judged and dismissed and this can be more dangerous than the weight itself.

We do need to be clear with our patients about the facts:

But facts can be shared without judgment and blame. Higher body fat percentage is a real health risk. Abdominal fat is the worst. It predisposes us to higher levels of chronic inflammation which can manifest in many ways – not just through pain.  Evidence shows that it’s inflammation that is the huge risk factor and linked with a host of diseases.

Doctors and patients alike need to be aware of the cold hard fact that body fat percentage can be dangerously high in underweight, average weight and overweight people.  This is why everyone of absolutely any size, needs to avoid being sedentary, eliminate inflammatory foods and care for their stress levels and stress coping – all of which have been shown to play a role with inflammation which is the ultimate killer.

It’s never just the weight alone.

When there is pain, the pain chemistry needs to be addressed first and foremost.  Yes, fat cells contribute to inflammation which can stack the deck against us and cause pain, but every person’s situation is unique.  Look at the mechanics.  Consider individual body chemistry.  Inquire about psycho-social factors.  These are the inroads to better, more compassionate self-care which is where weight loss can begin if indeed that is appropriate for that patient.

We are emotional creatures first.  The physical body is a reflection of who we are.  All bodies need to be greeted with kindness and respect first before change can be made.


image credit: By Peter Paul Rubens – The Prado in Google Earth: Home – 7th level of zoom, JPEG compression quality: Photoshop 10., Public Domain, https://commons.wikimedia.org/w/index.php?curid=22620913

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How Does Self Image Affect Your Pain?

How Does Self Image Affect Your Pain?

An excerpt from my book as seen over at InnerSelf Publications website.

Timely for the season of self reflection and internal work.

 “by Ya-Ling Liou, D.C. If you’ve only ever seen yourself as unsure and perhaps your self-esteem is not strong, you may be more vulnerable to becoming overwhelmed by fear—stressed by the worry that your pain might devolve into a worst case scenario of unknown proportions.”

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Pain Research – Someone’s Got To Do It.

Pain Research – Someone’s Got To Do It.

It’s abundantly clear to me after this weekend, that the folks at the Neuro Orthopoedic Institute (NOI) group in Australia have been busy doing exactly that.

img_6417My writing relies heavily on the hard research work of people like these and I am so happy not to have to be the one to produce it.  I have the utmost regard for the kind of mind it takes to do that sort of work.  I, on the other hand, much prefer bringing the information to real people for whom it has practical application in a way that makes sense to them individually.

This past weekend, I was able to attend part of the NOI group‘s EP3 West Coast version of the US edition on Friday at the Washington State Convention Center. Those in attendance were primarily physical therapists, some with doctoral PT training, a few medical doctors, a few adjunct providers – one other chiropractor, a couple of osteopaths, nurses and a some psychologists.

Axons and Dendrites and TLR-4 Cells Oh My!

tlr4What I love about this particular body of pain research presented by the NOI group, is the neuro-biology of it. While sitting in the conference and happily soaking up the neurological terminology familiar to me, I wondered how well the basic physical therapy education covers neurology in the US.  Chiropractors get extensive exposure to neurology with increasing detail through the progression of the 5000+ hours of doctoral level curriculum.  It appears that Australian physiotherapy schooling also includes a fair amount of neuro-physiology training.  As I looked about the room at the blank stares, I wondered if perhaps the American PT curriculum isn’t quite as rigorous in this area until perhaps the elective doctoral level? Something for the NOI instructors to perhaps become aware of.

The minds behind this approach to understanding pain via this group out of Australia, is headed up by the two Australian educators who created the book behind the tour. One is a clinical and research physiotherapist and professor of clinical neurosciences at the University of South Australia . The other calls himself a “freelance educator” and sports the suffix EdD, also a physiotherapist who holds a graduate degree in “advanced manipulative therapy” which I believe is the Australian preference over chiropractic although it seems there is significant overlap. As with many different regions in the world there are political reasons that one profession is regarded more highly or accepted more widely.

This weekend they were joined by a local talent, editor-in-chief of the Journal of Pain and University of Washington professor in the Department of Rehabilitation Medicine.

Guess What? “Sh*t” Happens and That Same “Sh*t” Matters When it Comes to Pain.

statue_trippingWhat tickles me about the NOI group research – at least as presented by the neuro-literate educator of the group – is that it is finally providing scientific evidence of things that we all as humans at some level already know.  Life experiences affect our relationships with pain.

Happy or sad, the things that happen to us as we navigate life, impact us in ways that can cement in time, our cellular reality. Our neuro-physiological responses to pain are significantly dependent upon the molecular patterns set up by a wide array of events and can set us up to experience recurrences of pain more easily or keep us from being able to find our way out of pain.

I was pleased to see that the substance of their work corroborates what many of us who work extensively with patients in pain have always known, and that is the practical reality that pain is often independent of tissue damage. Long after a legitimate tissue disrupting trigger has passed, pain can linger. Pain can also return in the absence of proportional local tissue damage and this is where things get quite fascinating.

The entire premise of my book series about everyday pain is that helping patients grasp the reasons behind their pain and helping them see that they are not irreparably damaged, massively speeds recovery from pain and keeps relapses to a minimum.

Teaching the Teachers

landaff_1940sThe most lovely thing about these three clinical research masterminds is that they have uncovered and provided the science and research behind the validation needed to implement this pain education. The NOI group seems to be working to educate more clinical educators which is truly going to the source to effect change and I applaud that.

It’s extremely important to refine the professional messaging behind how we greet pain in the practice setting and it will go a long way to changing our pain culture. But what I want to do and am focusing on with my publishing project  these next few years but also farther into the future, is to bring much more of this directly to the patients – the everyday person.

Pay to Play – Healthcare as Usual?

dandy_pickpockets_divingI learned that it was primarily a few local larger medical institutions that brought this conference to their employees by virtue of allotted benefit dollars that provide them with reimbursement for continuing education. The cost of the conference was unfortunately prohibitive to anyone not affiliated with an organization with deep pockets.

The financially prohibitive nature of these conferences (geared specifically to the mainstream medical institutions) presents a discriminatory challenge to equally qualified and information-hungry solo (or small practice) practitioners from a wide variety of relevant specialties. Nevertheless I must applaud the forward-thinking by these health care organizations and hospital groups for embracing the reality and changing attitudes towards the psycho-biology of pain.

It is a changing world and there is hope.
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Do You Know How to Name Your Pain?  Here’s Why You Should:

Do You Know How to Name Your Pain? Here’s Why You Should:

The_Cluster_HeadacheWhen I ask patients about pain, I’m always intrigued by the amazing variability in terminology or often the complete lack thereof.  Maybe it’s because of growing up in a multilingual environment that I have a personal fascination with words and language in general.  What’s particularly interesting to me is how inadequate words can be for all of us when trying to fully convey pain and sensation.

Not only is there an endless variety of quality and severity, people who make a habit of “toughing it out” in the face of pain, actually lose their language for pain.  Depending on modeled pain behavior in your childhood home, it’s also possible that this language was never even allowed to develop .  Based on what I see, I believe firmly that it’s only through the re-learning (or learning anew) of how to speak about our physical pain that allows healing to begin.

First of all, on a simply practical level, if you cannot describe your pain with any convincing accuracy, someone like myself who is interested in learning about your pain in order to help you troubleshoot it and get rid of it, is working with hands tied.  It’s not until I spend time with someone who has no language for their pain that I am reminded of how important it is to the successful outcome of any bodywork treatment.

Secondly for yourself, how can you forge ahead successfully towards a cause – in this case eliminating your pain, if you don’t even have a name for it?  For many people pain conjures up fear.  The first rule of thumb about conquering fear is to name it and face it.  If you say to yourself you’re unhappy, don’t you need to know what it is that you’re unhappy about before you have any hope of being happy again? Same thing with pain.  Get specific. Dig deeper.

I notice that the people who are the most conflicted about using the word “pain” tend to be the chronic pain sufferers – the people with high pain tolerance.  (A topic for a separate blog post: people with a high tolerance for pain often are the ones who end up in chronic pain because of their inability to register the early warning signs – and yet they seem to be the ones who worry the most about being pain-“wimps”). These are the people who hesitate and insist instead on using a different, less loaded word because “pain” sounds too serious compared to their perceived discomfort.

It’s okay if you don’t want to refer to your discomfort as “pain”, but you should know that by repeatedly dismissing the idea of pain you lose the ability to describe any aspect of it.  For example, “pins and needles” is an important sensation that leads to very different approach in treatment than “stabbing” sensation.  An “ache” can be very different than “stiffness” and both are significant to me but will change how I treat it.  Sometimes the sequence and timing of sensation is meaningful and sometimes it’s the combination of sensations that points to the cause.  Everything and anything that you notice is significant – even if you don’t want to give it any weight.

I believe this widespread issue of inadequate command of and connection with our language for pain, is what causes some physicians to quickly dismiss complaints as fabricated or baseless.  If you are someone who is unable to describe your pain as anything other than “it hurts”, your concern will most likely be dismissed and you’ll be urged to  medicate it away because no one has the words to understand it.

If you’re like any reasonable person, after years – or even just weeks – of pain, certainly you would like nothing more than to distance yourself from it. Why would you choose to dive deeper into your awareness of it?  Well this is exactly what I’m asking a lot of my patients to do and yes it can be a frustrating process.  But it is an important step to solving the puzzle and taking control of what is within your reach.

Start with basics like: “sharp”, “dull”, “burning”, “throbbing”, “grabbing”, or “stabbing”.  If you’re still having trouble coming up with words that seem right, try thinking of how you can compare your pain or discomfort to other sensations you’ve had in your life like: a tooth ache, a stomach pain, stubbing your toe, catching your finger in a door or a drawer and other things like that.  Those are all good starts and you will probably find that once you start the conversation the words will come to you more and more easily.

I would venture to guess that at least half of the failed outcomes in physical medicine with any given practitioner has to do with how accurately the practitioner was able to interpret the patient’s pain language.  I certainly have failed my share of patients in the past when there’s pain that I don’t know about or fully appreciate, which is why I’ve learned to ask so many questions about the “pain”.  I will probably never seem alarmed by a sensation you’re describing but that is because most pain and discomfort makes sense to me.  What doesn’t make sense and worries me more is when something I know should be hurting, is instead shrugged off or does not even seem to register.

Start talking about your pain. Be creative and daring; find your pain-language. It’s personal, unique and valid.  There’s a good reason for your pain and it’s not out of your reach to figure it out and with some help to put an end to it.

Above all, be patient with yourself.   Pain is your ally not your enemy.  It’s an important message to you about something that needs your help and attention.


Practitioners: How does pain language affect your practice?

Patients: Have you encountered this language barrier with your practitioners?

Don’t be afraid to share your thoughts below…

 


Image Credit: Wikimedia Commons: By JD Fletcher (http://arowmaker.tripod.com/AROWMAKER/id6.html) [GFDL (http://www.gnu.org/copyleft/fdl.html) or CC-BY-SA-3.0 (http://creativecommons.org/licenses/by-sa/3.0/)%5D, via Wikimedia Commons

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Stretching Out the Pain: Feels Good But is it Good FOR You? – Stop Everyday Pain

yoga-dancer-1024x855Recently I’ve had a few questions from patients who are reading the book.  One that keeps coming up is about whether or not stretching is good or bad for us.  Stretching is a very confusing topic and has been one of scientific controversy for years which makes the answer not so straightforward.

In this first volume of my book series Every Body’s Guide to Everyday Pain™, Put Out the Fire I spend some time explaining that stretching is actually a mechanical stressor and therefore risky for people dealing with everyday pain.  This means that the elongation we cause by stretching can result in stress to the underlying structure.  Usually  when all things – mechanical, biochemical and emotional – are in balance, a reasonable stretch doesn’t cause any trouble.  However, when we are out of balance in any one of these areas and if we are already in pain, then stretching the compromised area is a terrible idea.

We often get away with stretching without consequences during times when we are not in crisis. Unfortunately with this sort of benign experience in mind and due to the fact that stretch-sensation neurologically eclipses the pain of inflammation, the concept that stretching is not good for your pain, is a very puzzling one to accept.

If you stretch a muscle in distress, you are basically signalling to your body that the tightening over-reaction – the one you are trying to find relief from – is indeed justified.  In this case, your stretch will perpetuate the underlying reason for muscle pain and tightness instead of resolving the problem.

The reason muscles grab and get tight is 100% protective in nature.  It is always the most reasonable response to unreasonable conditions.  You may not agree that the conditions are “unreasonable” but your brain and body’s assessment is all that matters during times like this.  If you don’t stop and find out what they’re protecting you from, there may be much worse discomfort lurking around the next corner.

Another interesting point is that the elongation stress associated with stretching can happen without, what looks to us like, a traditional intentional stretch.  Lengthening stress to muscle fibers is something that can be produced with sustained pressure on a muscle or a tendon.  When a muscle bundle is made to deform in this way it’s perceived by the brain as elongation. If that area is already inflamed, it will be a problem.  So, all of you foam rolling or ball rolling advocates beware!

A large part of my mission in educating patients is to highlight the subtleties in movement and posture that matter when we are in pain, but which often don’t seem very obvious to us.  By learning about these not so obvious contributions to pain, we can stop berating ourselves for “falling apart” and acknowledge the way forward. Recognizing the validity in our pain is a vital step towards feeling better and staying out of pain in the future.

An important part of Volume Two – Fix the Fire Damage will include information about exactly how and when to stretch safely and how to solve the problem of muscle tightness for the long term.

Click on this link for more at the original article Source: Stretching Out the Pain: Feels Good But is it Good FOR You? – Stop Everyday Pain

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Taking My Own “Medicine”

Taking My Own “Medicine”

Dobbins'_medicated_toilet_soap,_advertising,_1869When you’re a chiropractor, what does it mean to “take your own medicine” ?

“Walking my own talk” consists of more than just making sure I receive chiropractic care myself.  It’s about seeking balance in all areas of health.  With balance in sight, the need for professional treatment decreases.

My motivation is maybe a bit more intensely fueled than for most people because my body is my essential work tool.  If mechanical, biochemical or emotional balance is off, it directly affects the ability to fulfill my commitment to patients which in turn could potentially risk my livelihood.  This is an intense interdependence that I would never trade for anything but it can be more than stressful to be even just a little bit laid-up.

In last week’s post I alluded to a recently renewed return to health by restoring balance to my own life, after a year of pushing to get my book out, followed by the release and adventures in promotion.

Block Quote 4I cannot emphasize enough how much this pursuit of balance can differ from person to person.  I am taking a moment to briefly outline what this looked like for me at this particular juncture, to give you a very general idea of the factors to consider when thinking about your own balance in wellness.  In particular I want to illustrate some of the principles outlined in my book (Every Body’s Guide to Everyday Pain, Volume One – Put Out the Fire). Don’t wait until you’re in pain to find your true healthy balance. The everyday variety of pain is always a sign that something has fallen by the wayside in one of the three main categories (mechanical, biochemical or emotional) but things can be “off” long before pain strikes.

In my case, this time I needed first to focus on returning to a more regimented sleep/wake schedule.  I’ve learned that my body and mind operate optimally with 6,1/2 – 7 hours of sleep per night and this means I need to exercise a little discipline about getting to bed on time because I am not willing to get up late.  The morning hours are treasured time and important to my emotional well-being.  I’m very lucky to have good sleep hygiene and my body cooperates well when put to bed.  For times when that’s not the case (as everything ebbs and flows), I reach for homeopathic remedies, herbal teas or magnesium to calm the nervous system before bed.  A controversial trick that isn’t advisable for everyone but that works well for me, is to have a small bite to eat before bedtime as well.

Test tubes science backgroundRe-balancing my biochemistry is something that I dedicated the better part of two consecutive months to. Resetting my organ systems and aiding the natural detoxification, involved some herbal and food therapy.  I returned to eating simply by avoiding my known sensitivities: dairy, all animal protein, simple starches (sugar), nightshades and a few other specifics that I’ve come to recognize over the years as taxing to my system.  I’ve since then slowly returned to more variety based on what my appetite dictates.

Block Quote 2Some signs that will tell you about your sensitivities can be as subtle as an increase in heart rate within 1/2 hour of eating. Sometimes it’s just a little tickle in the back of the throat that passes quickly but is still a significant sign of intolerance.  Other times it can be a generalized increase in mucous production and that might be harder to spot.  The need to clear your throat or blow your nose in the morning might be signs of excess mucous production in response to a food trigger from the day before.  The point is that foods (sometimes very delicious food), not overtly considered as “allergenic” like peanuts, can still be considered by your body as a burden for your biochemistry.  So, it’s always important to pay attention to subtle reactions.

When I commit to helping my body unload excess waste, I also utilize dry sauna sweats, infrared if possible and pay extra attention to optimizing kidney and bowel function.  This makes a big difference in the associated discomfort of “detox”-related headaches and body aches that can happen when large amounts of waste are mobilized throughout the body for elimination.

My herbal and nutrient based regimen was also targeted, in part to facilitate elimination via the kidneys, liver and colon.  There are many different philosophies on which herbs are most appropriate and this is something that is best done with the advice of a natural health care doctor.  Focusing on aiding natural elimination is the best way to help decrease your body’s chemical burden from exposure to complex molecules in our air, food and water.

Balancing RocksFor me, restoring mechanical balance can’t happen without first adequate rest and attention to nutrition.  After re-setting sleep and nutrition I found my energy returning and started to increase activity based on that, but not until then.  If fuel or rest and recovery are lacking, then the exercise output ends up adding stress to the system instead of strengthening it.  This is why sleep and nutrient intake is first priority. It sets the stage for successful return to exercise.  Without this in place, workouts are pointless and counterproductive, potentially resulting in inflammation-causing stress.

Block Quote 3What my body and mind are willing and able to do changes with the seasons, years and stages in life.  This Spring, yoga was the doorway back to physical empowerment.  It helped me begin to feel able to return to swimming and weightlifting.  Now, my routine includes one yoga class per week and two other days of gym workouts which consist of a warm-up swim followed by an upper body or lower body weight resistance workout.  That’s three days a week of 1-2 hours of exercise. They are strategically spaced from my days with patients so that I am not too sore to be effective in the office, but also to avoid muscle fatigue related injuries.

There’s nothing rigorous about this current exercise schedule which is what makes it completely sustainable.  When starting a new routine, being consistent is more important than making a huge impact.  Come wintertime, it’s possible that my needs will change and I will change my exercise accordingly.  Perhaps in a future post I will take some time to address the how of tuning in to your own changing needs from season to season or depending on life and work situations.  It’s mostly a lifelong process of trial and error.

It can be tricky to walk the fine line between the intended exertion of exercise and inescapable demands of work life. But as you slowly increase physical activity, what always holds true is that you increase your body’s capacity for emotional, chemical and physical stress to keep from rebounding into exhausted inactivity.  It must be done in a loving way. Self-care routines are best implemented with gentle caring instead of harsh reprimands.  If you’re someone who thrives on hard line tactics for motivation – find a trainer or someone outside of yourself to play that role.

Even though it’s not an easy daily practice for many, being loving and yes even permissive with yourself makes room for healthy choices.  Remember real health can and does exist in imperfect bodies everywhere.  It’s about balance, not perfection.

Block Quote 1Lastly, you should know that it takes at least two full months – often three months – of consistent activity in order to surpass the “transition reaction” of new exercise.  When introducing a change in routine or physical demands, the brain and body will express themselves by exhibiting physical sensations that aren’t always 100% comfortable.

Sometimes the transition to a better balance in life includes re-visiting old pain that might feel like re-injury as we work to strengthen around these old vulnerabilities.  This is why it’s important to line up some outside help during these transitions either via massage, acupuncture, or chiropractic.  It’s the time when I see the greatest need for support in my patients.

Food for thought while you consider your own healthy balancing act: When we act in reaction or opposition to an idea or a feeling, we set the stage for inevitable failure. When we act out of caring and acceptance for the imperfection that is, we make good and sustainable choices.


Image Credits: Wikimedia Commons, Fotolia

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