Group Wellness Program relieves Pain per Henry Ford Center

DETROIT, Aug. 3, 2011 /PRNewswire/ -- A group wellness program has been shown to significantly relieve pain and stress, and improve stress-related chronic illnesses, according to Henry Ford Hospital researchers.

Henry Ford's Center for Integrative Wellness conducted on-site group wellness programs for local corporations to improve employee health and wellness, and found participants were able to reduce and eliminate chronic pain of all types, while simultaneously alleviating stress.  

The results of the controlled clinical trials will be presented at the Hospital Association of Southern California's Hospital Wellness Conference in Los Angeles, August 4.

According to the American Academy of Pain Medicine, one out of four Americans has persistent or chronic pain with an estimated annual cost to employers of more than $61 billion in lost productivity. The leading causes of recurrent or persistent pain affecting Americans are headache pain, back pain, and neck pain.

"Reductions in disability, depression symptoms, perceived stress, and sleep disturbance were reported by program participants," says Robert A. Levine, Ph.D., director of the center. "Results also showed improvement in stress-related conditions such as high blood pressure, diabetes, obesity, anxiety, and fatigue."

The researchers looked at more than 1,400 program participants since 2007 and found: 

• 76% of chronic pain conditions were improved
• 39% of all chronic pain conditions were eliminated (defined as average score of "0" on a 0-10 scale), including back, neck, hip, sciatica, shoulder, knee, headache, and abdominal pain
• 74% of participants reduced their stress
• 50% of reported stress-related conditions (including high blood pressure, diabetes, high cholesterol, allergies, anxiety, fatigue, gastrointestinal distress, etc.) were improved
• 70% of participants were able to eliminate the need for and use of pain medications

The multi-session group wellness programs, delivering 18-24 hours of in-session time over several months, work simultaneously with the mind and body to produce stress relief and release muscles in excess contraction that contribute to pain.

Program participants learn simple movement techniques and strategies to sense and regain control of their muscles, leading to noticeable improvements in pain, stiffness and mobility, as well as improvements in stress-related conditions. They also learn to relax, breathe properly, and intervene with unwanted thought patterns and stress reflexes that contribute to pain and stress.

"Chronic pain and stress are intricately related and the importance of stress as a causal and/or aggravating factor in most chronic illnesses cannot be underestimated," says Alba Rodriguez, Ph.D., associate director of the center.  "These group programs have proven to be more effective than other approaches, and are more efficient and less expensive than most one-on-one care, whether conventional or alternative."

The programs were recently recognized by American Hospital Association in its Creating a Culture of Health report, namingHenry Ford as one of seven hospitals nationwide that are examples of best practices in wellness programs.

BALANCE IN EFFECTIVE CHRONIC PAIN MANAGEMENT

Seeking Balance for Effective Chronic Pain Management

Posted on Saturday, July the 16th at 3:28pm

By: Dr. Stephen F. Grinstead, LMFT, ACRPS, CADC-II

To find a balance point you must be able to identify what the extremes are that you need to balance. Below you will see each of the target five balance points you need to strive to obtain in your life. In the remainder of this article you will see what the extremes of each point are and why it is important to find the healthy balance point in each of the five areas.

•    Positive Self-Talk
•    Appropriate Emotional Expression
•    Healthy Support Network
•    Spirituality/Humility
•    Effective Pain Management

Most people pay little attention to all the random thoughts that go through their head each day. Unfortunately, this is not the best way to go through life if you want to thrive. Here is a quote by the Dalai Lama that I especially like: Watch your thoughts, for they become words. Choose your words, for they become actions. Understand your actions, for they become habits. Study your habits, for they will become your character. Develop your character, for it becomes your destiny.

Balance Point One: Positive Self-Talk

Balance Point One is positive self-talk. On one end of this continuum is repressed self-talk. When you are at this end you do not pay attention to your thoughts, and eventually they will create your destiny. It is important to monitor your thinking patterns so you do not create negative consequences for yourself.

At the other end of this balance point is negative self-talk. You covered some of this type of thinking earlier when you learned about anticipatory pain and pain versus suffering. Another way this plays out for people living with chronic pain is the negative thinking can worsen depression or self-hatred. Both ends of this spectrum put you at risk of hurting yourself. Some people hurt themselves by trying to medicate this condition while others go for the long-term solution to a short-term problem—suicide.

The premise for striving for this positive self-talk balance point is; if you change how you think, it will start changing how you feel. If you can change how you think and feel, it will change the decisions you make and the actions you take. If you change your behaviors to more positive habits and make them habitual, you will feel better about yourself and obtain a more positive way of life—your destiny. Some people need to start by thinking their way into positive behaviors while others might need to behave their way into healthier thinking—I recommend doing both.

Balance Point Two: Appropriate Emotional Expression

A trap I see some people fall into is labeling feelings or emotions as either good or bad. I do not believe in “good” or “bad” emotions. I do believe that many emotions can however be comfortable or uncomfortable. Some emotions such as happiness or joy are sought after, while other emotions like fear or loneliness are to be avoided at all costs. This type of paradigm can lead to going to one dangerous end or the other of this spectrum.

As with the first balance point appropriate emotional expression also has a continuum of extremes. One end of the spectrum is becoming emotionally numb. For some people this numbness is chemically enhanced or induced. But for most people the numbness is more of an acquired defense mechanism due to a constant barrage of living with extremely uncomfortable emotions in addition to high levels of physical chronic pain. This numbness can lead to pushing friends and loved ones away or becoming hopeless.

Then there is the other extreme—emotional over-reaction. The example I like to explain this one is to imagine being in a situation that triggers anger. The trigger might be getting cut off in traffic or having someone cut in front of you when waiting in a line for services. For most people this might trigger two pounds of emotional response—getting mad or frustrated. Unfortunately, people at this end of the spectrum might react with twenty pounds of pressure—rage or even blind rage. So it is with other uncomfortable emotions like fear, sadness, loneliness, anxiety, etc.

Another problem with this balance point is that some people can vacillate between the two extremes and never stop at the balance point. The first step toward appropriate emotional expression is being able to recognize, articulate and rate your emotions. Once this is accomplished the next step is learning how to appropriately express your emotions. Making better choices on what to say and do when you experience emotions, especially strong uncomfortable emotions, will lead to much more positive outcomes for you and those around you.

Balance Point Three: Healthy Support Network

It is extremely important to build a chronic pain support network for yourself. This balance point of a healthy support network also has two dangerous extremes—isolation and enabling. Let’s start with the isolation extreme. This is usually fueled with the belief that I have to do it myself. Sometimes this is coming from a power position because of a mistaken belief like “I can’t trust/depend on others.” While for other people the mistaken belief might be “I have to do it myself because I’m no good; or nobody is there for me.” Either way you lose the chance to have someone in your corner when it really counts.

The other end of this continuum is enabling. Some people at this end have developed a system of “support” where they overly depend on others—even when they can and should be doing things for themselves. The denial pattern of Fear of Change, usually leads to this type of system. I’ve seen some of my patients recognize this and want to change and gain their power back and the old enabling support system goes crazy. The enablers are also stuck in the Fear of Change defense pattern. Again that is why you have had many opportunities in this book to learn about building a healthy support network.

People are not enabling you if you really do need support in achieving a goal and you do not in fact have the ability or means to do it by yourself. You need to do this chronic pain management journey for yourself—but not by yourself. It takes a collaborative team approach to obtain the best chronic pain management plan. This team must be comprised of professional healthcare people along with other guides and coaches in order for you to obtain true freedom from suffering and move on to thriving.

Balance Point Four: Spirituality/Humility

The next balance point of spirituality/humility also has problematic extremes. Here too people can vacillate between the extremes and never stay in the middle. On one end of the spectrum people are at risk for moving into pride and/or arrogance while at the opposite end is shame and guilt.

As mentioned in one of my earlier articles, spirituality is a complex and multidimensional part of the human experience. It involves beliefs, perceptions, thinking, feeling, experiential and behavior aspects. The thinking or belief and perception aspects include the search for meaning, purpose and truth in life and the beliefs and values by which a person lives their life. The experiential and emotional aspects involve feelings of hope, love, connection, inner peace, comfort and support. The behavior aspects of spirituality involve the way a person externally demonstrates their individual spiritual beliefs and inner spiritual state.

When people are at either end they close themselves off to the spiritual energy that will enhance their quality of life and improve their pain management. When in pride and/or arrogance the mistaken belief is I am in control. Well sometimes that can be a good thing; however, when people mistakenly believe they are in control when they really aren’t they can experience a lot of trauma and drama in their lives as well as pain and suffering. False pride—or arrogance—also keeps you from reaching out to others for appropriate and healthy support.

The other end of the spectrum has its own negative consequences if you get stuck in shame and guilt. I believe that healthy shame and appropriate guilt have a place in our lives. This problem I’m talking about here is toxic shame and dysfunctional or paralyzing guilt. Healthy shame lets us know we have limits. Toxic shame leads us to seek dangerous cover-ups to cope with it. Appropriate guilt lets us know what our behavior needs modification. Dysfunctional guilt leads us to becoming over-responsible and accepting blame that we really don’t merit. In addition, shame and guilt also keeps us from reaching out to others.

Balance Point Five: Effective Pain Management

This last balance point of effective pain management is what this article is all about. The two extremes here are ignoring pain or suffering. I believe that there are times when ignoring pain—or avoidance by healthy appropriate distraction—can be a good thing. I don’t believe it is ever a good thing to be in suffering from your pain—freedom from suffering is your right and your responsibility.

Ignoring pain becomes a problem when you are not listening to what your pain is trying to tell you. When you’re not listening it is impossible to take appropriate action. In fact, ignoring pain will often lead to suffering—sometimes quickly and sometimes it may take awhile. One common reason many people ignore their pain is the mistaken belief that if I ignore my pain, it will go away. Another reason is that sometimes your ignoring the pain is because you don’t know what else to do about it.

Effective chronic pain management is often a challenging and sometimes frustrating journey. Achieving these five balance points can help smooth out your journey and lead to more hope and happiness. I want to end with my favorite Sanskrit Proverb below.

Today well lived, makes every yesterday a dream of happiness, and every tomorrow a vision of hope.

11 Chronic Pain Control Techniques- Some Helpful Ideas!

11 Chronic Pain Control Techniques

By: Andrew R. Block, PhD

To prepare for any chronic pain coping technique, it is important to learn how to use focus and deep breathing to relax the body. Learning to relax takes practice, especially when you are in pain, but it is definitely worth it to be able to release muscle tension throughout the body and start to remove attention from the pain.

Coping techniques for chronic pain begin with controlled deep breathing, as follows:

• Try putting yourself in a relaxed, reclining position in a dark room. Either shut your eyes or focus on a point.
• Then begin to slow down your breathing. Breathe deeply, using your chest. If you find your mind wandering or you are distracted, then think of a word, such as the word "Relax", and think it in time with your breathing...the syllable "re" as you breathe in and "lax" as you breathe out.

• Continue with about 2 to 3 minutes of controlled breathing.
• Once you feel yourself slowing down, you can begin to use imagery techniques.

Eleven specific imagery and chronic pain control techniques that are effective for pain control include:

1. Altered focus
   This is a favorite technique for demonstrating how powerfully the mind can alter sensations in the body. Focus your attention on any specific non-painful part of the body (hand, foot, etc.) and alter sensation in that part of the body. For example, imagine your hand warming up. This will take the mind away from focusing on the source of your pain, such as your back pain.
2. Dissociation
   As the name implies, this chronic pain technique involves mentally separating the painful body part from the rest of the body, or imagining the body and mind as separate, with the chronic pain distant from one’s mind. For example, imagine your painful lower back sitting on a chair across the room and tell it to stay sitting there, far away from your mind.

3.      Sensory splitting
This technique involves dividing the sensation (pain, burning, pins and needles) into separate parts. For example, if the leg pain or back pain feels hot to you, focus just on the sensation of the heat and not on the hurting.

4.      Mental anesthesia
This involves imagining an injection of numbing anesthetic (like Novocain) into the painful area, such as imagining a numbing solution being injected into your low back. Similarly, you may then wish to imagine a soothing and cooling ice pack being placed onto the area of pain.

5.      Mental analgesia
Building on the mental anesthesia concept, this technique involves imagining an injection of a strong pain killer, such as morphine, into the painful area. Alternatively, you can imagine your brain producing massive amount of endorphins, the natural pain relieving substance of the body, and having them flow to the painful parts of your body.

6.      Transfer
Use your mind to produce altered sensations, such as heat, cold, anesthetic, in a non-painful hand, and then place the hand on the painful area. Envision transferring this pleasant, altered sensation into the painful area.

7.       Age progression/regression
Use your mind’s eye to project yourself forward or backward in time to when you are pain-free or experiencing much less pain. Then instruct yourself to act "as if" this image were true.

8.      Symbolic imagery
Envision a symbol that represents your chronic pain, such as a loud, irritating noise or a painfully bright light bulb. Gradually reduce the irritating qualities of this symbol, for example dim the light or reduce the volume of the noise, thereby reducing the pain.

9.      Positive imagery
Focus your attention on a pleasant place that you could imagine going - the beach, mountains, etc. - where you feel carefree, safe and relaxed.

10.   Counting
Silent counting is a good way to deal with painful episodes. You might count breaths, count holes in an acoustic ceiling, count floor tiles, or simply conjure up mental images and count them.

11.    Pain movement
Move chronic back pain from one area of your body to another, where the pain is easier to cope with. For example, mentally move your chronic back pain slowly into your hand, or even out of your hand into the air.

Some of these techniques are probably best learned with the help of a professional, and it usually takes practice for these techniques to become effective in helping alleviate chronic pain. It is often advisable to work on pain coping strategies for about 30 minutes 3 times a week. 

With practice, you will find that the relaxation and chronic pain control become stronger and last longer after you are done.

Sometimes, after you are good at using the techniques, you can produce chronic pain relief and relaxation with just a few deep breaths. 

You can then start to use these techniques while you are engaged in any activity, working, talking, etc. With enough experience you will begin to feel a greater sense of control over the chronic pain and its effects on your life.

  Article written by:

  Andrew R. Block, PhD

Article on Managing Chronic Pain by Karen Lee Richards

How I Manage My Chronic Pain, by Patient Expert Karen Lee Richards ProHealth.com by Karen Lee Richards July 14, 2010 Karen Lee Richards is Lead Expert specializing in Fibromyalgia and ME/CFS, for HealthCentral's ChronicPainConnection.com. She is a co-founder of the National Fibromyalgia Association, a former Executive Editor of the NFA's FibromyalgiaAWARE magazine, and a long-time contributing writer for ProHealth.com. ____________________ “Over the years, I have gradually found a number of things that have helped improve many of my symptoms. The key is, I don't stop trying.” -Karen Lee Richards I am often asked, “What is the best treatment for fibromyalgia?” or “What is the best pain medication?” I wish there was an easy answer. The truth is, we are all very different, particularly when it comes to medications and alternative treatments. What works very well for me may not work at all for you – or may even cause adverse reactions. Each of us has to embark on our own personal journey to discover what works best for us. One thing I can tell you is that I've never talked with anyone who has successfully managed fibromyalgia or any other chronic pain condition just by taking medication. It pretty much always takes a combination of medication, complementary therapies and lifestyle adjustments. Even though we each have to find our own individualized treatment plan, there is value in learning what has worked for someone else because it just might work for you, too. Generally speaking, treatments that are considered to be effective will usually work for about 30% to 40% of the people who have that particular condition. I know firsthand how frustrating it is to try one treatment after another and nothing seems to work. But don't give up. Eventually you will begin to find things that will help. In the end, it's worth going through some trial and error to find the treatment combination that works best for you. What Works for Me I have lived with chronic pain from fibromyalgia and ME/CFS for more than 20 years. Over those years, I have gradually found a number of things that have helped improve many of my symptoms. The key is, I don't stop trying. In fact, in just the last few months I've discovered two new weapons to add to my treatment arsenal. Following are the medications, therapies and lifestyle changes that have made a difference for me. 1.  Medication For the first seven years, I lived with ever-increasing pain while doctors told me it was stress and I was “just getting older.” During that period of time, I took massive doses of ibuprofen, which we now know to be very dangerous. Once I was finally diagnosed with fibromyalgia, my doctor suggested I try tramadol. That turned out to be a huge blessing for me. For the first time in years, my pain levels were down enough that I could function fairly well most of the time - and I even had some periods of time that were pain free! Since that time, three new medications have been approved for the treatment of fibromyalgia, but I have continued to take the tramadol. My philosophy has been, “If it ain't broke, don't fix it.” Tramadol still works well for me and I see no reason to take a chance on something new that may not work as well and may have unpleasant side effects. For the past couple of years, my doctor has also been giving me a prescription of Lortab® to have on hand for breakthrough pain. I generally only take it once or twice a month, when my pain level is up and I have to go somewhere or have a project due. 2.  Complementary Therapies A wide range of complementary therapies may help improve pain and other symptoms of fibromyalgia and ME/CFS. I've heard from people who have found things like massage therapy, yoga, biofeedback, hypnosis, and even bee-sting therapy to be helpful. For me, three complementary treatments have been the most effective: Myofascial Release Therapy – I learned about MRT about 12 years ago. It is similar to massage therapy but much more gentle. Basically, the therapist gently manipulates and loosens your body's constricted fascia, which helps release muscle spasms and ease pain. When I first started MRT, I was walking with a cane. Two months later, I laid my cane down and haven't picked it up since. MRT did a lot to reduce my pain and help my body move and function better. You can read more about MRT here:  “Myofascial Release Therapy” Acupuncture – Acupuncture came into my life about eight years ago when my MRT therapist decided to go back to school to study it. While acupuncture is certainly beneficial for pain, the two areas where I noticed the greatest differences were irritable bowel syndrome and sleep. Except for an occasional flare, my IBS is pretty much under control. Prior to acupuncture, I could never sleep more than an hour and a half to two hours at a time without medication. After starting acupuncture, I could usually sleep for one four-hour stretch, followed by two or three two-hour segments without medication. Here is more information on acupuncture: “Acupuncture” Supplements – I've only been taking supplements on a regular basis for about a year. My most recent find in the supplement world is CoQ10. I've been amazed at how much my energy level has increased since starting it. I take three 100 mg softgels of Ubiquinol (the most usable form of CoQ10) each day. Other supplements I've found helpful for FM and ME/CFS symptoms are vitamin D3 for pain, vitamin B-12 for energy, and acidophilus pearls for digestive health. I'm still experimenting with one new supplement at a time to see what else might prove to be beneficial.   3.  Move/Stretch One of the most important things I've learned is that I need to move as much as possible. Sitting or lying in one position for too long will cause my muscles to stiffen and significantly increase my pain. I try to do a few simple stretches several times a day. If I'm having a particularly bad day, just standing up and doing a few full-body stretches can make a big difference. Exercise can be a tricky thing for FM and ME/CFS patients – especially for those like me who have both illnesses. Fibromyalgia patients are taught that exercise is an essential component of any treatment program, but overexertion can send ME/CFS patients into a tailspin. It's hard to know what you should do. For me, short walks - even just walking through my house - and frequent stretches with plenty of rest breaks in between seems to work best. 4.  Breathe Breathing may sound like an odd “treatment” but I've found that most of us who have FM and/or ME/CFS tend to hold our breath a lot without even realizing it.  I'm not sure why. Perhaps because it's somewhat natural to hold your breath when you feel pain. The problem is, shallow breathing and holding your breath will actually cause your body to be more tense and increase your pain. As strange as it may sound, I try to remind myself to breathe several times a day. I've found that taking several good, deep breaths can help relax me and ease the pain a little. You can learn more about how to breathe properly here: “The Importance of Breathing Properly” 5.  Distraction I learned a long time ago that the more I think about and focus on my pain, the worse it seems to get. So I try to always keep my mind occupied with something else. Following are some of my favorite distractions: Help Others – The more I focus on trying to help others with their problems, the less I think about my own. I spend quite a bit of time each day answering questions and writing articles trying to help others find ways to better cope with their health problems. ProHealth's Message Board is a good place to connect with, help and encourage others: http://www.prohealth.com/blog/index.cfm Laugh – The old saying, “Laughter is the best medicine” has a lot of truth to it. Research has shown that laughter has positive physiological effects on us like reducing pain, stimulating the immune system and improving brain function. Because of that, I regularly record a variety of comedy shows and movies so I always have something funny to watch if I'm having a rough day. Mental Activities – Since I enjoy working with words, I spend some of my free time each day doing crossword puzzles or playing electronic games like Scrabble. Not only do they keep my mind occupied, but I feel like they help improve my cognitive functioning and keep fibro fog at bay. 6.  Sleepwear Three months ago I would never have dreamed that I would be listing sleepwear as a method for coping with chronic pain. But then Goodnighties came into my life. I was invited to become a “Jammie Tester” for a new product line of what was called “recovery sleepwear.” The fabric is infused with negative ions, which are known to have many positive effects like increasing serotonin and melatonin levels, increasing blood flow and oxygen to the brain, and helping us reach REM sleep more quickly. Much to my surprise, I find that since I began wearing Goodnighties to bed every night, I fall asleep more quickly, sleep for five to six hour stretches and awake feeling refreshed – something I hadn't experienced for more than 20 years. On top of sleeping better, the hip and low-back pain I have been plagued with for years is gone. Needless to say, this new sleepwear has become a key component of my treatment protocol. You can read my full review of Goodnighties here: “Goodnighties Recovery Sleepwear: A Product Review” In Summary It's taken me 20 years to put together what I feel is a pretty effective treatment plan for myself. No, I'm not “cured,” and I still have some bad days. But I have a good life and many more good days than bad, which is a drastic improvement. I hope at least a few of the things that have helped me will help you as well. ___ Note: This information has not been evaluated by the FDA. It is general and anecdotal, and is not intended to prevent, diagnose, treat or cure any illness, condition, or disease. It is very important that you make no change in your healthcare plan or health support regimen without researching and discussing it in collaboration with your professional healthcare team.