Which bodywork therapies help you manage chronic pain more effectively?

For many people bodywork therapies, such as massage, chiropractic and osteopathy are an effective way to support themselves when they are managing pain and particularly chronic pain. At a recent symposium on pain it was surprising to hear that the research really wasn’t there to support the use of bodywork therapies for reducing chronic pain long term, however there were studies to show that it did have benefit in the short term for symptom relief. The absence of studies does not mean that it doesn’t work it just means that not a lot of research has been done.

The research that has been undertaken does show the value of an holistic approach to treatment for chronic pain and include the use of graded exercise therapy, cognitive behavioural therapy as well as bodywork. So what are the best options for people when they are experiencing pain and how do you decide what will work for you?

Generally if the problem is structural its ideal if you can be assessed by a chiropractor or osteopath. An osteopath can support patients with manual therapy interventions including exercise prescription, needling and education to improve movement and reduce pain. Osteopaths also work on soft tissue with either massage or gentle activation. Chiropractors tend to focus more on the spine and alignment and will do manual adjustments to improve the nerves and their function.

When you are considering massage therapy look at what type of pressure you can cope with? For example for those who cannot deal with a strong massage it might be worthwhile looking at lymphatic massage, reflexology or gentler therapies such as craniosacral therapy. Let’s consider the relative strengths and benefits of each style so that you can decide what will best provide you with support.

Remedial Massage

Remedial massage assists in improving soft tissue or muscle function by improving the flow of blood to the area. It can also support you through recovery from an injury and reduce pain. Remedial massage can be tailored to the pressure that you can tolerate but generally involves a stronger style of treatment.

Lymphatic Massage or Manual Lymph Drainage

This is a gentle style of massage which works on the superficial lymph structures that sit below the skin. This is ideal for anyone recovering from surgery or an injury with significant swelling. The gentle flowing strokes can assist to improve the flow of lymph and reduce swelling and pain. Ideally with a lymphatic therapist look for someone who has done additional training such as the Dr Vodder course in Applied MLD. The therapists who complete this training are often qualified in other tools such as low level laser, taping and bandaging. This type of therapy works well for those who have been treated for cancer to support them particularly after the loss of lymph nodes.

Reflexology

Predominantly working on the feet , reflexology can assist with pain management through pressure on the soles in areas related to the underlying source of pain. By identifying areas that are congested or unbalanced the therapist can assist with the flow of energy to assist in healing. Reflexology can slow down nerve transmission which may interrupt pain pathways. It also helps with releasing endorphins which can then make you feel better. Reflexology assists with circulation and increases the flood of blood and nutrients around the body. Reflexology by promoting the relaxation response is an effective way to release stress and tension.

Reflexology is often used in palliative care settings as it is a gentle therapy where the client does not need to be mobile.

Craniosacral Therapy

Craniosacral therapy is a type of bodywork that relieves compression in the bones of the head, sacrum and spine. It uses gentle pressure on the head, neck, and back to relieve the stress and pain caused by compression. It’s thought that through the gentle manipulation of the bones in the skull, spine, and pelvis, the flow of cerebrospinal fluid in the central nervous system can be balanced which then improve the body’s ability to heal.

Craniosacral therapy is deeply relaxing and it will often take 48-72 hours for the full benefit to develop. It is common to see improvements in sleep after a treatment and it is useful for people who have had a history of concussion or indeed other trauma.

To find a practitioner who is appropriately qualified make sure you refer to the natural therapy association websites such as atms.com.au and also look for referrals from your other practitioners.

If you are recovering from surgery or an injury and would like more information about the best strategies for managing chronic pain please have a look at the recent Understanding and Managing Chronic Pain webinar on my website.

Six ways to increase your energy

One of the most common reasons for people to see a naturopath is that they are really tired and lack energy. If you are feeling like this at the moment its important to understand why your energy is low but there are also several things you can introduce which may help improve your energy levels on a permanent basis.

The area of the body that produces energy is a component of each cell called a mitochondria, think of them like little factories. As we get older the number of mitochondria in the body can reduce, typically we see a halving of the levels between 20-40 and then again by the time we reach 70. These mitochondria can also be damaged by a range of environmental factors which means they don’t work as effectively and produce less energy.

There are a number of “hacks” which can improve both the number of these little factories and also the quality. Most people are aware of the benefits of regular exercise however they may not be aware that muscle cells will build more mitochondria as a result and they will operate more effectively. However often when people are really fatigued they are not in a position to exercise so these are my top six strategies for improving cellular energy. There are other strategies however this list focuses on those with minimal costs.

  1. Thirty minutes of daylight as close to waking as possible. This is an invaluable reset for your body’s circadian rhythms and helps you produce a reasonable amount of melatonin. Melatonin is important to generate sleep but turns out it also helps with cell repair and can improve energy. Literally one week of eating my breakfast outside followed by a short walk saw a significant improvement in my energy levels.
  2. Mild stressors for the body such as cold can improve energy quality. Its really important with this strategy to start with a very modest amount and slowly increase. A cold swim in a mountain stream might be the goal but start by having a minute or two of your shower with cold water. If you are very temperature sensitive start with it on your arms and legs and then gradually move to the trunk.
  3. Eat in a 11-12 hour window. Allow the bodies waste systems to function effectively by giving them a reasonable window to operate with. This is particularly important if you suffer from brain fog as a result of tiredness. This is really fairly straightforward and may just see you have breakfast at 8am and dinner at 7pm.
  4. Reduce your exposure to blue light from computers and devices. This could involve using blue light blocking glasses however a lower cost solution is as simple as switching off all devices at least one hour before your bedtime. Blue light blocks the production of melatonin and results in more difficulty in getting to sleep. Low melatonin will also reduce the ability of the mitochondria to repair themselves and result in a worsening of fatigue.
  5. Sleep in complete darkness using blockout curtains and turning off all lights and devices. Good quality sleep is essential for energy as cell repair happens during our deep REM cycles. Typically if you aim for 7-8 hours of sleep you will have between 3-5 REM cycles. Each cycle tends to be longer with the first being about 90 minutes. For more information on improving your sleep quality read my blogs on Can you build up sleep Pressure and Six Sleep Myths Debunked
  6. Reduce inflammation in your diet as much as possible. Chronic inflammation reduces your ability to produce energy in your cells. The first step could be avoiding any known allergens or intolerances and the second to try and ensure that you are having at least three cups of vegetables a day. For more information on reducing inflammation my blog on Post Viral Fatigue has some useful resources. More generally to understand which vegetables are most useful for your health What are the best vegetables for feeding your gut ?

There are also a range of strategies to improve energy using tailored diet plans and supplements however these need to be prepared in consultation with a practitioner to ensure that underlying triggers are identified and addressed.

Christine Pope is a naturopath and nutritionist based at Elemental Health at St Ives. You can make appointments on 02 8084 0081 on online at Elemental Health .

Terry Wahl’s diet for Multiple Sclerosis

shutterstock_227550832At the Bioceuticals Symposium in Melbourne recently I was fortunate to hear from keynote speaker, Dr Terry Wahl’s on the program which put her Multiple Sclerosis into remission. One of the refreshing things about this presentation was the strong focus on diet first, then exercise second and then supplements. The benefit of this approach is that it isn’t just suitable for MS but also anyone suffering from an autoimmune disease and current indications are that this could be in excess of 20% of the population.

Dr Wahl’s was diagnosed with MS in 2000 and used conventional therapies to manage the symptoms. She deteriorated to the extent that she was in a tilt wheelchair and needing to resign from her position at the hospital. Motivated by the downward spiral and with a background in clinical research she started looking for options in the medical literature and looked more broadly at other degenerative conditions such as Parkinson’s and Huntingdon’s disease. The drug therapies being tested were decades away so her research then led her to vitamins and supplements. What she found was a number of nutrients that slowed the pace of her MS but did not resolve the underlying condition. After discovering Functional Medicine in 2007 she decided to redesign her diet to try and incorporate those nutrients from food. This had such a significant impact that she went from a wheelchair to walking in one year.

The basis of her program is significant dietary change, basically flooding the body with nutrients. This is done by removing gluten, dairy and sugar and replacing it with a lot of nutrient dense vegetables and phytochemical rich fruit as well as small amounts of good quality protein and fats. The program encourages the use of butter which has been demonised for so long although ideally only the butter of grass fed cows so its rich in nutrients. It also includes small amount of organ meats, ideally organic, for their nutrient density. So pate is back on the menu but you can’t eat it with bread!

Key components of the diet are as follows;

  1. Up to 9 cups a day of vegetables and fruit of which ideally 3 cups are green leafy vegetables and 3 cups are sulphur containing vegetables and the remaining are brightly coloured vegetables and fruit.
  2. Small quantities of good quality protein ideally grass fed or organic.
  3. Fermented foods in small quantities initially to assist in feeding beneficial gut bacteria.
  4. Seaweed to provide adequate amounts of the essential mineral iodine
  5. Organ meats such as liver or heart once or twice a week, these should ideally be organic but particularly important to have organic liver as many toxins can be stored in the liver.
  6. Good quality fats such as olive oil and  grass fed butter.

For more information on the specifics of this diet her book is invaluable and she also has many resources on her website including meal plans.

In addition to the dietary changes, adequate sun exposure for Vitamin D as well as regular exercise are critical. Typically exercise is often difficult for MS patients however she recommends working with a suitably qualified exercise therapist to ensure that activity is appropriate and builds up gradually. The advantage is that regular exercise increases the number of mitochondria which assist in building energy, so this is helpful with the fatigue associated with MS and other auto-immune conditions.

Christine Pope is a Naturopath based at Elemental Health at St Ives and can be contacted for appointments on 8084 0081. Christine works with clients to optimise the diet and support them with supplements and herbal medicine.

Are you reacting to your dinner ?

If you constantly have an upset stomach, headaches or skin problems chances are you have thought about whether something you were eating was triggering your symptoms. So what options are there for finding out whether a food is upsetting you ?

The medical testing for allergies consists of either skin prick testing to determine if a substance provokes a reaction or blood testing for antibodies to Immunoglobulin E known as RAST testing. Naturopathically there are a number of other options including an Elimination Diet,  Food Intolerance Panel or Bio Compatability Hair Testing. So what are the advantages of each of these forms of testing ?

Skin prick testing involves scratching the skin with a range of allergens to see what generates a reaction. Usually done by a specialist you do need to be under supervision if a topical reaction causes full on anaphylaxis to an allergen so that you can be treated appropriately. Understandably many parents are not enthusiastic about this option however it does accurately identify  true allergens. A blood test to detect antibodies can be done where the skin prick testing is too invasive. It detects antibodies to specific allergens such as dust, pollens and foods.

Another option for determining intolerances is to use an elimination diet. Basically you eat very simple plain foods for 7-10 days  and then gradually introduce new foods to determine if it provokes a reaction. The elimination diet generally takes up to 6 weeks but has the advantage of being focussed on real food. Ideally you would also exclude any of the foods below that triggered a reaction.

What you can eat on a food sensitivity elimination diet:

  • Vegetables, well-washed (preferably organic), eliminate nightshade vegetable (such as eggplant,tomato and capsicum) if you suspect they are a problem
  • Fruits, well-washed (preferably organic), start with berries initially
  • Meat and fish (preferably organic and free range meats and wild fish)
  • Fats and seasonings – Extra-virgin coconut oil for cooking, and extra-virgin olive oil for dressings and other low-temperature applications, sea salt, herbs
  • Drink: only water (filtered if possible)

Naturopaths often conduct a food intolerance panel which looks for an immunoglobulin G reaction. It’s useful but will usually only tell you about foods you have been eating in the past few months. So if you haven’t had wheat for a year it may not show up.

Recently I have also looked at Biocompatibility Hair Testing conducted by Naturopathic Services. It has the advantage of not requiring a blood test and covers 500 widely available foods including a significant list of health foods. The test is reasonably priced and far less invasive for young children. It also has the advantage of covering foods which the client isn’t currently consuming. Blood testing will only reveal antibodies to a food that you are currently eating.

Other practitioners I know who use the test advised that it was making a big difference in cases involving skin and irritable bowel syndrome, two conditions I see frequently in clinic. Certainly in the last few months I am already seeing some significant changes in symptoms simply from removing aggravating foods from the diet.

If you have any questions about testing for food intolerances email me at Christine@elementalhealth.net.au or you can make an appointment on 8084 0081.

 

 

 

 

 

http://kidshealth.org/en/parents/test-ige.html

Back to grassroots

bigstock_homeopathy_7963486Spending a weekend in Hobart for a homeopathic conference is a good way to really focus on your practice. You query whether there is a better or faster way to get people well. Is someone else going to give you a gem that makes homeopathy crystal clear and straightforward? Well like a lot of homeopathic practice there were a few insights but I still feel I need to do more work and study.

Dr Joe Kellerstein, the keynote speaker, pvovided a good structure for case taking with his four quadrant approach. Reassuringly I recognised most of the key areas and took out of it some useful ways to drill up or down with questioning.

For perhaps the first time at a conference I also quickly recognised the homeopathic medicines presented. Now it was fairly easy with the Solomon Island’s homeopathy by numbers however identifying a homeopathic medicine I rarely use in a complex case was a bit more exciting.

The other aspect of any conference which is always useful is catching up with colleagues, particularly interstate ones who I haven’t seen since the last conference. The last night a few of us headed down to the Lark Distillery for a whiskey tasting and a great seafood meal at The Drunken Admiral. This was a real highlight for me as like so many small business people homeopaths are often isolated and it is good to be reminded that you have a “tribe” .

Usually with courses I am happy if I get one or two useful things which improve my practice. So what did this conference give me? I guess reassurance that I was on track with my case taking and remedy knowledge and perhaps a reminder to reconnect with my homeopathic roots a little more often.

Water Medicine in the Solomons

Island

At the 2014 Australian Homeopathic Medicine Conference in Hobart, Jane Lindsay, a Queensland homeopath, shared her experiences in the Solomon Island’s. Homeopathy was originally brought out by the missionaries from the South Sea Evangelical Church as a way of looking after their own health and that of their congregations over a hundred years ago. Today is is prescribed by 150 dispensers as a primary form of health care for over 60,000 people in the Solomon’s. They use a simple numbering system as the common language is a form of Pidgin English. Symptoms can include such gems as “Belly Stop” and “Belly Run”.

The homeopathic medicines are numbered and the dispensers have simple symptom descriptions to decide which medicine is appropriate. Originally starting with 36 remedies now it has expanded to 51 as changes in the population’s diet and the introduction of vaccines has created the need for additional homeopathic medicines. (Jane also shared that they would love any materia medica’s that were no longer needed as they don’t have access to a lot of books)

bigstock_Homeopathic_Medicine_3415467

I really resonated with the idea of a simple number of medicines as I am always surprised by how many clients, once they do my first aid workshop, are able to successfully treat a range of illnesses and injuries. My favourite story was a client who travelled to Israel with her small first aid kit and treated her family’s headaches, PMS and stomach upsets.

This system seems to work reasonably well and it really brings into question for me why as homeopaths we seem to have so many medicines (I have over 600 in my own dispensary!!). I really think we might be better off focusing on a smaller group of better understood medicines rather than trying to choose own of the 1000 in our books. Are we over complicating it for ourselves as homeopaths and making it harder to practice?

So what do you think?