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Cognitive Behavior Therapy for Lower Back Pain

“We tend to get what we expect.” — Norman Vincent Peale

Cognitive Behavior Therapy for Lower Back PainAllow me to be blunt. I have helped literally tens of thousands of people from around the world overcome back pain and sciatica. I have failed to help many thousands more. And almost always the difference lies in the attitude, expectations, and willingness of the person I’m trying to help to actually be helped.

One might reasonably think if someone asks for help, that they are prepared to take action on the advice given in response. For example, by reading this very article you’ve indicated you would like information on how to get rid of lower back pain.

So what separates those who take action and achieve success from those who will not? Belief.

No, this isn’t an Amway convention. But Mr. Peale was right when he said we get what we expect. That’s because our belief drives our actions. If we believe we can overcome chronic lower back pain we’re much more likely to implement the advice given. If we do not believe the advice will work for us, we’ll either give it only a half-hearted attempt then blame the advisor or technique when it fails to deliver the results we would like, or we won’t even try at all.

This isn’t some pie-in-the-sky concept without impact on the physical world of back pain either. It’s a proven fact that even with chronic lower back pain treatments our expectations and attitudes directly affect the outcome. Literally.

Take a just published five-year study of over 700 patients diagnosed with subacute or chronic lower back pain as an example. Patients were randomly assigned to either a standard advice and treatment from their general practitioner, or the standard advice and treatment from their general practitioner plus six group sessions of cognitive behavioral therapy.

In layman’s terms, both groups got standard medical treatment for their lower back pain but the second group also atteneded six sessions of group therapy with the primary goal of “patient education to counter negative beliefs about lower back pain.” The only difference between the two groups is the second group was taught how to change their attitude about their back pain and prospects of recovery.

End result? The second group experienced measurably increased lower back pain relief and freedom from disability than the control group. Other studies have repeatedly found the same impact of emotional thoughts and beliefs on physical pain and recovery.

So if you want to accomplish any goal, including relieving your lower back pain, you first need to believe that you can achieve it. You don’t have to sit in a group therapy session, but if that’s what it takes for you then it’s probably worth it to end your back pain, right?

A less expensive option is to participate in an online back pain forum with other people facing similar challenges. Plus you can find several more mind-body healing techniques here.

Here’s the bottom line. If you want to change the way your lower back, and indeed your whole world, feels then consider putting this final word of advice from Mr. Peale into practice:

“Change your thoughts, and you change your world.” — Norman Vincent Peale

Related references:
Lamb, SE. Group cognitive behavioural treatment for low-back pain in primary care: a randomised controlled trial and cost-effectiveness analysis. The Lancet, Early Online Publication, 26 February 2010.

Kröner-Herwig B. Chronic pain syndromes and their treatment by psychological interventions. Current opinion in psychiatry. 2009 Mar;22(2):200-4.

Lindell O, Johansson SE, Strender LE. Subacute and chronic, non-specific back and neck pain: cognitive-behavioural rehabilitation versus primary care. A randomized controlled trial. BMC musculoskeletal disorders. 2008 Dec 30;9:172.

Smeets RJ, et al. Treatment expectancy and credibility are associated with the outcome of both physical and cognitive-behavioral treatment in chronic low back pain. The Clinical journal of pain. 2008 May;24(4):305-15.


Fibromyalgia Syndrome and Chronic Pain

Fibromyalgia Syndrome and Chronic PainFew widespread health maladies have the ability to camouflage their root cause as well as fibromyalgia. It’s known to mimic symptoms of chronic fatigue syndrome, osteoarthritis, post-traumatic stress disorder, lupus and a host of other disorders. Somewhere, hidden among all the symptoms, is a root cause and an elusive cure.

First recorded in 1904, fibromyalgia has grown into a modern era scourge affecting as many as 6 million Americans. Women are nearly nine times more likely to become afflicted than men, but no one is immune.

So what is fibromyalgia?

Fibromyalgia is named after the pain commonly reported in sufferers’ muscles, ligaments and tendons (Fibro = fibrous tissue, myo = muscle, and algos = pain). Research shows fibromyalgia is a syndrome which launches an all out attack on the central nervous and musculoskeletal systems.

Intense muscle pain caused by systemic inflammation is a very common description. One patient gave an account of her pain like “having arthritis in your muscles or charlie horses all day”. More than half of all fibromyalgia sufferers complain of chronic or migraine headaches. Extreme fatigue, sleep disorders, sensitivity to medicine, irritable bowel syndrome, memory loss, difficulty exercising, dizziness, non-cardiac chest pains, stiff joints, numbness and tingling sensations in extremities are also frequently reported.

Diagnosing fibromyalgia

Diagnosing fibromyalgia can be a supremely frustrating experience for patient and doctor alike. Since so many symptoms mimic those of other common disorders, making a diagnosis often comes down to a process of elimination.

Fortunately the American College of Rheumatology published standards to assist physicians with fibromyalgia diagnosis in 1990. The doctor simply applies pressure to 18 different trigger points found along the base of the patient’s neck, backbone, in front of the hip and elbow, and at the rear of the knee and shoulder. If the patient indicates at least 11 of the 18 sites are tender to the touch in addition to widespread pain a diagnosis of fibromyalgia may be warranted.

What causes fibromyalgia?

Some studies suggest individuals with fibromyalgia were genetically predisposed. Others indicate fibromyalgia is a dormant disorder that is triggered by a viral or bacterial infection or a traumatic injury. For example, one woman said she lived a normal life until she was struck from behind while driving. The severe whiplash sustained in the accident was the beginning of a new period in her life dominated by fibromyalgia pain.

That’s the long answer. The short answer is, we don’t know yet – exactly. However, enough evidence has accumulated to show fibromyalgia is typically preceded by a pattern of imbalances. These imbalances may be excessive stress levels, hormone imbalances, inadequate nutrition, poor sleeping patterns, and the list goes on. Discover what imbalances triggered your bout of fibromyalgia and you have the key to recovery in your hand.

How to treat fibromyalgia

There are no set guidelines for treating fibromyalgia since the underlying imbalances vary from one person to the next. What works for one person may not work for someone else, although heat seems to offer nearly universal short-term pain relief.

Drug treatments for fibromyalgia range from analgesics and anti-depressants to hormone replacements. Cortisone treatments may give some temporary relief at $400 per shot too. But long time readers already know my thoughts on these trouble-laden conventional medicine approaches.

A number of alternative medicine pain treatments have found growing acceptance from fibromyalgia patients seeking pain relief without the expense and dangerous side effect risk found with many conventional medicine treatments. Fibromyalgia patients have found practices as diverse as acupuncture, acupressure, Qigong therapy, chiropractic care, and massage therapy to be helpful. A good diet and sticking to a sleep routine is important too. Magnesium has been proven to help muscles relax and 400mg-600mg taken before bed refreshes muscles as you sleep.

The answer to fibromyalgia I found

I’ve studied pain, particularly back pain, for many years. Yet fibromyalgia is one of those chronic pain ailments that left me scratching my own head for quite awhile – until I was introduced to a guy named Greg Fors.

Actually, it’s Dr. Greg Fors, a board-certified neurologist. But I won’t hold that against him because he’s a truly brilliant old school physician. Why brilliant? Because he’s one of the rare breed of doctors who understands that solving a problem requires finding and fixing the underlying cause. Not just covering up the symptoms with drugs or fleecing your patients with unnecessary surgery.

Anyhow, Dr. Fors released a 398-page healing resource awhile back called Why We Hurt: Your Total Self-Care Guide for Backaches, Headaches, Shoulder Pain, Arthritis and Fibromyalgia. It truly gets to the bottom of why we acquire chronic pain ailments, including fibromyalgia. And as a chronic pain survivor himself, Dr. Fors also tells you in his book what he found for himself: how to fix the problem.

After I read his book I was so impressed I decided to give it away free on our company’s main website because the information inside is simply too important for fibromyalgia sufferers. If you’re suffering from fibromyalgia or any other kind of chronic pain, this book can help.

I don’t know how many free copies are left, so I suggest requesting your own free copy right away. If we’re out, try calling my office to see when we’ll have more available.

Related References:
Questions and answers about acupuncture. National Cancer Institute.

Good Living with Fibromyalgia. Atlanta, Ga.: Arthritis Foundation; 2006.

Wolfe F, Smythe HA, Yunus MB et al. (February 1990). “The American College of Rheumatology 1990 Criteria for the Classification of Fibromyalgia. Report of the Multicenter Criteria Committee”. Arthritis Rheum. 33 (2): 160–72

Schweinhardt P, Sauro KM, Bushnell MC. (October 2008). “Fibromyalgia: a disorder of the brain?”. Neuroscientist. 14 (5): 415–21.


Is That Pain Down Your Leg Sciatica?

Pain Down Your Leg SciaticaDo you have a sharp pain that frequently radiates through your buttocks, down the outside of your leg, right into your foot? If so, you might ask me as so many others have: Is sciatica causing my leg pain?

That’s an easy one. No.

How can you say that without ever meeting me you ask? Let me explain.

The term sciatica can describe the symptoms you are feeling. But it doesn’t describe what causes those symptoms.

Mere semantics? Not really. Because ending your sciatic pain doesn’t require finding out what your pain feels like (the symptoms, called sciatica). It requires finding out what is causing it (the underlying condition).

So, what causes sciatica?

Glad you asked. But let’s first clear up what sciatica actually is with a more formal definition to make sure we’re on the same page.

Sciatica is the symptom of radiating pain felt in the lower back, buttocks, hamstring, back of the knee, outside of the calf, and / or the foot. It may also be associated with muscular weakness, numbness, or even an electrical tingly feeling. Yep, tingly is a technical term.

The underlying cause of sciatica is generally the compression or irritation of either the actual sciatic nerve or one of the major lumbar nerves (L4 or L5) or sacral nerves (S1, S2, or S3).

Outside of trauma or the very rare spinal tumor, most cases of sciatica are caused by one of these four underlying conditions: a herniated disc, spinal stenosis, spondylolisthesis, or piriformis syndrome.

Sometimes women experience sciatica during pregnancy as the enlarged uterus presses against the sciatic nerve and postural dysfunctions associated with carrying the extra weight pulls their spine out of proper alignment.

When it comes to sciatica, the right question isn’t “Is sciatica causing my leg pain?” Instead ask, “Is my leg pain sciatica?” This short video will help you visualize what may be causing your sciatica so you can quickly treat it properly and end your sciatic pain.


Menthol for Pain Relief

Menthol for Pain ReliefMenthol, one of nature’s most effective natural pain relievers, can already be found in products throughout your medicine cabinet, purse, and even your pocket.

Fully 3,000 tons of menthol are manufactured every year for products like mouthwash, toothpaste, breath-mints, gum, lip balms and on the list goes. Yet menthol really shines when used in pain relief creams.

What is menthol?

Menthol is the powerful organic compound found in the plant family ‘genus Mentha’, more commonly known as the mint and peppermint plants. While mint and peppermint are found world-wide, menthol is extracted in crystallized form from the oils of the wild mint or corn mint plant native to India, western and central Asia, the Himalaya, Siberia and North America.

How does menthol help relieve pain?

You may know from experience rubbing on a pain relief cream with menthol instantly brings cool, soothing pain relief to aching muscles. What you may not know is how menthol actually tackles pain in three different ways all at once.

Menthol has a natural analgesic (pain reliever) attribute when used in lotion, gel, or cream form. As the lotion is applied, molecules called ligands attach themselves to receptors in your cell triggering a change. The menthol ligand attaches to the kappa Opioid receptor, which produces a numbing effect.

Another reason menthol works so well when you rub it on those aching muscles is because it triggers a process called vasodilation. Blood vessels in the area widen, increasing blood flow to the area and reducing the skin barrier function. As a result, other medicinal ingredients typically found in that lotion along with the menthol get to work faster while the increased blood flow itself bring nutrients necessary for cellular repair and carry away waste.

Finally, one of the biggest culprits behind muscle aches and pains is inflammation. The Latin word for inflammation is inflammare which means “to set on fire.” Menthol brings a wonderful cooling sensation by stimulating thermoreceptors in the skin cells which help your body recognize temperature changes. Your skin doesn’t actually change temperature. Instead, menthol causes a signal to be sent which your brain interprets as cold, relieving the uncomfortable heat of inflammation. That’s why many first aid products use menthol for cooling in place of ice.

Clearly the mint plant gives us much more than good flavoring. It provides one of nature’s most effective natural pain relievers which even speeds up healing.

Related references:
Leffingwell, J.C. & R.E. Shackelford, Laevo-Menthol – Syntheses and organoleptic properties, Cosmetics and Perfumery, 89(6), 69-89, 1974

Ting, Lillian. Publication on neurons, cellular reaction, medicinal qualities of menthol. Science Creative Quarterly

Galeottia, N., Mannellia, L.D.C., Mazzantib, G., Bartolinia, A., Ghelardini, C. (2002). “Menthol: a natural analgesic compound”. Neuroscience Letters 322 (3): 145–148. doi:10.1016/S0304-3940(01)02527-7.

Braina, K.R., Greena, D.M., Dykesb, P.J., Marksb, R., Bola, T.S., The Role of Menthol in Skin Penetration from Topical Formulations of Ibuprofen 5% in vivo, Skin Pharmacol Physiol, 2006;19:17-21 [1]

PDR for Herbal Medicines, 4th Edition, Thomson Healthcare, page 640. ISBN 978-1563636783


Congress Threatens Your Access to Supplements… Again

Congress Threatens Your Access to SupplementsThree months ago I sounded the alarm about dangerous calls in the media to repeal the Dietary Supplement Health and Education Act of 1994 (DSHEA). I explained then how the DSHEA actually protects our rights as consumers and why supplements should not be regulated in the same fashion as prescription drugs.

Now, Senator McCain (R-AZ) and Senator Dorgan (D-ND) have introduced a bill called the Dietary Supplement Safety Act (DSSA) which dismantles key provisions of the DSHEA.

If passed, the FDA would be granted broad new powers to curtail the sale of vitamins, minerals, herbs, fish oils and other supplements along with the potency of those sold. In fact, many supplements already available would suddenly become illegal to purchase.

How’s that? The new legislation mandates all dietary supplements must undergo a new process of governmental review just to stay on the market. Just imagine having your glucosamine and chondroitin supplement suddenly pulled off the shelves simply because the FDA wishes to run it through the same multi-million or even billion dollar review process prescription drugs undergo.

Would it be fair to place supplements under the same testing restrictions as drugs? Not at all. Prescription drug companies can afford this costly process as their products are patent protected. Supplements, derived from food and other natural sources, don’t enjoy that luxury. This cost prohibitive requirement would cause supplements you rely upon to keep you healthy to either disappear or become much more costly.

The existing law already provides for supplement safety. Most supplement ingredients have already stood the test of time — in many cases, centuries of use. Supplements with any new ingredient must be reported to the FDA with scientific proofs before product release. The current DSHEA law strikes the right balance between product safety and the consumer’s right to choose the supplements that can improve their health.

Don’t confuse the mislabeled Dietary Supplement Safety Act with real safety. If passed, the new DSSA bill would interfere with your right to safe and affordable health supplements and should be vigorously opposed. Your health just may depend on it.


 
 
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