In a probably not so recent blog I wrote about the ability of thrilling music to reduce pain. Thrilling music is defined as ‘music that sends tingles up your spine’. I hope that you’ve all felt it. Yet another way to reduce pain is by sheer physical effort. I trust that you’ve felt this too – the runners high, the cresting of a mountain, a hard day in the garden, that euphoric feeling at the end of a hard workout. These efforts all produce endorphins and enkephalins. The topic of this blog is effort.
Just over two years ago a 60-something woman, ND. trudged into my treatment room having being sent by a local Pain Care Center. She came with her older brother, who filled in the gaps with my questioning. She had been diagnosed with fibromyalgia, chronic widespread pain etc. and along the way had many therapies and procedures performed on her. She was highly medicated and seemed like a character from an old black and white zombie movie. She described pain from head to foot. She stood the whole time, bracing first on one leg then the other. She could not sit for the pain.
I began in traditional Neuromuscular therapy fashion with postural assessment, palpation, muscle length testing and ROMs. She had a noticeable scoliosis and boggy or flaccid musculature, but not much else. I attempted to put out the various trigger point and tender point fires in the order of her pain priority. At the beginning of subsequent visits she handed me pages of hand-written notes describing her pain hour-by-hour. Her file started to fill up.
Later, her family contacted me to ask whether I thought she was as mad as they thought she was. I said no. Then they decided to put her in an assisted living facility. Despite this semi-incarceration she found a woman to regularly drive her an hour each way to my clinic. I realised that orthodox NMT wasn’t working well; I needed to think outside the box. I started to use movement retraining techniques à la Feldenkrais. These gentle, rhythmic and rather complex movements have the legs going one way, the arms the other way and the head yet another way. They seemed to help, possibly working like a neurological resetting mechanism.
Along the way I suggested that she either stop her fixated note writing, or better still only write about the pain-free moments. The notes stopped coming. I started a regular, safe strengthening programme to address her poor muscle tone, and gently progressed its challenge.
For the last 6-12 months I have trained her using free weights and body weight. The only bodywork I do is on her neck for her forward head position. She now sits on a Swiss ball with her feet on wobbly objects without complaint as she works out. This is a far cry from the woman who shrunk back in horror from the chair I offered.
She is really putting in the effort. She sweats. She corrects me when I forget to switch to the 5lbs from the 4lb weights (I really need 6’s now). She has lost the sense of damage and danger in posture and position and she seldom mentions any pain. She’s back home living independently and volunteering at the local school. There’s a spark in her eyes and a smile on her lips and she’s being weaned off the meds.
Throughout this 2 year period ND has kept up her choir singing, even when she couldn’t sit between songs on the hard bench. Thrilling music and physical exercise may have turned this woman’s life around. It just took a bit of finely tuned and gently graded effort.
Cheerio for now