Authored by Dr. David Alter

The conductor of the body’s orchestra is the mind. That is why it is so critical that chronic pain treatment includes methods of restoring the mind’s ability to function as the body’s conductor, and to lead the body back to producing the harmonious rhythms among the different parts of the body that define good health.

Chronic pain affects the body the way an orchestra is affected by the absence of a conductor. Chronic pain causes the body to:

•Lose the coordinated rhythms of the body that define good health

•Develop sleep problems and other essential biological rhythms of the body

•Develop fatigue, weight gain or loss

•Develop increased risk for depression or anxiety patterns

•Develop metabolic disturbances

•Develop focusing, concentrating and learning and memory problems

•Develop problems in your key relationships

When the conductor arrives on the scene and steps onto the podium baton in hand, the individual musicians in the orchestra undergo a wonderful and magical transformation. The conductor transforms the chaos of uncoordinated individual musicians into a coordinated and choreographed unit that produces beautiful music.

At Partners in Healing of Minneapolis, we teach you to be the conductor of your body. We help you to restore the mind to its rightful place as the conductor of your body so that you can overcome pain and restore healthier levels of functioning. We offer many treatment approaches. Contact us at 763-546-5797 or visit us at www.pih-mpls.com for more information. Find out what is right for you and your body.

Authored by Dr. David Alter

It is said that fences make good neighbors.  The saying implies that boundaries are often important to the effective regulation of relationships.  Most fences have gates in them that allow for the selective exit or entry across the fence-defining boundary.

The saying about fences and neighbors fits well when it comes to successful management of pain.  Every part of the body (except, ironically, the brain tissue itself) has pain signaling cells that live right next door to the tissues the pain signaling cells are designed to protect.  Most of the time, the gates between the tissues and their pain signaling cell neighbors remains closed.  When injury, infected or compromised in some manner, the pain gate opens and the pain signal makes its way to the brain, when plans for corrective action can be developed and implemented.  Once the injury or source for other pain-inducing problem has been resolved, the pain gate closes and the presence of pain disappears.

A number of years ago, Drs. Ron Melzack and Patrick Wall discovered that in chronic pain conditions, for a wide variety of reasons we are still discovering, the pain gate remains open.  The pain signals continue to fire.  Chronic pain settles in.  Sadly, after a time, even when the original problem has been solved, pain gates in the spinal cord and brain stem can remain open.  The research by Melzack and Wall, as well as by many others since then, have taught us about the many approaches that exist to close the pain gates, reducing the experience of pain in   important and lasting ways.

Here are examples of ways to close the gate of pain.  You can learn more ways to close the pain gates by contacting Partners in Healing of Minneapolis at info@pih-mpls.com.

• Manual therapies (acupressure, shiatsu massage)
• Energy-based therapies (acupuncture)
• Cognitive therapies (cognitive-behavioral pain management)
• Self-regulating therapies (biofeedback, guided imagery, clinical hypnosis)
• Relaxation and breathing-based approaches (meditation)

An exciting benefit of developing the habit of utilizing pain gate-closing therapies is that they promote the release of the natural pain numbing chemicals that are produced by our body’s innate pharmacy: endorphins and enkephalins.  Give us a call so you can learn to erect a secure fence between you and your pain.

Authored by Dr. David Alter

In the last entry we introduced the idea of pain as a faulty memory signal; a state-dependent signal that can be activated by many triggers.  We emphasized the importance of learning memory-modifying steps you can take to put you back in charge and learn to have the remembered past – the pain signal that keeps on firing – pass right on by.  By recognizing that The Pain, its Plain, Stems Mainly from the Brain, here are six suggestions to consider that help free the brain from old pain memory patterns, and allow it to express different nerve firing patterns that modify your experience of pain.

1.    Shifting the focus of attention from what can be done for you to what you are able to do for yourself.  This shift in focus orients the brain to how and where you can exercise control, which disrupts old patterns of helplessness in the face of failed efforts to obtain relief.

2.    Develop a toolbox of safe and simple movements.  The body is designed for movement.  The body needs movement the way it needs food and sleep.  Whether the safe movement involves simple stretches, a walk to the mailbox several times per day, or involvement in a yoga class, develop a movement routine you maintain.  It disrupts the memory circuits that say movement is dangerous and painful.

3.    Restoring restful sleep. While we sleep, the brain filters our experience from the past.  Sleep revises, discards or strengths aspects of past experience.  Without adequate sleep, our ability to restore energy reserves, rebound from the past experience, and feel prepared for the future is hobbled.  Explore proven methods for re-establishing restorative sleep so you give the brain the energy it needs to construct new habits of functioning during the day.

4.    Learn focused awareness skills.  When pain is present, it can be like a magnet that draws attention to it.  Pain-focused attention almost always makes the perception of pain worse!  A number of methods for developing the capacity to direct attention away from pain, or toward perceiving sensations in the body in new ways can be very useful.  Meditation, breath awareness, guided imagery and self-hypnosis are examples of focused awareness skills you can learn.

5.    Become a “sensualist”.  We are blessed with five senses.  Pain tends to make us aware of only one of them.  If pain becomes the dominant sensation that people experience, awareness of other sensations dulls.  It is important to involve yourself with activities that bring alive other sensations – taste, sight, sound, smell, taste and touch.  In addition, there is good evidence that laughter and humor release molecules that flood the brain and body with strong pain dampening effects!

6.    Letting go of what’s past (passed).  People with persistent pain tend to have much higher rates of depression, anxiety and even high rates of histories that include past traumas of various sorts.  Of course, having persistent pain can be depressing, anxiety provoking and traumatizing!  Still, past trauma tends to keep the doors to pain in your present life wide open.  Therefore, it is important to learn methods of resolving the on-going influence of past trauma on your daily life.  Doing so powerfully rewires the brain and frees up the mind to experience life anew.

Authored by Dr. David Alter

In the movie musical My Fair Lady made famous by Audrey Hepburn, she sings a song whose words begin, “The Rain in Spain Falls Mainly in the Plain.”  Her song signals her growing ability to achieve her full but untapped potential.  Every day, millions of people struggle to overcome the limitations imposed by their personal histories.  These are individuals who face the misery and despair that all too often arises with chronic pain.

Chronic pain has bedeviled healers for thousands of years.  Invisible, untouchable, and yet so many are touched by it – more than 70 million Americans per year!  A key aspect of chronic pain that makes its successful management so challenging is its disconnection from obvious tissue injury.  Typically, as the physical body heals, the process of healing turns off the nerve signals that generated the pain sensations in response to the original injury. 

What is difficult to understand is that over time pain signals become disconnected from actual tissue damage.  This involves a modification to the body’s pain signaling process.  Pain is an experience that is encoded in the brain in through state dependent learning experiences.  In other words, the experience we call pain is a type of memory that is encoded into the neural circuits of the brain, ready to be reactivated when any of the other elements that were present at the time of the original injury are once again present.  For example, when my young adult son was injured playing his favorite sport he needed stitches that were sown into his mouth without sufficient anesthetic.  When he began to anticipate going to have the stitches removed, he began to hurt again.  The hurt he felt involved reactivation of the state dependent learning that linked together the memory of stitches with the memory of pain.  The anticipation of going to have stitches removed reactivated pain!  The original emotional state (scared), the physical context (doctor’s office), the sensory cues (white coat, hospital smell, overhead paging, etc.) also served to reactive the pain because they were encoded as part of the original state dependent pain experience.

While this example involves an acute pain experience, you can appreciate the relevance to chronic pain conditions, where the encoded emotional, contextual, sensory, and cognitive cues linked to pain are more common and have been reactivated so much more powerfully over a longer period of time.  Still, the implication is clear: As hard as it is to accept, the fact of the matter is that chronic pain really is “in your head!”  It is wired into the brain’s network of nerves, ready to “fire” in response to so many different triggers. 

That the pain is in the head makes it no less real!  In fact, it allows a whole new approach to managing it: learning ways to re-program pain program wired into the brain.  To return to our theme, the key to management of chronic pain involves learning to change the “remembered pain,” the memory pattern that gets established in the brain and which is responsible for the activation, maintenance and exacerbations of chronic pain conditions.  If Audrey Hepburn were to star in a pain management movie, perhaps she would sing, “The Pain, its Plain, Stems Mainly from the Brain!”

There are a number of ways to modify chronic pain memories: the pain-maintaining signaling patterns that are at the core of chronic pain conditions.  In the next entry to this blog, six suggestions for modifying pain maintaining memory circuits will be introduced to you.  Each of the pattern-modifying techniques is useful precisely because of its proven capacity to alter the ways in which remembered pain signals are generated. 

Authored by Dr. David Alter

Chronic pain. Depression. Gut dysfunction. Anxiety.  Relationship discord. Sleep disturbance.  Post-traumatic difficulties.  Energetic imbalances.  When people begin to describe their difficulties, they often use these labels.  Each of these labels is a blend of sensations, thoughts, feelings, emotions and behaviors that persist over time.  It is the fact that they repeat over time that makes them into symptom patterns.  I am going to offer four important questions that will help you learn to alter these symptom patterns.  By changing the symptom pattern, you can change your illness process – almost always for the better!

At first, the symptom pattern of chronic pain may seem unrelated to a pattern involving gut dysfunction, (Irritable Bowel Syndrome, for example), but all symptom patterns represent a loss of adaptive flexibility of the mind and body.  Adaptive flexibility involves the capacity to adjust to the ever-changing circumstances of your life while maintaining a steady sense of balance and control in your life.  The greater your ability to adjust and adapt to the circumstances of your life the greater the likelihood that you would describe yourself as healthy.  And the more you can learn to increase your adaptive flexibility, the more likely you are to regain or restore your health. 

The idea that we are designed to seek healthy balance is not new.  Ancient traditions described health in terms of the capacity to maintain balance among competing urges, functions, energies, or qualities (e.g., warm-cold; wet-dry; optimistic-guarded; active-sedentary; spicy-bland; thin-heavy; fast-slow; fiery-calm; stoic-vulnerable; thoughtful-emotional, etc.).  Sounds strange?  Think for a few moments about the kinds of suggestions we hear or give ourselves each day and you’ll recognize they are still suggestions about improving our ability to adjust and adapt in ways that are not all that different from what Hippocrates might have advised a patient in Greece 2500 years ago:  “I’ve got to stop burning the candle at both ends;” “I should eat less and exercise more;” “I’ve got to stop picking the same type of relationship partner over and over again;” “I have to take some risks if my situation is ever going to change;” “I have to get ‘in touch’ with my feelings;” “I have to give more and expect less;” “I have to over-extend less and take better care of myself.” “I have to live my life with integrity that is consistent with my basic values.”  Each statement reflects the recognition that you have gotten stuck in a repeating pattern of functioning that is negatively affecting your health.  Repeating unhealthy patterns of living is the primary sign of the loss of adaptive flexibility, and often predicts that a loss of physical, emotional or mental health will soon follow. 

Most of the time, our deeply wired ability to maintain balance in the face of constant change is something that occurs automatically (e.g., we don’t have to think about how heal a paper cut to a finger or how to walk, even though walking involves controlled falling!).  Sometimes, we have to make conscious decisions to maintain healthy balance (e.g., “Even though I want another helping of my dinner, I will listen to my body’s signals and push myself away from the table now.”).  And then there are times when we need to seek the help of a professional who is trained to identify what accounts for our imbalance and the symptom pattern the imbalance is generating. So, where to begin your efforts to alter the pattern of your symptoms?  In the next entry to this blog I will introduce you to what your own cells have to teach you about restoring your health.