Today's Webinar on Chronic Pain and Special Offer to Blog Followers

Chronic Pain Webinar - March 15, 2012
Thank you to everyone who attended today's webinar on Chronic Pain. We will be sending all participants a link to download the webinar recording as soon as it is processed - probably sometime next week. We would also like to extend special thanks to Dr. Richard Sherman for sharing his expertise. At one point during the webinar, Dr. Sherman talked a bit about the field of biofeedback and the importance of proper training. He also mentioned the need for those working in the field to spread the word about biofeedback and its potential. Next week he'll be doing just that in a second webinar.

Psychophysiological Assessment and Biofeedback Webinar - March 22, 2012

This webinar is ideal for professionals who are new to the field and for members of the general public wanting to learn more about biofeedback. In this presentation, Dr. Sherman will introduce psychophysiology, the study of interrelationships between the mind and the body and a popular technique used in applied psychophysiology: biofeedback. 

On behalf of Dr. Richard Sherman, we would like to invite readers of this blog to attend the presentation as our guests.

Whether you're a follower, or just stopping by, we hope you'll join us online next week. To register, send us a message at greenchronicpain@gmail.com. If you are a member of a support group for chronic pain sufferers, please feel free to share this information with your group.

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Upcoming Webinar on Chronic Pain and Biofeedback

We are pleased to announce announce an upcoming webinar on Chronic Pain in which Dr. Richard Sherman will share his expertise on the topic.

Psychophysiological Assessment of Chronic Pain

Thursday, March 15, 2012

1:00 to 2:00 PM Eastern Time (US & Canada)

Dr. Sherman will describe to how psychophysiology provides unique assessment and interventional approaches to pain. He will demonstrate how the use of these diagnostic techniques and interventions permits clinicians to make far more accurate assessments of their pain patients and increase the level of success with many pain disorders than is possible with other techniques.

The cost to attend the Chronic Pain webinar is $69.00 USD and it can be purchased in the BFE online shop. The webinar provides continuing education unites through the American Psychological Association.

We hope to see you there!

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Dr Richard Sherman Discusses Headaches and Biofeedback

Migraine and Tension Headaches Can be Treated with Biofeedback Based Behavioral Interventions 

About 4 of 5 of people who have tension and migraine headaches which did not start with trauma can reduce their headache frequency, intensity, and duration by an average of about 80% (with many having no remaining headache activity for at least 10 years) by using biofeedback based behavioral interventions.

Tension Headaches
“Tension” headaches originate from muscles kept too tense for too long anywhere in the head and neck -especially including the jaws. People who have muscle related pain usually cannot tell how tense their painful muscles are as well as people without muscle related pain. The inability to accurately relate actual levels of muscle tension to sensations from the muscles leads to muscles being kept tenser than necessary for longer than necessary given the task at hand. Muscles kept only five percent tenser than necessary for less than a half hour longer than necessary leads to pain which can be sustained for an entire day.

Biofeedback for Tension Headaches
Biofeedback devices record tension in the muscles generating the pain and show those levels to the patient. The patient learns to associate actual levels of tension with sensations from the muscles so muscles are kept appropriately relaxed. Most people learn to recognize their levels of tension and to automatically keep them at appropriate levels. This eliminates or vastly reduces head area pain from this source. People who successfully learn this skill and apply it eliminate or vastly reduce the intensity, duration, and frequency of their tension headaches.

Migraine Headaches
“Migraine” headaches usually begin during adolescence or young adulthood with no obvious initiating incident. They may begin abruptly or gradually and may or may not be related to sexual maturity. These are the type of migraine headaches which can be effectively prevented through behavioral techniques such as biofeedback. Migraine-like headaches which begin with trauma such as an auto accident or which come in clusters usually cannot be effectively treated through behavioral interventions.

Migraines and Blood Flow
Nearly all people with migraine headaches have less near-surface blood flow to the fingers and toes (and sometimes noses) than those who do not have migraine headaches. As all of the heat emanating from the fingers and toes is generated by near surface blood flow, these people tend to have relatively cool extremities. Biofeedback devices can accurately record the temperature of the fingers (or any other body part) and show the temperature to patients so they can learn to recognize and then control finger temperature sufficiently to maintain normal levels of finger temperature. People who can learn this skill and maintain normal levels of fingertip temperature do not get migraine headaches as often or as severely as previously. Many entirely eliminate their headaches. Most also significantly decrease or eliminate their need for migraine medications.

People who do not learn to control their muscle tension or finger blood flow do not change their headache activity.

Evidence Supporting The Effectiveness of Biofeedback
The evidence supporting the effectiveness of biofeedback (frequently used in conjunction with related techniques such as progressive muscle relaxation training) for the treatment of tension and non-traumatic origin migraine headaches is very strong. Numerous controlled studies with reasonably large numbers of patients and long follow-ups (of up to ten years) show that biofeedback is highly efficacious for these types of headaches with about 4 of 5 people showing an average of an 80% reduction in headache activity. The evidence supporting this assertion and the reviews of the peer reviewed literature are summarized below.

Other types of headaches, such as those caused by trigger points and nerve over-reactivity cannot be treated effectively with behavioral interventions.



For information about biofeedback:
To watch a slide show on biofeedback, go to www.biofeedbacktraining.org. On the home page’s left column, scroll down to “biofeedback info and equipment” then click on “what is biofeedback”. This will lead you to the slide show.



THERAPISTS: 
If you are a therapist and would like to find out more about how to treat headaches using behavioral interventions such as biofeedback, please contact us at contact@behavmedfoundation.org or look at the courses on the web site www.biofeedbacktraining.org.

PATIENTS: 
If you have migraine or tension headaches and would like to look into biofeedback based interventions, go to the web site www.bcia.org to locate a certified biofeedback practitioner near you.

Craig Adams - His Pain, Their Suffering

This is Part 2 in a series on Craig Adams and his battle with chronic pain.  

Click here to read Part 1.

Craig with his daughter Thalia.

Any professional who has worked with chronic pain patients knows of the challenges this work can bring. Pain cannot be measured on an X-ray or an MRI and each patient experiences pain differently. One thing that is common with all pain patients is the fact that their loved ones suffer as well.

His Pain...

Craig suffered an injury to his right ankle in October of 2003. A suspected rupture in the calcaneofibula ligament, his doctor originally thought it would heal on its own with a couple weeks of rest.  After months of swelling and instability in the joint, Craig underwent surgery in April of 2004. He began physical therapy, but continued to experience swelling and pain. As Craig recalls, "The pain was getting worse and coming up my leg. I have never experienced so much pain in my life. I had excruciating pain all the time now. Daytime it was not so bad but a lot of swelling day and night. At night it was explosive pain as soon as night came on 4,5,6, o’clock. No mater how much medication I had, it did nothing for the pain."

The swelling persisted.

His condition continued to deteriorate and he was eventually prescribed anti-depressants along with his pain medication, but nothing seemed to help. It was even suggested that the pain was all in his head. He still had swelling, burning pain, discoloration of the limb and intense headaches. His physical therapist thought he might have RSD. He continued with his therapy but felt he was on a downward spiral. He began to experience a different type of pain in his head, along with blackouts and the inability to move his right leg or arm. His neurologist suspected that he suffered a stroke.

Eventually, he injured his left leg and knee and in 2005 underwent a second surgery with a different surgeon. That surgeon confirmed the diagnosis of RSD in the right ankle and expressed concern over it spreading to the left side as well. His right ankle required another surgery, but due to the aggressive nature of RSD, he was not a candidate for surgery. Craig was bedridden with severe swelling, in pain from his ankle to his hip, dribbling from the right side of his mouth and unable to control his urine. When he thought he had reached rock bottom and his pain could not get any worse, it progressed to the left side, his back and even his neck.

Their suffering...

It was now 2007. For four years Craig's wife and daughters offered support and helped in any way they could but felt helpless as they watched the husband and father they once knew slip away from them. His youngest daughter Thalia, born in 2006, used to touch his leg and say "Dad sore...sore". Meanwhile, his eldest daughter, Sophie, born in 1996, searched for a way to help her dad with RSD on the internet for days and nights in between her school work. She called to him, "Dad! Get up, get out here, I've found something!" When asked about this moment Craig recalled,

"The pain is unbearable. There’s nothing possible I can do to get away from this pain. I think I’m going to die. I can't, my legs have no feeling, my back...I do not know it any more...I can’t move, I want to get up but I can't! my brain wants to go, but my body can't. I don’t know if I will be here tomorrow...my heart is aching and stinging...I double up each time it happen."

It was eleven o'clock at night, and Sophie said she found something and it’s called the International Reflex Sympathetic Dystrophy Foundation. Sophie called out, "Hey dad! Come here and look at this, there’s other people out there just like you, with same symptoms as you". Sophie went and got her mother to help and Martha said to Craig, “Get up I’m sick of seeing you in bed. I know you're in pain but we’ve got three kids and I’ve been raising them by myself for months. I love you but you have to get up. Sophie’s found something and you have to see this. There’s this bloke Eric Phillips his got RSD and he's in America, you should ring him and talk to him. Now get up! I going to keep hassling you until you get up, so you may as well do it.”  Martha and Sophie ripped the blankets off Craig, got hold of him and pushed him and pulled him around until he got so annoyed that he got up. Altogether, they helped him to the computer.

After four long years, he finally felt there was hope.

In Part 3 of Craig's Story we will learn about how biofeedback and neurofeedback helped control his pain.

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Craig Adams - An Uplifting Story from Down Under

Meet Craig Adams

Craig Adams is a 40 year old, happily married father of three from Sydney Australia. For the past seven years, he has suffered from chronic pain.

Craig's story begins many years ago when he left school at a young age to work with his father’s business Des Adams & Sons Transport. He started by working the forklift in the yard and by the time he was eighteen, he was driving semi's across the country. The company grew and Craig eventually had a truck of his own that he nicknamed "Dreamweaver" as a tribute to the music he loved. He married and had three children. By all accounts, life was good. But that was all about to change.

Reflex Sympathetic Dystrophy (RSD)

In 2003, Craig suffered an ankle injury at work that required surgery the following year. As a result of the surgery, he developed Reflex Sympathetic Dystrophy (RSD) that  led to Chronic Regional Pain Syndrome (CRPS). The RSD spread from his right ankle up his leg into his spine. Eventually, it spread to the left leg and ankle, to the arms, hands, face and neck. It even affected his inner body functions. Craig experienced burning; stinging, swelling, skin discoloration, and weeping sores on the infected limb - all typical symptoms of RSD.  In effect, his whole body was powerless. The once vital man needed crutches to walk and at times relied on a wheelchair to get around. His family stood by him as his suffering increased and he steadily lost the use of his right ankle.

To make matters worse, he developed kidney and heart problems and had minimal bowel control. The pain was almost too much to bear. The lyrics to the song Dream Weaver that inspired the naming of Craig's truck seemed almost prophetic:

I've just closed my eyes again
Climbed aboard the dream weaver train
Driver take away my worries of today
And leave tomorrow behind
Ooh dream weaver
I believe you can get me through the night
Ooh dream weaver
I believe we can reach the morning light

Fly me high through the starry skies
Maybe to an astral plane
Cross the highways of fantasy
Help me to forget today's pain 

(by Gary Wright)

Part 2 of Craig's story will continue with his battle with chronic pain and how he learned about bio/neurofeedback.

Click here to read Part 2.

Meet Dr. Richard Sherman

The BFE Chronic Pain team was honored to work with Dr. Richard Sherman on the development of the Chronic Pain suite. His extensive knowledge in the use of biofeedback for treating chronic pain as well as phantom pain made him the ideal partner to help design the specific training screens for software.

Richard A. Sherman, PhD 

Dr. Sherman received his doctorate in biology/psychology from New York University in 1973 and is currently Master Instructor at Chapman University as well as Dean of Clinical Psychophysiology at the University of Natural Medicine and Director of the Behavioral Medicine Research and Training Foundation. He is certified by BCIA, approved by BCIA to teach the general biofeedback certification course, and currently teaches A&P, Pain Assessment and Intervention, Research, and Pelvic Floor Disorders for the Behavioral Medicine R&T Foundation. He is a professional psychophysiologist with extensive training and has nearly 30 years of experience in the field. He has had numerous grants to study various aspects of pain mechanisms and interventions and has well over a hundred publications.

To learn more about Dr. Richard Sherman and his work, visit the Behavioral Medicine Research and Training Foundation website.

The BFE Chronic Pain Team

A bit about us...

This blog has been created and is maintained by the Chronic Pain Team sponsored by the Biofeedback Foundation of Europe in order to share knowledge about the use of biofeedback as a safe and effective treatment for pain. To help guide clinicians in how to use EMG (electromyography) biofeedback to treat chronic pain, we've created a software suite that provides clear instruction in SEMG biofeedback and pain management. The suite, based on the methods of Dr. Richard Sherman, is available in the BFE online shop. (The suite is compatible with the Infiniti software platform by Thought Technology.)

We also aim to share our  knowledge with health professionals outside the field of biofeedback who are treating pain patients. Below are a few excerpts from a recent story in the Montreal Gazette. The comments were from Laszlo Bagu, a retired physician and pain sufferer.

"At the centre is the patient. When suffering persists without any apparent hope for relief, it leads to despair. Those who live in despair are isolated from the rest of humanity."

"Therapists who accept the responsibility to help have their authority challenged and their competence questioned, if not mocked, by chronic pain. What was the point of all that training, hard work and sacrifice if, at the end of it all, they are still helpless and frustrated when confronted by the chronic-pain sufferer who keeps coming back begging for relief?"

 "The first step in the right direction is to stop bowing down slavishly to officially sanctioned medical authority as the ultimate source of all answers. I’m a member of this fraternity, so trust me when I tell you that we don’t have all the answers. If only we did."

The full article can be found at: http://www.montrealgazette.com/health/chronic+pain+doctors+have+answers/5582494/story.html#ixzz1f1GXCWJ6

Although Dr. Bagu does not mention biofeedback, he conveys the challenges faced by physicians and the need to be open minded about treatments that may provide relief to patients. Which brings us to our last goal, and that is to reach out to those suffering from chronic pain and introduce them to the potential of biofeedback as part of their treatment plan.

Breathing and Chronic Pain

The following paragraph from an article on the website of the London Pain Clinic nicely sums up the benefits of diaphragmatic breathing for pain:

"Diaphragmatic breathing has an extremely therapeutic effect on chronic pain. It has a major influence on relaxing the muscles which tense up as a result of pain and in turn further aggravate the pain itself. Experts insist that individuals with tensed muscles and in an anxious state of mind are generally known to breathe through their chest. This type of breathing will lead to a disruption of the balance of oxygen and carbon dioxide, which are essential to be in a relaxed state. It is this state of health that the correct technique of diaphragmatic breathing facilitates."

To help teach proper breathing techniques, the Biofeedback Foundation of Europe offers a breath pacer called EZ-Air Plus. It is a PC compatible software program that places a bargraph or linegraph on your computer that instructs the user to breathe at an optimal pace. For a free 30-day trial, visit their website at http://www.bfe.org/.