I have discovered a unique, highly effective form of physical therapy that combines the best elements of personal training with muscular therapy. Valerie Ruccia Eagan has developed her own brand of physical therapy that uses hands-on techniques, core- strengthening, and flexibility-building exercises, as well as mind-body energetic work. Her method cuts to the root of physical pain and mobility problems to provide deep and lasting healing.
Tag Archives: Chronic Pain
Despite the media hype of books that promise to “banish your pain,” the reality is that chronic pain is just about impossible to extinguish, whether in “five simple steps,” “four quick weeks,” or whatever the latest tantalizing promises are. The truth, as you probably know if you have been experiencing chronic pain, is that the goals of controlling, managing and living a satisfying life with pain are much more realistic. As both a person who lives with chronic pain and a medical writer, I have come across a useful website with a realistic, helpful approach to chronic pain. Full disclosure: I have written some articles for this site, in consultation with several reputable medical professionals. In so doing, I have come to respect both the source of the information and the approach of the site. I have also learned a great deal.
The site is painAction.com, and here are some of the articles I wrote, although I recommend reading any others on topics that are of interest! The site covers back pain, migraine pain and cancer pain, and includes articles, lessons and interactive tools. The focus is on developing skills in self-management, gathering knowledge, medication safety, working with health care professionals, communication and emotional coping. Given my interest in integrative medicine, I am also pleased to report that there is information on alternative/complementary modalities to manage chronic pain.
In 1995 I woke up from routine heart valve surgery with the left side of my body paralyzed from a stroke caused by the surgery itself: A tiny piece of tissue had broken away from the valve, traveled through blood vessels and lodged in my brain, blocking the flow of blood with its essential supply of oxygen to the neurons that controlled movement on my left side. I was 43 years old, married, with two young children.
If I had obediently followed the prescribed role of stroke patient in the world of conventional medicine, I would be an invalid in a wheelchair today. Instead, I am back at work as a medical journalist, paying taxes instead of collecting social security.
I recovered because “adapting” to my disability — which is what the insurance company doctor (who had never met me) told me to do after two months of occupational and physical therapy — was not an acceptable option for me. I didn’t want to buy shoes with Velcro, buttonhole fasteners or devices to hold a tomato steady so I could slice it. I didn’t want to walk with a cane or use a wheelchair in the airport. And I certainly didn’t want to spend valuable recovery time learning to use adaptive devices.
During my recovery, the health providers whom I found most helpful were those who recognized the devastation and despair that I felt as the result of this physical calamity. They saw me not just as a patient, but also as a wife, mother, writer and even amateur musician. In their understanding I found the encouragement, strength and hope that I needed to fight back to recovery.
The doctors I found least helpful were those who saw me not as a whole person, but rather as a “stroke patient:” These included the neurologists who shrugged and said “wait and see” when I told them that they must be wrong: I needed my left arm and I needed to be able to walk; and the heart surgeon who breezed into my hospital room just long enough to say, “Sorry you stroked, but heart-wise you’re fine.”
I quickly learned that while the advances of modern surgery can save your life, the conventional medical system — along with the insurers who pay for it — is not set up for full recovery. The goal of the system was to get me out of the hospital or rehabilitation facility and send me home. What happened after that was up to me. The insurance company doctor (the one who never met me) told me that I had “plateaued,” which meant that while I had made progress in physical and occupational therapy, there would probably be no further improvement. I was at an impasse and additional intervention would be counterproductive (not to mention expensive).
As a patient, it feels as if the health insurers and many doctors want us to accept and “adapt” to our disabilities — whether we are recovering from a heart attack or stroke, suffering from chronic illness or pain or trying to manage the difficulties of growing older. It is easier to prescribe pills and adaptive devices than to help us take responsibility for our bodies and our health.
I chose to fight my way back to recovery, and this is a tough thing to do for those of us who are accustomed to seeing our doctors as omniscient beings who control our health. I learned about methods of healing outside of mainstream conventional medicine,including Traditional Chinese Medicine, chich has used acupuncture for thousands of years to treat stroke patients . Yoga, from the equally ancient Indian Ayurvedic system of medicine, gave me strength, balance and peace of mind. The Alexander Technique — a powerful system of movement education — taught me to use my body with less effort and reduced pain. Pilates exercise coaxed my weakened muscles back to work and craniosacral therapy restored my body’s natural rhythms.
I was fortunate: I had the will, the family support, the research skills and the financial means to pursue unconventional healing methods. Fighting the system is much harder for those who don’t have the money, the knowledge of alternative therapies or the emotional strength to keep up the lonely struggle for recovery. Too often, such people live with pain, disability and despair.
Doctors must understand what illness means in the lives of their patients. They must use their positions, their authority and their words wisely. They have the power to heal, but they also have the potential to destroy hope and, along with it, the chance to recover.
One Sunday morning in February 1997, Jacqueline Miller was standing on a stool hanging curtains in her son’s room. The last thing she remembers before she found herself covered in blood on the floor is beginning to get down off the stool. “We figured out later that I must have lost my balance, “ she says. “I had apparently hit my face — hard — on the corner of my son’s desk.” The impact had severely injured her spinal cord in the area of her neck and she would need 150 stitches for the lacerations in her face.
Jackie’s spinal cord injury had transformed her in an instant from an outdoor enthusiast, scientist and mother of two young boys to someone who could not walk, turn a page or feed herself. The prognosis was grim: Doctors told her that she would be permanently paralyzed below her waist, with minimal movement in her arms and hands. “One of my doctors told me that the best recovery I could hope for was to be able to eventually shuffle 10 feet down the aisle — with a walker — at my son’s wedding,” says Jackie, adding quickly, “They were wrong.” When the extent of the traumatic injury finally sank in, Jackie was in shock and disbelieving. “All I wanted to be able to do was hug my children,” she says. “And I couldn’t even do that.”
Those who know Jackie best describe her resilience and determination, and these two qualities, along with her sense of humor, have helped her reclaim her life. She is back at work “more than” full-time and recently got back from a trip to Rome and Morocco with her husband. Her son called the donkey “Mom’s Moroccan wheelchair.” Read more of Jackie’s inspirational recovery here
— Here are pictures of Jackie on her trip; She had been told she would be quadriplegic:
This fall, I participated in the American Heart Association HeartWalk in Boston. This was significant for me on several levels: I did the walk with my two children, now 25 and 21. These are children I was not supposed to have— according to the doctors I had seen when I was growing up—because the stress of pregnancy and childbirth was considered too much for a heart compromised by Marfan Syndrome. But thanks to the skill and watchful care of a wonderful cardiologist, I was able to thrive through two pregnancies (with planned C-sections), and rejoice with my husband at the birth of our children, who are now well-launched in their own lives and continue to be two of the joys of ours.
The HeartWalk was also significant because I was actually able to complete two of the miles without pain—thanks to the benefits of “physical therapy boot camp” and my new program of regular gym workouts. Again, I feel as if I have “outwitted” some of the usual problems of Marfan Syndrome—joint pain— as long as I am faithful to the exercise routine. Walking that distance was meaningful for another reason: In 1995 I had mitral valve replacement surgery and woke up with half my body paralyzed by a stroke caused by a wayward piece of tissue that had lodged in my brain. I recovered by using integrative medicine (another story), so doing this walk without a cane or other assistance was particularly sweet!
Last—and certainly not least—my family and I walked on the HeartWalk team of the very cardiologist who, 30 years ago, heard and understood how important it was for my husband and me to have children, and who helped make our dream come true. Now, all these years later, here is the result. As I look back on the past 30 years, I realize even more how imporant it is not only to “own our health,” but also to find the right medical partners to help us.
I recently helped to organize a Healing Arts workshop for the National Marfan Foundation annual meeting, which was held in Boson this year. More than 30 participants heard and asked questions of a panel of complementary/alternative practitioners who discussed managing the symptoms of Marfan syndrome—particularly chronic joint pain—with Tai chi, the Alexander Technique, acupuncture, Traditional Chinese Medicine (TCM), nutrition, and craniosacral therapy. Combining alternative treatments with conventional care is called “integrative medicine,” and putting together your own personal healing combination is an excellent way to take responsibility for your health. These healing modalities have applications for anyone suffering from chronic pain.
The workshop began with Tai chi and Alexander teacher Jamee Culbertson leading us in the opening movements and breathwork of a Tai chi form that is thousands of years old. Research has found that these ancient, graceful, meditative movements improve balance and reduce falls. As we breathed deeply and moved slowly in unison, the room seemed to transform into a kind of “sacred space,” as the group united with a shared purpose and energy. With two volunteers, Jamee then demonstrated how the Alexander Technique reduces pain and eases body movement through simple awareness of habitual actions that may be restricting activities. Both Tai chi and the Alexander Technique are gentle, non-invasive practices, and do not stress joints or ligaments.
Eurydice Hirsey, a trained chiropractor and craniosacral therapist, then talked about the use of craniosacral therapy to ease pain and improve movement by enhancing the circulation of cerebrospinal fluid. This is done through gentle touches on the head and sacrum, following the body’s own natural rhythms and movements, without force or pressure. While chiroporactic may not be indicated for most people with Marfan syndrome, the light touch of craniosacral therapy can ease tight muscles and reduce pain, even in those who have had spinal fusions, by focusing on other areas of the body where movement is possible.
Acupuncturist and researcher Stephen Cina shared his orthopedic investigations into the nature of connective tissue and its possible relationship to the meridians (energy pathways) used in Traditional Chinese Medicine. A practitioner either inserts tiny needles into “points” on the skin that correspond to the energy meridians (the needles are usually painless), or applies pressure with the hands (acupressure) on these same spots, in order to reduce pain. And naturopathic intern Amanda Daeges–who has Marfan syndrome, talked about maintaining integrity of connective tissue through what we eat and drink: specifically whole foods and whole grains that include nutrients and trace minerals. She also stressed the importance of drinking enough water. (Divide your body weight in half to find out how many ounces of water you should drink each day.)
All of these complementary modalities (and many more) are described in detail here, has well as profiles of practitioners and personal experience stories.
VERY important: Before you try any complementary/alternative practices, always check with your doctor.
Some people have questioned the evidence behind hydrotherapy, especially the cold water treatments that are described in the book that Alexa Fleckenstein and I co-authored. German research supports the effects of cold water used on the skin as therapy. Unfortunately, the studies are in German, and they are small. (1) Because Pharma firms have no interest in inexpensive water cures, there probably won’t be big studies any time soon. Fact is, the German insurance system pays all or part of physician-prescribed treatments, including hydrotherapy and herbs. The importance and therapeutic potential of water, and especially cold water, are now simply taken for granted in Germany.(2) Here are some specific research studies supporting the health benefits of cold water treatments. Citations are listed at the end. (More cold water research details in Own Your Health (2003)
Boosting the immune system
A pilot study of immune effects from cold water therapy with a small number of breast cancer patients found significantly increased disease-fighting cell counts in every category examined, including neutrophils, lymphocytes, monocytes.(3)
Reducing the perception of pain
In a study in Japan, cooling by ice water was one of the “competitive stimuli” that reduced the perception of the pain of a laser beam on the skin. (4)
Improved circulation and function in the legs
A Swedish group administered three weeks of alternating cold and hot hydrotherapy to the legs of patients suffering from intermittent claudication (reduced blood flow) and found that improved systolic blood pressure in ankles and toes, reduced pain, and markedly better walking ability went beyond the results of standard treatment and persisted for at least a year after treatment.(5)
Swimming in the winter?
Ten healthy subjects who regularly swim during the winter were evaluated at Berlin’s Institute of Biochemistry at Humboldt University Medical School. Their blood and urine showed increased levels of anti-oxidants, which prevent cell damage, indicating their bodies’ increased tolerance to stress.(6)
(1)Summarized in Bühring, M., Naturheilkunde: Grundlagen, Anwendungen, Ziele (Natural Medicine: Basic Application and Goals), Munich, Verlag CH Beck, 1997.
(2)Haas, S.S., Hydrotherapy and more: Adapting Kneipp’s Natural Medicine to the U.S., Complementary Medicine for the Physician, 2000; 5(8):57,61-64.
(3)Kuehn, G., Sequential hydrotherapy improves the immune response of cancer patients. In: Mizrahi A, et al., (eds.) Potentiating Health and the Crisis of the Immune System: Integrative Approaches in the Prevention and Treatment of Modern Diseases. New York: Plenum, 1997.
(4)Kakigi R., et al. Pain relief by various kinds of interference stimulation applied to the peripheral skin in humans: pain-related brain potentials following CO2 laser stimulation. J peripher Nerv Syst 1996;1:189-198.
(5)Elmstahl, S. et al., Hydrotherapy of patients with intermittent cluadication: a novel approach to improve systolic ankle pressure and reduce symptoms. Int Angiol. 1995;14:389-394.
(6) Siems, W.G., et al., Uric acid and glutatione levels during short-term whole body cold exposure. Free Radic Biol Med. 1994;16:299-305.
Research is increasingly demonstrating the effectiveness of certain complementary/alternative treatments such as acupuncture, massage, tai chi, yoga, meditation and biofeedback for chronic pain, reduced mobility and other ailments. Why then are more insurance companies not paying for them? I think more of us need to “vote with our feet” by demanding coverage for proven alternative treatments and switching to insurance companies that pay for them. We and the health care system will all benefit. As one study found, support for lifestyle changes that prevent disease is far cheaper than hospitalization and expensive pills!
A relatively new approach to chronic back pain is beginning to make headway into mainstream medicine: It is called “physical therapy boot camp” and I am in my fourth week of the program run by New England Baptist Hospital. The results, at least for my Marfan-related back pain, are miraculous. For the first time in what seems like years, I can walk longer and engage in daily life activities without pain in my lower back and hip. It takes work, rather than popping pain pills (which I don’t take): I go twice a week for directed stretching and an hour of closely supervised weight training on gym machines, with steadily increasing weights and repetitions. At home, I follow their program of stretching, walking and weights. And it is really working. This is going to become a regular part of my life.
The slow, flowing movements look like a dance, but it is what goes on inside the body that makes Tai chi different: During a class recently, I felt as if my body were getting hooked up to a universal “filling station” and being replenished with energy. The result? Better ease of movement, increased flexibility and a sense of peaceful well-being. I do a “short form” almost every morning that takes all of ten minutes, one of the helpful ways I have found to live with Marfan syndrome.
Tai chi originated thousands of years ago as part of the ancient system of Traditional Chinese Medicine. The movements have their origins in martial arts, but are performed slowly, with controlled breathing and an awareness of the flow of energy inside the body. Tai chi has been called “moving meditation.”
Studies have found that Tai chi strengthens the immune system and can help with pain caused by osteoarthritis of the knee. In other research, Tai chi has been found to improve balance and coordination in older people, and reduce falls. It can also help with osteoporisis by increasing bone density.
All in all, not a bad ten-minute investment of time. Anyone else have Tai chi stories to share?