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Hands-on Approach to Pain Management, Part 2

Carola Janiak

Presenter

Carola Janiak

Founder and Director, Hands-on Medical Massage School

Conference

Recorded

  • January 30, 2012
    3:30 PM
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I get started and now that you're all therapy after I manager all lies okay will talk about what you mean because this is a hands-on approach to pain management right management in its name in the medical field because a lot of times the .net people were now you have been vital signs here everything else was good but a person was in pain and a doctor would still send them home and face are there's nothing we can do for you and people were going home in Maine so pain often fall through the cracks in the medical field they can go to physical therapy they can guide you now have surgeries and things of the orthopod or whatever a man not being in pain right so who's going to help these people right we thank Doctor Thomas as we got a lot of people that were given up on by the medical field the medical field could do nothing more for them other than prescribed in all different types of medications that designed the noun and make the evening function so pain is a big thing when your name can you think about spiritual things you know anything about other things in your pain I remember when I came back I was overseas yes I was overseas one year right after nursing school I went to a place in Micronesia called to violence then they call the truck islands and an expected ship violence again and boy do I wish I would've known the size and hydrotherapy before or I went there in a natural remedy because here I was the school nurse and I taught fourth grade in while I was there I saw all kinds of things I look back now and fight all we could taking care that which our home we had a half-hour from Chronicle writing now and as things that and so I think angry missionary goes overseas it really soon learn all of these bangs so hopefully one of these days let out when I went overseas I picked up a blog that got into my kidney and I had terrible pain and the doctors for a couple years didn't even know what was going on they knew there was something wrong they were fully stuff out of my mouth my ureter for my kidneys but could not identify it I mean it was terribly sanitary CDC and anarchy I mean all different labs and things but couldn't really figure out what was going on until I was finally diagnosed but until that time I had kidney pain for years and I often had Percocets in my pockets or Percodan and that's what the doctors gave me they would give me so much medication that viruses sometimes Whitney bank you know fill the prescription he's like I can do that your young persons are way too many drugs that was very careful taking them I only took them really if I had to have him but I was passing stones a lot because of this and just in a lot of pain as a young person and I wasn't sure if I can live with this pain rest of my life but I remember going to the book ministry of healing I would read everything on healing in the Bible because I lost a lot of energy when you're in pain he just can't think of anything else in there is a wonderful quote ministry of healing and I should have it up here when these days but it was in your mind is filled our food if you are filled with pain do nothing just relaxing my arms resting my arms and I will take care of you is pretty much the gist of the Koran have to look it up but it's a beautiful quote out of ministry of healing so from after I read that I remember thinking Lord there is nothing else that I can do I can't even think straight I'm in so much pain so I pray to him I say Lord I'm just imagine resting in your arms on his interest in your arms you created me you creatively with the purpose I know that you tell me what you want me to do here I am you do with me what you want and I just imagine a curled up in his arms and from that point time it was like I began to heal I got medication and it still took a long time for things that are reverse around and in acts when I can get his thing in my head to go to we mark the light now I want to visit later big role book out like no I will be Hamlet abrogated as but you know why when I finally just let go of everything and said I'm yours God you do with me what you want I started to heal and got made me well enough that I did find it scared me more and learn all these things and get on the path of medical missionary work so you never know you know what condition you might be had or what career you might be an don't give up hope because God is there to lead and guide and so I'm actually thankful that I went through that because what I have gone in the medical ministry maybe not you know that's a scary thing so God has a way of leaving on into the past that he has for us in and I can say now due to hydrotherapy and all of that once I went out to Doctor Thomases and M icon that we mark I'm I'm now totally pain-free I have no pain whatsoever because even when organic you had pain in an organic polymer muscles around it farmer it you know like an armor like those nights in the armor it shields this will sell all of the apostles became so nice all the time to protect and I I protected all the time to walk is like don't bump into me don't need because it hurt me now and all my muscles were there to protect to the mainland my kidney function was beautiful are no longer that I have that illness I was still having pain it was because nobody to care of getting red in the ischemia in the talks and in all of that stuff in this area in the guarding that our muscles due to protect not how I learned deep tissue in my instructor would work on me just couple times after class I know such a significant difference he freed up that muscle got lots of oxygen and nutrition into this whole area here to where I could be pain-free and you can even touch my skin it hurt so bad just my skin and in that part of chronic pain when you're in pain for a long long time a lot of times even your skin is very sensitive but it's your body protecting itself so we have to learn how to reverse this process because how many people are having chronic pain writing were now look at the difference year between different types of pain you think that her son he also said she had a sore gel that is physically alike that I these things happen right than ever bike by yourself but yeah what about sapping accidents happen yet I think they get beat up and wonder wow and they get up and they continue on fly outs if you take a look at his flat in so we know what pain is right you guys I fear sympathizing I ready I think this was in the Olympics or something are they later had that's a print server afterwards our noses bleeding and every bank bailouts the people 's heart we now know what pain is an imaginary friends never experienced this the babies writing out pain answer is to align business that not no bank so means that some pain cycle it's truly a cycle in order to break that we have to figure out what to do right this whole cycle so if you look at here the initial cause of pain my mother keeps asking if I have a pointer like one of these days mom but anyways and it does the unconscious muscle tightening right because on-site man that people have never used one before a few times that I contacted always Atlanta's laser thing though wow this is heavy-duty what would I do a various wiki there okay so here's our initial cause of pain in an unconscious muscle tightening the price and the body protects itself to farmers that area always muscles become tied to protect right in a lot of times nobody paid attention after the pain is gone whether you that gallbladder pain or whatever else they don't pay attention to that opinion with the muscle spasm when it muscles that morning it becomes height right right room I can you get a lot of circulation fluid tight muscle right we have our nerves we have our land we never blunt supply right with you briefly squeeze that seminar from how my circulation are you getting now how much of the caucuses are leaving the eleventh comments ear nerves supply are you getting not much right now is muscle spasm I write then we hadn't be impaired circulation right into the muscles that family and not enough oxygen into that area and not enough toxins that are being released so what do foxes do they fit there right they sit there and be kind you don't have enough oxygen we get what we call ischemia right our ban on your finger really really tight and a few days of having your finger but all it starts turning colors L turned blue and you get black and grand green in an is not pretty and doesn't smell good either so insufficient oxygen increase talks and then it's increased stress even on your whole body but in that area I hear afraid to move that is due to decreased range of motion so then you start to protecting yourself and you're not moving in as much and trigger points they can collect all along the way here in order to talk a little bit about trigger points you and it just keeps going through the cycle getting higher in my start and a small plate think it's bigger and bigger and bigger the whole area is silently look it seemed at first it tends to be small in minute when family has chronic pain for a long time they'll say I have pain in this whole area they can to save this is where I have pain or area here because it's really spread the certain pain center that we deal with I live my renowned death I noticed a couple people have talked to here at the conference have fibromyalgia with black headaches in your whiplash just trip hanging out you don't even have to fall on the ground just your head whipping back like that you can get whiplash it even gone twenty thirty miles an hour you get it that can cause whiplash and emotion right carpal Connell tennis elbow golf fell down pain associated with automobile accidents who's never been in a automobile accident wow you guys are lucky but probably white eighty to ninety percent new bride then an automobile accident muscle imbalance another connective tissue disorders there's all kinds of different diseases and conditions pain management makes lots and lots of different pain management techniques we have all the myofascial we have a neuromuscular and in part of trigger point trigger point actually comes under the neuromuscular with you guys are going to be learning some of that there's so many different ways see even using defeat here to get interfered out for Thai massage trying to beware by Tony back off if they need to let a wonderful wonderful massage actually we have a workshop this week now we have a workshop next month we have a guy that actually went to Thailand he studied it here in Atlanta time he loved it so much that he teaches it for workshop brought hydrotherapy lower dealing with pain one of the simple things that you can do after you've had a treatment instead taken absence all that how many of you have ever used Epson salt right that old magnesium sulfate magnesium cons are not hold down the nephew of exercise in your life when it is weekend warriors Yemen played soccer for lounging and apply a whole gained by young kids how you feel the next day I usually decreased that saying by right of way taken absent salt bath your depression at least three to four cups of absence all don't just sprinkle in your time don't panic at three to four so Canada's size you can just soak in it for about twenty men and that helps to release talk sense and bring in the magnesium which really helps to call on your muscles down sensory assault is wonderful it's not expensive even if the ninety nine cent store they haven't now liked lavender and in a different different types of herbal things mixed in with that for the aromatherapy so said feel free to use that now with saying we want to find out before we work on someone how much pain you are having how do we know how much pain a person is having and I look it's you and say you're having three on a scale of pain no can we say that we have to trust people if they had pain don't wait its objective which means they have to tell our how much pain that may have otherwise happy a sense he Worker's Comp. they would like to be it would assess pain right always people there paying month after month a claim lower back pain are they catching up on the roof and different things like that right they would love to be in a measure pain taken x-ray and say about this is how much pain you had your okay will pay you the hour whatever so pain assessment is very important find out how much pain where's the pain what kind of pain you know where to go real deep into that but we want to find out a little bit of history how did you get the hey allowing their way when you got the passion and how constant imaginary actually work on them do you have more or less pain by more or less naturally sent back pain is subjective here so if you look here at the pain scale this one with the face is experts said and now when you gone to the hospital of any of the name by hospital lately he noticed the pain scale up on the wall usually above the bed or at the head of the button now he undersigned a wall but it is now considered a vital sign you take the temperature blood pressure Paul's respiration and pain level is now fifth vital sign that's how important it is now within it Leon medical field so we usually ask adults the numbers okay if you're a monarchy senior essay about effects that means you're really feeling you know your you it's it's really making a difference in your life if changing your life the DNS and you know what a person is in chronic pain for more than find a six weeks their personalities already began to change any imagine they start feeling hopeless Ryan has all kinds of things that go with that worst possible pain right so they come in and they say there in it and you know this is severe severe pain and usually we start out with hydrotherapy and then very very light massage and things like that so on so this is the pain scale that we use so what were doing trigger point the size we want the pain or the discomfort when someone presses on their about a six knots ago one Bubba said they and it should be our hurt so good paying and we'll talk about that window I acute pain is pain that happen right away his sprain in a him all trauma surgery is now within maybe five or six weeks it should fade away you should be doing a lot better again that's acute pain chronic pain is when you had it for a long time you had more than a couple months now and he keeps lingering might be six months it might be a year and has turned into chronic pain remember likely said he can even change their personality I it changes their person I said chronic pain may be associated with long term intractable medical condition or disease and rarely resolves itself spontaneously and immediately just doesn't go way by itself they need help they need you guys had so this take a look at this competition works just a simple little thing we feel pain right and it goes right up the nerves to the spinal cord and straighten the brain such as the various sample halfway to feel pain and it's time you sent to pain can be a good thing because it's a warning sign for us the problem with people with leprosy they lose the feeling right and what they used to do is they would lose my part scenarios or phase of their fingers and a lot of it was because they would squeeze a door knob and not be able to feel the pressure in the doorknob would see would squash right into their fingers and they would actually gain an edge their fingers and they would lose parts of their fingers and things like that because they didn't have the pain sensation if you didn't have pain and just sat on a inner put your hand down on a hot stove you could burn your hand right off right if we didn't have any subpoenas something that God is giving us as a warning sign for us now you find her in the gate control theory and I read before you are really understand it but we know that saying goes to the brain right back to the brain a cloudless day on passing take my hand off the stove or whatever to get out of the pain move out of the way pain fibers are very very tiny our pain fibers that we had that the campaign are very tiny fibers such as vibration high pressure their large their big bigger nerves although most of our nerves are quite small but there are bigger nerves so are small pain fibers can be overridden by the large fibers by doing things like vibration just like we did that in our architect somebody down vibrate and you might be seeing the tens units that they wear sometimes I put on it just vibrates a little bit then asked to override smaller nerve fibers of the brain will read the nerve are the vibration and kind of bypass the seller wanted different things that they used do that and fortunately must size does that as well massage overrides the smaller pain nerve fibers right the body tells us aware to work it is so neat when you start working on somebody remember I said when they have chronic pain it's very general why write so they may have pain all over their shoulder as you work on it it becomes more pinpointed some may be one or two treatment center that strengths down and down to where you know exactly where the pain it even now the pain doesn't always come from exactly where the pain and the lonely now where the pain as we can figure out what also might be pulling on him causing it in time a lot more about that to you tomorrow but he starts out diffuse and he gets smaller as we work on a more specific so kindness and antagonist muscles I say we have our biceps muscle here right bar and happiness muscle would be within the opposite muscle they're just words for opposite is art triceps right side-by-side spring harmonicas or muscles shorten and then the triceps extend our right now which muscle is injured on time and pain in my biceps right which muscle is injured you it could often be back easily its book is this bad and in pain at this scheme is not enough oxygen all of those things right and it's painful it's the one that's that's crying out in pain and Emily have this one here because this one is so tight this one is getting stressed so it's getting very stressed and loosened up because this one since overlaying it this way so they're really all not healthy muscles so when we look at the body we always want to look at the opposite muscles because everything in balance right and I love how one can Wilson brought that out at medical ministry is a balance right CQ was look at one end or the other end is same thing with muscles we have to look at the balance so when somebody has a sore muscle say if it's your quads here what's the opposite muscle of your quad your quadriceps right your hamstrings you have to treat them both okay you have to treat them both here we have the other same ones are quite here are my knees my point archives here and enter hamstrings so while one is getting scratched the other one is is more in spasm it are the opposite so we need to pay attention to both of them anybody know what this muscle is it so sad because I've seen people go through massage schooling don't even now what this muscle is huge and lower back pain and sciatica is a nerve that runs through hell they did back in this area here that I heard I heard somebody that sell as good as I can so somebody knows their anatomy this is our cell has been also see this long line here innocently iliac guests because it's part of the ileum of the inside of the ileum so we caught the iliac gas and a lot of times people call this the ilio 's cell at because it works together so this is your ilio cell as where on your body do you think that muscle is any point to it writing writing and editing deep muscle you see where can ask where does it connect on till to the line in the upper back are the lower back and right how many people have lower back pain right they go for treatment and they still have lower back pain because a lot of times they're not working on his cell as which keeps pulling on his fine air so we learned that the more that you can work on the saddle landing if they sell as con down you can actually help to relieve lower back very simple I am working to teach you guys how to do that A it's a little scary at first but solved I want to get to the lower back part I write so remember this muscle you'll see it again okay so again what is this muscle in a ballet it starts with a P P and OAS your cell as right anybody know the opposite muscle the salads I gave it away the opposite my father fell as if a cell as this year went the opposite muscle right the gluteus the seller has bring your knees that right and the glue DLs are in your legs back never people who get older and think they should not be doing so much anymore in trouble getting out of a chair right UCLA push the button people of chairs lift up because I don't have the strength anymore to get out of their chairs and part of that is because their glutes and hamstrings are so weak so it's important decline in sales especially the older you get flying all over the unfunny so you're really working these are rollerblading grades Chris that's not always the safest as you get older but that you want to work those glib muscles and your so as muscles as well try and now here we see are included under colluvial muscles with 3M on we had the gluteus maximus and choose the big one we had the media right nurses know that because naturally give the shots because the sciatic nerve runs down through here never want to give a shot in the sciatic nerve and then we also have the men in that which is kind the brain in underneath their right and you'll be working underneath the outlook will probably be working out a little bit because I had people that are starting hello Matt all they have to work on a lot of elderly people around Palm Springs area on desert ensure athletes in their seventies and eighties and they were still winning medals and ten Aston different things like that in my again and very active and they wanted to stay young and active so I working on them it didn't matter how much AIDS these people are giving gentle therapies such as trigger point you can free summons had bought from Jane within five or ten minutes and I remember just we had one of my guys that are used to work with his sister came into town and she woke up with some type of a hip pain a doctor said all you know your x-ray show that you have arthritis you better not do any more exercise in here take these pills so she was really discouraged and she was visiting her brother at the time that you not know what to do like I get red paint it if I stop exercising every day I am going to really be in trouble 's cell she was very reluctant to get massage therapy sightseeing I just give me a few minutes so I just pulled up her initiate a little dress on her something and was wearing her nylons insisted a few little trigger points on her hip area in the next day maybe even by that afternoon she was fine and she was out exercising again we know it's a shame that the doctors do that of course the older you get your arthritis Michelle maybe you have a slip this but that's not using the prom a lot of people have arthritis and slip it in a do just fine you know so that's not always the case so you can help people wet weight weights locator point and you can help so many conditions that trigger point therapy used to diffuse small muscle spasms or changes that cause pain theoretically they don't even know really what a trigger point as they water fairies about it but we know that by passing on someplace we can actually relieve the pain from apostle and make them more mobile and not there was a gown her name is Bonnie network with Doctor Trammell back in the days when they used in Jack trigger point so the doctors used to do it and somebody would like Bonnie she would hunt down feel so there's a fair point you can feel it you hit it radiates pain 's issue of the little acts there initially passing on a Doctor Trammell to inject them with saline or something like that inject that trigger point and a lot of times the pain would go away so one day Bonnie was doing her usual job and she pressed on the trigger point and on and it really hurt this one down but they were talking and how women do right so so they were talking about something and down in the ladies like me that plainly when because she didn't think that there's some pressure off she kept it on their inches like so it's like serendipity right we we see things that happens like how many try this on my next client and send ascending the market to valve for the injection she would hold them she would hold them and let them fade away and cellulite that you want to read a really cool book is called pain he registered by Bonnie Pruitt and she has all these mappings of trigger points and you can try just go on to Amazon.com I think she's got two books one's pain a race sure I remember the name of the other pain erasure yet three race pain erasure things of God Bonnie NPR new DD act I remind loved her book after I got out on the side school I read all through this amazing stuff and then I went to see her at a workshop I know she was already like eighty years old or something I'm expecting this young person 's income that will jogging suit then now but at amazing things that you can do exist trigger point massage when I first learned trigger point I remember going back on a Pennsylvania and I be so excited when I live in the size I take my cable with me on the plane are through the luggage and that work on anybody I could I'd come in charge sent it out if you can give me around I work on anybody does for donations so that's what they would do no and they would get these people all lined up for me to work on it it was some fine United having different people working on them for paying inheritance one lady she was at home got a sexy visiting her house and had severe pain in her back and environmental practices I did take two days off work this pain is still driving me crazy and so I'd like that just a little bit and check it out here I did maybe one or two trader points are back in the next day she was at church the rude held Nomar back pain now more you know so after a while you start learning it's like all okay the people that have gotten cramps that are into sports that get have to prance all the time cramps in their glutes one treatment and I'll come back to me months later and say I've never had that pain again and pain never came back again so I thought wow this is just too simple too easy now and it really has said anything is as you want to find the main SharePoint because what you could have is a whole bunch of little points everywhere just like the stars within their that's bigger than all the vast that will take care of the pain so pondering the size and part of the fun part of investigation right we get to investigate and get outside source one which is a one is really radiating pain in our effort Arafat I Macri start seeing down my arm then you know you're on a good one right that's the one you want to hold you want to get this text you want to play around with all the tiny lies otherwise be for ever in L China to help people get out a key and is slowly applied pressure with your son or your elbow condition on UBL Bell be careful with that one but if you're in the glued speed sometimes you need the elbow but normally you are using your found or this cool thing here we have called the son be taken favorite son Ennis actually will stay up on the wall that misfires old music for demonstrations for a while reconfigured to the wall and if you have a point here if you're having fat hangers on when did these muscles on the side heating this lien against it like that Arafat hand now you're back to stick up on the wall in Leon or you have a friend is to you that your surroundings that sat down with the society so some place your thumb with that resell them at the school you can probably find it online under Sunday .com or something to be pH you and the B Y .com it's a newer advances come out yet is Google Sunday but it's a wonderful thing because it saves you and you can do a lot of self stuff with it and then we want to slowly apply the pressure until it hurts so good once we replied the pressure we keep it right there okay here's the level where it hurts right right there we stopped and then we wanted to be about a level six right so once you're down to six year you hold it right there and you have on Bree Riley talked about freedom have them breathe and relax then you ask him is fading why in most of the time NASA fading away so he asked him what a pain scale is it now no silence about two or three okay so you don't back out Gatland just a little bit further Felix back up to about a six inning you haven't breathed again MLB lights are you sure not lifting your thumb up because that's what it feels like a van but actually be on you can even feel sometimes a little spasm jump underneath your time or you can feel it just kind of melt away sale holding down the right audience back down at three three one more time you apply pressure again some apply just a little bit more pressure till he gets back up to a six if it does and you don't worry about it and means you've gotten to the level on that and you don't go beyond three times usually and then after it's back down to two or three you slowly come out of it and usually it just do like little circles now edit the size of the little bed and see how they're doing and a lot of times of the life where you know they can get their range that they feel so much better than all that miraculous but on you know aren't finished feel it too maybe a day later because now you've got circulation going in there it takes a while for the body to heal so get the toxins out of circulation in their in the body will heal so we wanted this is a little hurt so good puppy and you guys now it feels like it's how I've yet heard spaceflight always governs that you know that feeling so check your client therapy asked the radiation right when you're on the pain going down is it going are you feeling move anywhere you mean by pain radiation seed can hit some spots in there and accept grants on your infraspinatus see that there is a muscle it sits on now and and you can hit any of those points a lot of times before I love trigger points right there so a lot of times people don't know they have trigger point if they are paying for you can get rid of them before they ever even have a problem seeing a lot of people say all it was that cold on my knack it was a slept wrong was because you had a trigger point therefore while but something aggravated it in a natural cause your pain that's why when we do missiles were always looking for trigger point says are going along release them before they even cause the problem though there lately trigger points before they cause the problem okay and in this is like a appointed gastrocnemius a lot of athletes enter complaints right now their calf and then I'm getting crack cramps every time you now in her calves underplaying her afterwards you can take care of it just by that I worked on soccer players and different people in there like it's never come back again at least play ultimate Frisbee and him I remember which one our coach I actually did this tale and she she was just like told me a year later she never had pain again and your cat every time after games you get cramps that we did that and I just worked on her right on the field laid down in the young grass they are and it never came back again so anyways that's some are set up so to find the size went to trigger point I want all muscle spasm or so can you feel it terrifying yes normally because it's a little bit on it maybe a little round like a little piece size bang they may be bigger like a big not as full of a lot of trigger points so but for the most part you don't feel it right so working with them just a few more minutes what I'd like for you to do is find that area here that's common and for sure most of you probably work on computers on the mouse to whichever mouse finger whichever fingers you use choose that farm in you come down from your elbow right in this area here any tenderness kind of feel like your fingers if there's any tenderness yes you have some may feel some closer although they are so find the most inner slot and ran quickly do a trigger point on yourself to say you know how it feels before we set you loose on anybody else again so you find that point in our day to put some pressure on their when you put pressured easier anything laying or anything radiating down your arm try to relax it is much as possible when you handed is anybody feeling any pain radiates now I thought okay here's one okay so you got worse irradiating film okay sit down the arm to the singers you feel it to southward hold it they are bring in up to close to a six to five or six timer hurts so good right and in Paris and relax it's harder to do it on yourself than other people is yet to really be relaxed then I found a pattern NASCAR wacky the tenderness of our latest on the same pressure right but the pattern this is going away right so we waits gets down and maybe a two or three anyway got just a little bit deeper and you have that many layers of muscles in your arms and maybe can only go a couple times and can you feel it when you press more than that it's little more paying brings it up on a scale not dead and are you having any radiation this a little bit tingling or something okay so how do you feel has it calmed back down again down head like a character that enamored to come out and it's slowly little circles nice and slow enemy missiles a little bet anyone times you have every little red spot area shall you really brought in circulation into the area and we work the muscles alone then help you feel better and that's it and you can hopefully you feel better because these muscles connecting your fingers sound that takes time and idea of kind of trigger point because he goes through layers of muscles so sometimes you got trigger points in more layers than one cents I will go down to three to go down to three by to get it completely gone that way he may never have that problem again and unless you're doing the same thing over and over so okay and you will be using more anime in limine as we go along when I went to have been the main news media was used by the maneuvers will begin the APL summoned if you would like to learn more about the him him please visit www. time to help someone .com or would like to listen more bringing online sermons please visit www. audio Bruce John Ward

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