Engaging Patients in Resolving Chronic Pain

Mags Clark-Smith MA, PGCE, BCPT, BMC Dip

SIRPA (Stress Illness Recovery Practitioners Association) Ireland

Overview

Body Centering Stress Illness Recovery Sessions typically comprise: education about the autonomic nervous system; stress response/sympathetic nervous system and relaxation response/parasympathetic nervous system; how positive thoughts and beliefs activate the parasympathetic nervous system. The patient makes an active health plan this includes responsibility for their own healing and movement guidelines to support the relaxation response.  The approach includes supporting healthy relationships and good health in other areas such as: professional life, financial matters, beliefs and creativity. This poster presents two case studies describing this approach: Case Study 1 - Low Back Pain and Abdominal Pain and Case Study 2 – Low Back Pain and Pelvic Pain during pregnancy.   In both cases, pain resolved after Body Centering sessions.

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Conclusions

These 2 cases presented with severe pain. Medical investigation did not discover anything untoward. Conventional medical intervention did not alleviate the pain. Similar cases during  the past 12 years illustrate that a treatment procedure outlined above can reduce or eliminate chronic pain such as IBS and PPGP. 

There is an established link between stress and IBS, but no established  treatment plan, and as yet no established link between stress and PPGP.

Recent research and literature about the stress and relaxation responses of the autonomic nervous system and their role in chronic pain may explain these results. An overuse of the stress response (sympathetic nervous system) and underuse of the relaxation response (parasympathetic nervous system) has been linked with chronic pain.  More research is needed to investigate if an educational programme can help balance the ANS.


References

  • D O’Malley , EM Quigley, TG Dinan, JF Cryan (2011) ‘Do interactions between stress and immune responses lead to symptom exacerbations in irritable bowel syndrome?’, Brain Behaviour and Immunity 25pp. 1333-1341

  • N.K Kanakaris, CS Roberts, PV Giannoudis (2011) ‘Pregnancy-related pelvic girdle pain: an update’, BMC Med, 9:15
  • Clarke, D (2007) They Can’t Find Anything Wrong.SentientPublications. 
  • Rankin, L (2013) Mind over Medicine. Hay House Inc.
  • Personal Communication: Dr Adam Al-Kashi Head of Research and Education Backcare, UK.

Aim Of Investigation

Treating patients using positive belief and nurturing care enables dramatic pain recovery.  Do the stress and relaxation responses of the autonomic nervous system explain this?

Methods

The body is equipped with natural self-repair mechanisms.  If these self-healing processes are interrupted by ANS dysfunction the patient can be taught how to restore normal ANS function.

Code of Ethics - Body Centering Stress Illness Recovery Sessions (BCSIRS) are appropriate for chronic pain not acute pain. They can only take place after initial medical screening, all clinical tests and any red flags must be investigated beforehand.

General Methodology which is adapted to the individual:-

 Psychophysiologicl Disoder

Psychophysiologicl Disoder

1) Practitioner-Patient respect:

listening; positive touch; movement guidance;  nurturing care with a healing intention.

2) Educational programme:
completing a comprehensive assessment form; discussing relaxation and stress response; adopting good health supports; designing a whole health plan.

3) Contact time supplementation:
agreed research; reading; writing; movement programme.

4) Choice and personal responsibility:
the patient commits to an independent learning approach, which puts them in charge of their own health care, selecting appropriate health practitioners when necessary.

5) The intention of this methodology is to increase body awareness, emotional intelligence and empower patients. It appears that ANS function then stabilizes  and self healing processes are restored.

 Symphysis Pubis Dysfunction (SPD) a common component of Pregnancy related Pelvic Girdle Pain (PPGP)

Symphysis Pubis Dysfunction (SPD) a common component of Pregnancy related Pelvic Girdle Pain (PPGP)


Acknowledgments

  • Peter Lenehan MD, Gynaecologist, Blackrock Clinic, Dublin
  • David Clarke MD, President Psychophysiological Disorders,Oregon Health & Science University, USA
  • Luke Maishman, University of Cambridge, UK

This academic poster was presented by BackCare Professional Member, Mags Clark-Smith as the Annual Scientific Meeting of the Irish Pain Society on 2nd November 2013 in Dublin City Centre.