What IBS, Crohn's Disease & GI Disorders Have To Do With Coping Skills

Health psychologists have begun treating gastrointestinal disorders that are strongly affected by stress, including irritable bowel syndrome (IBS), Crohn's disease, functional heartburn, functional dyspepsia and ulcerative colitis.

Biochemical signaling between the brain and the GI tract, known as the brain-gut axis, can have a major effect on gastrointestinal disorders. The normal stress of everyday life can aggravate certain GI conditions. And in a vicious cycle, worrying about or dwelling on severe pain, constipation, diarrhea and other GI symptoms can make the symptoms worse, which in turn increases the stress, said Sarah Kinsinger, PhD, ABPP, a Loyola Medicine health psychologist who specializes in treating GI disorders.

Dr. Kinsinger offers behavioral treatments specifically designed to target brain-gut pathways. These treatments teach patients coping strategies to manage symptoms and reduce stress. She provides cognitive-behavioral therapy, an evidence-based treatment for irritable bowel syndrome. She also offers behavioral relaxation techniques, including diaphragmatic breathing (also known as belly breathing or deep breathing) and gut-directed hypnotherapy.

In many patients, psychological or behavioral interventions can be more effective than medications, Dr. Kinsinger said. She usually sees patients for five to seven sessions, and the treatments typically are covered by insurance.

"It is very gratifying to see patients get better after in some cases suffering for many years," Dr. Kinsinger said. "Psychological and behavioral interventions do not cure their disease, but the treatments can provide patients with safe and effective coping mechanisms and greatly reduce the severity of their symptoms."

For some conditions, such as IBS, psychological and behavioral treatments can be the primary treatments. For other conditions for which there are effective drugs, such as Crohn's disease and ulcerative colitis, psychological and behavioral treatments can be effective adjuncts to medications.

Dr. Kinsinger earned a PhD degree in clinical psychology from the University of Miami and completed a health psychology fellowship at the University of Illinois Medical Center at Chicago. She is board certified in clinical health psychology by the American Board of Professional Psychology.

This article originally appeared on Science Daily.

A Must Read For People in Pain: 'Explain Pain'

If I could make only one recommendation to individuals living with chronic pain, it would be to read the book Explain Pain by David Butler and Lorimer Moseley.

Directed at both clinicians who work with chronic pain patients and patients who live with chronic pain, Explain Pain shows how the discoveries of modern pain science can be put to practical use. Written in understandable language with a touch of lighthearted humor, Butler and Moseley take a complex subject and make it possible for the average person to understand and use. One client remarked that she thought it would be hard to read and was delighted that she did not find it difficult at all. 

Pain education can help

Research has demonstrated that pain education can help to reduce chronic pain. For instance, a recent study by the army followed 4,325 soldiers over a two year period and found that one session of pain education could help lower the incidence of low back pain. Understanding how pain works is not a magic bullet that will make pain go away immediately, but it can help to take some of the fear and anxiety out of the experience which can then begin to help alter the experience. With time, thinking a little differently about pain can lead to more successful strategies for reducing, limiting, and eliminating pain.  

Pain is useful and should not be ignored. Pain is a protective mechanism generated by the brain in response to perceived threat. However, when pain is chronic and there is no direct or immediate threat to the body, understanding how the body can get "stuck" in pain can suggest ways to help it get "unstuck." 

Butler and Moseley provide some amazing stories to illustrate the surprising discovery that pain is not directly related to tissue damage. While this concept may, at first, seem odd and difficult to grasp, they produce convincing evidence to support this idea. Consider this: a paper cut produces very little tissue damage, yet can cause a lot of pain. A soldier can get shot in battle, yet not realize he is injured until he is off the battlefield. Amputees may experience phantom limb pain in tissue that no longer exists. How does that happen? The part of the brain that corresponded to the amputated limb can still generate the sensation of pain, even after the limb is gone.

Pain can be influenced by context. If everyone around us seems to be in pain, we may also expect to be in pain. Athletes involved in vigorous sports ignore impacts that would upset most of us because to them it's all part of the game. In that context, it is expected and not a threat. 

Butler and Moseley describe how pain is generated by the nervous system. Understanding that pain is generated by the brain, rather than by damaged tissues, does not mean that pain is "all in your head" and should be ignored or dismissed as imaginary. In fact, understanding that pain is the body's alarm system highlights the importance of treating pain so that the alarm system does not become oversensitive. 

The book describes what happens in different systems of the body and how they may be affected by pain. Normal responses to painful stimuli are contrasted with what happens when the responses become altered. The influence of our thoughts and beliefs is examined for the role it can play in chronic pain.

Practical suggestions

The last few chapters of Explain Pain suggest practical tools that can be used to manage chronic pain. Using "the virtual body" is explained, as is the use of graded exposure to break the association between particular movements and pain and to cultivate successful movement without pain. 

Pain education should be part of every client or patient's rehabilitation.Explain Pain provides an excellent model for pain education.

One of my clients suffered for many years with a painful chronic condition and found this book immensely helpful. Although she had seen many doctors and therapists, she had never been given any pain education. After reading this book, she asked, "Why didn't anyone tell me this?" My response was, "They didn't know." Although Explain Pain was first published in 2003, pain science is still only slowly finding its way to practitioners. 

Since I've begun studying pain science, I've incorporated information the information presented in Explain Pain into my practice. It has been a useful tool for helping clients get out of pain and feel in control of their lives once again.

Additional resources

I've posted a fifteen minute TED Talk by Lorimer Moseley on Why Pain Hurts in a previous post. There is also, in the same article, a forty-five minute lecture to a professional audience for those geeky folks who want to understand details about the biology of pain. Recently, I've found a twenty-five minute video by Moseleywhich has become a favorite because he addresses how we think about conditions like herniated discs and how our thinking can feed and perpetuate fear, anxiety, and pain. If you watch only one of these videos, this is the one I recommend. These videos are educational and entertaining. Moseley, who is both researcher and clinician, has a charming Australian accent and a great sense of humor. Imagine Crocodile Dundee giving an introduction to pain science and you'll get the picture.

For more information about understanding pain, I also suggest the following: 

Painful Yarns by Lorimer Moseley (stories to help understand the biology of pain)

Also, check out this article about understanding how pain works by Paul Ingraham of SaveYourself.ca. 

Cory Blickenstaff, PT, has put together some useful videos of "novel movements." Here are links to the ones on the low back, neck, and hand, wrist, forearm, and elbow. 

This article originally appeared massage-stloius.com and was written by 'Ask the Massage Therapist'.
 

Headaches: Causes, Diagnosis and Treatments

Headaches are one of the most common complaints, and most people experience them at some point in their life. They can affect anyone regardless of age, race, and gender.

The World Health Organization (WHO) reports that almost half of all adults worldwide will have experienced a headache within the last year.

A headache can be a sign of stress or emotional distress, or it can result from a medical disorder, such as migraine or high blood pressure, anxiety or depression. It can lead to other problems. People with chronic migraine headaches, for example, may find it hard to attend work or school regularly.

Migraines, cluster headaches, and hangovers are some of the causes of headaches.

Contents of this article:

1. What causes a headache?
2. Types of headache
3. Diagnosis
4. Treatment

What causes a headache?

Headache is a common complaint worldwide.

A headache can occur in any part of the head, on both sides of the head, or just in one location.

A headaches can radiate across the head from a central point or have a vise-like quality. They can be sharp, throbbing or dull, appear gradually or suddenly. They can last from less than an hour up to several days.

There are different ways to define headaches. The International Headache Society (IHS) categorize headaches as primary, when they are not caused by another condition, or secondary, when there is a further underlying cause.

Primary headaches

Primary headaches are stand-alone illnesses caused directly by the overactivity of, or problems with, structures in the head that are pain-sensitive.

This includes the blood vessels, muscles, and nerves of the head and neck. They may also result from changes in chemical activity in the brain.

Common primary headaches include migraines, cluster headaches, and tension headaches.

Secondary headaches

Secondary headaches are symptoms that happen when another condition stimulates the pain-sensitive nerves of the head.

A wide range of different conditions can cause secondary headaches.

These include:

Eating something very cold can lead to a "brain freeze."

• An alcohol-induced hangover
• Brain tumor
• Blood clots
• "Brain freeze," or ice-cream headaches
• Carbon monoxide poisoning
• Concussion
• Dehydration
• Glaucoma
• Influenza
• Overuse of pain medication, known as rebound headaches
• Panic attacks
• Stroke

As headaches can be a symptom of a serious condition, it is important to seek medical advice if they become more severe, regular, or persistent.

For example, if the headache is more painful and disruptive than previous headaches, worsens, or fails to improve with medication or is accompanied by other symptoms such as confusion, fever, sensory changes, and stiffness in the neck, a doctor should be contacted immediately.

Types of headache

The symptoms of a headache can depend on the type.

Tension-type headaches

Tension-type headaches are a common form of primary headache.

The person can feel as if they have a tight band around the head, with a constant, dull ache on both sides. The pain may spread to or from the neck. Such headaches normally begin slowly and gradually in the middle of the day.

Tension-type headaches can be either episodic or chronic. Episodic attacks are normally a few hours in duration, but can last for several days. Chronic headaches occur for 15 or more days a month for a period of at least 3 months.

Migraines

Migraine is the second most common form of primary headache and can have a major impact on the life of an individual. According to the WHO, migraine is the sixth highest cause of days lost due to disability worldwide. A migraine can last from a few hours to between 2 and 3 days.

A migraine headache may cause a pulsating, throbbing pain on one or both sides of the head. The aching may be accompanied by blurred vision, light-headedness, nausea, and sensory disturbances.

Rebound headaches

Rebound or medication-overuse headaches are the most common secondary headache.

They stem from an excessive use of medication to treat headache symptoms. They usually begin early in the day and persist throughout the day. They may improve with pain medication, but worsen when its effects wear off.

Rebound headaches can cause a range of symptoms, and the pain can be different each day. Along with the headache itself, rebound headaches can cause neck pain, restlessness, a feeling of nasal congestion, and reduced sleep quality.

Cluster headaches

Cluster headaches are a less common form of primary headache. They strike quickly, one or more times daily around the same time each day and often without warning.

They usually last between 15 minutes and 3 hours, and they persist for the duration of what is known as a cluster period, which normally lasts 6 to 12 weeks.

The pain caused by cluster headaches is severe, often described as sharp or burning, and it is normally located in or around one eye.

The affected area may become red and swollen, the eyelid may droop and the nasal passage on the affected side may become stuffy and runny.

Diagnosis

A doctor will usually be able to diagnose a particular type of headache through a description of the condition, the type of pain and the timing and pattern of attacks.

It may be a good idea to keep a diary detailing the symptoms of regular headaches and any possible triggers. This can help both the patient and the doctor in identifying the exact nature and possible cause of the headaches.

If the nature of the headache appears to be complex, tests may be carried out to eliminate more serious causes.

Further testing could include blood tests, X-rays, and brain scans, such as CT and MRI.

Treatment

The most common ways of treating headaches are rest and pain relief medication.

Generic pain relief medication is available over the counter (OTC), or doctors can prescribe preventative medication, such as tricyclic antidepressants, anti-epileptic drugs, and beta blockers.

It is important to follow the doctor's advice because overusing pain relief medication can lead to rebound headaches.

The treatment of rebound headaches involves the reducing or stopping pain relief medication.

In extreme cases, a short hospital stay may be needed to manage withdrawal safely and effectively.

Self-care

A number of steps can be taken to reduce the risk of headaches and to ease the pain if they do occur:

• Apply a heat pack or ice pack to your head or neck, but avoid extreme temperatures
• Avoid stressors, where possible, and develop healthy coping strategies for unavoidable stress
• Eat regular meals, taking care to maintain stable blood sugar

A hot shower can help, although in one rare condition hot water exposure can trigger headaches.

Exercising regularly and getting enough rest and regular sleep contribute to overall health and stress reduction.

Several alternative forms of treatment for headaches are also available, but it is important to consult a doctor before making any major changes or beginning any alternative forms of treatment.

Acupuncture is an alternative therapy that may help relieve headaches.

Alternative approaches include:

• Acupuncture
• Cognitive behavior therapy
• Herbal and nutritional health products
• Hypnosis
• Meditation

(Research: Acupuncture and Migraine)

Sometimes, a headache may result from a deficiency of a particular nutrient or nutrients, especially magnesium and certain B vitamins.

Nutrient deficiencies can be due to a poor quality diet, underlying malabsorption issues, or other medical conditions.

Anyone with a suspected nutrient deficiency should work with a qualified health professional to diagnose and correct the deficiency in a sustainable and holistic way, rather than relying on an isolated supplement.

The WHO points out that headaches are often not taken seriously because they are sporadic, most headaches do not lead to death, and they are not contagious.

They call for more resources to be allocated for the treatment of headache disorders, because of the huge health burden they represent.

This article originally appeared on medicalnewstoday.com Written by James McIntosh

What Flotation Therapy Can Do For Depression

Study Demonstrates What Flotation Therapy Can Do For Depression, Stress, Anxiety & More

A study published in the journal BMC Complementary and Alternative Medicine explores sensory deprivation in a flotation tank as a form of preventative healthcare. Its results showed substantial reductions in levels of stress, anxiety, depression, and pain, and along with improved sleep quality and overall mood, proving that flotation therapy is an excellent way to prevent and treat many  emotional and physical ailments.

Sensory deprivation cuts off all the senses from the mind, removing it from the average barrage of stressful situations that most of us face each day. In the absence of distracting external stimuli, the mind enters a state of deep relaxation and meditation. The research shows how this state can actually be medicinal, as it has tremendous potential to reduce stress and thus the damaging symptoms that come with it.

Chronic stress expresses itself through things like depression, insomnia, and anxiety. Flotation therapy can directly relieve this, but how?

The relaxation response method (RR) is essentially the exact opposite of the fight-or-flight response. It is the physiological process that relieves stress, occurring during states of deep relaxation. RR is able to combat stress so efficiently because of its calming effects on the parasympathetic nervous system, the portion of the nervous system responsible for many physiological changes within the body including energy conservation and deep relaxation. It is through this process that RR lowers heart rate and blood pressure and slows down breathing.

The authors of the study noted that to successfully ignite the RR response while the body is under stress it is crucial to reduce all sensory input and movement by the body — which makes floatation therapy the perfect solution. The research described the mechanisms of this method: “During flotation-REST (Restricted Environmental Stimulation Technique) an individual lay in a horizontal floating posture immersed in highly concentrated salt water (magnesium sulphate) in a flotation tank. All incoming stimuli are reduced to a minimum during this period (usually 45 minutes), i.e. sound and light, and the water is heated to skin temperature. ”

The Study

Sixty-five participants — 14 men and 51 women — took part in the study. The participants were divided into a flotation-REST group, which consisted of 37 people, and a wait-list control group, with 28 people. The flotation group received 12 45-minute sessions over the course of seven weeks. Subjects were assessed for depression, anxiety, stress, sleep quality, energy, pain, and optimism before and after the study. These same measurements were assessed for the control group.

The flotation group displayed radically improved scores in comparison to the control group, with participants exhibiting reduced anxiety, depression, pain, and stress.

Here’s Some Data

The average score for stress before flotation treatment was 1.86; afterwards, it dropped to a remarkable 0.95. The control group scored 1.84 before and 1.89 after treatment, meaning their stress actually increased during this period.

The score for anxiety for the flotation group was 7.92 before treatment and 4.28 afterwards. On the other hand, the control group scored 7.03 before and 6.96 afterwards.

For depression, the flotation group started out with a score of 4.42, which then dropped to 2.25 after treatment. The control group started at 4.00 and ended the period at 4.30, another increase.

Researchers also saw an improvement in various lifestyle factors. Sleep quality, pain, optimism, and mindfulness were all measured and shown to increase with treatment. These results further strengthen the case for flotation therapy.

In the conclusion of the study the researchers were confident that flotation therapy can be an excellent practice to improve overall health by greatly reducing stress (and thereby stress related illnesses) while increasing psychological factors in healthy participants as well.

Final Thoughts

Isn’t it just amazing what a little bit of rest and relaxation can do for our mental and physical well-being? While it’s easy to say we should all just make the time to relax more, the issue here is that many of us won’t. If you actually make the effort to go to a float spa, which are becoming increasingly popular across North America, then you will be dedicating this time to yourself and will experience the ultimate form of relaxation. In fact, flotation therapy is one of the most potent methods of activating the relaxation response, and shows how our environment can directly impact our physiological and psychological well-being. Instead of taking prescription drugs for such ailments, consider giving this a try!

This article originally appeared on collective-evolution.com and was written by Alanna Ketler