Managing Pain without Meds

Resilient Life Public Resilient Life
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The Peak Affordability Lifestyle

If I were to summarize everything I have learned from Dr. Martenson and this community over the last few years into one statement, it would be “our future is unaffordable.” The mechanism by which our unaffordable future is realized - be it inflation, deflation, Peak Oil, resource scarcity, currency crisis, or overt corporate corruption - is largely irrelevant. The bottom line for each one of us and our families is that we can no longer expect the macro economy to provide for our needs. Our best chance at surviving the myriad of future predicaments facing us is to develop the capacity to provide for our own needs and to progressively achieve functional independence from the economy-at-large. I like to refer to this daunting process as “adapting the Peak Affordability lifestyle,” as it is really much more than just an agenda of preparations; it’s a way of life.

One particular personal need that is destined to become increasingly unaffordable, or even unavailable, is healthcare. The field of healthcare encompasses an infinite number of subjects and topics, but today I want to focus on one particular aspect of healthcare that people frequently feel helpless to address on their own: managing physical pain. Although physical pain complaints, such as low back pain, headaches, etc, are typically not life-threatening conditions, they nevertheless are perfectly capable of destroying a person’s life. This is an extremely unfortunate situation, because the majority of these pain complaints result from a simple misunderstanding about the nature of physical pain. 

My intention with this post is to provide the reader with an understanding of common pain complaints that will empower them to effectively deal with these disorders on their own, without the need of professional healthcare services. My wife and I run a small pain clinic in Houston, and the insights shared in this post are garnered from several decades of study and clinical experience. 

Don’t Kill The Messenger

The natural reaction for a person in the throes of a physical pain complaint is to identify their pain as the problem itself, and overlook the fact that the sensation of physical pain is merely a form of communication. As such, most people mistakingly turn to painkillers as a solution to these particular disorders. This approach never works, because by “killing the pain,” one is also blocking the very information that is needed to find an effective solution to it. 

The most effective use of painkillers is to promote sleep, as regular sleep is critical to the body’s healing process. When you are awake, however, you are best served by avoiding the use of painkillers. Pain is information, and the first step to finding a solution to your pain complaint is being open to the flow of this information.

Your Pain Has A Purpose

The purpose of pain is to protect an injured body tissue. While this statement seems dreadfully obvious, it is remarkably easy to overlook this fact when pain has seized control of your daily life. The mechanism by which pain acts to protect an injured tissue is a twofold process.

  1. The sensation of physical pain itself is an attempt to make you consciously aware of the injury; it is seeking your attention. At first, it may attempt to get your attention with a “whisper,” but this quickly escalates to a “roar” if you choose to ignore it. 
  2. It uses your conscious awareness of the injury to modify your behavior and physical activity in a way that prevents you from damaging the injured tissue further.

A simple example of this process occurs when you sustain a cut on your foot. The pain associated with the cut both makes you aware of the injury and prevents you from walking on the foot so that the cut can heal. But in many cases, the injury is not as obvious as a simple cut. This is particularly true in pain complaints involving the neuromuscular system, such as low back pain, shoulder pain, hip pain, etc. The key to identifying the injury (or injuries) in these disorders lies in understanding how the presence of a particular pain modifies your normal bodily movement or physical activity.

Get To Know Your Pain

Early on in my study of the various manual therapies, I came across the remarkable story of Moshe Feldenkrais (D.Sc.). Dr. Feldenkrais worked as a physicist during World War II, and was the first European to earn a black belt in Judo after the war. Throughout his adult life, he was plagued by pain in a knee that he had injured playing soccer when he was younger. Several doctors he consulted advised that surgery was his only option, and that even with surgery, his chances of ever walking normally again were only 50/50. Frustrated with his lack of viable options, Moshe became determined to fix his knee himself. One day he surprised his colleagues by jumping up in the air and slapping his injured knee several times. All were astonished that he was apparently pain-free after so many years of suffering. Several months later, over libations, Moshe revealed to them how he had healed his knee; he personified his knee pain and made a real effort to ‘get to know it.’ Instead of trying to avoid his pain, like he had done for most of his adult life, he gave it his complete attention. “I soon as I had complete awareness in my knee joint” Moshe said, “I had no pain in it.”

Dr. Feldenkrais went on to write numerous books on his method of pain-relief, and his work became collectively known as The Feldenkrais Method of Somatic Education. While I would highly recommend becoming familiar with his work, the essential application of his method boils down to taking some time to understand your pain in greater detail. This process involves answering these two basic questions:

  • What activities, body movements, and body positions make the pain worse?
  • What activities, body movements, and body positions make the pain better?

Take some time to explore your pain. You will be amazed at how the simple act of giving physical pain your complete conscious attention, if only for a short period of time, can transform even the most unbearable pain into a kinesthetic sensation that is both tolerable and manageable.

Trigger Points And Referred Pain

While many in this community may be familiar with the term “trigger point” from an economic perspective, this term is also used to describe a very common, but relatively unknown, type of injury that occurs in muscle tissue. A myofascial trigger point is most simply described as a micro-spasm within a muscle. Trigger points occur when we place a demand on a muscle that it is unaccustomed to, or not “conditioned” to perform. As the muscular system takes most of the brunt, or “wear and tear,” of our daily life, trigger points are much more common than injuries to the joints, tendons, and bones.

One of the more fascinating aspects of trigger points is that they produce a type of physical pain known as referred pain. Referred pain simply means that the pain is experienced in a region of the body that does not contain the injury, or source of the pain. As you might expect, this phenomenon can create a great deal of confusion, as the actual injury is often not found where it appears to hurt. 

An example of trigger point referred pain is the common headache. A person experiencing pounding pain in their temples, is naturally going to conclude that the problem is systemic in nature. Maybe they think it’s caused by high blood pressure, a migraine attack, or if the pain persists long enough, they may even entertain the idea of a brain tumor. But, the most frequent cause of a pounding headache is referred pain from trigger points in the Trapezius muscle, that lies in the upper back and neck region of the body.

This begs the question, “Why would the pain from an injury in an upper back muscle be experienced in the head?” To answer this question we only need to examine how this referred pain causes you to modify your activity and movement. Most people, when faced with a pounding headache, are inclined to lay down for a while and immobilize their head. As the Trapezius muscle functions to move the head, immobilizing the head serves to allow this muscle group to rest, and prevents further aggravation of the trigger point(s) contained within it. 

Another fascinating aspect of the referred pain phenomenon involves phantom limb pain. It is quite common for people who have had an arm or leg removed because of traumatic injury or disease, to continue to experience pain in that limb. Quite often, this phantom limb pain is referred pain from trigger point activity in trunk or neck muscles, and responds very well to the appropriate Trigger Point Therapy protocol. 

What Should I Do?

So let’s say you find yourself in a situation where you or a loved one is incapacitated by physical pain, and no doctor or professional treatment is available to you. What do you do? My advice would be the following;

  • Before you get into that situation, educate yourself on Trigger Point Therapy. One excellent book that I would recommend is The Trigger Point Therapy Workbook: Your Self-Treatment Guide for Pain Relief, Second Edition by Clair Davies. You can also view parts of this book in Google Books. 
  • My wife, Dr. Laura Perry, and I also host a website where you can get information about trigger points and Trigger Point Therapy. You can visit our site at www.PainWhisperer.com. Additionally, for those interested in learning more about the practice of Trigger Point Therapy, you might want to take our free online introductory course in Clinical Trigger Point Therapy. While this course is geared towards the professional therapist, many nonprofessionals have found its content valuable.
  • And most importantly, don’t try to avoid your physical pain. Give it your complete attention and learn from it. Now if only we could get the politicians to adapt this approach to the “3 E” pain facing us all, the world could be a better place.

Thank you for reading this and I hope you find this information useful.

Best, JAG

P.S. Don’t tell my wife that I’m CaptainSheeple, LOL!

  

This What Should I Do? blog series is intended to surface knowledge and perspective useful to preparing for a future defined by Peak Oil.  The content is written by PeakProsperity.com readers and is based in their own experiences in putting into practice many of the ideas exchanged on this site.  If there are topics you'd like to see featured here, or if you have interest in contributing a post in a relevant area of your expertise, please indicate so in our What Should I Do? series feedback forum.

If you have not yet seen the other articles in this series, you can find them here:

This series is a companion to this site's free What Should I Do? Guide, which provides guidance from Chris and the PeakProsperity.com staff on specific strategies, products, and services that individuals should consider in their preparations.  

This is a companion discussion topic for the original entry at https://peakprosperity.com/managing-pain-without-meds-2/

2

Thanks JAG

3

Truly appropriate.  Thanks for this quality piece.
Regards, Joanne.

4

JAG

Nice article.  I’ve read about people with fibromyalgia having pain centered around trigger points.  Have you had success in relieving this?

Travlin 

5

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6

Jeff,
I appreciate your effort to teach people to manage their own pain.  I’d like to offer some clarifications of what you wrote, however.  I happen to be a Feldenkrais practitioner trained under Mia Segal (and a number of others).  The Feldenkrais Method has very little to do with pain and everything to do with somatic awareness.  Also, the story about how Feldenkrais “cured” his pain is not quite accurate.  He essentially psychocybernetically took himself through all the various movements, positions, activities, etc. that caused him pain and developed motor strategies that were the most efficient and therefore, the least painful. 

Also, Janet Travell’s work on trigger points (and subsequent evolutions of her work) is very effective for myofascial pain but not effective for pain arising from other somatic structures such as discs, joints, etc.

In addition, true phantom pain is not referred pain.  It is a very different phenomenon.

The PRRT (Pain Reflex Release Technology) work of John Iams is some of the most effective work on treating pain of nociceptive reflexogenic origin that I’ve seen after 32 years in the business and teaching in 40 different states and several universities.

The Total Motion Release work of Tom Dalonzo-Baker is another effective strategy for self treatment of musculoskeletal pain.

The McKenzie Approach is the most effective self treatment  single (not aggregtate) method I’ve seen for spinal pain of discogenic origin. 

But most importantly, where musculoskeletal pain is involved, treating function is the most effective way of treating pain.  Treating pain without treating function leads to a high rate of recidivism.

Also, a key thing to remember is that virtually all pain (except that of psychogenic origin) is secondary to one of only two factors, chemical irritation or mechanical deformation.  Pain of chemical origin is best treated chemically and pain of mechanical origin is best treated mechanically. 

A good (but overly expensive for what you get book) for explaining pain to the layperson is Explain Pain by David Butler.  Another neat little book (that unfortunately is out of print) is The Brilliant Function of Pain by Milton Ward.

Pain, unfortunately, is such a complex and misunderstood subject that even most health professionals seem or are poorly equipped to effectively resolve it.  Kudos for tackling such a tough subject.

 

7

Thanks, JAG.  This is a nice addition to this series.  Finding ways to be in good health is a neglected area – but if you can stay off unnecessary meds and avoid unnecessarily invasive medical treatments you’ll conserve a lot of resources.  And if you are not in decent health, preparing for your (own) future in other ways may be a waste of time.
A good generic resource for health is the book Eat, Move and Be Healthy by Paul Chek.  It discusses some of these methods and gives some simple exercises with diagrams.  My favorite part of his advice is that if the person giving you health advice is not in excellent shape, the advice is probably not worth very much.

I’ve also been favorably impressed with the Egoscue method for back pain.  Very simple and effective.  See www.egoscue.com and try the Get Help Now under the Method tab.  This was recently featured in Tim Ferris’ “4-Hour Body”, which is an interesting read because he turns himself into a human guinea pig and tries all sorts of medical and non-medical treatments and exercise and eating regimens.  (A lot of things in the “Don’t try this at home” category, though.)

8

[quote=Travlin]JAG
Nice article.  I’ve read about people with fibromyalgia having pain centered around trigger points.  Have you had success in relieving this?
Travlin 
[/quote]
Hi Travlin,
On the average, we see about 20 fibromyalgia patients/year in our practice. The majority of these patients have a component of their symptom presentation that is effectively treated with trigger point therapy protocols, but this component is usually a concurrent complaint that is clinically distinct from fibromyalgia. There is some overlap in the location of the tender points that clinically define fibromyalgia, and the location of common trigger points that contribute to various pain disorders, and some researchers consider the presence of trigger points to be an important factor in the severity of fibromyalgia symptoms. In our experience, we typically can help in the management of the fibromyalgia disorder, but a solution to this disorder is beyond the scope of trigger point therapy.
Best…Jeff
 

9

Thanks for your contribution to this thread ao.
From reading your posts over the years, I have no doubt of your expertise in the healthcare field. And if you didn’t live on the other side of the nation, I think we could engage in some excellent professional discourse over libations.  I had the idea of contacting you to do a joint post on this subject, but given the limited scope of this post, I thought your time would be better served elsewhere.

I recognize that their are many effective approaches to dealing with physical pain complaints, but I thought Trigger Point Therapy and the Feldenkrais Method the most applicable to the self-treatment scope of this post. 

Thanks for the book recommendations, I think I could probably get joyously lost for days in your personal library.

Best…Jeff

10

Nice article.  I don’t have any special expertise in pain - I just whack it with pharmaceuticals, same as most other docs - but I am trying to create a framework which may help and encourage physicians to continue to offer healthcare in a post peak world:
www.postpeakmedicine.com

I created the website because I remember feeling very confused when I first learned about the economy and peak oil and wondering “what do I do now?” and this is my attempt to reach out to physicians in a similar position.

11

[quote=Dragline]A good generic resource for health is the book Eat, Move and Be Healthy by Paul Chek.  It discusses some of these methods and gives some simple exercises with diagrams.  My favorite part of his advice is that if the person giving you health advice is not in excellent shape, the advice is probably not worth very much.
I’ve also been favorably impressed with the Egoscue method for back pain.  Very simple and effective.  See www.egoscue.com and try the Get Help Now under the Method tab.  This was recently featured in Tim Ferris’ “4-Hour Body”, which is an interesting read because he turns himself into a human guinea pig and tries all sorts of medical and non-medical treatments and exercise and eating regimens.  (A lot of things in the “Don’t try this at home” category, though.)
[/quote]
I concur with Paul Chek’s book being a very good resource for overall health.  Some of the exercises may be a little bit daunting for some patients with pain and pathology, however.  He is very knowledgeable, especially considering that he is largely self taught, and I respect him for not only talking the talk but also for walking the walk. 
Egoscue is also self taught and makes some good points.  His method can be beneficial but he tends to hype it beyond its capabilities.  In my opinion, his method lacks biomechanical, neurophysiological, and pathological specificity and often fails to produce rapid short term results where some other methods would.  IIRC, he was on San Diego area TV and “treated” some patients.  None of them had their pain relieved in the short term.  John Iams was also on TV and obtained immediate results with pain relief.  Pete Egoscue certainly knows how to market his method though.  As an ex-Marine officer, he knows how to motivate people.  For better or worse (depending upon how you look at it), the public tends to believe most or all of what it hears with regards to marketing and doesn’t have the knowledge and experiential base to critically evaluate what they see, hear, and feel.  If you have a lot of time and a lot of money, it’s OK and relatively safe.  Otherwise, you may want to look elsewhere.  
 
 

12

Thanks for posting this thread.  Another great low-cost option for treating pain is acupuncture.  Community acupuncture is a new model in the acupuncture world that utilizes a low-cost, no-insurance business model.  It is also a decentralized network of practitioners that share information and help each other.  Treatments are based on a sliding scale of $15-35 and often times lower for those who can’t afford it.  Check it out!
http://www.communityacupuncturenetwork.org/

13

Thanks for the good information JAG.  This could be very important to individuals going forward, but it might be an even bigger issue for our society in general.
The number of people I come across regularly who are on pain meds is amazing.  I know whenever I mention one of my many aches and pains to an MD, they are quick to offer me something pharmaceutical for it.  We’re getting to be a society of addicts.

My back went out on me doing hard physical labor in my early 30s and the medical establishment was ready to put me on disability and prescribe pain killers for the rest of my life.  A couple of bouts of not being able to get out of bed because of the pain, and I can understand the appeal.  Instead, I parlayed some worker’s comp into a start on getting a BS degree, and spent about 15 years working very actively in the natural resources field for the US Forest Service.  About 5 years ago I left that and am now operating a one-man vegetable farm.  When I think of how easy it would have been to go the other way, I can only thank dumb luck and a higher power.

I have a tenant who has a bad back, and am pretty sure he would be utterly helpless without his meds.  As it is, he manages to work a part time job to supplement his SS payments, but it seems to me that he just sleeps or watches TV the rest of the day.  His son had an injury on the job, and got strung out on the pain killers, too.  I’m pretty sure there’s no way the country can go on that way.

During the Katrina recovery I was in a relief center eating lunch one day and there was a husband/wife team of medical volunteers at the same table.  I had barely gotten started in an interesting conversation with them when word got around the table that he was an MD.  The number of people at that one table who started trying to find a way to get him to get them the meds that they were used to was  frightening.  A lot of the “instantly homeless” from Katrina who were in the camps were probably people who were pretty close to the edge to begin with, but a lot were regular, middle-class people.  I also suppose some might well have been trying to game the system to get something for recreational use or to sell, but for me, this was a leading indicator of how far down this culture has gone.

So from where I sit, I can’t be too optimistic about how a large segment of the population is going to be able to withstand any disruption to our system.  Add to that the people on psych meds (I have a doozy of a Katrina story about that, too), and the situation could be more than scary.

Now, I’m not saying pain killers whould be withheld in general.  I know they can do a lot of good for people in severe pain.  I also don’t want to contribute to the sadistic, puritanical regulations we have controlling drugs.  I watched my brother die of lung cancer, and we we had a very hard time getting him good pallative care.  The irony is not lost on me.  I guess it’s just another example of a dysfunctional legal, political and social system.

 

14

JAG,
Nice article! I broke a lumbar in my lower back when I was 17. The pain came and went, but 4 years later, it was much worse and I went to a MD to see what I could do about it. Rather than prescribe pain medications, the MD told me to strengthen my stomach muscles and keep them taut while walking. I exercised by doing abdominal crunches and consciously kept the stomach flexed whenever standing or walking. After a few months, the pain disappeared and since then it only returns when I forget this simple rule.

I’ve also had “bad” knees all my life. In 1995, I dislocated my knee pretty severely at the end of a backpacking trip. I went to the doctor, got an MRI, and the doctor said that I had deteriorating cartilage. His prognosis was that there wasn’t anything to be done except deal with it until the pain became unbearable. When I couldn’t tolerate the pain any longer, I should get a knee(s) replacement and it will seem to be an improvement. By 1997, the pain and inflamation were getting severe enough that I was ready to make the appointment for the replacement of both knees. Then, a friend told me about a Knox Gelatin product called “Nutrajoint” which is ground up deodorized beef cartilage with 7 added minerals. I was desperate, so I bought a can. The product still has a beefy odor, but orange juice covers it fairly well. After a few weeks of drinking it daily, my knees started feeling better. Over the course of about 3 months, the pain disappeared completely. Now, nearly 14 years later, I still have my organic knees - and they still feel great.

From doing a little reading on the subject, I found that I’d probably get the same results by eating the cartilage on the ends of chicken or cattle bones. It is one of those natural things that our ancestors used to do before the act of gnawing on the ends of bones became uncouth. I think a lot of our medical problems stem from differences in evolutionary versus current practices.

Grover

15

JAG, thanks so much for your article, and for starting such an important thread!  Ao, Grover and others, thanks also for sharing your knowledge, recommended resources and suggestions.  This is such an important topic. 
I hurt my lower back early last summer (carrying water and bags of manure to my garden?:), and am now learning what chronic lower back pain is like.  Having always been one who loves walking, exercising regularly, and doing (moderate)  physical work, I have been distressed by the degree to which something so simple sounding as “lower back pain” can be almost crippling, in terms of limiting motion and activities.  I have seen a doctor (no help there), and have since been pursuing alternative means of helping my back.  So I look forward to trying out some of the info and references provided here.

My husband also suffered from back pain and painful sciatica some years ago.  Through trial and error, he found a book on back pain that made all the difference for him.  As soon as I get a chance, I’ll ask him what the title and author are so I can post them.  But one of the techniques he learned from it was a relaxation and visualization technique.  It goes something like this: He squats, with his back and head gently curled forward, (kind of like a squatting fetal position).  While doing the squat, he holds lightly onto a post or something else in front of him, to help maintain an easy balance.  He says it is important to take care not to be in a position that puts any pressure (to maintain balance) on your back when you do this .  Then he closes his eyes, and visualizes the pathway his blood takes to his spine as if it iwas a big tube, with blood cells filled with oxygen traveling down to his spine.  He visualizes this pathway expanding as he relaxes more and more, while taking deep breaths, allowing more blood flow and oxygen to reach his spine.  He only does this for a couple of minutes at a time, until his back has relaxed. But he tells me the trick is to do this a number of times a day, whenever you feel the back pain kicking in. 

My husband says he did not think this technique would work, out tried it out of desperation.  To his surprise, it worked even though he didn’t think it would. I think he said it tool maybe 2 or 3 weeks. I’ve tried the relaxation technique now and again, and it does feel good, although I have to admit to not being disciplined enough at sticking with it to give it a fair shake. Ok, so I’m also afraid to get caught in the ladies room at work squatting down, holding onto a stall…

Thanks again for the great post, Jag!!

16

[quote=ao]I concur with Paul Chek’s book being a very good resource for overall health.  Some of the exercises may be a little bit daunting for some patients with pain and pathology, however.  He is very knowledgeable, especially considering that he is largely self taught, and I respect him for not only talking the talk but also for walking the walk. 
Egoscue is also self taught and makes some good points.  His method can be beneficial but he tends to hype it beyond its capabilities.  In my opinion, his method lacks biomechanical, neurophysiological, and pathological specificity and often fails to produce rapid short term results where some other methods would.  IIRC, he was on San Diego area TV and “treated” some patients.  None of them had their pain relieved in the short term.  John Iams was also on TV and obtained immediate results with pain relief.  Pete Egoscue certainly knows how to market his method though.  As an ex-Marine officer, he knows how to motivate people.  For better or worse (depending upon how you look at it), the public tends to believe most or all of what it hears with regards to marketing and doesn’t have the knowledge and experiential base to critically evaluate what they see, hear, and feel.  If you have a lot of time and a lot of money, it’s OK and relatively safe.  Otherwise, you may want to look elsewhere.  
[/quote]
 
Oh, I completely agree that some of these methods can get over-hyped and you can pay too much for them.  But I’m cheap, so I take what I can from them that is free or low cost.   That’s why I mentioned the 4-hour body book.  The author went through all the Egoscue stuff and came back with “here’s the five most useful exercises and how to do them”.
What did Bruce Lee used to say – I think it was  “Use only that which works, and take it from any place you can find it…”

17

[quote=Dragline]Oh, I completely agree that some of these methods can get over-hyped and you can pay too much for them.  But I’m cheap, so I take what I can from them that is free or low cost.   That’s why I mentioned the 4-hour body book.  The author went through all the Egoscue stuff and came back with “here’s the five most useful exercises and how to do them”.
[/quote]
Dragline,
The problem with the statement in bold is that it is so general that it lacks any usefulness.  If I could offer an analogy, it’s like someone saying here are the five best investments.  For who, at what age and stage in their life, with what risk tolerance, with what investment experience, with what financial status, etc., etc.  For example, the best exercise for low back pain originating from a central posterior disc derangement in a 30 year old may be the worst exercise for a 70 year old with spondylolisthesis, even though both individuals are suffering from low back pain.  There’re some things that Tim Ferris may be expert at but therapeutic and remedial exercise is not one of them.
Even Bruce Lee, who I have the greatest respect for and who was very knowledgeable about training for his time didn’t understand the risks involved in performed a good morning lift, especially when one has a considerable leg length difference as he did.  It’s the reason he blew out his back. 

18

[quote=pinecarr]I hurt my lower back early last summer (carrying water and bags of manure to my garden?:), and am now learning what chronic lower back pain is like.  Having always been one who loves walking, exercising regularly, and doing (moderate)  physical work, I have been distressed by the degree to which something so simple sounding as “lower back pain” can be almost crippling, in terms of limiting motion and activities.  I have seen a doctor (no help there), and have since been pursuing alternative means of helping my back.  So I look forward to trying out some of the info and references provided here.
[/quote]
pinecarr,
I can’t emphasize this strongly enough to anyone who has low back pain (or other forms of musculoskeletal pain for that matter).  There can be MANY different causes for the same type of pain.  Buffet style or trial-and-error selection of treatments is usually destined for failure or less than optimal results.  Find a well trained, experienced, board certified orthopaedic physical therapist with manual therapy training and skill and an excellent reputation who (1) fully understands spinal problems, (2) will perform a thorough, detailed evaluation to determine the exact cause of your problem, (3) will develop an accurate, detailed, specific, scientifically based treatment plan, (4) will effectively render that treatment, and (5) will teach you how to take care of yourself once you are pain-free.
All treatments and all practitioners are not equal … far from it.  While self reliance is great, sometimes consulting the right professional can make all the difference in the world and save you a lot of pain, suffering, and money in the long term. 
Hint: if someone has to advertise heavily, take a pass.  I’ve never had to advertise (knock on wood) and neither have most of the other top practitioners that I know.  Just today, I treated someone who had “physical therapy” in an orthopaedic surgeon’s office (which is a BAD choice for a number of reasons) for 10 sessions and was not much better.  He had heard about me by reputation.  After one visit, he felt better than he had in months.  He asked me why the physical therapists at the doctor’s office hadn’t done what I did.  I gave him my stock answer, “You got me … go ask them.”  How do you explain to them the difference without sounding like you’re bragging?;-) 

19

Thanks for the advice, ao!  My experience was much more like the one you referenced in your last paragraph. A friend at work recommended a different doctor who helped her tremendously with back pain and sciatica after the birth of her second child.  I am planning to pursue that lead.  I think she called him an “osteopath”.  The term is new to me.  Does that imply anything good/bad/quacky to you?
Thanks again for the response.

20

[quote=ao]Also, a key thing to remember is that virtually all pain (except that of psychogenic origin) is secondary to one of only two factors, chemical irritation or mechanical deformation.  Pain of chemical origin is best treated chemically and pain of mechanical origin is best treated mechanically. 
[/quote]
ao,
I’m afraid you lost me on this statement. The mechanism by which trigger points create referred pain is distinctly a chemical process, yet their treatment is best achieved by mechanical means. In fact, there is no drug or nutraceutical that has shown any effectiveness in the resolution of trigger points (at least not in a double-blind, placebo controlled study). Even the injection of trigger points with a local anesthesia must be classified as a mechanical treatment method, because trigger point injection with a saline solution works equally as well.
Perhaps by “mechanical pain” you were implying nerve compression, in which case removing the mechanical compression would be warranted, and probably best done by mechanical means. But I know of one case of nerve compression that was effectively addressed by chemical means. My father came to me with a complaint of sciatica-type pain. I knew from X-rays that I had taken of my father when I was in Chiropractic College in the late 80’s, that he had a spondylolisthesis, so I suspected that his symptoms were secondary to nerve trunk compression in his lumbar spine. I told him surgery would probably be needed at some point. My father, who was at the time being treated for lymphoma at M.D. Anderson Cancer Institute, mentioned his sciatica symptoms to one of his doctors there, who then referred him to another doctor in the M.D. Anderson ecosystem. This doctor suggested that my father try a treatment protocol involving the drug Neurontin, before committing to a surgical option. To my amazement, the neurotin actually worked for my father. It took about 6 weeks for all his symptoms to subside, but he has been off the drug for several years now and is still pain-free. 
I realize that discussing alternative healthcare topics is a bit like discussing politics or economics, as many professionals in the field hold deep-seated beliefs about the efficacy of their particular approach, myself included. I think it’s important to remain open to other approaches, but to always have a foundation of good medical research to base your work on. To this end, no alternative treatment to pain has more medical research supporting it than Trigger Point Therapy, which is why I felt comfortable recommending it here.
Thanks to everyone for their comments on this thread…Jeff