Guest blog: rethinking chronic pain

Guest blogger Georgie Oldfield, founder of SIRPA™, looks at the role of non-physical factors in our perception of chronic pain

Chronic pain image

Have you ever wondered why (or noticed that) many of your clients have persistent or recurring pain, which began while doing something they normally did without any problem, or maybe soon after? Or maybe they woke with pain, yet it persisted for months or even years? This is so common, yet are we really that fragile that we can cause ourselves damage while doing something as innocuous as bending, getting out of a car or turning over in bed?

Despite a lack of supporting evidence, musculoskeletal pain is usually blamed on physical causes, such as poor posture (for example, reduced lumbar curve or one shoulder higher than the other, and so on), muscle imbalance (for example, poor core stability or hypermobility) or structure (for example, spinal degeneration such as a prolapsed disc or facet joint disease).  In fact no correlation has been found between pain and posture, structure or biomechanics (Lederman, 2011).

There are in fact numerous studies to demonstrate that degeneration – for example in the spine (Kim et al, 2013), shoulders (Connor, 2003), hips (Silvis, 2011) and knees (Kaplan et al, 2005) – are just a normal part of ageing.  Although the development of diagnostic procedures such as MRI and ultrasound scans have been invaluable, often when ‘abnormalities’ are found, it is assumed these must be the cause of any symptoms present, even though often the symptoms don’t match the findings on the scans. In fact, the studies highlighted above, found that about 80% of people without pain also have these ‘abnormalities’.

It is now widely accepted that stress ‘affects’ pain, so addressing this will clearly help in the management of pain. In fact, when you ask clients to consider what was going on in their lives in the lead up to the onset of pain, many will relate this to a challenge they were facing in their life, rather than a physical event.  Interestingly, a couple of studies (Christensen et al, 2012; Feyer et al, 2000) looked at the physical, biomechanical and psychosocial aspects of individuals’ lives and the only factor involved in the triggering of new episodes of back pain were psychosocial factors.

Another study (Castro et al, 2001) used personality profiling to see if they could determine who might develop whiplash symptoms after a placebo car crash, despite the fact that the force induced could not possibly cause any biomechanical injury. They found that they could predict with 92% accuracy who would have symptoms a month after the ‘accident’ – based on their personality profile.

Not only have personality factors been found to be a determinant of whether symptoms might persist or become more severe, so have greater exposure to past traumatic events; early beliefs that pain may be permanent; and depressed mood (Young Casey et al, 2008).  Add to this the strong link between adverse childhood experiences and ill-health in later life (Felitti, 1998) – including chronic pain (Goldberg, 1999) – and you can see why our focus needs to shift from the belief that there is always a physical reason for an individual’s pain.

In fact when you consider Kim’s study (2013), the poor results from non-surgical treatment for non-specific back pain (Keller et al, 2007), plus the lack of evidence to support the use of spinal surgery (Nguyen, 2011), injections for back pain (Chou, 2015) and morphine for chronic pain (Berthelot, 2015), it is clear we need to change our approach to the treatment of chronic pain.

Chronic pain has actually been found to be caused by the activation of nerve pathways in the brain. This results in persistent activation of the fight or flight response (our reaction to danger), which can cause real physical symptoms in the body. Most people have experienced a version of this when their face turns red with embarrassment or they feel a ‘knot’ in their abdomen in a tense situation.  When this normal human response becomes very strong it can cause very real, severe pain or other symptoms that can be disabling. Treatment consists of education about how the fight or flight response works; changing behaviour that might unintentionally keep it ‘turned on’; and working through current, and sometimes past, challenges that trigger our danger signals. Once the signals are turned off, the pain usually improves and often resolves completely, resulting in life-changing results for individuals.

As a physiotherapist who came across this concept 10 years ago, the results I have observed with my clients has completely changed the way I treat chronic pain and other persistent symptoms. I love the fact that the approach is non-invasive and we can help individuals recover through education and by becoming self-empowered and taking responsibility for their own health.

For references: visit www.sirpaconference.com/infographic

About Georgie Oldfield

SIPRA Georgie Oldfield

Georgie Oldfield MCSP is a leading physiotherapist and chronic pain specialist, promoting a pioneering approach to resolving chronic pain through her SIRPA Recovery Programme.

Hear her speak at the 2017 SIRPA conference, Chronic Pain: The Role of Emotions, being held on 15 October 2017, at the Royal Society of Medicine, London.  To read about leading experts who will be presenting at the conference and to book, visit  www.sirpaconference.com/conference-programme/

NB: This article refers to persistent, chronic pain, as opposed to tissue-damaging conditions, such as cancer, fracture, infections and autoimmune diseases.

Announcing the 2017 FHT Members’ Dinner

We are thrilled to announce the 2017 FHT Members’ Dinner, which will take place at the Royal Pump Rooms in Leamington Spa, on Friday 17 November.

Pump Rooms Leamington Spa

Bringing together like-minded members, expert professionals, and key industry contacts, the FHT Members’ Dinner is a great way to relax, have fun and network in style.

Also home to the 2017 FHT Excellence Awards, this dinner will feature a sparkling drinks reception, sumptuous three-course meal, and perhaps a spin or two around the winter dance floor.

enter 2017 Excellence Awards

Awards entries are still open so don’t delay in entering in the category of your choice. Enter here.

Pump Rooms Leamington SpaThe Royal Pump Rooms is one of the oldest surviving bath houses in the UK, and we’re excited to share with you this unique and striking venue. Opened in 1814, the Royal Pump Rooms was one of the UK’s premier spa establishments of the Regency era, and attracted thousands of people every year to take to the healing waters. With original marble architecture, ancient sculptures, and original features, this venue is truly captivating and fascinating for therapists and non-therapists alike.

2016 Excellence Award winners group

Join us in this incredible venue as we celebrate excellence in the therapy industry. Hear inspiring stories from members who have made big changes to others’ lives through their work, and help us celebrate the achievements of all of our therapists, be they great or small, and say thank you, for their continued hard work in practice. So bring along your friends as we party into the night!

Following member feedback, we’ve heavily subsidised the event for you so early bird tickets start from only £35 – don’t delay, book today! Early bird tickets close: 31 August, 2017.

BOOK NOW

Exclusive Aromatherapy Awareness Week offer in FHT shop

In honour of Aromatherapy Awareness Week this week, we have an exclusive offer available to FHT Members in our online shop.

Aromatherapy bundle

For a limited time only, members can purchase our aromatherapy consultation forms and aromatherapy leaflets for the discounted price of only £10!

The leaflets are designed to highlight the benefits and features of aromatherapy to your clients, in a professional and stylish design you can rely on!

The consultation forms are sold in a pack of 50 and are for your clients to fill in to help you assess their problem areas, and disclose pertinent medical information. You and your clients sign the declaration allowing you to manage their records accurately while following industry best practices.

Find out more and shop now!

 

FHT partners with SIRPA for 2017 conference

The FHT has joined in partnership with SIRPA to sponsor their 2017 conference – Chronic Pain: the role of emotions – held at the Royal Society of Medicine, London on 15 October.

Sirpa Conference 2017

SIRPA (Stress Illness Recovery Practitioner’s Association) is an organisation committed to engaging and educating health professionals and people affected by chronic pain, with the aim of aiding recovery through education.

Sirpa logoTheir conference this year will take place in October, and feature a plethora of expert speakers discussing the cause and treatment of chronic pain.

Over 64% of FHT members treat clients who are seeking support for long-term health conditions and the FHT is proud to sponsor this pioneering conference to ‘understand the links between emotional stress and real physical symptoms and how they can be successfully treated with education and self-empowerment using a mind-body approach.’

Find out more about the conference here

FHT responds to Charity Commission consultation

The Charity Commission for England and Wales is currently reviewing its approach to deciding whether an organisation that uses or promotes complementary and alternative medicine (CAM) is eligible to have charitable status.

As such, it opened a public consultation to seek views on: the level and nature of evidence to support CAM; conflicting and inconsistent evidence; alternative therapies and the risk of harm; and palliative alternative therapy.

As a key stakeholder, the FHT responded to the consultation and was also invited to attend a discussion chaired by the Charity Commission, where we represented the interests of our members working in the charitable sector. Amongst others, the FHT:

  • Stressed the level of health and wellbeing support complementary therapists offer the public, with many patients/clients accessing complementary therapy services via registered charities
  • Highlighted some of the challenges concerning evidence base for complementary therapies
  • Directed the Commission to appropriate sources of research and data regarding the beneficial impact of therapies
  • Stressed that complementary therapies should only be used alongside, and never as an alternative, to conventional medical care
  • Highlighted the benefits of the Accredited Registers programme, which aims to protect the public.

Mary Dalgleish, FHT Vice President, attended the Commission’s stakeholder discussion and responded to the consultation on behalf of the FHT. ‘The results of our most recent survey clearly show that FHT members are playing a vital role in helping the public to live with and self-manage different health challenges,’ says Mary. ‘What is vitally important is that those seeking a complementary therapist are signposted to practitioners who are listed on an Accredited Register, independently approved by the Professional Standards Authority, so that they can choose a practitioner with confidence.

‘As charities, by their very nature, tend to provide access to support services to those populations who are most in need – and often least likely to be able afford to pay for these support services otherwise – we stressed to the Charity Commission how important it is that organisations that promote and use complementary therapies remain eligible to apply for charitable status, albeit with appropriate criteria in place, such as practitioners being listed on an Accredited Register.’

The Professional Standards Authority also responded to the consultation, along with at least 200 other interested parties.

The Charity Commission is now considering all of the information received as part of its review process, and will update the FHT and other parties of any progress or decisions ‘as soon as possible’. We will, of course, keep our members informed.

Accredited Course Provider shares benefits of infant massage at Malawi orphanage

Gayle Berry, FHT Accredited Course Provider, and owner of Blossom and Berry Baby Massage spent time in Malawi to help teach baby and infant massage to staff at the Ministry of Hope baby orphanage.
Here Gayle tells us her story:

Gayle Berry‘I am an expert on baby massage and yoga and have worked hard to build up Blossom & Berry Baby Massage – a successful business with international recognition and over 200 teachers across the world. I have been teaching, as well as training others to teach, infant massage and yoga, for over 15 years and I am passionate about the positive benefits of nurturing touch in early years.

‘In 2014 I stumbled across some incredible sunglasses called LOVE SPECS. Love Specs turn any light into rainbow love hearts and more importantly, through sales at music festivals, they generate income for Love Support Unite Africa. LSU was founded by Alice and Nina Pulford to provide sustainable education to the poorest children in Malawi. Their work has ensured powerful and lasting change, built on people rather than proceeds.

 

Gayle Berry in Malawi
‘I decided to volunteer with the charity using my experience in infant and baby massage to benefit babies in orphanages who were not receiving regular touch. I provided free training to the staff at the Ministry of Hope baby orphanage, so the babies could receive the vital interaction they were missing. Massage provides so much more than touch; it helps to support the development of the emotional brain in children, teaching them about the world and human relationships. Babies thrive and grow on love and baby massage provides a window of gentle stimulation and nurturing experience.’
‘I set up Growing Babies: Little Blossoms Project, working alongside Love Support Unite Africa Foundation, aiming to harness the power of parents, families and communities to improve mother and baby health and early brain development in children aged 0-3 years, through educational programs and nutrition. We use infant massage to provide the vital love, positive communication and attachment needed for healthy physical and emotional development, whilst providing women with skills and knowledge they can share. I have taught, funded and now support five infant massage Nurture Ambassadors to teach six women’s groups infant massage and safe motherhood. I was able to teach hospital physios, special needs massage, as many children have cerebral palsy as a result of premature birth, due to malaria. I also set up a sustainable farming project to provide food security.
Gayle Berry in Malawi
‘Growing Babies-The Little Blossoms Project has two volunteer trips a year for baby massage instructors who have changed many lives in Malawi with goals to focus on carers, mothers and babies and the wider family unit. We aim to provide education, training and support to parents and babies, increasing the health and wellbeing of families, using infant massage, baby health care guidance and first aid techniques. Out main goal is to empower women within the community and give these babies the best start in life. All my teachers have the opportunity to become volunteers in Malawi. I also donate 10% of my baby massage enrolments to the project so one student’s education helps to fund the safe motherhood and infant massage education of women and babies in poverty through our Nurture Ambassador’s classes in Malawi.
Gayle Berry in Malawi
‘What I hadn’t reckoned on, was exactly how much I could, and would, continue to give. Nor how much joy I would receive back from this trip. I went from being a curious volunteer to being a knowing participant and now, UK Director of the charity.’
You can find out more about Gayle’s company and project here.

Mother’s Day promotion

The FHT has produced the above social media advert for you to promote your therapy practice this Mother’s Day. Simply share it on Facebook, Twitter, LinkedIn and Instagram along with your contact details. Adverts can also be printed at postcard size – just click to full size, then print.

Looking for other social media adverts to promote your therapies? Leave your suggestions below.