Posts Tagged ‘Pain Management’


A client recently asked for help with an inexplicable pain in her left shoulder. There was no recent injury or incident that directly or indirectly caused the pain.  I asked her to describe the sensation she felt in her shoulder.

“Small, round, heavy, like a dark cloud.”

She wondered aloud if it was a bursitis, similar to one experienced in the opposite shoulder, related to a work injury that occurred more than 11 years ago. I asked if there was any particular person from her former workplace now coming to mind.

“There were many unresolved issues from work.”


I asked if any particular person came to mind as she focused her attention on her shoulder.

“My boss.”

“If your shoulder could speak, what would it do or say to your boss right now?”

(Pause.) “It wants to punch her in the nose.”

With the image of her boss’ face in her mind we did slow motion punching gesture in the air. She laughed. Her arm began to tingle through to the fingertips and the pain magically disappeared.

The body stores all memory. When we experience a real or perceived threat, the most primitive part of our brain, the brain stem, which we refer to as “reptilian brain“, triggers the nervous system to fight or flee. The body releases hormones that makes our hearts race, the blood moves to the extremities and our focus narrows. Nowadays we seldom have to scramble up a tree to escape from a wild tiger.

However, while our daily external conditions are less precarious, our threat response may be triggered while being reprimanded by an authority figure at a workplace or by engaging in a challenging relationship. In difficult interpersonal situations, we often hold back our impulses to strike, yell or kick. In general this is a good thing. We do not wish to physically harm another being. We can resort to dialogue rather than dueling to resolve difficult situations and no one gets physically harmed in the process.

However, the lizard doesn’t understand negotiation. The lizard only knows that it wants to rip someone’s head off. Every time the lizard brain perceives a signal in the form of a threatening voice, the familiar scent of the boss’s perfume, even the sight of a a familiar-looking car model parked in a nearby lot, the lizard brain involuntarily triggers the nervous system to respond with the flood of hormones, tightening of the muscles and the impulse to fight or flee. It’s just that the rest of our brain doesn’t immediately make the connection.

When we hold our bodies back from responding in these situations, our inner lizard gets confused. It receives the impulse to move, but remains still. The energy in the body remains bound up in the system which over time may manifest as pain in the shoulder, pain in the hip, pain in the foot. Inexplicable chronic pain. The dull ache that cannot be attributed to any accident or injury. In extreme cases, an incomplete defense response, the learned inability to fight may cause the body to turn on itself and manifest as frozen shoulder, depression, irritable bowel syndrome, chronic fatigue or fibromyalgia. A strong desire to escape, or an incomplete fleeing response, may develop into severe anxiety or panic attacks.

When these incidents occurred a long time ago, perhaps when we were young adults, children, or possibly even earlier, how can we work to resolve the issue and make the pain go away?

  • The body stores all memory.
  • Trust the body.
  • Pay attention to the pain.
  • Focus on the pure quality of sensation.
  • Notice words, images or people bubbling up in the periphery.
  • Linger with these sensations that are connected to these words, images or people.

The body is attempting to heal itself. It needs to move. Long ago, an interrupted incomplete defensive response took place that lizard brain remembers through the body and has been nudging you to complete it. We can address and resolve the issue, via the nervous system, and bring mind and body into balance. Trust that the body knows what it needs to do. All it requires is that we pay attention.



There is no cure-all drug for arthritis, but certainly a good start with a correct diagnosis makes a lot of difference in terms of pain management, if not pain prevention, for millions of arthritis sufferers. An early and accurate diagnosis can help prevent irreversible damage and disability that is likely to happen when the onset of the disease is ignored and allowed to progress without treatment. Doctors recommend a properly guided exercise program, rest, medications and physical therapy.

The treatment for all types of arthritis cases revolves around the following objectives:

  • Relieve pain and inflammation
  • Reduce risks of therapy
  • Slow down disease progression
  • Provide patient education
  • Prevent work disability
  • Enhance quality of life

With early and accurate diagnosis, arthritis sufferers are given the chance to try the less costly means to control the pain of arthritis through exercise and diet. Exercise provides the least expensive option to keep the joints healthy. Moving the joints daily through regular exercise helps keep them active and working, but regular consultation with a health professional is needed for proper guidance and monitoring. It is also important for the patient to understand the diagnosis as it relates to the exercise routine.

Two exercise routines commonly used by arthritis patients are the range of motion exercises and strengthening exercises:

Range-of-motion exercises are soft and moderate stretching routines designed to move joints through their normal maximum range of motion. They should be done on a regular basis everyday to help keep the joints moving and to prevent stiffness and deformities due to inactivity. These exercises are crucial for arthritis patients, especially those who are not inclined to move their joints through their full range because of the chronic pain they experience. It must be stressed here that normal daily activities, such as walking, dressing, washing, and cooking are not substitutes for range-of-motion workouts.

Arthritis patients likewise need strengthening exercises to help increase the strength of the muscles that supports the joints. Strong muscles help joints to be firmer and more stable to make them move more easily with less pain. Of course, these treatments for arthritis are only possible for mild cases which have been detected early enough. As the disease progresses, arthritis patients may have to opt for more invasive treatments.

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