The idea of music as a healing force is not new. The ancient Greeks put Apollo, one of their gods, in charge of both music and healing, suggesting that there has long been an understood connection between the two. There are many theories as to why music therapy works. Some studies support the idea that music helps the brain make new connections between nerve cells, and helps organize the firing of nerve cells in the part of the brain responsible for higher functions. Others look at the rhythms of music and feel that we respond to rhythmic repetition, much like our heart, breathing, and brain waves.
What can music therapy do?
The healing power of music is well-documented. It has been proven to reduce anxiety and depression, and also to lessen the symptoms of Parkinson’s disease, Alzheimer’s, autism, schizophrenia, and many other psychological disorders.
Additionally, music therapy has been found to improve motor function, communication skills, emotional stability, and the ability to focus. It is considered to be an evidence-based therapeutic approach to mental health treatment, and there are plenty of mainstream studies to back it up.
For example, according to the American Psychological Institute, music therapy should not be thought of as an “alternative therapy” due to the weight of clinical studies that can back the results. These studies prove that music therapy can help patients in the areas of physical health, emotional health, mental health, and also in a social manner.
How music therapy is applied
Depending on the diagnosis and the approach decided on by your therapist, music therapy might involve singing along to music or simply meditating and relaxing as you listen. Various exercises or movements might be performed with music as the catalyst, supporting outcomes that range from improving self-image to improving memory and physical coordination.
At Roots, music therapy not just something we offer, it is woven into the fiber of our program, with several groups a week tapping into the power of music and healing. David Hickman, a UCLA-trained Music Medicine Facilitator, provides a Drumming for Healing group, in which clients are able to use Native American and African drumming rhythms to communicate internal feelings, and support for the peer group. This extremely powerful group has become one of the cornerstones of our program.
Rock to Recovery, founded by veteran guitarist, Wes Geer, employs song writing, and performing and recording as a “band”, to focus on creating a sense of belonging and increasing self-esteem. “…It was when I was in treatment that I realized how much music could help [me] get through those tough emotions that run so rampant, especially in the early days. Being totally sober and dealing with the bottom I had hit, strumming the guitar was the only thing that would bring me peace,” says Geer. The group of professional musicians, who are also in recovery, brings fun into treatment and recovery by offering a natural escape from the fear-based mind.
Music therapy for pain
Music therapy has also proven helpful in managing pain. In one study, cancer patients were split into two groups; one group received talk therapy while the other received music therapy. In the talk therapy group, there was no noticeable reduction in pain, while the music therapy group showed a “statistically significant reduction” in pain scores.
The findings supported the theory that music therapy is a safe and nonpharmacological alternative to pain reduction, even in cases of severe and chronic pain.
Music therapy for depression and anxiety
According to the American Music Therapy Association, music therapy can help patients with a wide range of psychosocial needs. In cases where patients are resistant to other treatments, it has enabled them to develop relationships, communicate emotions, and express ideas that they may not be able to address with words alone.
The stimulation that music provides tends to provoke responses that stem from familiarity, comfort, and feelings of security associated with the music itself.
Drum circle set up for the Drumming for Healing group with David Hickman.
Other mental health outcomes that have been observed through music therapy include:
Improved personal relationships
Decrease in anxiety/phobias
Increase in verbalization
Safe emotional release
Reduction in muscle tension
In conclusion, music therapy can be highly beneficial in addressing a range of disorders. It is a safe and evidence-based practice that is effective when integrated into a multidisciplinary approach and supporting other modes of healing therapy like yoga, nutrition, and art therapy.
CT Scans, MRI Scans, X-Rays: Anyone struggling with chronic pain will be all too familiar with the many scans and imaging ordered by physicians as they attempt to diagnose the source of the pain. While these scans or imaging can be helpful, there comes a point when they do more harm than good.
Many psychologists tend to agree that 80 percent of chronic pain is emotional. This does not mean it’s not real – it is still happening to you, after all – but it does mean that you have some control over it.
Stress reduction is a key focus in managing chronic pain. We learn how to respond to situations in such a way that it mitigates, rather than aggravates, the pain response. We practice mindfulness and steer clear of high-pressure environments. We are aware of our reactions to certain stimuli so we can avoid what makes us feel worse and embrace what makes us feel better. It’s a daily struggle, and sometimes, the things that we think will give us some peace will actually do the opposite.
The mechanics of pain: the elusive diagnosis
One of the biggest problems with chronic pain is that it is often impossible to quantify using diagnostic tests. Scans, imaging, and x-rays don’t usually show anything obvious, and this, in itself, can be highly stressful.
For many who suffer from chronic pain, there is a disconnect between the brain and the nerves. The brain sends out pain signals, and the nerves respond, causing pain response that doesn’t seem to be connected to a specific source. While there may be a physical component—an identifiable cause or injury that is the source of the pain—your body’s chemistry plays a significant role in how that pain is perceived.
Because of this, an accurate diagnosis can be elusive. As a result, your doctor may order various tests and scans in the hope of gaining a better understanding of where your pain is coming from.
Types of scans your doctor may order
Today, science is closer to finding a way to quantify pain using imaging. However, all we know right now is that chronic pain looks much different than acute pain in terms of how the brain responds. This corresponds to the current understanding that pain may continue and persist long after the physical cause of the pain has been removed.
Not all pain-causing issues will be picked up on a scan, but an MRI or a CT scan (CAT scan) may show something. MRIs are better for picking up nerve damage, as they show fine details of the spinal cord and neural system, including where the nerve roots exit the spinal sheath and whether or not they are being compressed, which might be the case if you had a herniated (bulging) disc.
A CT scan will highlight any problems with bone and tissue, but they won’t help much in determining nerve damage.
X-rays, also, are not very effective in picking up neural subtleties, but they will show if there is a break, fracture, or if something is out of place in the musculoskeletal system.
Why scans may not be the best idea for chronic pain
In the quest for an accurate diagnosis on the road to chronic pain relief, there are many tests, treatments, medications, and scans that can be applied. However, undergoing a scan when it’s not medically necessary may actually do more harm than good.
Read on for the argument against excessive scans for chronic pain:
Scans won’t make you feel any better
If your scan shows something specific that can be attributed to why you are feeling pain, that’s great. However, most of the time, they don’t show much of anything at all, and this can lead to more scans, more tests, and a great deal of anxiety. Without a clear diagnosis, stress can be exacerbated, and this actually has the potential to increase chronic pain.
Every scan comes with a risk
Each time you have a scan or an x-ray, you are exposing yourself to high doses of radiation, and this can pose a cancer risk. If you are of childbearing age, you should be especially mindful of this risk and avoid having unnecessary scans.
MRI scans use radio waves and a high-powered magnet to create their images. This means that people who have pacemakers, cochlear implants, implanted neurostimulators, certain IUDs, or any iron-based metallic implants should not participate in an MRI under any circumstances.
Additionally, anybody who has surgical wire mesh, metal sutures, pins, plates, or screws anywhere in their bodies should avoid MRIs. An MRI is also contraindicated for patients with epilepsy, and pregnant women should avoid having this type of scan if at all possible.
Your scan may show something unrelated to the pain
Many people have abnormalities in their spine or other parts of their body. They may go through their whole lives not knowing about the issue because it doesn’t cause them pain or have any measurable impact on their quality of life. For example, many people live with scoliosis or osteoarthritis and do not suffer any pain from it. If there is no pain, and if it isn’t causing any mobility issues, there is little reason to be concerned. It is certainly no cause for alarm.
If your scan shows abnormalities that are unrelated to the pain you are experiencing, it may lead to more testing, procedures, and even having surgery that you don’t really need. At the very least, it may cause you a great deal of stress and worry, which is a common trigger for chronic pain.
When scans make sense
If your symptoms are worsening or if there is evidence of nerve damage, a scan may tell you and your doctors more. Signs of a serious problem that might indicate the need for a scan might include:
Sudden, unexplained weight loss
A history of cancer
Loss of bladder or bowel control
Loss of muscle strength
Numbness and weakness/loss of feeling in the legs or limbs
Unless you have one or more of these symptoms, a scan will not likely tell you and your doctor anything you don’t already know.
Sometimes, your doctor will order a scan simply to rule out other, more severe issues on the road to a pain diagnosis. If you suffer from fibromyalgia, for example, blood tests may fail to show any anomalies. If so, the next order of business may be to see if there is any nerve damage or abnormalities that are affecting the brain or spinal cord.
With fibromyalgia, especially, diagnosis is a process of elimination, and a physical examination is generally the most reliable approach. Scans for this purpose are usually inconclusive.
Your pain is real
Scans may seem like a good idea, especially when your healthcare practitioner can’t find a specific cause for your chronic pain. Inconclusive scans can lead to unnecessary procedures and treatments that can actually amplify the stress and frustration you are already feeling.
If you find yourself in this situation, your best course of action is to focus on the things in your life have a noticeable impact on your pain and its intensity. Practicing mindfulness and self-care is a critical defense in the fight against chronic pain. While medicines and certain procedures may work for some, they may not bring relief for others and may actually make the situation worse.
Back pain is one of the leading causes of disability in the United States. Whether caused by injury, defects of the spine, or a degenerative disease, the pain can make even the most routine tasks seem like a massive effort.
Sciatica, especially, has the ability to stop you dead in your tracks. The gripping, intense pain that it brings is not easily relieved, often causing frustration, anxiety, and dismay. Herniated discs are often the cause of sciatica, so it’s fair to say that the two go hand in hand.
What is sciatic nerve pain?
Sciatic nerve pain, also known as sciatica, is pain associated with the sciatic nerve. When the nerve is compressed, pinched, or trapped, it can cause intense, even excruciating pain that radiates down the leg, sometimes all the way to your feet.
The pain can be sharp and stabbing, but it is also characterized by numbness and tingling that radiates down the back of one or both legs. For some, sciatic spasms can be so intense that it is impossible to think about anything else.
Causes of sciatica
We all have two sciatic nerves, one on either side of our body. These nerves start in the spine and extend down the leg. When there is a herniated disc present, it may compress the nerve and cause it to flare. However, there are several other possible causes of sciatica.
Sciatica can also be caused by an inflamed piriformis muscle, which runs directly over the sciatic nerve at the bottom of your buttocks. If this muscle is overworked or stiff, it can compress the sciatic nerve, causing intense pain. If this is the cause of the sciatica, stretching the piriformis muscle may give you relief. In severe cases, a steroid injection may reduce the inflammation enough to release the nerve.
Spinal stenosis is a narrowing of the spinal canal, which is essentially a conduit for your nerves and spinal cord. This narrowing may put pressure on the sciatic nerve and cause it to flare up. Stenosis is something you can be born with, but it can also develop later in life. It is most common in adults over the age of 60. There is no cure for stenosis, but anti-inflammatory medications may help if there are symptoms present.
Herniated discs are hands-down the most common cause of sciatic nerve pain. Positioned in between each vertebra, the discs in your spine can best be described as cushions. As we age, they tend to degenerate, but other things can cause them to bulge, such as injury, or being overweight. If a disc herniates, bulges, or slips out from between the vertebrae, this may cause it to press on the sciatic nerve. Depending on the disc that is affected, the pain may manifest itself in various places, including the lower back, the hip, the side and back of the leg, the calf, or the foot.
Spinal disc herniation
Treatment for herniated discs and sciatica largely depends on the severity of the situation and can range from stretching exercises to orthopedic or neurosurgery.
NSAIDs can sometimes help, as can steroid injections and medications for nerve pain, such as pregabalin. In any case, it is essentials to obtain an accurate diagnosis before committing to a course of treatment.
If you are suffering from sciatica, with or without herniated discs, we can help. Reach out today to find out how to get started. Call Roots Through Recovery via (866) 766-8776 to schedule a FREE consultation with our team or visit us at 3939 Atlantic Ave, Suite 102 Long Beach, CA 90807.
Opioid-induced Hyperalgesia, or OIH, is a condition that is caused by the extended use of opioids, medications that are often prescribed for treating chronic pain. For acute pain, such as you would experience after surgery or following an accident or injury, opioid pain medication can be beneficial. In the days and weeks that follow, your injury will heal, and the pain medication will no longer be needed.
In cases of chronic pain, however, the mechanism of opioids is markedly different. In the initial stages, these medications will do a good job of blocking the pain. After four weeks or more of treatment, your body will change the way it responds to pain medicine. It will increase the number of receptors so that the pain signal will begin to break through more frequently.
As a result, once the drug wears off, you will feel increased pain. As time goes by, these medications will be less effective, and the pain will increase. This is called opioid-induced hyperalgesia.
What is hyperalgesia?
Hyperalgesia, essentially, is a heightened pain response. It is typically caused by an injury, but it can result from the use of opioid painkillers.
Someone with hyperalgesia would tend to feel pain from things that would not cause pain to another individual. They might also feel significantly more pain than would normally be expected from an injury, or they may experience pain spreading to a non-injured part of the body.
In cases of opioid-induced hyperalgesia (OIH), you may feel increased pain even though the pain-causing issue has not gotten any worse.
The symptoms of OIH will increase even with an increase in dosage and include:
An increase over time in the amount of pain you feel
Pain has spread to non-injured parts of the body
Increased pain and sensitivity to external stimuli
Is it just an increase in opioid tolerance?
Many patients wonder if an increase in pain or the failure of opioids to relieve their pain is caused by an increased tolerance to the drugs they are taking. If this were the case, increasing the dosage of the medication would likely work to relieve the pain. For someone with OIH, an increase in dosage would make the pain worse.
The mechanism of OIH
Our nerves have pain receptors, called nociceptors, that respond to pain signals. When we are injured, the body sends out a number of different chemicals and compounds, some of which can stimulate the nociceptors. When these receptors become more sensitive, it results in hyperalgesia.
Who gets hyperalgesia?
Occasionally, patients may experience hyperalgesia following surgery, due to tissue or nerve trauma at the site. Fibromyalgia patients may experience hyperalgesia, and it may occur in people with shingles.
People who suffer from chronic pain and who take opioid pain medications are at risk of developing OIH, as are post-operative patients on a short course of opioids.
If you are experiencing an increase in your pain and the opioid pain medication is not giving you relief, your doctor may suspect OIH. Once a worsening of your condition has been ruled out, other strategies can be applied to get your pain management back on track.
Gabapentin, also known by its brand name Neurontin, is a prescription drug initially marketed as an anti-seizure medication. Recently, however, it has shown great promise in the treatment of nerve-related pain from shingles, diabetes, and other types of neuropathy. Some of the other complaints that gabapentin can be prescribed for include restless leg syndrome and alcoholism.
Widely considered non-addicting and a low risk for abuse and overdose, gabapentin has been touted as an alternative to opioid for the relief of chronic pain. However, studies have shown that the use of gabapentin for chronic pain without neuropathy comes with a high risk of side effects. There is no current evidence to prove its efficacy in reducing chronic pain, whether taken on its own or with opioids.
The dangers of combining gabapentin with opioids
When combined with opioids for chronic pain, a potentially life-threatening interaction can occur. The combination of opioids with gabapentin has been responsible for an almost 50 percent higher risk of a fatal overdose. This is largely because it acts as a CNS depressant, amplifying respiratory depression.
Side effects from gabapentin include dizziness, fatigue, changes in visual acuity, memory lapses, and impaired mental function.
Higher risk, no significant difference in pain reduction over opioids alone
Though many patients who struggle with nerve pain find gabapentin very effective, a recent study concluded that patients whose pain was non-neuropathic did not find any more relief than they did using opioids alone.
For patients with low back pain, for example, there is no discernible benefit to taking gabapentin, either alone or in combination with opioids.
If the pain was neuropathic in origin, its use could be justified. Lacking this diagnosis, taking gabapentin for non-neural chronic pain would carry far more risks than benefits.
How gabapentin works to control pain
As an anti-epileptic medication, gabapentin takes aim at the dysfunctional release of pain-controlling neurotransmitters, decreasing or stabilizing irritated nerve membranes to soften their response.
As not all pain is nerve-related, this action would not be likely to deliver the desired analgesic effect. Pain that stems from musculoskeletal injury, osteoarthritis, or any idiopathic pain (in other words, pain that can’t be attributed to a specific source) should not be treated with gabapentin as a frontline intervention.
Weighing in: gabapentin pros and cons
Even though the FDA has only approved gabapentin for epilepsy and seizure disorders, plus pain from spinal cord injuries, diabetic neuropathy, fibromyalgia, or for other neuropathic pain, doctors continue to prescribe it judiciously for chronic pain.
In recent years, gabapentin has become one of the top ten most prescribed medications in the United States. While it has proven itself to be highly effective in treating patients with very specific nerve-related pain issues, its application in chronic pain management is limited. At this time, most medical experts agree that not enough research exists to justify taking on the additional risks associated with its use.
Are you taking gabapentin for chronic pain, or would you like to learn more about holistic alternatives? Reach out today to speak to us about chronic pain recovery. Call Roots Through Recovery via (866) 766-8776 to schedule a FREE consultation with our team or visit us at 3939 Atlantic Ave, Suite 102 Long Beach, CA 90807.
Many people who struggle with chronic pain will experience a dramatic increase in their pain from time to time. This is what we refer to as breakthrough pain or, more simply put, a flareup.
The intensity and duration of the pain during each episode may vary, but when it happens, it can cause a significant amount of disruption to your life, forcing you to cancel plans, miss work, or decrease activity until the pain subsides.
What causes flareups?
Many things can cause flareups, and the circumstances vary from person to person, making it challenging to offer a “blanket” solution that works for everybody.
Knowing the triggers that lead to a flareup may help you avoid them, but again, these are different for each individual. For this reason, it is important to be mindful and to make at least a mental note of your activity, what is going on around you, and what you are eating and drinking right before the flareup happens.
Overwork or overactivity, stress, injury, and fatigue are just a few of the triggers that may lead to an increase in pain. Sleeping poorly, cold or damp weather can also be at the root of the problem, as can inflammation-causing food and drink, medication, or environmental factors.
For some, simple tasks like getting dressed, coughing, going to the bathroom, or exercising can cause a flareup. Sometimes, however, there may not be any discernable reason at all.
If you are taking a long-acting opioid or another type of long-acting pain medication, you may experience a flareup if the medicine stops working in between doses. According to the National Pain Institute,
Listening to your body, being cognizant of your surroundings, and being willing to do what it takes to mitigate the situation is critical.
How to avoid pain flareups
There are many effective techniques to help you manage your pain and prevent flareups. One of the most significant is pacing.
Pacing and goal setting are frontline strategies in chronic pain self-management. Pacing involves breaking down your daily activities into smaller, more manageable chunks. The philosophy is such that once you know how long it takes to start feeling pain from a particular task, you should decrease the time you are engaged in that activity by at least 20 percent.
For instance, at work, you may want to take “mini-breaks” every 20 minutes or so, just to give yourself time to reset, change positions, walk around a bit, get a change of scenery, drink a glass of water, or have a stretch. Some people find it useful to set a timer on their smartphones or computers to remind them.
When your flareup is active
When you experience a flareup, your best strategy is to address the symptoms immediately.
Stop doing the activity that is causing you pain.
If you have been prescribed medication for breakthrough pain, take it right away.
Apply ice, take some ibuprofen or naproxen.
Do not stay inactive for too long: get up, stretch, and move around if you can.
Practice deep breathing, mindfulness, and relaxation techniques.
Don’t panic – this will make the pain worse.
Always remember – flareups will pass. Learning strategies like pacing and goal-setting will help to lessen their frequency.