SMOKING LINKED TO CHRONIC BACK PAIN

  If you suffer from chronic back pain, be aware your smoking habit may be part of the problem.  A study  by A. Vania Apkarian, PhD, professor of physiology at Northwestern University Feinberg School of Medicine in Chicago, found that smokers are three times more likely than nonsmokers to have chronic back pain.

    Although researchers are not sure why this surprising link between smoking and back pain exists, it is believed that smokers have a stronger connection between the regions of the brain controlling chronic pain and addictive behavior.  In the study, participants who quit smoking showed a drop in the connectivity between those two regions decreasing their risk of chronic pain.

    If you are  smoker suffering from chronic back pain, you have still another reason to stop smoking.  Hypnosis can be a valuable tool to Be a Healthy NonSmoker and BE WELL. 

    

CHRONIC PAIN AND HYPNOTHERAPY

     If you are among the 100 million Americans who suffer from chronic pain, you know how debilitating it can be.  In recent years, there has been a great deal of focus and research on pain.  The Institute of Medicine reported the shocking pain numbers.  The annual cost of chronic pain, in lost productivity and in treatment is estimated at $635 billion.  In fact, 4.6 hours of productive time was lost weekly by 13 percent of workers due to pain.

     Researchers and physicians continue to try to understand chronic pain.  Most doctors now believe that chronic pain is not just a symptom but a disease in itself.  They identify a number of different causes including inflammation and genetic causes particularly on the HCN2 gene.  An even more complicated cause may be that with long term exposure to physical pain, the nerves may be hard-wired into a neurological memory.  So pain may continue to occur after the original cause is gone.

      With 26 million Americans reporting frequent back pain and 42 million Americans saying pain keeps them awake at night, sufferers are desperate for help.  Typical ways of treating chronic pain have included treatment with over-the-counter drugs (like aspirin and ibuprofen) to treat inflammation and morphine and codeine, narcotics prescribed by medical doctors to block the pain.

     Integrative medicine combines these treatments along with complementary therapies like massage, acupuncture and massage.  Studies at the Stanford University Center for Integrative Medicine indicate that medical hypnosis can reduce chronic pain.

    Before you begin any attempt to relieve pain, you need to understand why you are suffering.  Pain is a warning system.  If you have chronic pain, you need to see your medical doctor for a diagnosis.  Sometimes clients come into my office and say that they have chronic headaches.  Before I would work in hypnosis with that client, I would need a referral from a medical doctor.  The pain could be a symptom of a serious medical condition such as a brain tumor.  If, on the other hand,  the client had seen a doctor and has a referral, hypnotherapy could be a valuable tool for the pain sufferer.

    Dr. Helen Crawford at Virginia Tech says, "Hypnosis seems to eliminate or reduce the perception of pain as well as the anxiety that accompanies it.  It's as if the brain sends out a message that it does not want to feel the pain; it wants to inhibit it."  If you suffer from chronic pain, hypnotherapy can help you feel better and BE WELL. 

MEDICAL HYPNOSIS

    Guy Montgomery, director of the Integrative Behavioral Medicine program at Mount Sinai Medical Center in New York and the leader of many studies on use of hypnosis for medical reasons once said, "Hypnosis is like a good kid with a bad reputation.  Everybody is interested, but in the back of their minds, they're thinking of Bela Lugosi."  Many people have images of hypnosis based on old movies, tv shows and comedy club hypnosis performances.  Sometimes I will meet with a first time client and they will joke, "I don't want to bark like a dog, quack like a duck or cluck like a chicken."  But people with illnesses also ask if hypnosis can be used for medical issues.

    The good news is that hypnosis used for therapeutic purposes can be a valuable tool to give clients more control over their bodies.  Over the past few years increasing studies have been done on hypnosis for medical issues. Studies have shown diminished side effects from chemotherapy after using hypnotherapy.  Medical situations such as high blood pressure, asthma attacks, hot flashes and migraine headaches have been shown to improve with the use of hypnotherapy.

     In 2012, two Swedish studies found that symptoms of irritable-bowel syndrome (IBS) eased 40% in patients after a one hour a week hypnotherapy session for twelve weeks.  The researchers reported that the positive effects could last as long as twelve weeks after the hypnotherapy.

    Over the years, I have worked with cancer patients.  These people often undergo grueling treatments including surgery, radiation and chemotherapy.  These patients often work with me not only to control pain but also to control the anxiety that goes with the treatment and a frightening diagnosis. David Spiegel, a psychiatrist and director of the Center for Health and Stress at Stanford University who has studied hypnosis for 40 years, noted that "We can teach people how to manage pain and anxiety."

    Hospitals are using medial hypnosis as part of a broad program of services for their patients.  Tanya Edwards, director of the Center for Integrative Medicine at the Cleveland Clinic says that about half of the center's patients are referred, particularly by primary-care physicians, gastroenterologists and primary care physicians.

   Anxiety is often an underlying problem for medical issues.  Even taking the medical tests can provoke extreme anxiety in some people.  Having an MRI (magnetic resonance imaging) is a painless procedure unless you have a fear of enclosed spaces.  MRIs are confining and the loud banging, clanging sounds that are a part of the procedure can also cause discomfort. A bronchioscope pushed down the throat in a lung exam can be frightening as can an instrument inserted to go down your throat in an upper-GI endoscopy.  A hypnotherapy session before the test could make this much easier on the patient.

    From trying to conceive, to dealing with nausea, to delivery, hypnobirthing is a specialty of  medical hypnosis. Another specialty is dental hypnosis which is particularly valuable to patients who are phobic and have avoided the dentist for years. Preparing for surgery by doing a hypnosis session can be very valuable as well.

    In my practice, I always ask for a medical referral before working on a medical issue.  Sometimes people come in and say, "I'm having headaches.  Can you do a session for me?"  I always say that I would be happy to work with them on referral from their medical practitioner.  I certainly don't want to help disguise a serious medical issue such as a brain tumor.

    If you or a loved one has a medical issue, call a hypnotherapist to see how hypnosis could help you deal with the issue so you can BE WELL.

STRESS MANAGEMENT FOR BRUXISM AND TMD

     Ten million Americans suffer from the painful condition known as temporomandibular disorders (TMD).  These disorders affect the facial muscles and or the jaw joint and can cause pain and other symptoms in the ears, neck face and head.  Among common symptoms of TMD are: a clicking or popping sound in the jaw, aching facial pain or face fatigue, headaches and ear pain and stuffiness.  In fact, many people are surprised to learn that people with TMD do not always suffer jaw pain.  Instead misalignments of the jaw and bite can produce painful inflammation causing all the earlier mentioned issues.  Cases of TMD are usually diagnosed by a dentist who may do disk manipulation to temporarily eliminate the pain or make a bite plate appliance to help with tooth grinding.  About five per cent of sufferers may need surgery to get relief.

     So what causes TMD?  Even slight misalignments of the jaw can cause aching pain because of the constant movement of the jaw as we speak, chew and relax and tighten facial muscles.  Another common cause of TMD is bruxism.  This is when people grind their teeth while sleeping. Some people get only occasional pain from bruxism while others are chronic teeth-grinders which can cause long-term damage to teeth and gums.

    So what can be done to deal with these painful side-effects of bruxism?  Of course, you should work with your dentist who can evaluate your bite and the height and tooth positions and make whatever adjustments are needed to relieve discomfort.  This may include grinding down a tooth or adding height with a crown. Your dentist may do disk manipulation or custom-make you a bite plate appliance.

    In addition, you can relieve bruxism by finding ways to manage the stress that exacerbates teeth grinding. Relaxation tips such as massage therapy, biofeedback and hypnotherapy can be helpful.  Hypnosis can be a valuable tool to provide relaxation and relieve the chronic stress.  Manage your stress, relieve bruxism, BE WELL.

HELP FOR INSTERSTITIAL CYSTITIS/PAINFUL BLADDER SYNDROME

     If you have been diagnosed with Interstitial Cystitis/Painful Bladder Syndrome (IC/PBS) you are aware of how painful and inconvenient it can be.  IC/PBS affects up to 6% of American women with women being affected more than nine times as often as men.  Symptoms include:  frequent urination (more than 8 times in 24 hours), pain, pressure, or discomfort in the lower pelvis or vulva, bladder pain or pressure, pain during or after sex, an urgent need to urinate and flare-ups during menstruation.  This may all be triggered by a bladder wall becoming inflamed and super-sensitive. This in turn may cause pinpoints of bleeding and ulcers may appear and stiffness and scarring may occur.

    Once you have received a diagnosis of interstitial cystitis or painful bladder syndrome, your doctor may prescribe a variety of treatments and medications.  Intravaginal Thiele massage can be done by a physical therapist and you can learn to do the procedure at home.  Electrical nerve stimulation and medications including anti-inflammatories antispasmodics and pain medications may be prescribed.  

     Your doctor may also recommend lifestyle changes  such as using a personal lubricant for sex, soaking in colloidal oatmeal, reducing the intensity and duration of workouts during flare ups and  making dietary changes.  You should avoid cranberry juice which is acidic and may irritate a sensitive bladder.  Other irritant drinks and foods include: caffeine products (sodas, coffa, tea), carbonated drinks, alcohol, citrus fruits, artificial sweetners, tomato products and spicy foods.  Drinking more water may seem counterintuitive to a person running to the bathroom often.  But skipping on water makes urine more concentrated and more irritating. 

     A technique called bladder retraining may be valuable.  Urinating relieves pain temporarily, but some IC/PBS patients are using the bathroom so often that it reduces the bladder's capacity to hold urine comfortably.  Retraining the bladder involves increasing your typical time between bathroom trips by 15 minutes.  After two weeks, increase by another 15 minutes.  The goals is to continue until you can wait at least two hours.

    Finally, there are mind-body therapies that can be of value including, cranio-sacral therapy, acupuncture, yoga, meditation and hypnotherapy.  Hypnotherapy can be a great tool to deal with the discomfort, prolong the time between trips to the bathroom and reduce stress and increase relaxation.

THE USE OF HYPNOTHERAPY WITH CHILDREN

        In the last week, I have had a number of parents call my office asking if hypnotherapy can be used with children.  The good news is that not only can children be hypnotized but that children are generally more hypnotically responsive than adults.  Children tend to have active imaginations and few, if any, preconceived ideas about hypnosis.

        Although some hypnotherapists work with children under the age of 5 or 6, there is little published research on the effectiveness of hypnosis with toddlers.  I have found that it is difficult for young children to focus enough to address their needs.  If you are seeking hypnotherapy for a young child, you may need to interview several hypnotherapists to find one who has worked successfully with very young children.

       By the age of six, most children are able to comprehend metaphors and have the emotional, linguistic and cognitive capability to make excellent hypnosis subjects.   A study by Olness and Gardner in 1988 found that most hypnotic ability is limited in children less than three years of age and reaches its peak during middle childhood up to the age of fourteen.

       What kinds of things could hypnotherapy be used for in working with children?  Last week I worked with an eleven year old boy who sucked his thumb, a young teenager who had test anxiety and another who procrastinated and a ten year old who wet the bed.  Hypnotherapy can be used in many of the same areas as with an adult.  Habit modification is one of those.  Where an adult doesn't want to give up cigarettes, a child may have difficulty giving up his "blankie".  Undesirable habits like hairpulling, nail biting and overeating may be addressed just like with an adult client.

       Hypnotherapy may also be used in dealing with childhood trauma like physical, mental or emotional abuse.  These issues should be addressed in hypnosis by a psychotherapist who has hypnotherapy training or as an adjunct therapy to the work being done by the psychiatrist, psychologist, counselor or psychotherapist.  Note that not everyone who practices hypnotherapy is an appropriate practitioner for a traumatized child.

       Other psychological applications of hypnosis with children include: tics, learning disorders, behavior disorders, anxiety and somatoform disorders. Medical issues that may be addressed with hypnotherapy include: eating disorders, pain management, treatment of nausea and/or vomiting and bed wetting.  Again, These issues should be evaluated by appropriate medical doctors and mental health professionals who may refer a child to a hypnotherapist as part of a treatment plan.

      A couple of notes about the session itself.  The parent or guardian who brings a young child to the session will be in the room during the entire session. Teenagers often prefer their parent to wait in the waiting room so they can talk more openly during the clinical interview that precedes the hypnosis.  Some teenagers are also self-couscious about how they might look during hypnosis (is my mouth open?).  I suggest that the child make the decision after the age of 12 or 13. 

     During my time with the child before hypnosis, my primary goal is to build rapport with the child.  Sometimes I will tell a story or have a toy to help establish that rapport.  I will try to identify an interest to build a relaxing metaphor.  One child last week pictured himself in a "wonderland of toys" (his words).  I suggested he imagine himself there putting his favorite Lego toy together.  Another child liked Sponge Bob Square Pants so he imagined himself in the pineapple house under the sea and eating crabby patties.

    Hypnotherapy is a tool for change.  It can be a valuable tool for children as well as adults. If you are thinking about hypnotherapy for your child, find a well-qualified, highly trained person and then give your child and the hypnotherapist a chance to work together.

USE OF HYPNOTHERAPY FOR STRESS AND PAIN

      Studies have shown that people who are stressed or depressed are more sensitive to pain.  The pain seemed to increase and be more intense no matter what its source.  Some studies using imaging have shown an increase in activity in areas of the brain associated with pain in patients who were stressed.  This is called stress-induced hyperalgesia.

    If you are suffering from pain caused by emotional issues, seek help for the underlying stress or depression.  Talk to your medical doctor and be honest in describing emotional problems such as anxiety, stress or depression.  There are medications to deal with depression and may reduce pain as well.

   Use distractions to help you be less focused on pain.  Listen to music.  Watch a video.  Participate in a hobby - scrapbook, woodwork, read.  Distract your mind from the pain by calling a friend or getting on facebook. Play a computer game or participate in one of the activities like Pintarest.  Distraction can be a great tool in relieving stress that may be causing your pain to feel worse.

   Hypnotherapy is another tool to deal with stress, depresion, anxiety and pain.  In many cases, hypnotherapy is an adjunct therapy to the medications of your doctor or the treatment of a psychotherapist or counselor.  A recording of the actual session can be a nice tool to use at home for relaxation and to reinforce the work of the session.  By relieving the underlying stress or depression, the pain will be less intense and more manageable.