It would also include the same thorough physical examination and diagnostic tests that would be performed conventionally.

Less testing might be done if the practitioner is more comfortable with a structural examination.

Bodywork and Body Movement

Maintaining the structural alignment of the muscles, tendons, joints, bones, and fascia (the lining of muscle) is an essential component of the holistic treatment for chronic back pain. Several treatments by an osteopathic physician, chiropractor, or other trained or certified practitioner may be needed.

Lasting benefit is most likely to be obtained with the more indirect  of treatments, such as myofascial release or craniosacral osteopathy. The more direct or high velocity thrusting techniques, which force areas that are out of alignment back into alignment, are usually more helpful with acute injuries than with chronic back pain.

However, other forms of osteopathic or chiropractic treatments, which usually consist of gender techniques, can be helpful in some cases of chronic pain. But if these modalities or any other form of therapy do not offer noticeable improvement after three to six treatments, it is important to evaluate whether to continue.

Physical therapy performed by a highly skilled therapist using a variety of modalities, such as heat, ice, ultrasound, and electrical stimulation, is often helpful. However, these are adjunct therapies and are not substitutes for structural treatment. They are unlikely to provide lasting relief with chronic pain when used alone. Standard physical therapy often utilizes strengthening exercises to overcome areas of weakness or misalignment. A holistic treatment program is designed to help the body to realign itself, thus healing the weakness and directly treating the cause of the problem.

There are several other forms of bodywork or body movement therapies that may be helpful in treating chronic low back pain. These therapies utilize methods to retrain the nervous system to improve posture, alignment, balance, coordination, and self awareness. They can help you to move more efficiently and to be more aware of your body and how it works. Some of the more common body based therapies include Trager psychophysical integration, Feldenkrais awareness through movement, the Alexander technique.

These approaches often involve both hands-on treatments and instruction from the practitioner for exercises to be done by the patient at home. These exercises can directly address the cause of the back pain by helping the body to integrate its functions and resolve areas of dysfunction. These practitioners are becoming much easier to find. You can either evaluate them on your own or you can obtain a referral from a holistic physician.

Exercise

Yoga has demonstrated remarkable success in both treating and preventing chronic low back pain. Find a teacher, a class, or a videotape, and start out veiy gradually. Remember DON’T PUSH YOURSELF. If you keep it slow and steady, practicing every day, you might very well end up with a healthier back than you had prior to the onset of your back pain.

If you do not practice yoga, you should at least do several stretching exercises every day. A physical therapist can teach you, or you can refer to the book Stretching by Bob Anderson.

Brisk walking, swimming, or any other gentle form of aerobic exercise is recommended for treatment and prevention of chronic backache.

Acupuncture

Acupuncture may be helpful both for both acute and chronic back pain. It may offer substantial and long lasting relieve and it often works wells in combination with structural approaches. The sooner the problem is addressed with acupuncture, the better the chance that it will work.

Hydrotherapy

Hot baths with mineral salts (Epsom salt) and/or the following essential oils:

chamomile, marjoram, lavender, or a combination of wintergreen, camphor, and eucalyptus. These same oils can also be applied as a hot compress or massaged into the back. There are also exercises that can be performed in a hot shower or bath.

Sleep support

Be sure your bed provides good support. Waterbeds and soft mattresses should be avoided.

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Please see your own physician before embarking on any treatment program for pain. We doctors treated pain patients by ourselves back then, without the help of a psychologist to handle emotional upsets, without the assistance of a skilled social worker to identify and rectify certain home problems, without dentists, chiropractors, physical therapists and others at our sides

This began to change toward the end of the 1960s as allied health professionals fought to have their voices heard. By the 1970s, many new treatments were used for chronic pain biofeedback, meditation, acupuncture, nutrition, hypnosis, electrotherapy, group therapy and  other modalities that proved their value.

The power also began to shift from the physician back to the patient, where it belonged and we learned that pain must be treated as a multifaceted problem, strongly influenced by the things that make a person who and what he or she is .

Here are eight important points that I use as a basis for building anti pain programs for many of my chronic pain patients.  They are designed to strengthen the patient mentally and physically so the body has the best possible chance to heal.

1. Take control of your health
2. Assemble a multi disciplined team to assist you
3. If you’re overweight, slim down.
4. Working with your physician, eliminate as many of your medications as you safely can
5. Use the appropriate nutrients to strengthen natural defenses
6. Use DLPA, as necessary, to relieve pain and lift your mood
7. Exercise as much as possible you can always do some exercise, even while sitting in a chair
8. Believe that you are going to get better.

Now, let’s take a closer look at the eight point.

1. Take control of your health. We doctors have been telling people to passively wait for us to “fix” them. We were wrong. Healing is quickest and most sure when the patient takes control of his or her own health, playing an active role in the decision making and the treatment.
2. Assemble a multi disciplined team to assist you. The chronic pain equation is complex and too difficult for a single healer to solve. There are many factors contributing to pain: the patient, the patient’s feelings and fears, the doctor’s attitude, the “germs,” the medicines and treatments, the family and more. There is rarely a single cause for chronic pain. It often takes a team of experts, including perhaps a neurologist, orthopedist, chiropractor, physical medicine specialist, physical therapist and psychologist, to solve complex pain problems. The team should be led by your personal physician, the one who knows you best and whom you trust.
3. If you’re overweight, slim down. I have seen many patients whose pain was worsened by their obesity, and many who felt much better when they shed their excess pounds. Not only that, but eating a low fat, low cholesterol diet based on fresh vegetables, fruits and whole grams and small amounts of lean meat and nonfat dairy products means that you’ll have fewer other diseases to complicate your pain. Vegetables are sources for many vitamins, minerals and enzymes, as well as dietary fiber A diet including plenty of vegetables also lowers blood fats If you cook your vegetables, do so for as short a time as possible just until they are tender and crisp. Eat more raw than cooked vegetables, as cooking destroys many vitamins and minerals. Fruits are packed with vitamins, minerals and fiber and are appetizingly sweet. Eat them whole and fresh, rather than cooked, canned, frozen or dried two to four fruits per day are recommended.  Whole grains are rich sources of B vitamins, minerals, fiber, low fat protein and complex carbohydrates. Use whole grains as cereal or in breads and pasta The number-one ingredient in breads, cereals or pasta should be a whole grain. Legumes are dried beans and peas, such as black beans, garbanzos, Great Northern beans, kidney beans, lentils, lima beans, red beans, small white beans and split peas. Legumes are high in vitamins Bi, B6 and others. They’re high minerals such as iron and copper, high in fiber, low in fat and contain up to 20 percent protein.  Protein provides the building blocks of the body’s structures, muscles, organs, tissues, even fluids. It also helps to stabilize the blood sugar. Eat two to three small servings of low-fat protein daily, such as vegetable proteins, fish and white meat of chicken or turkey. Dairy products are the most concentrated and easily absorb able source of calcium. Drink nonfat milk or buttermilk, eat plain nonfat yogurt or low-fat cheese. Two to three servings per day are recom- mended to help prevent the thinning of the bones (osteoporosis). Nuts and seeds are delicious, but are also high in fat. Use them  sparingly, just to add flavor or runch to your foods. Avoid salted,  roasted or coated nuts and seeds.  Water is a terrific weight loss aid, as it actually helps to reduce water retention. And we need lots of water to ensure proper functioning of the kidneys as well as replenishment of fluid to all of the body’s cells. Drink eight or more 8-ounce glasses of water daily.
4. Working with your physician, eliminate as many of your medications as you safely can. Many patients have come to my office with grocery bags filled with the 20 to 30 medications they’ve been given. The inevitable side effects of drugs complicate matters, often making patients feel worse. Simply stopping the unnecessary medications has helped many patients.
5. Use the appropriate nutrients to strengthen your natural defenses. The following is the basic supplementation plan I use for pain, modifying it to each patient’s needs.
6. Use DLPA as necessary to relieve your pain and lift your mood. When appropriate, I start my chronic pain patients on 375 mg of DLPA, three times a day taken right after breakfast, lunch and dinner. If there is no improvement, I increase the dose to 750 mg, three times a day. It takes about a week to begin to feel the improvement.
7. Exercise as much as possible. Exercise helps to keep the muscles strong, “lubricate” the joints, burn off calories and help you feel good about yourself. Whenever possible, and without hurting yourself, get out there and exercise. Even if you can only walk around the block, keep active. Almost everyone can do some form of exercise.
8. Believe that you are going to get better. Several years ago, doe toes at the University of Tennessee Center For Health Science measured the endorphin levels in 32 patients who were suffering from chronic pain. Then they gave the patients a placebo, a “sugar pill” that had no medicinal effect, although they told the volunteers that this was a medicine that would help relieve their pain.

Sometime later, 14 of the 32 reported feeling better. That’s not unusual, because the “placebo effect” works 30 to 40 percent of the time. What was unusual, however, was that when the doctors retested
those 14, they found that their endorphin levels had gone up. It was the endorphins, not the placebos, that relieved the patients’ pain. But what made the endorphins rise? Not the placebo, but the patients’ be- lief Just by thinking they would get better, they changed their bio- chemistry (increased their endorphins) and healed themselves.  This study, and others like it, prove that what we believe plays an important role in our health. That’s why it’s important to believe that you can and will get better. Strong belief is a very powerful medicine.

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1. Drugs That Can Cure Chronic Pain

Anticonvulasant, for example, which were originally developed to cure epilepsy, can diminish some types of shooting pain. Antispasm medications, also called muscle relaxers, control muscle spasm and thereby cut back on pain that stems from this source.

But the drugs that can cure chronic pain are, surprisingly the antidepressants.

Why is this so?

Endorphins, the natural painkillers produced by the brain and the spinal cord, are not effective unless the brain also produces adequate levels of the natural antidepresaant serotonin, just as people with depression do. Antidepressant medications, by raising the amount of seretonin available to the nervous system, increase the effectiveness of endorphins and thus relieve pain.

So these drugs could just as well be called “endorphin enhancers” or the like. The point is that they are multipurpose drugs, so you don’t have to be concerned about the psychological connotation of their name.

The most commonly prescribed antidepressants painkillers that are particularly good to cure chronic pain are Sinequan, Elacil, Pamelor, Norpramin and Tofranil.

It is a good idea to talk with your doctor about antidepressants and the other drugs discussed above. Not all doctors are aware of what pain specialists have discovered about the pain uses of these drugs. Most likely he or she will want to follow up on this information, but if not, you might want to review the matter with a pain medicine specialist.

My conviction is that antidepressant painkillers  drugs,, in particular, can be a highly valuable part of a pain management program. One of their greatest advantages is that they can help you sleep. Quite often, when i put patients on antidepressants, they report sleeping better almost immediately and many, within a fairly short time, are sleeping well for the first time in years.

So good sleep can be encouraged by the use of appropriate medications, but just as critical are the attitude you develop and the ations you take in order to sleep better.

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1. How To Deal With Chronic Pain

The tissue damage message is conveyed by nerve fibers to the spinal cord and then to the brain. These messages are coalled nociceptive stimuli.

They have a purpose. They tell the brain that tissue damage has occurred. And the body reacts reflexively to protect itself. If you have put your hand on something hot, for example, you pull it away. If you have struck your finger with a hammer, you rub it. If an injury illness seems to be severe, you seek medical attention.

Chronic Pain tells us ” Go and get help.” If we didn’t have that signal, we could die, because we wouldn’t seek to avert the damage that was taking place. Thus, acute pain, despite the suffering it creates, is an important ally.

With treatment, and in time, the tissue damage caused by an injury or an illness heals. Gradually pain diminishes. That red light telling you that something is wrong begins to fade. Finally it turns itself off completely, and you feel like yourself again.

You pain began the same way, with an accident, an operation, an illness, or perhaps something you weren’t aware of at all. You felt pain perhaps in your lower back, abdomen, neck, or head and you sought help. But with the passage of time the pain hasn’t really diminished, though its quality may have become more “nagging” than acute. Or it may have even grown worse.

When pain continues longer that the medical profession would expect a simmilar condition to last, it is termed “chronic pain”. Back pain for example, is usually considered chronic when it has lasted more than three months.

The odd thing is that in most cases a medical examination will show that the body has healed. And the physiological changes that accompany acute pain increased heart rate and respiration, among others have returned to normal. There seems to be no substantial for your pain. Still, you are hurting.

If chronic pain affected only a few people, we might think they were ‘imagining” it in some way. But more than fifty million people in this country suffer from chronic pain. Sq we have to assume that chronic pain is a problem that has not been fully understood by the medical profession.

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