How writing can help alleviate chronic pain

Writing down negative thoughts, then destroying the piece of paper, is the recommendation made by surgeon Dr David Hanscom to patients with chronic pain.

Do not think about it, or question what you are writing – just do it.

Dr Hanscom explains: ‘This process is essential to healing your chronic pain, and you’ll begin to get better the day you begin to write. Even if you don’t want to own your thoughts, write them down. Then rip up, crumple, trash or burn the document.

The more you try to suppress your dark thoughts, the stronger they will become. Writing them down and then destroying them acknowledges them and allows you to separate from them.’

Dr Hanscom believes that by talking about your pain, you reinforce the pathways that trigger the pain, so the problem does not resolve. Thoughts are just a series of connections between neurons in your brain and have no substance. Your body produces chemicals in response to the thoughts, and this creates sensations, but they are not real. By writing down thoughts, you can detach from them.

Writing helps by:

  • creating new pathways between nerves, linking thoughts to feelings and sight
  • creating space between ‘you’ and ‘your thoughts’
  • slowing down the circuits that spin automatically in response to thoughts.

Dr Hanscom says: ‘Writing helps people to see the impact a thought is having on them. They then have the option to create a new response’.

‘This is not a quick fix’, Dr Hanscom advises. Repetitive writing, as many times a day as feels right for you, works. But not to a set timetable.

Chronic pain is driven by how the brain works. Writing helps because it targets how the brain works.

While many examples of chronic pain can be helped by writing, it is not a substitute for getting yourself checked out to rule out physical causes for your pain.

A chiropractor can help. Call us for an appointment on 9922121556.


Working posture of dentists impacts their health

Dr Smaranika Das of Curamos Physiotherapy Clinic was invited by the Indian Dental Association to talk about work-related injuries in dentists.

Her presentation, to staff and students at Goa Medical College plus private practitioners, focused on how tense, asymmetric postures involved in dental work lead to musculoskeletal pain and impact the health of dentists.

Dr Das discussed prevention and self-care strategies to help dentists prolong their careers and improve their health.

If you are a dentist experiencing musculoskeletal pain, you can contact Dr Das on  9421498449.006

Getting away from your desk

If you have a job that involves sitting down, getting up and moving regularly is an important part of protecting your back.

The spine is under greater pressure when we sit than when we stand upright, so it’s important to take regular breaks during the day. Ideally, none of us should sit anywhere, any how, for longer than 30 minutes at a stretch. If you have to sit, make your desk and chair optimal for you. For example:

Adjust your chair height so your feet sit flat on the floor (of if the chair is too high and you cannot lower it, place a block of wood or pile of books to put your feet on)
Place a small cushion under your seat bones, so your knees are slightly higher than your hips. This creates the optimum position for your pelvis to support the rest of your spine.
Use the back rest, or place a cushion between you and the back of the seat if it’s too far back
Have any computer screen level with the top of your eyes – use an external monitor, or place a laptop higher up and use a plug-in keyboard, if necessary
Either use a seat with arm rests, or have your table at the same level as your elbows, so you can rest your lower arms on the desk.

Take every opportunity to get up and walk around. Go and get a drink of water – better for hydrating your spinal discs than tea or coffee – regularly, up to 2L a day for most people.

Also look for extra opportunities to be a bit more active during your day. Take the stairs rather than the lift; get off the bus/train one stop early; go for a walk during your lunch break.

If you experience back, neck or shoulder pain, either while sitting or on rising from sitting, make it a New Year Resolution to visit our chiropractors. Call us on 9922121556.

Keeping your head over your heels this party season

Many women like to dress up for New Year. Posh frocks and high heels. However the next morning they may wonder whether it’s their heels that have made their back hurt.

Here are Walking Tall’s tips for dressing the part while protecting your spine

Keep your heels for the party – travel to and from in flat shoes
Remember your posture – knees soft, and ears, shoulders, hips and knees aligned
Gently tighten your stomach muscles, to protect your back
Practice tensing and relaxing your pelvic floor, as this also protects your back
Try to keep your head upright and your shoulders back and down, avoid sticking your chest out
Spread your weight over the whole shoe when walking
Walk more slowly – elegantly – which also minimises the risk of tripping and/or falling.

Have a wonderful New Year’s Eve from everyone at Walking Tall. And call us in 2014 if and when your back, knees, hips or neck hurt!

The right pre-event massage for marathon runners

It’s that time of year when people are preparing for the Mumbai and Goa marathons, and associated events.2012 (11)
Sports Massage is an integral part of many athletes’ pre-event preparation. It involves the therapeutic manipulation and stretching of soft tissues, to assist the athletes’ performance and help protect them from injury during the race.

Martin Bale, sports therapist with Walking Tall, explains: ‘The purpose of the pre-event sports massage is to help prepare the athlete for high-intensity activity. My job is to help get the muscles loose without causing significant physiological changes.

‘In the pre-event situation, I am not looking to correct dysfunction or reduce stress. Too much deep work too close to the event can make the athlete’s legs feel “dead”1. Also too much relaxation work can inhibit performance, and right before an event is not the time to look for increases in flexibility as the athlete may not have the strength to sustain increased range of movement while competing.’

A pre-event massage may be performed on the day of the event, or a few days before.
If you are taking part in either the Mumbai or Goa events and would like to take advantage of Martin’s work to support your training and help you prepare, please contact him for an appointment on 9922121556.

1 Hunter AM, Watt JM, Watt V, Galloway SD. Effect of lower limb massage on electromyography and force production of the knee extensors. Br J Sports Med 2006; 40 (2): 114-8.

Back pain after sleeping? It might be your mattress

woman-sleepingResearch has shown that sleeping triggers back and neck pain for 30 per cent of people, yet one fifth (21 per cent) admit to changing their mattress less than once a decade and 10 per cent have never changed it at all.

Research released by the British Chiropractic Association (BCA) shows that over two fifths (42 per cent) of people have been kept awake by their back or neck pain. However, one third (33 per cent) of people only change their mattress once every ten years, despite recommendations to do so every seven*.

While a mattress is a significant investment for most, other items of bedding that can make a big difference to back and neck health are also overlooked – 64 per cent of people admit to not testing a pillow before buying it.

It is perhaps unsurprising then that a huge 83 per cent of people feel stiff or ache when they wake up in the morning.

Will Thompson of Walking Tall says: ‘How often you should change a mattress depends on lots of factors including your weight and how well you have cared for your mattress. But as soon as a mattress stops supporting your back it’s vital you get a new one. A mistake that people often make when choosing a new mattress is thinking the firmer the better – this is not always true – one bed does not fit all.

‘We spend a third of our lives in bed so it’s important to spend time choosing your new mattress and remember; if you’re planning on sharing your bed with your partner, take them with you to test it!’

Five signs that it’s time to change your mattress:
1. You wake up feeling stiff or aching
2. You had a better night’s sleep somewhere else
3. Your mattress is misshapen or sagging
4. Your mattress creaks when you move
5. You can feel individual springs

In terms of the best position to sleep in to avoid back and neck pain, Walking Tall advises to lie either on your back or side and avoid sleeping on your front. If you lie on your side, ensure that the pillow and mattress allows your head, neck and spine to be parallel to the floor with no bowing or sagging.

If you are experiencing pain or stiffness regularly on waking, make an appointment to see us on 9922121556, to get to the cause of your proble m.

*Information taken from the Sleep Council.

What is dry needling?

Dry Needling is the technique of inserting a solid filiform needle into trigger points to release them. Trigger points are irritable nodules that can be felt within tight bands of muscle (see our trigger point blog). It is one of the most effective methods of releasing trigger points and has the advantage of being able to reach points that are hidden deep within the muscle. Dry needling has been found to be as effective as injection of substances such as lidocaine for treating muscle and connective tissue pain.

The procedure:
Single use, sterile needles are used and the area to be needled is cleaned. The needles are extremely thin so they often can’t be felt going into the skin but a pinprick may be felt. On contact with a trigger point the patient will typically experience a brief, localized cramping sensation possibly with referral of pain to other areas of the body. Directly needling the trigger point often causes a local twitch response (LTR), this reflex is a good indication that the muscle will relax and the condition will improve.

After treatment
In most cases there will be some soreness after needling which can last between a few hours to a couple of days. This can be reduced by keeping the muscle moving and you will be shown how to stretch the area to minimize this soreness. It also helps to apply a moist heat to the area for 10-15 minutes at home. Vigorous exercise should be avoided on the day of treatment.

How many sessions?
Your clinician will advise you on the number of sessions required as this depends on your case and treatment goals. Dry needling is usually used in conjunction with other therapeutic approaches and typically produces improvements in the first three sessions.

Pain patterns due to infraspinatus trigger point
Pain patterns due to infraspinatus trigger point

How many sessions will I need?

This is the question we get asked more than any other. It isn’t easy to answer, because the number of sessions depends on many factors including your age, how long you have had the condition, your overall state of health, how fit you have been in the past, and what your goals are for the future.

Most cases require a course of treatment spaced appropriately to keep building on the previous sessions and allow time for recovery. We provide courses of 5, 10 or 20 sessions which may take a week to a couple of months to complete. Most patients are simply looking for pain relief and this is often the initial focus of our treatment. We usually expect to achieve a reduction in pain within the first 4-6 sessions although many patients respond faster and for others it can take longer. Even when pain has reduced, it is usually recommended to continue working on any problematic areas that can still be found at treatment sessions. This is especially advisable if the problem has been there for a long time or keeps returning.

When you have completed your course of treatment we will review your progress, at this stage long term expectations will become clear and we can make further recommendations. If all goals have been reached then you will be given some advice and discharged. There are usually steps that can be taken to help avoid recurrence such as an exercise program done at home or under supervision in the gym.

If you have responded well to the treatment but there is still some discomfort or it is thought that the problem is likely to return, we may advise that you have maintenance care where treatments are spaced out in order to address problems early. These may be at monthly intervals or whatever is most appropriate for you and may continue for as long as you feel the benefit.