When Life Hurts
Understanding the Reality of Chronic Pain as Disability
Denise Gaulin
Cranial Sacral Therapy
Cranial Sacral Therapy (CST) has its roots in osteopathy. Since the 1970's Dr. John Upledger has transformed this art and science into an accessible protocol and evaluation and therapy for the nervous system and all its functions throughout the body.
CST focuses on the complex tissues encapsulating the brain and spinal cord. The therapist listens with her hands to the gentle wave - like motion of the production and absorption of the cerebrospinal fluid and its effect on its boundaries. The therapist then facilitates the release of the restrictions detected; CST's magic comes from the patient use of light pressure or traction (the weight of a nickel) to bring healing, balance and freedom to the body's tissues.
A CST session with a skilled therapist last approximately one hour. You are fully clothed, lying on your back on a soft treatment table. Most clients experience a deep sense of relaxation during and after their CST session.
By virtue of its gentleness and body-centeredness, CST is highly effective for many conditions. Because of its non-invasive gentleness, CST is the therapy of choice for young children.
- Chronic pain from stress or injury
- Migraines & headaches
- Sprains and severe bruises
- TMJ or pain from dental work
- Scoliosis and Torticollis
- Traumas to the head & spine
- Tissue memory of abuse or traumas
- Chronic fatigue
- Motor coordination and balance impairments
- Endogenous & post-partum depression
- Chronic ear infections
- Learning disabilities
One of the greatest contributions CST brings to us in these times of ill-health and stress, is its inherent support and strengthening of the whole person's coping and healing mechanisms.
In a nutshell, CST works with the body's incredible wisdom to heal its core and will attain to balance. Get to know and engage your body's best abilities to support you at all levels of your healing. Treat yourself to a better state of health and well-being.
Appendices
- Formal Text of Dr Ellen Thompson Keynote Address
- Reference and Readings in Chronic Pain by Dr J.L. D'Eon
- Internet Resources by Sammi Ha, Microsoft Canada
References and Readings
Breakthroughs and Advancements
Traditional Management of Chronic Pain
Dr J.L. D'Eon
Burns, J.W., Johnson, B.J., Mahoney, N., Devine, J., Pawl, R.(1998). Cognitive and physical capacity process variables predict long-term outcomes after treatment of chronic pain. Journal of Consulting and Clinical Psychology, 66,2,434-439.
Blanchard, E.B., & Diamond,S. (1996) Psychological treatment of Benign Headache Disorders. Professional Psychology: Research and Practice, 27,6,541-547.
Brietbart,W. HIV,AIDS, and pain (1999). In R.J. Gatchel & D.C.Turk, Psychosocial Factors in Pain. Guildford Press: New York.
Canadian Pain Society. (1988) Consensus Statement and Guidelines: Use of opioid analgesics for the treatment of chronic non cancer pain - A consensus statement and guidelines from the Canadian Pain Society. Pain Research and Management, 3,4, 197-208
Carter, B.(1998) Perspectives on Pain - Mapping the Territory, Oxford University Press, New York
College of Physicians and Surgeons of Ontario (August 1999, draft). Evidence-Based Recommendations for Management of Chronic Non Malignant Pain.
Compas,B.E.,Haaga, D.A.F., Keefe, F.J. Leitenberg, H. & Williams, D.A. (1998) Sampling of empirically supported psychological treatments from health psychology, smoking, chronic pain, cancer and bulimia nervosa. Journal of Consulting and Clinical Psychology, 66,11, 89 - 112
Crombie, I.K., Croft, P.R., Linton, S.J.,LeResche, L., Von Korff, M. (EDS.) (1999) Epidemiology of Pain. International Association for the Study of Pain. ISAP Press: Seattle, WA
Cooper, R.A., et al. (1999) Research on physical activity and health among persons with disabilities: A consensus statement. Journal of Rehabilitation Research and Development, 36,2.
Currie, S.R., Wilson, K.G., Pontefract, J.J. and deLaplante, L. (In press) Cognitive-behavioural treatment of insomnia secondary to chronic pain. Journal of Consulting and Clinical Psychology
Diener, E., Suh, E.M., Lucas, R.E., Smith, H.L.(1999) Subjective well-being - Three decades of progress. Psychological Bulletin, 125, 2, 276 - 302
Fields, H.L. (1999) Pain: an unpleasant topic. Pain, 6, S61 - S69
Gatchel, R.J. & Turk, D.C.(1999) Interdisciplinary treatment of chronic pain patients. In R.J. Gatchel, & D.C. Turk, Psychosocial Factors in Pain. Guildford Press: New York
Gatchel, R.J. & Turk, D.C.(1999) Psychosocial Factors in Pain. Guildford Press: New York
Ferrel, B.R., & Ferrel, B.A. (Eds). (1996) Pain in the elderly. International Association for the Study of Pain. ISAP press: Seattle, W.A.
Feuerstein, M.Huang. G.D. & Pransky, G. (1999) Work style and work related upper extremity disorders. In R.J. Gatchel, & D.C. Turk, Psychosocial Factors in Pain. Guildford Press: New York
Field, TM (1998) Massage therapy effects. American Psychologist, 53, 12, 1270 -1281
Goffman, E. (1963). Stigma : Notes on the Management of Spoiled Identity. Englewood Cliffs, N.J.: Prentice-Hall, Inc.
Holroyd, K.A. & Lipchik, G.L. (1999)Psychological management of recurrent headache disorders: Progress and prospects. In R.J. Gatchel, & D.C. Turk, Psychosocial Factors in Pain. Guildford Press: New York
Katz, J., et al. (1999) A randomized, controlled study of the pain - and tension reducing effects of 15 min workplace massage treatments versus seated rest for nurses in a large teaching hospital. Pain Research & Management, 4,2, 81-88
Lazarus, R.S. (1983). The trivialization of distress. In B.L. Hammonds & C.J. Scheirer (Eds.) Psychology and Health: APA Master Lecture Series, 3, 125- 144
Linton,S.J. (1999) Prevention with special reference to chronic musculoskeletal disorders. In R.J. Gatchel, & D.C. Turk, Psychosocial Factors in Pain. Guildford Press: New York
Merskey, H. & Bodguk, N. (Eds.) (1994). Classification of Chronic Pain (Second Edition) International Association for the Study of Pain. ISAP Press: Seattle, W.A.
Nagler, M. (1993). Perspectives on Disability. Health Markets Research, Palo Alto: Ca.
Paul, G.L. (1967). Strategy of outcome research in psychotherapy. Journal of Consulting Psychology. 31,109-118
Scully, D., Kremer, J. Meade, M.M. Graham, R & Dudgeon, K. (1998). Physical exercise and psychological well being: A critical review. British Journal of sports Medicine, 32,2,112-120
Shrey, D,E,, & Lacerte, M. (Eds.) (1995) Principles and Practices of Disability Management in Industry. GR Press Inc: Winter Park, Florida
Talo, S., Rytokoski, U., Hamalainen, A., & Kallio, V. (1998). The biopsychosocial disease consequence model in rehabilitation: model development in the Finnish work hardening programme for chronic pain. International Journal of Rehabilitation Research, 1998, 21,2,113-126
Taylor, Paul. (1999, September 21) Treating Chronic Pain - Counting our narcotic blessings. The Globe and Mail, C6
Teasell, R.W. (1997). The denial of chronic pain. Pain Research & Management, 2,2, 89-91
Teasell, R.W. & Merskey, H. (1997). Chronic pain disability in the workplace. Pain and Research Management, 2,4, 197 - 205
Turk, D.C., Okifuji, A. (1997) . Evaluating the role of physical, operant, cognitive and affective factors in the pain behaviours of chronic pain patients. Behaviour Modification. 21,3, 259 - 280
Turk, D.C., Rudy, T.E., et al. (1996). Dysfunctional patients with temporomandibular disorders: Evaluating the efficacy of a tailored treatment protocol. Journal of Consulting and Clinical Psychology, 64, 1, 139-146
Von Korff, M. (1999) Pain management in primary care: An individualized stepped care approach. In R.J. Gatchel,& D.C. Turk, Psychosocial Factors in Pain. Guildford Press: New York
Woolf, C.J., & Decosterd, I. (1999) Implications of recent advances in the understanding of pain pathophysiology for the assessment of pain in patients. Pain, 6, S141-S147
The College of Physicians and Surgeons of Alberta gratefully acknowledges the helpful advice of Dr. Russell K. Portenoy in the preparation of the document.
Personal story
March 31, 1999. "You appear to be in remission and this will be the end of your chemotherapy treatment". The oncologist wanted to keep going for a few more chemotherapy cycles as insurance against return of the cancer, but had to acknowledge that any more would probably kill me and thereby force the conclusion that the treatment had been successful, but unfortunately the patient had died.
Sure, it might take time for the effects of chemotherapy to wear off, but here we were on the first step of the road towards recovery and a return to normal life. I would gradually be able to reduce medications and resume normal activities and the pain, weakness, fatigue and lassitude would disappear as this happened. I was so wrong.
Some signs of some improvement raised hopes of a slow, steady recovery, culminating in eventual resumption of a productive life. But then it all started. I started to deteriorate, with the return of most of the old chemotherapy /cancer symptoms and a whole bunch of new ones. Since then my life has been a roller coaster with ups and downs, sudden changes of direction and totally unexpected surprises. Here's what has happened, much of it starting after chemotherapy was over:
Toes: Poor circulation, swollen, numb, pain
Feet: Poor circulation, swollen, numb, pain in soles
Ankles: Swollen
Lower Leg: Swelling, pain, very weak (cannot get up unaided from kneeling)
Thighs: Occasional pain, very weak (shuffle, cannot climb stairs unaided)
Stomach: Alternating constipation / diarrhea, poor appetite
Breasts (male): Swollen, painful
Lungs: Shortness of breath and fatigue upon moderate exertion, violent hiccups
Heart: Occasional angina, constant very low blood pressure
Arms: Skin friable, bleed easily and profusely. Bruise for no obvious reason
Left Hand: Numbness, pain in thumb, forefinger and back of hand
Mouth: Dry, some distortion of taste sensation
General: Occasional mild depression, overall lassitude and fatigue,
staggering/ shuffling gait, stooped posture, short steps.
A lot of symptoms may really be direct long term effects of chemotherapy, although in many instances - particularly pain - they did not appear until some time after chemotherapy was terminated. It was a hard job getting the medical profession to accept that my pain was treatable and not just an inevitable side-effect. However, with the moral help and support of family and friends and the treatment of my family physician the pain is now significantly reduced. There are side effects to pain control. Morphine causes constipation and I need to take a lot of laxatives. Other side effects are probably due to doctors trying to juggle medications, to keep a balance in treating the many and very varied problems without neglecting possible interactions between the many drugs used in these treatments.
Anyway, here's what I have learned. Even if you haven't been warned about it, expect that after chemotherapy things may get worse before they finally start improving somewhat on a permanent basis. The other one: get treatment for pain, even if it is not offered or suggested in the first instance. Acknowledge to yourself that the pain is real. Advocate on behalf of yourself because nobody else knows about your pain as much as you do. Once the pain is reduced, you walk better, stand straighter, have more tolerance for exertion and, most important of all, you think, talk and react better, because pain is completely all-pervasive and the only thing you can think about.
It will take over your whole life unless you get help and do something to manage the pain. Don't forget:
You cannot gain with pain - do something about it today!
not one person ever mentioned neuropathy from chemo was even going to happen. No one warned us of the intensity of this pain as we struggled to find the road to recovery. And what constitutes "recovery"? Is it just that there are no cancer cells present? No one mentioned that the pain might never go away. There are so many unanswered questions. Someone please help us!
There are too many questions and no answers where you'd expect to find them. Cancer treatment is still an imperfect science . But what was stunningly obvious was the lack of support out there for someone in such profound pain. A pain clinic with a 1-year waiting list does makes me feel hopeless: my husband cannot live all these days in this awful pain. One day of pain feels like a life time.
My husband was seeing a number of specialists and though we spoke about the numbness and pain with each and every one of them, every single visit, not one offered any medication or support; we not even referred to a pain clinic - ever! We were completely on our own!
A cousin, someone else who was living with pain and cancer, shared his personal experiences and suddenly we become aware that we had options. My husband did not have to live with the pain. This person explained that we should begin by rating the pain - every single day, to record the levels, frequency and duration of the pain. Rating pain makes one feel more aware and helps you to take charge of your own situation. You become involved in doing something about it. When morphine was first mentioned we were shocked. We thought morphine was just too much, too alien to normal people like us. Little did we realize the morphine would become the ultimate path to healing and to a normal life. Though I knew my husband was in pain, it wasn't until we began rating the pain that I learned just how much he was suffering.
Over the next several weeks, my cousin referred us to a pain specialist; we did more research together before finally visiting with the family doctor. Armed with information, we demanded that the doctor do something - today - to help my husband get his life back. We experimented for a while (it seemed like forever) until we found the right combination to manage the pain.
There is still pain. There will always be pain and some days are better than others. But pain management has provided hope and healing. More than anything, it is essential to seek interventions for pain that work. You cannot have a life and live in constant pain, nor do you have to. If necessary, get angry like we did. Demand treatment. This is the only way you will ever get your life back - by taking control over your own situation.
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