Sunday, February 9, 2014

Words Create Pain, Despair and Can Have a Lasting Impact With Chronic Pain Patients


Most people don’t think a lot about the words they speak, what they say, how it comes across or how it may affect the person they are speaking to.  The one thing that we do need to consider is words are, of course, the most powerful drug used by mankind. – Kipling, 1923.  Think about those words...

 

Just prior to my diagnosis with Complex Regional Pain Syndrome (CRPS), I had several close colleagues that said to me, “You have to get a definite diagnosis because if this is CRPS or RSD it will end your life as you have known it!  We pray we are wrong, but if we are correct it will be life altering, your life will be forever changed – not in a good way.”  These were physicians that were speaking to me!  They were already planting the seeds in my head that if I was diagnosed with Complex Regional Pain Syndrome that it was going to be a train wreck or worse.  They were crushing any hope that I had for remission or for gaining control over the condition before I was even diagnosed!

 

In 1923 Kipling spoke some famous words to the Royal College of Surgeons in London:  “Not only do words inflect, egotize, narcotize, and paralyze, but they enter into the colour the minutest cells of the brain…”  Kipling understood how words could change the way another person thinks and feels, and influences people to do things they might not otherwise do.  Similar to drugs. 

 

Other words that were spoken thousands of years ago still ring in many minds today:  “Do unto others as you would have others do unto you.”  These words, often attributed to Jesus, are responsible for stirring the conscience of countless millions.

 

Words can heal.  Words can have lasting impact.  Words can destroy.

 

 

How Words Can Affect Chronic Pain Patients

 

Words retain their power even when they are spoken to a patient when under sedation or anesthetic.  Most people don’t realize that the medications utilized for sedation or anesthetic for a medical procedure or surgery are called hypnotics.  They affect your subconscious. 

 

When I was in the process of getting several Lumbar Sympathetic Blocks for my CRPS, I had several occasions when they tried to sedate me with Versed and Fentanyl.  Unfortunately, due to other medications I had been on for some time I was still awake when taken into the surgical suite.  While I was trying to get the attention of the OR nurses and my Pain Management doctor to let them know that I was still fully with it, I could hear the nurses talking about how painful the procedure was going to be, how sorry they were to see me having to go through this so many times, and many other negative comments about pain, the procedure and recovery.  At the time I was not thinking about what they were saying, I was more worried about getting their attention to get more medication on board so I would not have to be awake during this procedure!

 

Although I wasn’t thinking about what was said during this one procedure, everything that was said was recorded into my subconscious.  It was tucked away with the other information that I was told before my diagnosis, by other healthcare professional and even my own doctors.  As time goes on the words of caregivers, physicians, nurses, loved ones, friends and even our own words build up and can become detrimental to us in the long run.  Our subconscious is a very powerful tool, especially when it has been filled with negative comments, words and suggestions as to our situation and our outcome as Chronic Pain patients. 

 

There have been many studies at Stanford and Harvard Universities on the power of the subconscious mind.  It can be similar or related to the placebo effect.  I don’t want to down play any part of the negative comments by stating that, but it is the easiest way to explain it.  If you are going in for a procedure and the nurse or anesthesiologist tells you when you come out in the recovery room you will most likely feel nauseous, dizzy, and have pain… Then you have a very high likelihood that you will experience all of those exact side effects after the procedure.  On the other hand if they think about their words and tell the patient that everything well go smooth, you will return to recovery are warm, very comfortable and they will be there to meet your needs.  You will have a much better outcome.  More and more hospitals, surgical centers, ambulatory facility and doctor’s offices are looking at these statistics.

 

Words do have consequences, it remains a dilemma for many when they realize this. 

 

As my journey with CRPS continued I went through many Lumbar Sympathetic Blocks, Regional Blocks, Physical Therapy, many medication changes, and three Spinal Cord Stimulators (the last one was taken out as it was causing a build-up of scar tissue on the Dura of my Spine that would have caused paralysis), etc…  This all occurred over a matter of three to four years.  After my last Spinal Cord Stimulator was ex-planted (removed) my Pain Management doctor sat me down and told me he was at a loss.  He had no idea what to do anymore.  I had one of the most aggressive cases of CRPS that he had seen, it was extremely volatile and everything he had tried only made it worse.  He had no words of encouragement, no positive words, only words of discouragement!  I knew he was frustrated and I even asked him if I was not willing to give up, how was he willing to give up.  He had no idea what to say or how to react to this comment or question. 

 

By this time my CRPS had moved from my left foot/ankle up into my calf region, it had tried to mirror over into my right leg several times, it had moved into my back and was definitely on the move to other areas of my body.  It was apparent from his facial expression, his mannerisms and more importantly his words that he was throwing in the towel. 

 

I refused to give up!  I continued to search for answers, for some way of getting my CRPS into remission.  I knew in my heart that there had to be a way and I was determined to find it.

 

In my journey the one big thing that I found out was that all of the negative words that I had heard from prior to my diagnosis, in my procedures, at home, in my doctor’s office, from other’s with this condition that felt there was no cure or chance for remission, etc… that it impacted a part of my brain – the subconscious.  This only continued to feed my pain and made it worse.  It also lead to a diagnosis of PTSD in addition to my CRPS.  A lot of Chronic Pain patients have no idea that they are also dealing with Post Traumatic Stress Disorder (PTSD) in addition to their Chronic Pain.  This is a common combination that pain patients face, but are not diagnosed with.

 

Think of it this way, if someone tells you, you will have an awful headache following a procedure the odds are you will have that headache!   If they would have said you will come out of this procedure feeling great, pain free, etc… you would have a different outcome. 

 

Bottom line is that it is very important for those individual that are around Chronic Pain patients to pick their words wisely.  This includes the Chronic Pain patient themselves. When we get down and think negative words or play various negative scenarios through our mind it can be just as damaging. Physicians, nurses and those in the medical community have a larger responsibility as their words can change the way the patient thinks and feels, and influence patients to do things that they may not otherwise do or feel.

 

 

Find Your Voice

 

Finding your voice can and will change your life.  If you don’t believe you have the right or the confidence to speak up when you know you should, you will suffer.

 

If you have a physician, nurse or someone in your life that is speaking to you in a negative manner and affecting your outcome, speak up.  This is your life, you have to be your advocate or no one else will be.

 

If you resolve to develop confidence, you’ll change through your words.  Learn to speak up for yourself and you will help define who you are in the long run!

 

 

I hope this short article will help others with Chronic Pain, CRPS or RSD.  Should you have any questions or comments please leave them for me.  I enjoy hearing from you.

Wednesday, January 15, 2014

Sleeping Better and Setting a Sleep Routine




Tips for Getting a Good Night’s Sleep for CPRS/RSD & Chronic Pain Patients.

I have seen more and more posts on Twitter about Pain Patients having problems sleeping.  I know with my CRPS at its worst I had a terrible time with sleep and that is an understatement.  Finding a ‘Sleep Routine’ helped me to gain the additional sleep that my body needed so much.  I hope by sharing the information that I was taught it can help others to gain some much needed ‘shut eye’ too.

How you feel during your waking hours hinges greatly on how well you sleep. Your sleep schedule, bedtime habits, and day-to-day lifestyle choices can make an enormous difference to the quality of your nightly rest. The following tips can help you optimize your sleep so you can feel better, emotionally balanced, and have more energy throughout the day.

The secret to getting good sleep

Well-planned strategies are essential to deep, restorative sleep. By learning to avoid common enemies of sleep and trying out a variety of healthy sleep-promoting techniques, you can discover your personal prescription to a good night’s rest.

The key, or secret, is to experiment. What works for some might not work as well for others. It’s important to find the sleep strategies that work best for you.

The first step to improving the quality of your rest is finding out how much sleep you need. How much sleep is enough? While sleep requirements vary slightly from person to person, they say most healthy adults need at least eight hours of sleep each night to function at their best.  While this is great information to know, as a Chronic Pain patient we all know that the likelihood of getting a full eight hours of sleep can be difficult.  Sometimes it seems like it is impossible, but with putting in place a bedtime routine it can help you find that nighttime slumber you are seeking.

How to sleep better tip 1: Keep a regular sleep schedule

Getting in sync with your body’s natural sleep-wake cycle—your circadian rhythm—is one of the most important strategies for achieving good sleep. If you keep a regular sleep schedule, going to bed and getting up at the same time each day, you will feel much more refreshed and energized than if you sleep the same number of hours at different times. This holds true even if you alter your sleep schedule by only an hour or two. Consistency is vitally important.

Set a regular bedtime. Go to bed at the same time every night. Choose a time when you normally feel tired, so that you don’t toss and turn. Try not to break this routine on weekends when it may be tempting to stay up late. If you want to change your bedtime, help your body adjust by making the change in small daily increments, such as 15 minutes earlier or later each day.

Wake up at the same time every day. If you’re getting enough sleep, you should wake up naturally without an alarm. If you need an alarm clock to wake up on time, you may need to set an earlier bedtime. As with your bedtime, try to maintain your regular wake-time even on weekends.

Nap to make up for lost sleep. If you need to make up for a few lost hours, opt for a daytime nap rather than sleeping late. This strategy allows you to pay off your sleep debt without disturbing your natural sleep-wake rhythm, which often backfires in insomnia and throws you off for days.

Be smart about napping. While taking a nap can be a great way to recharge, especially for Chronic Pain patients, it can make insomnia worse.  If you must nap, do it in the early afternoon, and limit it to thirty minutes.

Fight after-dinner drowsiness. If you find yourself getting sleepy way before your bedtime, get off the couch and do something mildly stimulating to avoid falling asleep, such as washing the dishes, calling a friend, or getting clothes ready for the next day. If you give in to the drowsiness, you may wake up later in the night and have trouble getting back to sleep.

How to discover your optimal sleep schedule

Find a period of time (a week or two should do) when you are free to experiment with different sleep and wake times. Go to bed at the same time every night and allow yourself to sleep until you wake up naturally. No alarm clocks! If you’re sleep deprived, it may take a few weeks to fully recover. But as you go to bed and get up at the same time, you’ll eventually land on the natural sleep schedule that works best for you.

How to sleep better tip 2: Naturally regulate your sleep-wake cycle

Melatonin is a naturally occurring hormone controlled by light exposure that helps regulate your sleep-wake cycle. Melatonin production is controlled by light exposure. Your brain should secrete more in the evening, when it’s dark, to make you sleepy, and less during the day when it’s light and you want to stay awake and alert. However, many aspects of modern life can disrupt your body’s natural production of melatonin and with it your sleep-wake cycle.

The bright lights at night—especially from hours spent in front of the TV or computer screen—can suppress your body’s production of melatonin and make it harder to sleep. However, there are ways for you to naturally regulate your sleep-wake cycle, boost your body’s production of melatonin, and keep your brain on a healthy schedule.

Increase light exposure during the day

Remove your sunglasses in the morning and let light onto your face.

Spend more time outside during daylight. Try to eat your breakfast or lunch outside in sunlight (weather permitting), take a leisurely stroll outside, take a few minutes each day to enjoy the sunshine or walk your dog (if you feel up to it) during the day.

Let as much light into your home/workspace as possible. Keep curtains and blinds open during the day.

If necessary, use a light therapy box. A light therapy box can simulate sunshine and can be especially useful during short winter days when there’s limited daylight.

Boost melatonin production at night

Turn off your television and computer. Many people use the television to fall asleep or relax at the end of the day, and this is a mistake. Not only does the light suppress melatonin production, but television can actually stimulate the mind, rather than relaxing it. Try listening to music or audio books instead, or practicing relaxation exercises. If your favorite TV show is on late at night, record it for viewing earlier in the day.

Don’t read from a backlit device at night (such as an iPad). If you use a portable electronic device to read, use an eReader that is not backlit, i.e. one that requires an additional light source such as a bedside lamp.

Change your bright light bulbs. Avoid bright lights before bed, use low-wattage bulbs instead.

When it’s time to sleep, make sure the room is dark. The darker it is, the better you’ll sleep. Cover electrical displays, use heavy curtains or shades to block light from windows, or try a sleep mask to cover your eyes.

Use a flashlight to go to the bathroom at night. If you wake up during the night to use the bathroom—as long as it’s safe to do so—keep the light to a minimum so it will be easier to go back to sleep.

How to sleep better tip 3: Create a relaxing bedtime routine

Chronic Pain patients have more barriers than the typical person, so it is even more important to try to get into a bedtime routine as we are dealing with prescription medications that affect our sleep in addition to our pain.  If you make a consistent effort to relax and unwind before bed, you will sleep easier and more deeply. A peaceful bedtime routine sends a powerful signal to your brain that it’s time to wind down and let go of the day’s stresses.  This is the same concept as setting a bedtime routine for babies.  This is done to calm them down, relax them and get them ready for a good night of rest.  As we become adults we forget to pamper ourselves and continue to set a bedtime routine for ourselves to take the stress out of our day, relax our muscles and set the tone for a better night of rest. 

Make your bedroom more sleep friendly

Make Sure Your Bed Is Comfortable

Keep noise down. If you can’t avoid or eliminate noise from barking dogs, loud neighbors, city traffic, or other people in your household, try masking it with a fan, recordings of soothing sounds, or white noise. You can buy a special sound machine or generate your own white noise by setting your radio between stations. Earplugs may also help.

Keep your room cool. The temperature of your bedroom also affects sleep. Most people sleep best in a slightly cool room (around 65° F or 18° C) with adequate ventilation. A bedroom that is too hot or too cold can interfere with quality sleep.

Make sure your bed is comfortable. You should have enough room to stretch and turn comfortably. If you often wake up with a sore back or an aching neck, you may need to invest in a new mattress or a try a different pillow. Experiment with different levels of mattress firmness, foam or egg crate toppers, and pillows that provide more or less support.

Relaxing bedtime rituals to try

Read a book or magazine by a soft light

Take a warm bath

Listen to soft music

Do some easy stretches

Wind down with a favorite hobby

Listen to books on tape

Make simple preparations for the next day

How to sleep better tip 4: Get anxiety and stress in check

Do you find yourself unable to sleep or waking up night after night? Residual stress, worry, and anger from your day can make it very difficult to sleep well. When you wake up or can’t get to sleep, take note of what seems to be the recurring theme. That will help you figure out what you need to do to get your stress, anger or anxiety under control during the day.

If you can’t stop yourself from worrying, especially about things outside your control, you need to learn how to manage your thoughts. For example, you can learn to evaluate your worries to see if they’re truly realistic and replace irrational fears with more productive thoughts. Even counting sheep is more productive than worrying at bedtime.

If the stress of managing your pain, doctor appointments, family, or finances is keeping you awake, you may need help with stress management. By learning how to manage your pain effectively, handle stress in a productive way, and maintain a calm, positive outlook, you’ll be able to sleep better at night.  Yes, I know – easier said than done.

Relaxation techniques for better sleep

Relaxation is beneficial for everyone, but especially for those struggling with sleep. Practicing relaxation techniques before bed is a great way to wind down, calm the mind, and prepare for sleep. Some simple relaxation techniques include:

Deep breathing. Close your eyes, and try taking deep, slow breaths, making each breath even deeper than the last.

Progressive muscle relaxation. Starting with your toes, concentrate on the specific muscle group; completely relax that area until it is limp or heavy. Work your way up from your feet to the top of your head.  This is also a good way to decrease pain levels.

Visualizing a peaceful, restful place. Close your eyes and imagine a place or activity that is calming and peaceful for you. Find a place that was calming to you prior to your Chronic Pain, get that image in your head, concentrate on it, see it clearly and set this as your place to go when you need to relax.  Concentrate on how relaxing this place makes you feel.

Mindfulness.  Close your eyes, take a three slow deep cleansing breathes to relax your body, say to yourself “I am calm, I am relaxed, I am sleeping…” (Do this three times prior to going to sleep.) If you awake during the night close your eyes and repeat this process, including saying to yourself, “I am calm, I am relaxed, I am sleeping…” 

How to sleep better tip 5: Ways to get back to sleep

It’s normal to wake briefly during the night. Chronic Pain patients’ have problems with sleep disturbances due to pain, medications affecting sleep cycles or being wrestles;  the reality is it happens more than we would like.  But if you’re waking up during the night and having trouble falling back asleep, the following tips may help.

Stay out of your head. The key to getting back to sleep is continuing to cue your body for sleep, so remain in bed in a relaxed position. Hard as it may be, try not to stress over the fact that you’re awake or your inability to fall asleep again, because that very stress and anxiety encourages your body to stay awake.

Make relaxation your goal, not sleep. If you find it hard to fall back asleep, try a relaxation technique such as visualization, deep breathing, or meditation, which can be done without even getting out of bed. Remind yourself that although they’re not a replacement for sleep, rest and relaxation still help rejuvenate your body.

Postpone worrying and brainstorming. If you wake during the night feeling anxious about something, make a brief note of it on paper and postpone worrying about it until the next day when you are fresh and it will be easier to resolve. Similarly, if a brainstorm or great idea is keeping you awake, make a note of it on paper and fall back to sleep knowing you’ll be much more productive and creative after a good night’s rest.

Sunday, December 29, 2013

Traditional - Western Medicine vs Complementary/Alternative Treatments For CRPS

There are a lot of opinions about how to treat Complex Regional Pain Syndrome (CRPS) aka RSD.

The majority or 99% of the physicians out there will want to start with Pain meds., anti-inflammatory meds, Physical Therapy/Occupational Therapy, local/regional blocks and then move on to Sympathetic Blocks.   If there is no improvement with these modalities the next conversation will most likely be about having a Spinal Cord Stimulator implanted.  Or a pain pump that delivers morphine directly to the nerves affected in the spine.



What happens to the patient when they are told by their physician there is nothing more they can do? Do you just continue on large quantities of pain medications and continue down the slippery slope?  Or do you fight to find something that will help, a treatment that can possibly put this awful condition into remission.



I have been on both sides of this.  I personally was diagnosed with a very aggressive, volatile case of CRPS.  Local & Regional Blocks did not work on me.  My Pain Management doctor was dumbfounded when this occurred.  Thus we moved onto Lumbar Sympathetic Blocks.  I had 13 LSB, until the last one caused my Adrenal Glands to completely shut down.  This landed me in the hospital for a week.  Following this my Pain Management doctor stated we could no longer do any LSB.  Thus, his next step was talking to me about having a Spinal Cord Stimulator implanted.  I was against the idea and had a really bad gut feeling about it, but I was told this was the last option I had to reduce my pain.  I went through with the trial and it went well.  Approximately 6 months later I had a Medtronic SCS implanted.  I had nothing but issues with it.  Every time I charged the battery it caused my affected foot to swell.  They could not figure out why this was happening.  The next step was to have the battery replaced with a non-rechargeable battery.  I underwent the surgery to change out the batteries in hopes this would correct any issues.  Keep in mind that with each of these surgeries I had to be admitted to the hospital to control my pain, even though they were supposed to be an out patient procedure.  Unfortunately, the second surgery to change the battery did not help.  I then started to have issues with the paddle that was implanted.  Long story short, they had to explant the Medtronic SCS and implanted a BostonScientific SCS. It was during this time that my CRPS moved into my back!  I had asked my Neurosurgeon if this could happen and was assured it wouldn't - it did happen after all...  I had this one for less than 6 months when I lost the ability to control the stimulation.  Upon further review of the situation and my symptoms it was determined that I had a build up of scar tissue on my Dura, that could cause paralysis if the SCS was not removed.  In Feb., 2011 the last SCS was ex planted from my spine.  At that point I was told by my Pain Management doctor, who is highly regarded, that there was nothing else he could do except to keep me on pain meds.  He was ultimately throwing his hands up in the air! This did not set well with me.  I'm not a quitter and this was no exception!



I had been inquiring into other types of treatment options that were available for CRPS.  I had received information on Calmare Therapy, and there had been a lot of promising write-ups on it.  My Pain Management doctor and I had even spoken with a doctor in Florida regarding Ketamine Infusion treatments.  I had been on oral Ketamine for years, so I had an idea of what Ketamine was capable of.  I also had some family members that gave me information on treatment options outside the US, in Frankfurt, Germany.  The treatments in Germany consisted of Alternative Medicine or what could be called complementary medicine.  My first trip to Frankfurt, Germany was when I was 6 weeks post-op from having my SCS removed.  I was on so many pain meds to just make that trip and I was still in pain!



Germany does more research on CRPS and is more advanced in the treatment options than in the US.  Plus, they do not have the same restrictions since they do not have to deal with the FDA.  My first visit there they worked on boosting my immune system, I did Stem a Cell therapy utilizing Stem Cells from my own blood, Neural Therapy with Ozone, PT, Lymphatic Massages, bodywork, vitamin IV's, blood ozone therapy, and more.  This dropped my pain levels, but I did not go into remission.

My Pain Management doctor did not know what to say when I returned with my pain levels
significantly lower.  He was dumbfounded.



Between 2011-2013, I was treated outside of the US 5-6 times.  I was the first CRPS patient in the world to be treated with 'Regional Hyperthermia'.  This significantly decreased my pain levels.  There were numerous treatments that were completed in Frankfurt, Germany that decreased my pain levels to a 5 but over the long run I was unable to stay in Germany long enough to get into remission.

Unfortunately, in October of 2013 my pain levels started to increase again.  I had been told of a Master Hypnotist, Retired Captain in the Navy, Advanced Practice RN, Nurse Anesthesiologist, NGH - Ron Eslinger.    He specializes in Pain Management, working with patients that have Chronic Pain, Phantom Limb Pain, Cancer Pain & PTSD.  His office is located in TN.  I contacted Mr. Eslinger and we spoke for quite a while.  I wanted to make sure I was comfortable with going through with a commitment of time and money to be treated by him.  He also wanted an outline of what I had been through, how I was diagnosed, what treatments I had completed, etc.  He is very thorough to say the least.  I will say that I had tried hypnosis previously and it did not help me, but I was told by several people that Mr. Eslinger was considered the Top, Master, Best of the Best when it came to Chronic Pain.  I had nothing to loose and everything to gain!  The second week in November, 2013 I flew to Knoxville, TN.  Then I drove to the city that Ron Eslinger's office is located.



I was told to expect an intense week of hypnosis, bio-feedback, imagery, working with EFT, learning self-hypnosis and doing homework every night.  We spent approximately 6-7 hours per day together, then I had reading and reviewing of the CD's of our sessions as homework.  It was a busy, intense week, but every day I saw progress that I had not seen else where.  By day 3 the CRPS pain in my back was down to a 3!  Unbelievable.  With continued work, on day 4, my back dropped to a ZERO!  Then on my last day with Mr. Eslinger we were able to get the pain in my left foot/ankle to a ZERO!  In addition to this I had a little to that was in continual spasm due to a knicked lateral plantar nerve, and we were able to get the spasms to stop for the first time since 2007.  No one thought that could happen.  When I left TN, I was given homework to follow up on at home.  This included self-hypnosis, listening to the CD 's of my sessions with Mr. Eslinger, etc.  This is key to my continued progress.



I followed up with my Pain Management doctor a week after I returned from TN.  I walked in without my cane for the first time in 6+ years, I actually had long pants on that could touch my ankle, and I had a pair of shoes on!  When my doctor came in he was shocked to say the least.  He made me take my shoe off, he wanted to see if my little toe was still spasming as it had been since 2007. When he saw it was not moving, my coloration was great in my foot, and we could both touch my foot/ankle - he pushed back on his stool, looked around the room for cameras and asked, "Am I getting punked?"  I had to laugh at him.  How could someone make this up?  He finally told me, if I would have called him with this news he would have laughed at me, but seeing me in person is believing.  I just saw him for another follow up, and he said he can not stop thinking about what I have done... It is blowing his mind.  He is considering going to get trained by Ron Eslinger on his technique.  No joke.



Whether you try Calmare Therapy which has had some great success stories with CRPS, hypnosis with someone that specializes in Chronic Pain, or other proven treatments - there are options available.  Or you may be an individual that just wants to stick with Traditional medicine - do what is right for you and your body.  What is right for one person is not necessarily right for all, but as you can see there are other treatment options out there.  Sometimes you have to search, find resources,
and do some homework but if it can help you in the long run it just may be worth it.

Tuesday, December 24, 2013

Can Hypnosis help CRPS/RSD Patients?


First of all let us start from the beginning – what is hypnosis?  There are so many misconceptions out there and different beliefs about what hypnosis is, what it’s about and does it really work.



Yes, there are the stage shows that we have all seen where you have they guy on stage that pulls several people up there with him and makes them look stupid, quack like a duck, take half their clothes off or even has a participant try to seduce someone.  Those are the types of things that have given hypnosis a bad name and people can’t get over the fact that there really is more to it.





Here are some facts and information on hypnosis: 

Clinical hypnosis is a procedure in which a trained clinician or therapist gives a patient a series of verbal instructions with the goal of helping the patient to enter a state of deep relaxation.  In the relaxed state, the patient is aware of everything that is going on, but at the same time, becomes increasingly absorbed in using his or her imagination as directed by the therapist.  Therapists use a variety of techniques to help their patients acquire the self-control and confidence to visualize, realize, and achieve goals such as reducing sensations of pain.  Therapists often teach their patients self-hypnosis methods that they can employ on their own to reinforce and continue to process at home.

Patients participated in a self-hypnosis relaxation session that involved deep-breathing and concentration techniques.  The researchers found that these patients required less than half the amount of painkilling drugs used by those receiving standard treatments.  Procedures also took less time for the hypnosis group, and they had lower levels of anxiety and pain at both one hour and four hours into a procedure.



In addition, a review of 13 studies of Chronic Pain published in the International Journal of Clinical and Experimental Hypnotherapy in 2007 found that hypnosis consistently reduced pain and was effective that physical therapy and educational efforts.  Clinical research shows that hypnosis can be effective in treating fibromyalgia, migraine headaches, chronic pain conditions and CRPS/RSD.



In 1958 the American Medical Association (AMA) endorsed hypnosis and hypnotherapy as a legitimate treatment tool for pain, stress and relaxation management, weight loss, smoking cessation, childbirth, preparing for surgery, as well as overcoming fears of medical, dental and other hospital procedures.



Hypnosis is older than medicine and has been with us since mankind had its beginnings.  Virtually every culture and race of people have used it.



In biblical times, people went to “sleep temples” to be cured of their illnesses by the Egyptian priests.  The ancient Chinese employed hypnotic techniques in the form of prayer and meditation.  There is evidence that the Romans used “magic sleep” for various purposes.  The Greeks unknowingly used hypnosis, thinking that cures came from the Gods.  Hippocrates wrote about impressing health on the ill by inducing trances and by making passes.

Throughout the centuries, many medical individuals have studied, researched, and experimented with hypnosis.  In doing so, they usually were labeled charlatans, quacks, or imposters.  It is impossible to mention all of those individuals who contributed to the development and progress of modern hypnosis, but in seems necessary to mention a few.

From 1932 – 1974, Milton Erickson, a psychologist and psychiatrist pioneered the art of indirect suggestion in hypnosis.  He is considered the father of modern hypnosis.  His methods bypassed the conscious mind through the use of both verbal and nonverbal pacing techniques including metaphor, confusion, and many others.  He was a colorful character and has immensely influenced the practice of contemporary hypnotherapy, and its official acceptance by the AMA.  His work, combined with the work of Satir and Perls, was the basis for Bandler and Grinder’s Neuro-Linguistic Programming (NLP).



Top Hypnotherapists that deal with Chronic Pain Patients and CRPS:

There are two gentlemen that are very involved with hypnosis and hypnotherapy that I would like to mention to you.  David Spiegel, MD is a Professor at the School of Medicine and Associate Chairman of Psychiatry and Behavioral Sciences, both at Stanford University School, where he has been a member of the academic faculty since 1975.  He is also director of the Psychosocial Research Laboratory.  He received his medical and psychiatric training at Harvard University before going to Stanford.  He is the author of more than 280 research papers, chapters in scientific journals, and books.



David Spiegel has long had an interest in the use of hypnosis as treatment for medical symptom and treatment side effects.  In 1978, he and his father, Herbert Spiegel, MD, co-authored what has become a standard text book on the clinical uses of hypnosis, Trance and Treatment.  The use of self-hypnosis to help children undergoing painful procedures is among his current research funded by the John D. and Catherine T. MacArthur Foundation.  He is the past President of the Society for Clinical and Experimental Hypnosis, and in 1986, he was the recipient of the Schneck Award for significant contributions to the development of medical hypnosis.  In 1998, David Spiegel opened the Center for Integrative Medicine at Stanford Medical Center and serves as its Medical Director.



Dr. Spiegel has done many studies showing how hypnosis does affect the pain receptors in the brain.  They have utilized PET Scans before and after to show exactly where the pain shows in the brain when a patient is in extreme pain.  Then they have taken the same PET scan following hypnosis for pain and the area is no longer lighting up as it did when the patient was experience extreme pain.  This was a consistent finding thus it shows that hypnosis for pain does work.

Another person that is well known for Pain Hypnosis is Ron Eslinger, Captain, USN, Retired, RN, CRNA, MA, APN, BCH, CMI FNCH (Certified Registered Nurse Anesthetist, Master of Arts, Advanced Practice Nurse, Board Certified Hypnotherapists, Certified Master Instructor of Hypnosis, Fellow National Counsel for Hypnotherapy (United Kingdom)).



Ron Eslinger has dealt with chronic pain patients for many years now with phenomenal outcomes.  As a Certified Master Instructor of Hypnosis, Mr. Eslinger not only sees patients, but he also teaches others on how to treat Chronic Pain patients too.



When working with Chronic Pain patients or CRPS patients Ron Eslinger has found that the hippocampus, which controls memory, is another player within the Limbic System.  There are three types of memory:  working memory, declarative memory, and procedural memory.  The hippocampus is critical in cementing declarative memory, which can be compared to the memory in the hard drive of a computer.   Of these three types of memory – only declarative memory impacts our perception of reality. 



During recall, we fit together a piece of the puzzle here and a piece of the puzzle there and put it back together as a complete memory.  Hypnotic processes help reconstruct the pieces of a puzzle.  Hypnosis helps one to remember how they are supposed to feel, replacing the memory of pain or stress with a new memory of comfort.  Hypnosis brings memories back together completing the picture.  However, memories can be as false as they can be true.  All memories are based on perception and perception becomes the reality.



Procedural memory is stored as conditioned responses for reflexes.  Reflexes are actions, habits or skills that are learned simply through repetition.  We all develop procedural memories.



Hypnosis Relieves Pain:

Hypnosis has been used to relieve pain and influence behavior for more than 150 years now.  Evidence based research on the use of hypnosis to relieve pain is limited, but a larger, well-designed study did boost its credibility as a useful and cost-saving pain relief method for hospital procedure rooms.



Published In:  The Lancet in 2000, the study evaluated the effectiveness of hypnosis-termed “non-pharmacologic analgesia” – in easing pain and anxiety in people who were having minimally invasive surgical therapies such as angiograms, angioplasty, simply kidney procedures, or liver biopsies, during which they remained conscious.

Hypnosis allows pain relief without drugs or surgery.  Here is a link to an article from Harvard regarding this:  http://www.health.harvard.edu/special_health_reports/pain-relief-withouth-drugs-and-surgery.




If you would like additional information on hypnosis and chronic pain management please contact
Advanced Pathways Hypnosis at: Info@Advancedpathways.com  |  www.AdvancedPathways.com   |   714.717.6633






Monday, December 2, 2013

CRPS/Chronic Pain Patients & How Clinical Hypnosis Can Benefit Them


CRPS / Chronic Pain Patients and How Clinical Hypnosis Can Benefit Them



Complex Regional Pain Syndrome aka CRPS has been around since the Civil War.  Yet most recently when it is coming to the attention of the media it is being called, “The Mystery Illness…” as well as many other things.  Early on it was called Regional Sympathetic Dystrophy aka RSD, and then recently the name was changed to CRPS. 

According to most physicians that you will speak with they will tell you that they are not sure what causes CRPS.  What they do know is that your “Fight or Flight” nerves are continuously sending signals to the brain that there is trauma in the affected area.  Thus, the brain in turn sends back a pain signal and the patient is caught in a continuous loop of pain.  Yes, it is more complicated than this, but this is the easiest way to explain it so that everyone reading this can understand what is happening.  Now, the BIG question is how do we stop that pain signal?

For those of you that have read my earlier blogs, you know that I am a CRPS patient myself.  I was diagnosed in 2007.  I was diagnosed by a highly regarded Pain Management Doctor with two Doctorates and he is also an Associate Professor at a teaching University.  He initially thought he could have me in remission within 6 months… Well, as of the end of 2011 he had thrown his hands up as nothing he did worked and he was out of options.  That is not too comforting as a patient!  What he soon found out was that I refused to give in to CRPS, it had taken over my life, it had taken everything from me except for my will power.  I was originally diagnosed with CRPS type 2 in my left foot/ankle and after going through several Spinal Cord Stimulator surgeries, it also moved into my back.  After the usual traditional medicine failed me here in the US, I started flying to Frankfurt, Germany to get out of the control of the FDA to get treatment, and I even went to Mexico several times too.  Germany was able to get my pain levels from what you would know as a (10++++++) on the pain scale down to a 5.  I thought that was great, but after several months of being home it would slowly start to go back up.  I was treated in Frankfurt at a private clinic that I would highly recommend 5-6 times.  The Medical Director had dealt with CRPS previously and was not afraid to step out and try new things!  I was eventually introduced to what is called, Clinical Hypnosis, November of 2013.

I was referred to a person that specifically works with Chronic Pain patients, patients with CRPS, Phantom Limb Pain, Fibromyalgia, Cancer Pain, etc… 

Many people hear “hypnosis” and they think of the old stage shows, black magic, etc…  That is not what I am talking about at all! 

What is hypnosis?            The American Medical Association defines hypnosis as a temporary condition of altered attention, within which a variety of phenomena may appear spontaneously, or manifest themselves in response to verbal or other stimuli.  To state it simply, when a person is hypnotized or relaxed, their susceptibility to suggestion is increased.  Thus hypnosis or relaxation can be considered a learning process.

What is Chronic Pain?     Chronic Pain is pain that lasts longer than 6 months.  In some cases untreated pain may worsen as the nerve fibers which transmit pain signals to the brain become more efficient and effective at sending these messages to the brain.  This means that the intensity with increase to more than is necessary to get your attention and thus your brain will become more sensitive to pain.  If this persists then the usefulness of the pain will diminish and could instead lead to preventing individuals from going about their everyday activities / life.

When being in pain, pain causes stress or being stressed worsens pain – therapies including hypnosis, meditation and relation – may break the cycle (if taught by a Certified Clinical Hypnotist with experience in Pain Management).

Benefits of Hypnosis?    Research has shown medical / clinical hypnosis to be helpful for acute and chronic pain. In 1996, a panel of the National Institutes of Health found hypnosis to be effective in easing cancer pain.  More recent studies have demonstrated its effectiveness in pain related to burns, cancer, R.A. , Chronic Pain and the reduction of anxiety associated with surgery.  An analysis of 18 studies by researcher at Mount Sinai School of Medicine in New York revealed moderate to large pain relieving effects from hypnosis, supporting the effectiveness of hypnosis for pain management.

Overview:           A big part of chronic pain and dealing with it via hypnosis is an area of the brain referred to as the, “Limbic System”.  This area includes the Hypothalamus, Amygdala and Hippocampus.  When functioning properly, the Limbic System sets the emotional tone of the mind and influences changes throughout the body by using chemical messages.  However, when functioning abnormally numerous health problems can occur.  Physical problems, such as lack of sleep, too much stress, or chronic pain, exacerbates the problems created by an out-of-balance Limbic System.  In some cases, depending on the external factors, these imbalances can result in post-traumatic stress disorder (PTSD).  This is the essence of stress turning into distress. 

The Hypothalamus also regulates the functioning of the parasympathetic and the sympathetic (fight or flight) nervous systems, which in turn means it regulates things like pulse, blood pressure, breathing, and arousal in response to emotional circumstances.  Therefore, changing thoughts also changes our health.  Ultimately hypnosis is used, along with other techniques, to retrain the brain’s response through the Limbic System.

A good clinical hypnotherapist will take the time to find out where your Chronic Pain or CRPS is most prominent.  The person I saw explained the brain, the Limbic System, how cells regenerate every 90 days (and cells have memories… thus every 90 days you have the opportunity to reprogram your cells…), how the nerves fire in the brain and the biggest thing – “There is no pain, until the signal gets to the brain…”  How true that statement was!

We spent 30+ hours utilizing clinical hypnosis, bio-feedback, imagery, light/sound therapy and being taught ‘self-hypnosis’.   When all was said and done I found out that I too was suffering from PTSD in addition to CRPS.  This did make sense to me.  We worked on my pain levels or as he called them my, “comfort levels”, my sleep (going in I was doing good to get 2 hours per night), gaining control over what was important to me, etc… When I came home I had a copy of every session on CD, books, other CDs to listen to, my own light/sound therapy machine and felt fully equipped to keep my “Comfort Levels” at a ZERO.

If you would like more information on Clinical Hypnosis and how it could help you or a loved one dealing with Chronic Pain or CRPS please feel free to contact me!  I can be reached at rsd.crpsforum@gmail.com.




This is just an overview of hypnosis for pain management.  It is not meant as medical advice.  If you are under the care of a physician please continue their orders.