Opioids, Chronic Pain and Floatation Therapy

Pain. It can be consuming, frustrating, debilitating, distracting, yet always subjective to the individual experiencing it.  Chronic pain is of epidemic proportions and is a major cause of disability.  Until recently, pain was treated like a fifth vital sign. Blood pressure, pulse, respiration, temperature, and…pain?  

Problems arise in treating pain when there is no objective measure measurement. There is no thermometer to gauge how you are personally sensing that disc herniation, rib fracture, headache or inflammatory bowel disease.  Therein lies the undercurrent of how and why medical methods of treating chronic pain have both changed over the years and led to an opioid crisis.  

This is only complicated by the pharmaceutical industry who keeps pushing opioids and simultaneously disguising the addictive nature of them. For example, in February 2018, the associated press cited that Purdue Pharmaceutical will stop “actively marketing” Oxycontin to physicians. In March 2018, The Washington Post noted that the city of Alexandria, Virginia is suing sellers of prescription painkillers stating that “drug addiction has killed scores of residents and overwhelmed city services”. 

The opioid crisis has forced pain management professionals to consider alternative methods to manage or co-manage serial mind and body implications of chronic pain.   The McShin Foundation in Richmond, Virginia is one shining example of organizations seeking to find collaborative and effective ways to manage pain and recovery from opioid addiction.  Their programs view addiction, recovery and non-narcotic pain treatment with an equation involving a multitude of mind and body therapies.  

Floatation therapy is emerging as a valid, effective and adjunctive means for managing chronic pain in lieu of medication.  Due to the profound effects that floatation therapy has on decreasing inflammation, stress and anxiety, while increasing quality of sleep and musculoskeletal recovery, it is positively enabling for those suffering the mind and body effects of chronic pain.

As a result of positive outcomes in a series of recent studies at The Float Zone in Richmond, VA, a case study was conducted with a recovering opioid user as to the effects of floatation therapy and chronic pain.  The objective of this case study was to provide a concrete example of the positive effects of floatation therapy upon specific physical and emotional aspects related to an individual recovering from opiate addiction and who has been in recovery for 18 months.    

Click to read the Case Study or contact the author, Dr. David Berv, for more information on floating and chronic pain.

To learn more about other pain case studies, visit our Case Study results page.  

This article originally appeared on myfloatzone.com and was written by Dave Berv.

A Broken Body isn't a Broken Person

Cross-country skier Janine Shepherd hoped for an Olympic medal -- until she was hit by a truck during a training bike ride. She shares a powerful story about the human potential for recovery. Her message: you are not your body, and giving up old dreams can allow new ones to soar.

Outer Elbow Pain? You may have Tennis Elbow.

Could you be suffering from tennis elbow and not realise it?

The most common kind of elbow pain is a condition known as lateral epicondylalgia – or tennis elbow. Ironically, you also don’t need to be a tennis player to get tennis elbow. Many who have suffered from tennis elbow, actually do not play tennis. It’s also important to point out that recovery from tennis elbow requires a proactive approach involving diagnosis, treatment and strengthening. Through rest alone, your recovery will be very slow.

The causes of tennis elbow

This type of problem can occur at any age, but is most common between the ages of 35 and 50. Predictably, it is more common in your dominant arm but can affect both. The biggest misconception about this type of elbow pain is you don’t have to be a tennis player to get this condition. In fact it is just as common in people who repetitively overuse their forearm muscles such as office workers or tradespeople.

Referred Pain
A huge contributing factor to this condition which can be easily forgotten is referred pain from the neck or shoulder. This can either mimic symptoms of tennis elbow, or most commonly there is a combination of elbow and neck, shoulder or thoracic spine issues. You will need to have a thorough examination by a physiotherapist to determine if you have any referred pain from your neck and shoulder or if your elbow pain is isolated. This will assist in a more direct approach to your problem and a speedier recovery.

Tennis elbow and it’s symptoms

Typically, this condition presents as pain at or just below the lateral epicondyle- that is, the pointy part on the outside of your elbow. Generally people experience pain with gripping, lifting or wringing activities which cause tension over the tendon (see above picture). Clinically, we as physiotherapists often find people suffering this condition have weak and/or tight forearm muscles and stiff elbow and wrist joints.

There is a wide variation in the severity of this condition and how long the symptoms may last for. As with any injury, it is best that we see you as soon as possible to start you on an injury management plan. On assessment, your physiotherapist will be able to give you a guide as to how long your injury may last.

6 Steps to treating tennis elbow pain

Initial management of this condition is through pain relieving techniques such as soft tissue massage, joint mobilisations, stretching tight nerves and muscles, dry needling, heat and/or cold therapy and taping. We also sell tennis elbow braces to our clients that are effective in relieving pain in some people. I’ll cover these methods in more detail;:

1. Soft Tissue Massage: A massage therapist can use a range of techniques to release soft tissue, break down tension and realign the fibres. These techniques include myofacial release and transverse friction techniques.

2. Joint mobilisation: this management may include massage around the problem area or gently mobilising the joints of your neck and elbow.

3. Stretching: As soon as your pain allows, start stretching the area. Extension exercises of the wrist will be the most important stretches you can do to improve your range of motion and to increase the amount of load on the tendon.

4. Dry Needling: Dry needling is a technique that is fast gaining appreciation within the physiotherapy world, with many practitioners throughout Australia now trained in the use of acupuncture needles to assist with their client’s pain and rehabilitation. The insertion of needles at varying lengths and points are thought to alter the way pain signals are transmitted by nerve pathways.

5. Hot/Cold therapy: Apply ice to the elbow regularly to reduce the pain and inflammation will be a good start, particularly at the early onset of pain.

6. Kinesio Taping: Kinesio taping may help decrease the pain and can reduce the likelihood of injury aggravation.

Another exercise option is the ‘The Tyler Twist”, where clients are asked to perform an exercise using a FlexBar®. The experiment consisted of a group of 22 subjects who suffered from tennis elbow. These subjects were then split into 2 groups. The first group were asked to perform the FlexBar® exercise as well as receive standard physiotherapy. The control group received physiotherapy alone. It was found after 7 weeks of therapy that the first group had significantly more improvement than the group receiving only standard physio; in particular, the eccentric exercise group improved their pain level 81% vs. 22% in the standard group.

Ongoing management and prevention of tennis elbow.

Of utmost importance in managing this condition is a progressive strengthening program. Tendons require gradual load in order to heal correctly, so it is very important to continue to strengthen your muscles even if your pain is gone. At this phase of your rehabilitation, it is also important to look at contributing factors such as workstation setup and your posture. If you have some referred pain, assessing your pillow may also be necessary to ensure that your whole body is always in optimal alignment.

Sometimes patients are recommended by their GP to consider a cortisone injection into the elbow. The most recent research regarding this shows that it actually makes you worse in the longer term. Cortisone assists in settling inflammation, which may help in the short term, but generally this condition is not an inflammatory condition.

Recovery from tennis elbow pain

Typically, tendon overload injuries such as this can take anywhere between 2 and 24 months to be back to normal. No, this doesn’t mean you will be in pain for that long or that you will necessarily need one on one treatment for that long. It means that the healing process of tendons is longer than any other tissue in the body so you may need to continue with an exercise regime in the longer term- even after you stop seeing your physiotherapist. This will ensure that your pain stays away.

Remember, tennis elbow is not the same as Golfers elbow which we’ll be covering in a later post. If you are experiencing elbow pain, even if you’re not sure if it’s tennis elbow, it is important to seek treatment as soon as possible to reduce your recovery time. 

This article originally appeared on sportandspinalphysio.com.au and was written by Craig Honeybrook

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How Sensory Deprivation Float Tanks Deepen Your Meditation

I was first drawn to float tanks by stories I’d heard that sounded like mind-altering drug trips except the people telling them were completely sober. They were, quite simply, just floating on water. I had to try it and figure out for myself what made it a life-changing experience for so many.

Why were float tanks invented?

The flotation tanks, which are also called isolation or sensory deprivation tanks, were created in the 1950s by Dr. John C. Lilly. He was a neuroscientist and psychoanalyst with interests in philosophy and invention. He was deeply passionate about exploring human consciousness, particularly regarding what we could access within ourselves when we completely tune out outside stimuli.

He wanted to know who we are when we are completely free of the noise, sensations, and impositions of the outside world. Who are we when all we are aware of is our inner self?

This might sound like something you could answer through meditation, and I am a big proponent of meditation. However, as someone who meditates daily, I believe the isolation tank takes us on a journey far different from any meditation.

What is sensory deprivation, exactly?

It is a form of meditation but in a way more akin to yoga in that it is as much physical as it is mental. Float tanks interact directly with your body, and some even feel as if they become one with the water, which can create a feeling of being infinite. The water is warmed to 98 degrees, which is the same as body temperature. Each tank has around 1,000 pounds of salt in it, which ensures all people, of all shapes and sizes, will float on this buoyant water.

I feel completely held and taken care of. This mental release is a large part of what makes the isolation tank so powerful.

Floating on a cushion of saltwater for an hour counteracts the pressure of gravity. Your joints, tissues, and muscles will feel as if you’ve just received a superb massage, your spine will thank you, and the Epsom salt will do wonders for your skin and circulation.

The physical sensation of floating connects us right into the mental feelings of surrender and release. It’s one of the most comforting sensations I’ve ever felt. It’s as if I am being held in my own little cushion of support, and whatever it is that bothers me can safely be let go. I feel completely held and taken care of. This mental release is a large part of what makes the isolation tank so powerful.

Here's what happened when I developed a regular sensory deprivation practice.

Once you are comfortable with the sensation of floating (you may not reach this on your first time), you will gently ease into deeper and deeper levels of surrender and letting go. At some point, you will naturally lose track of time. You will slowly forget where you are, maybe even who you are. You will fall into your subconscious, but you will still be awake, allowing you to forge a connection with all of the power that resides there. The more times you go to the tank, the more you build and strengthen that bridge between your subconscious and conscious.

As a result, you may suddenly start being able to recall your dreams. You may have bursts of insight while in the tank. You may find your creativity at work heightens to new levels. You might also find yourself becoming more aware of how you react to life, what triggers you, and feel yourself taking greater control over what used to feel like out-of-control emotions.

Are there any downsides to float tanks?

Now that I’ve described a few of the possible benefits, you might be wondering why everyone isn't running out to try it. I suspect it's because all of this is done in an enclosed tank, in complete darkness. Simply envisioning closing the lid of a pod and sealing yourself in can trigger claustrophobia for some.

In my experience, after I’ve suggested someone go, they find that the anticipation was far bigger than the actual experience. Once inside it’s easier to understand how safe and serene it is. Each tank is in its own room, giving each person space to take things at their own speed. Most float spas have a shower in the room, so that you can shower before and after in privacy. The whole experience is designed to induce relaxation.

What can I expect on my first time?

Professional float spas have speakers built into the tank, and they will play soothing music for the first 10 minutes. They also have a light inside, and you can keep it on as long as you like—even the whole time. You don’t even have to close the door—it’s your experience and all up to you. If you keep the light on and the door open, you will not go as deep into that space of letting go. But that’s OK because this type of therapy is still new, and the fact that you are brave enough to be one of its first explorers is worth celebrating.

Most people say that once they close the door and the light goes off the feeling of the pod goes away. They no longer feel closed in but instead feel as if everything has opened up wider than ever before. Some even feel as if they then expand and connect with the whole Universe.

After dozens of trips to the float spa, I have found I can surrender and let go of things that used to hold me in an iron grip. I have gotten clarity on problems I was so deeply entangled in I couldn’t see any possible solution. And on one particularly wild trip, I had an out-of-body experience and a vision like I’ve never had before.

If this intrigues you, I hope you consider trying it out yourself. Float spas are opening with more frequency now, and it’s possible there’s one near you, waiting to take you on an adventure to your deepest resources of love, healing, and cosmic connection.

This article originally appeared on mindbodygreen.com and was written by Melissa Field,