In part 1 of this series, Your Pain Relief Plan Introduction I discussed why we feel pain and introduced the concept that the degree of pain felt could vary widely from one individual to the next due to lifestyle factors and that when long term, typically over 3 months, the brain would lock the pain in. Emotional trauma, even as far back as childhood, had been found to lock in pain for almost a lifetime.
In part 2 of this pain relief series, I will get into more detail about how pain works and discuss the implications of aging and the differences between acute and chronic conditions and the most effective ways of treating these. But first, a quick look at the brain, how it has evolved and how this relates to processing pain.
The oldest part of the brain is the reptilian brain, which deals with basic survival instincts. Next came the mammalian brain, which added the ability to feel emotion. The third part is the human brain, the Cortex, which gives us our human qualities of cognition, sensory perception and spatial reasoning and is in charge of the human decision making process.
How Pain Works
Your nerves transmit pain signals. Inside your nerves, you have sensors for temperature, stress, movement, pressure, immunity molecules and blood flow. Similar to car sensors, any damage or fault to any of these sensors will put a light on your dashboard, to alert you of a problem. The nerve does the same thing by increasing pain.
These pain impulses travel up the spinal cord, to a part of the brain which acts like a router(called the thalamus) and as a simple analogy, this router makes phone calls to other parts of the brain.
Hence our brains decide, like a panel of judges, how much pain is appropriate for us to experience at any one time
The pain experience is complex and involves many areas of the brain:
1. Body sensation and location
2. Movement – muscles may need to brace the area
3. Focus & concentration
4. Fear response
5. Memory area recalling a previous similar experience
6. Motivation - processes pain
7. Stress response - weight, digestion, sleep, temperature
All seven areas interact to decide on the suffering experienced. This may have little to do with the degree of injury and hence makes it clear that a qualified and knowledgeable therapist is needed to properly diagnose and treat the injury.
The Consequences Of Aging
As we age, we need to put more care into our diet, supplementation, exercise, and our workload. It sounds simple, but many of us fail to even acknowledge that as we get older, we have to change the way we use our bodies. As we age, naturally occurring enzymes are fewer, inflammation is greater, and the production of inflexible scar tissue becomes much more extensive. Therefore, long-term solutions for pain relief also need to address our ongoing biochemical changes.
Sleep quality tends to deteriorate and ongoing deprivation can lead to symptoms virtually indistinguishable from widespread pain, fatigue and diffuse tenderness. Early evidence also shows that anxiety, depression and sleep disturbances have been common reactions to the COVID pandemic. Thus the problems faced by Long COVID sufferers are likely to be with us for many years to come.
What is the difference between Acute and Chronic Pain?
Chronic pain, by its nature, may not be resolvable
Chronic pain is long term pain, beyond 3 months, as the brain has hard wired the pain in by that time. Chronic pain can occur because of numerous conditions, such as emotional pain, joint wear and tear (osteoarthritis), spinal disc thinning, bulging or rupture, bone thinning
Suffering is not related to the degree of injury
(osteoporosis), unresolved tendon or ligament damage, to name but a few. Chronic pain, by its nature, may not be resolvable. It may need a lot more treatment than acute pain to bring down to acceptable levels and will benefit greatly from ongoing maintenance or wellness treatment to prevent reoccurrence.
Modern science confirms benefits of a more holistic approach
The latest neuroimaging technology, which can see the electrical activity in the brain in response to different lifestyles, has allowed the world to delve deeper into the understanding of chronic pain. It has been confirmed that pain is modulated by factors such as attention, anticipation, empathy, placebo, meditation, fear, anxiety, posture, emotion and movement. This, in turn, has confirmed the benefits of a more holistic approach to assessment and treatment.
This new insight into chronic pain helps explain why, for example, X-rays showing the degree of osteoarthritis in joints has no correlation to the pain being felt.
To summarise, we have shown how each person's brain can process pain differently, to the extent that one person may feel tremendous pain, when another, with essentially the same condition, might feel little or no pain at all.
The availability of the latest MRI scanning technology has verified that many non-physical factors can impact the way pain is handled in the brain. This in turn supports the benefits of a more holistic approach to assessment and treatment.
Acute problems are usually caused by a recent injury and are best treated promptly, whereas chronic problems are longer-term and tend to be related to the ageing process. Chronic pain in many cases cannot be resolved and lends itself to a longer-term control of symptoms, rather than treatment of root cause as with an acute injury.
In my next blog Your Pain Relief Plan Part 3 I will explain neuropathic pain and the effectiveness of both exercise and drugs and where these may be the wrong solution.
Physiotherapy Treatment For Vertigo Caused By BPPV
Vertigo is a problem that affects around half the population at some point in their lives and is more common as we get older. Fortunately, the symptoms usually only last for a few seconds to a minute or so, but the symptoms are very unpleasant including:
• Nausea and vomiting
• A sense of rotating
• Inability to stand or walk
What Causes Vertigo
It is widely accepted as the most common cause of vertigo is BPPV (Benign Paroxysmal Positional Vertigo) and this is linked to the 3 semi-circular canals in the inner ear. The role of these canals is to sense the position of the head in the 3 axes of up /down, right / left, forward/ backwards. If any incorrect signals occur, the brain doesn’t know where your head is and gets confused.
Faulty signals are caused by very small chalk crystals becoming loose and getting into the semi-circular canals. These loose crystals then move in the canals, stimulating faulty signals.
The types of movement which most frequently initiate a vertigo attack are rolling over in bed, getting out of bed, sitting up after lying flat or looking up or down.
Left untreated, vertigo will usually resolve itself but may take several months. Fortunately, treatment is fairly simple and painless and typically no more than 3 specialised Physiotherapy treatments are needed over a couple of weeks.
David Paling, a senior physiotherapist and our clinical lead can diagnose and treat BPPV.
If you or someone you know is suffering from vertigo, then physiotherapy treatment with us should seriously be considered.
Call the clinic now on 01889 881488 and ask for an assessment with David.
Spinal Disk Bulge Physiotherapy For A Spinal Disc Rupture
Can a disc slip? The simple answer is no. It’s a layman’s term that is unfortunately very misleading to the general public.“My disc has slipped out, can you put it back in” is not an uncommon conversation opener on the telephone. Of course, it’s quite difficult then to get the caller to understand that this can’t actually happen, which is why Spinal Disk Bulge Physiotherapy is key to recovery.
Let’s look at the spine’s anatomy and in particular the role of the disc.
The spine is made up of 7 cervical (neck) bones called vertebrae, 12 thoracics (middle) vertebrae and 5 lumbar (lower) vertebrae. The top 2 vertebrae in the neck are a little bit different, so putting those to one side, between each pair of the remaining vertebrae there is a disc, the purpose of which is to provide shock absorption and allow movement. The disc itself is attached strongly to the vertebrae and cannot slip out.
A disc is made up of a tough fibrous structure on the outside, layered in exactly the same way we make cross-ply tyres. On the inside, there is a soft, crab paste-like moist material. As we age this tends to dry out. There are also endplates in contact with the vertebrae. The spinal disc is 70% to 90% water, so making sure you are well hydrated is very important to disc health.
There are two major types of damage to these discs. The first is when the disc is overloaded sufficiently to cause a protrusion, or bulge in the outer wall, as in the diagram above. This is similar to what you see on the side of a car tyre when it has hit a curb. Sometimes this is referred to as a slipped disc. It’s not possible to just push the bulge back in, but specific exercises can help to relocate this and over time the disc may heal itself.
The second and more serious damage is when the overload has been sufficient to rupture the outer fibrous structure and force the inner material to squeeze out. This is called a herniated or ruptured disc.
What Are The Implications Of A Disc Bulge Or Herniated Disc?
A disc bulge will cause pain if it is central and compresses the central spinal column, or if it bulges to one side into the exiting nerves. In either case, if the compression is significant enough, it will cause pain and/or numbness and weakness and possibly loss of control in the limbs.
If the disc bulge is central it could cause problems down both sides of the body. If the bulge is on one side, it will only cause problems on that side.
If the disc has been ruptured or herniated, the same problems with compression of the central spinal column and exiting nerves can occur. In addition, if chemicals from the inside of the disc come into contact with the nerves, it can cause severe pain even without any compression of the nerves. In such cases, a course of anti-inflammatories will most likely be prescribed.
Can Spinal Disk Bulge Physiotherapy Treat A Disc Bulge or Herniated Disc?
In many cases, a bulging disc and a herniated disc will over time heal themselves. The time required may depend on the severity of the problem and may take from weeks to months to resolve. Physiotherapy treatment can help reduce the pain much more quickly. The key is to get an accurate diagnosis through a physiotherapy assessment, possibly needing an X-ray or MRI. Treatment can include specific exercises to help reduce the disk bulge, Gunn IMS dry needling, electroacupuncture, laser, shockwave, core stability rehab and postural rehab. In severe cases, surgery may be needed.
If you have suffered a recent back injury or had a long-term problem then it’s advisable to get your condition assessed and treated. We have extensive skills in treating spinal pain and clients travel from all over the UK and abroad to seek our help.
Call 01889 881488 now.
‘The Body’ Nicky’s second instalment of her fantastic ‘Human Garage’ Trilogy is days away from release!
To celebrate we are offering an amazing 45% off any Magnetic Resonance Treatment. If you or someone you know needs help with Osteoarthritis, Bone Problems, Sports Injuries or Spinal Disc issues.
Call us on 01889 881488
“For a longer active life”
Offer ends 30th September
Terms and Conditions apply.
The key to healthly exercise is just that.Let’s take another look at why we should exercise so we can hold a green fitness key.Today I find that humans are far too sedentary, all too
often sitting in front of a computer by day, followed by
sitting in front of a TV at night. This lack of physical
activity causes emotional and physiological imbalances,
but we can change this by looking at how we exercise; improving your
fitness changes your chemistry, acts as a powerful antidepressant, promotes
mental clarity, and reduces the likelihood of cancer.
If you’re not happy with either how you look or feel about your weight,
then with correct guidance, you can break out of inactivity and be rewarded
by smiling at yourself whenever you see your reflection. I will guide you towards 4 green keys to health and tonight is fitness.
You can learn more about how and when you should
exercise, as getting the correct mix can extend your life.
When I am working at my clinic, I hear echoing around the walls: I am too
old to exercise, too old to work. Are you too old to exercise? Well, no one told
Jiroemon Kimura (born 1897) that he was too old. He passed away recently
at age 116, farming until he was 90 years old. Remember the Carry On films?
Well, did you know that Barbara Windsor carries on exercising in her late 70s?
You can find her in her gym wear keeping fit outside in Hyde Park.
Over 450,000 people in the USA and over 70,000 people in the UK risk total
knee replacement every year. Want to talk pain? Then talk TKR. What’s
worse is that it is unsuccessful 10% of the time, and you can even die from
having total knee replacement. Furthermore, the age for TKR is constantly
dropping. Why? Anybody want to hazard a guess? That’s right: obesity.
Now, this isn’t proven yet, but it is most likely the biggest cause.
So, what happens when you get fat? Ladies, take the ‘C’ off chips and you
know what you get! Guys, you put it on around the waist and lose sight of
your favourite toy! What you probably don’t know is that your knees are
loaded with up to four times your weight, so every extra stone (14 lbs) is
an extra four stone (56 lbs) on your knees – that’s why knees are so often
the first casualty with OA. If you want to know why the four times multiple
occurs, it’s because of leverage. Now, you are intelligent people, and you are
surely interested in health or you wouldn’t be here. So, why have you made
the decision to get arthritis? Made the decision to get lots of pain? Made
the decision to risk surgery and even death? It’s because much of the pain
associated with the pleasure of eating too much is too far away, and anyway,
going to the gym is a pain for most. We need to change the way we think
about exercise, and hopefully this chapter will go some way to doing that
Here’s some more cheery news: an in-depth study into retirement found
that men in their sixties are every bit as good at driving business than those
physically and mentally in their prime. In later life, prescriptive exercise is
more effort than swallowing a pill, but it is well worth it; in a nutshell, you get
less senility and less pain. Exercise weaves its magic, strengthening the heart,
releasing more neurotransmitters for cell communication, boosting BDNF
for improving neural connections in the brain, aiding metabolism, improving
blood flow, stimulating toxic disposal systems, and strengthening bones.
This next fact gets me out running in howling gales and rain: current research
in Sweden shows that exercise alters the way genes work in the tissue that
stores fat, and changes in adipose tissue storage sites were measurable even
with just two workouts a week. Epigenetics has always fascinated me since
studying biology, and this is the study of how chemical alterations will
change how genes work in a cell. This allows us to fine tune our body to a
Exercise alters this process in muscle cells and improves how sugar is
processed. Furthermore, adipose tissue (fat cells) is an organ in its own right, producing active chemicals that have profound effects on the body. In
this tissue, 18,000 markers were found on 7,663 genes! This is leading to a
greater understanding of why exercise helps fatty tissue do its job properly,
which means that as we get older, we don’t have to have such a lumpy,
bumpy body. This smooth body needs a good structural support.
The 4 keys to health is all about investing in the healthiest happiest future you could wish for with sound scientific knowledge and big spoonfuls of commonsense and experience.Tonights blog is for nutrition week. The traffic lights approach to healthfor the 4 keys to health gives one point for every yes answer.
0 – 3: RED.
3 – 6: AMBER.
6 – 9: GREEN.
Scores: Now count up your scores – are you red, amber, or green for this key?
Once you’ve read the chapter and implemented any changes, take the
questionnaire again to see how much you’ve improved.This questionnaire is in 4 parts.
Diet and Blood Sugar Levels
• Is your weight good for your age and height?
• Do you have lots of energy and do you like to exercise?
• Are you free from joint pain?
• Do you rarely feel like dozing in the day and feel alert after eating?
• Do you hardly ever get stomach ache or bloating?
• Do you concentrate easily with a clear memory and few
• Do you hardly ever need sweet food or caffeine fixes?
• Do you jump out of bed, raring to go?
• Do you rarely feel dizzy / irritable / have mood swings in
gaps between meals?
• Do you rarely have thirst / dry mouth?
• Do you rarely get headaches?
• Is your urine a mild (not dark) yellow colour?
• Are your skin and lips moist, not dry?
• Do you have regular bowel movements most days?
• Do you have less than two glasses of alcohol a day?
• Do you have five helpings of fresh fruit and vegetables a day?
• Do you have several glasses of fruit water / juice / herbal
teas a day, even if resting?
• Do you avoid having too many salty snacks?
Healthy Low Homocysteine Levels (repairing DNA
and building nerves / cartilage)
• Is your weight satisfactory and stable?
• Are you a clear thinker with a good memory and rare
• Do you eat healthily with green veggies, seeds, and nuts,
but aren’t vegan?
• You are not an alcoholic, smoker, or heavy coffee drinker?
• Do you have little joint pain?
• Do you have great stamina without weariness?
• Is your cardiovascular system and blood pressure normal?
• Do you sleep well?
• Are you rarely angry, irritable, or down?
• Do you have healthy hair?
• Do you have flexible, pain-free joints?
• You are not taking painkillers?
• No arthritis, asthma, or eczema?
• No diagnosed cardiovascular problems?
• Do you spend more than thirty minutes a day outside in
• Do you eat healthily with oily fish, about four eggs a week,
seeds and nuts most days, and fewer than two alcoholic
drinks a day?
• Do you have a good memory, learning abilities, and
• You don’t get down, anxious or unnecessarily angry?
Anti-Ageing, Anti-rot, Antioxidants
• Are you a quick healer?
• Are you younger than middle aged (40)?
• Do you have healthy skin?
• No diagnosis of cancer or cardiovascular disease?
• Don’t bruise easily?
• Do you live in quiet, clear air, healthy countryside, not
near major roads?
• Do you eat healthily with five lots of fruit and veg a day,
raw seeds / nuts, and at least two oily fish a week?
• Do you take antioxidant supplements?
• Do you exercise and raise your heart rate five times a
week?If you got a red key read my blogs or get a copy of my book,through www.thepainkiller.co.uk,www.painreliefclinic.co.uk, or amazon.
Exercise is vital for healthy ageing, so get out of that chair! When we slouch
in our chairs, we don’t breathe correctly, we have less lung capacity, less
oxygen, a poorer blood flow, a weaker heart, and less nutrient delivery.
Smooth muscles tighten up to take up the slack, and our blood pressure
readings go up. Blood flow can’t accommodate sudden movements anymore,
so dizziness follows, and with it, increased accidents. Men’s sexual potency
falls, the gut slows, and digestion fails. Sugar metabolism struggles andcc
diabetes is more likely to take hold. In an article in Psychological Medicine,
Dregan and M.C Gulliford wrote about how intense exercise helps brain
function (Dregan & Gulliford, 2013), so you can remember where you put
your gym wear! Get my drift?
Here are some more facts I sourced for you to back up reasons to exercise
– for all you academic buffs out there. Whether you are old or young,
‘it’s widely acknowledged that a healthy body equals a healthy mind. The
government recommends a minimum of 150 minutes of exercise per week,
between the ages of 19 and 64’ (Dregan, 2013). A word to the wise – if you
don’t exercise at all, start. If you are new to exercise, start small and just walk
a little further than usual. Exercise doesn’t have to mean enduring lengthy,
intense programmes or taking up a gym membership, although I think the
discipline of going and the social angle is great. If you are exercising on your
own, you still need to add in working out with weights as well as aerobic
exercise, such as walking.
Did you know that at 44 years old, without exercising, we are at the peak
depressive age? However, at 70 – if we follow a fitness programme – it is
possible to be as physically fit and happy as we were when we were 20!
Another study got a group of 60 year olds to start doing three long swims a
week, and their medical measurements and tests were those of 40 year olds.
Exercise is much like medicine – it doesn’t have to taste nice, but the outcome
is more than worth it. Being disciplined about getting your exercise is your
key to longevity, so exercise regularly and effectively. Most people will say
they don’t like it, that it’s boring or painful, that they have no time to do it,
but they’re just in denial for the need to move. Well, couch potatoes, here
are some more facts for you:
• A study looked at 50 elderly people of an average age of 87.
Given a 10 week weights workout at this age, they doubled their muscle