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Adventure based strategies & chronic pain

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Presentation Objectives:
Review The State of Chronic Pain Today
Discuss the importance of emotions (Anxiety &Depression) with Chronic pain
Discuss the relationship of the Brain to Pain.
Describe, demonstrate the role nutrition, mindfulness, exercise and adventure based therapies has in treatment of chronic pain.

Published in: Health & Medicine
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Adventure based strategies & chronic pain

  1. 1. Mindfulness- Exercise- Nutrition -Adventure Based Strategies & Chronic Pain James Flowers PhD, LPC-S & Louise Stanger Ed.d, LCSW, CDWF 3-2018
  2. 2. To close your eyes Soften Your Gaze
  3. 3. Review The State of Chronic Pain Today Discuss the importance of emotions (Anxiety &Depression) with Chronic pain Discuss the relationship of the Brain to Pain. Describe, demonstrate the role nutrition, mindfulness, exercise and adventure based therapies has in treatment of chronic pain
  4. 4. Chronic Pain affects over 133 million Americans or over 1/3 of our population Annual cost of $635 million More common among women then men More common among older persons
  5. 5. Concussions Facial pain Neck Pain Accidents -Driving, Texting Exercising, Weekend Warrior Tasks Hips, Knees , Shoulders
  6. 6. Low back pain Osteoarthritis Rheumatoid Arthritis Migraines Fibromyalgia Pelvic Pain Carpel Tunnel Syndrome
  7. 7. Pain that lasting longer then 12 weeks For the most part pain has been treated in terms of body parts Scientists are now rethinking chronic pain
  8. 8. Is Chronic Pain-The Brain Game ? Neuroimaging shows that chronic pain alters the size of certain brain regions And the way certain brain regions talk to one another becomes abnormal It effects the dorsolateral prefrontal lobe - cognition motor planning and memory
  9. 9. Prevent certain regions from turning off when they should Result the brain is overly sensitive to pain and stimulates a feed-forward cycle that reinforces the chronic pain state
  10. 10. 77% report feeling depressed 51% feel they have little or no control over their pain 20% report sleep is disturbed Anxiety, Stress, Fear and Depression become bedfellows to chronic pain
  11. 11. Pain Patient becomes out of control with medications Becomes drug seeking - quality of life decreases Medication will continue or increase despite side effects . Hyperalgesia
  12. 12. Trauma Loss of Control Loss of Mastery Loss of Sense of Self Cognitive Error Overinterpretation Catastrophizing Personalization Daily Life Alters Trauma Loss of Mastery Loss of Control Loss of Sense of Self Loss of Self-efficacy Cognitive Error Denial Daily Life Alters
  13. 13. Traumatic Injury Back& Neck Disorders Complex Regional Pain Syndrome Headaches and Migraines Opiate hyperalgesia CNS Arthritis Oro-Facial Pain Fibromyalgia Other Disabling Impairments
  14. 14. Driftwood Recovery Complementary and Alternative Modalities
  15. 15. Get Moving Have Fun Outdoors Stress Relief Mindful Activities Challenge By Choice
  16. 16. What Everyone Gets Physical Pain Assessment 5 days a week exercise, as well as Sat and Sunday Have Fun- people do not know they can have fun
  17. 17. Pain Patients Receive Pain Assessment- what did they like to go Have fun outdoors everything from laying, biking to hiking, indoor rock climbing, frisbee, juggling have fun in the sun Stress relief -Heart Math Stem
  18. 18. Heath Math Technology
  19. 19. Other Therapies Infrared Sauna, infrared Heating pads Soft Gel Packs Nuerolumen Keep in Mind Collaboration with nursing staff, doctor and clinicians is the key to pain protocol
  20. 20. Stress Relief Activities Weekly lecture from Pain Doctor (mindfulness, medications , sleep and pain , food etc) Private appointment with Pain Doctor Morning Reflection with Clinicians
  21. 21. One deep mindful breath changes the chemistry of the air and helps take us out of AUTOMATIC STRESS REPOSE toward PARASYMPATHETIC HEALING STATE
  22. 22. “YOU CANNOT HEAL WHEN YOU ARE STRESSED ALL THE TIME. “
  23. 23. Meditation- Mindfulness Relaxation -Breathing Irritable Bowl Syndrome TMJ Rheumatoid Arthritis Fibromyalgia Migraines Abdominal Pain in Children or Surgery
  24. 24. Qi-“Subtle breath”,Gong-“Vital energy Slow movements warm tendons, muscles and ligaments & Muscles, Promote circulation of body fluids Effective for chronic illness , emotional frustration, stress and spiritual crisis etc (NQA)
  25. 25. Irritable Bowel Syndrome- TMJ Fibromyalgia Headaches, Abdominal Pain in Children, Pain from surgery Depression Guided Imagery for pain management
  26. 26. Mind-body practice Low Back Pain Arthritis 2011studies military
  27. 27. Music Fibromyalgia, arthritis , joint pain , nerve disorder
  28. 28. Chronic Back pain, (2010- 2012) Joint pain, (osteooarthritis) Knee and Hip pain Headaches/Migraine Fibermyalgia Detoxification
  29. 29. 43.8-57.6 million adults have had a massage once once 2016 (AMTA ) Chronic Neck Pain Osteoarthritis Tension Headaches Fibromyalgia
  30. 30. PT, Naturopaths, Osteopathic Physicians, Chiropractors AHRQ -Low Back Pain withers as effective as medications Headaches Neck Pain
  31. 31. Aquatic Therapy
  32. 32. Adventure Based Strategies Driftwood Recovery
  33. 33. Growing Organic Foods
  34. 34. Let’s Talk Food Reduce Pain and Inflammation
  35. 35. Oats, Red Pepper, Dark Chocolate, Black Beans, Broccoli, Olive Oil Tomatoes, Chia Seeds, Nuts , Green Tea
  36. 36. Meet Helen - 62 y.o FemaleHip replacement Knee replacement’ Shoulder Constant pain-anxiety Cancer survivor Tried to commit suicide Angry Husband & Family Addicted
  37. 37. IN THE BEGINNING Not able to take breaths - use of Heart Math Self Esteem was missing Smile was gone Only memories of what once was
  38. 38. I Have Lost Relationships Money Self Esteem Ability to Walk Smile
  39. 39. Strategies 15 day detox- Pain still 20% due to Hyperalgesia Education Cognitive Behavioral Therapy Mindfulness Mediation Yoga etc - Canoeing- walking Peer Support
  40. 40. Who would of ever thought Canoeing
  41. 41. Meet Doug
  42. 42. Back Pain Severe-Not able to lift young children- possible candidate spine surgery Mother Dying -house full of edibles and pills Previous treatment for substance abuse Unemployed Stealing from wife and mother Isolating Lying Family History- Ethoh and Pills Co-Ocurring About Doug
  43. 43. What’s working!
  44. 44. Showing Up
  45. 45. Testing Noticing Observing Experiencing Exposure
  46. 46. Am I doing to much or to little? How high can I lift with comfort? How much can I contract before a spasm? Where does lengthening cease to feel good? When I reach in one direction , How can I facilitate Movement? What level of force or effort feels right? Fast, slow or both ?
  47. 47. Combines MI- CBT along with precise, breathing mindfulness Empowers person to do things they fear in a gradual relaxed normal manner Requires confidence that pain be “RESPECTED” not feared
  48. 48. Meet Maddi 10 operations - 6 treatment centers
  49. 49. Maddi gains trust with primary clinician Maddi gains trust with exercises Maddi Starts to talk to therapist Family is confronted with their substance abuse and their need to detach Maddi experiences a difference in family Maddi experiences a Community Integration Approach Maddi could be your next client
  50. 50. Accepted to premed Family Changing - Truths Coming Out
  51. 51. Meet Ed Two Families Celebrity Personal Back Pain Opiods Marijuana
  52. 52. Celebrity Management Business, Personal, PR, Hairdresser, Stylist, Lawyer, Entourage, Security Etc Etc
  53. 53. Chad -32 y.o Motocross Accident
  54. 54. Mindfulness was key to his Recovery Battered Opiates On his own Family Not Interested
  55. 55. Meet The Family Susan
  56. 56. Stole Prescription books Put Spouses medical license at risk Nodded off at Outings Emotionally unavailable to Family Embarrassed, Ashamed, In Pain-Hand and Arm
  57. 57. Gardening - Nature Exercise - Water , gym etc Massage-Acupuncture Mindful Meditation 12 Step Service Work-Gratefulness Family Therapy
  58. 58. Family Work Couples Therapy Self-Support Groups Psych0-Education Children-Education Young Adult Child -ACA , College Support Group Teen- Education & Sports Change Agreements
  59. 59. R, L. Nahim, Estimates of pain prevalence and severity in adults, 2012, “j Pain, vol.16, no 8 pp789-80 A. May, “Structural Brain Imaging. A Window into Chronic Pain", The Neuroscientist,vol17,No 2,pp.2019-220, 2011 Napadow& R.E. Harris ,”what has functional connectivity and chemical neuroimaging in fibromyalgia taught us about the mechanisms and management of centralized pain ? Arthritis Research and Therapy .vol 16 Ingemanson, Morgan PHD , “Chronic Pain Lives in the Brin, April 17, 2017 Vox Brain Map http://evoxbrainmap.com/chronic-pain-lives- brain/
  60. 60. Nahin, R. ,Boineau, R, Partap. S. K., Stussman, Weber, N.D. Evidence -Based Evaluation of Complementary Health Approaches for Pain Management in the Inited States , Sept. 2016 Why Goldilocks is my Rehab Heroine https://meduim.com/cheryllee-98816/why- goldilocks-is-my-rehab-heroine
  61. 61. Nahin, R. ,Boineau, R, Partap. S. K., Stussman, Weber, N.D. Evidence -Based Evaluation of Complementary Health Approaches for Pain Management in the Inited States , Sept. 2016 Why Goldilocks is my Rehab Heroine https://meduim.com/cheryllee-98816/why- goldilocks-is-my-rehab-heroine
  62. 62. Fersum,K., Sullivan, PO, Skouen, JS , Smith .A, Kvale, A Efficacy of classification -based cognitive functional therapy in patients with non-specific chronic low back pain : A randomized controlled study

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