Massage therapy can provide best massage and get relief for some people with chronic pain. Massage can relieve back pain, headaches and arthritis. and any other area caused by bad alignment.
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INTEGRATIVE MEDICINE-
Recharge Your Mind and Body.
Explore non-invasive, complementary and alternative medicine and therapies.

KEY POINTS-
Awareness of and understanding viable options and integrative approaches to address wellness is key.
Cultivating homeostasis and recharging is essential to health and healthy living.
Complementary and alternative medicine focuses on treating the whole person.

It is widely accepted that the only constant in life is change. And its constant change in our external lives that impacts our internal mental and physical ecosystem. Being aware of and understanding viable options and integrative approaches to address health and wellness to cultivate homeostasis within, and recharge in a non-invasive complementary way is essential to health longevity, life, and living.

Homeostasis is the state of balance for a body to function properly and survive while continuously adjusting to surrounding conditions.

Jaden’s Story
Jaden is a young 42-year-old seasoned attorney at a prestigious DC law firm. He works long hours every day including weekends. Normally, he’s able to overlook how he feels and power through the many competing demands, but lately, he’s found himself taking more and more over-the-counter medications to dull the pain that’s consuming his life. The chronic tension headaches and low back pain he’s experiencing are debilitating at times and he’s not able to focus on his work the way he needs. And if that’s not enough, he’s sleep deprived, not rested in the morning, and has been contemplating options other than the OTC medications and even stronger prescribed medications he’s been taking, but he's not really sure where to turn or what to do. It is a conundrum.

Jaden represents many of us in the world — flowing with the hustle and bustle of everyday life while trying to navigate common health concerns like stress, headaches, low back pain, and sleep deprivation, wanting to tap into different ways to manage health and recharge mentally and physically, but not fully aware of viable options outside of conventional medicine. The U.S. population is a melting pot of ethnic, cultural, gender, and age groups and the rapidly changing demographics from a less homogeneous to a more heterogeneous society has given rise to growing demands for different but comprehensive and effective health care options. Integrative, complementary and alternative medicine (CAM) has emerged as a relevant form of health care used to address a litany of common health issues and for whole-body wellness.

As defined by the Academic Consortium for Integrative Medicine and Health, “integrative medicine and health focuses on the whole person, is informed by evidence, and makes use of all appropriate therapeutic and lifestyle approaches, healthcare professionals and disciplines to achieve optimal health and healing” (ACIMH, 2023). Furthermore, according to a 2017 National report by the NIH National Center for Complementary and Integrative Medicine (NCCIM), there was an increase in the use of yoga, meditation, and chiropractors between 2012 to 2017 which were identified as commonly used approaches to health and wellness (Clark, T. et al, 2018).

While traditional medicine is steeped in a system of treating symptoms, complementary and alternative medicine and integrative approaches focus on a system of treating the whole person; mind and body are one and affect each other physiologically. Integrative health emphasizes multimodal interventions, two or more, such as conventional health care approaches (e.g., medication, psychotherapy), and complementary health approaches (e.g., yoga, probiotics) in various combinations, with an emphasis on whole-body integrative treatment (NIH, NCCIH, 2021). National data from a 2000 study which included a sample of nearly 10,000 participants, when CAM was emerging, examined the relationship between mental disorders and the use of complementary and alternative medicine and found “relatively high rates of use of complementary and alternative medicine among respondents who met criteria for common mental disorders” (AJP, 2000). Under the parent organization, National Institutes of Health (NIH), the National Center for Complementary and Integrative Health (NCCIH) divides CAM into five major domains:

CHRONIC PAIN-
Mind-Body Approaches to Coping With Pain.
Pain treatment can be optimized by involving mind and body.
Reviewed by Davia Sills

KEY POINTS-
Chronic pain can wear you down emotionally and mentally.
Focusing only on the physical element of pain is one of the factors in many cases of narcotic overuse, with serious consequences.
An anti-inflammatory diet that includes whole grains, healthy fats, lean protein, and berries can reduce inflammation and help decrease pain.
Neuroscience research tells us that becoming mindful for less than an hour during your day can help ease symptoms.

If you’ve ever stubbed your toe or touched a hot stove, you’ve experienced acute pain. An injury or natural process can cause this type of pain, but it goes away relatively quickly.

If your pain lasts three months or more, most healthcare providers agree on calling it chronic pain. It’s something you live with for a while and doesn’t go away. This experience can wear you down emotionally and mentally. Many common conditions, such as arthritis, migraine, fibromyalgia, and cancer, involve chronic pain.

Pain’s mental and emotional toll
A sudden injury can be scary. You may experience shock or even post-traumatic stress.1 Living with chronic pain can create anxiety, depression, and overuse problems with medication, alcohol, and other substances.

Experiencing pain affects our thinking and emotions. In turn, these responses can affect your healing. When Dave, a firefighter, strained his back at work, a doctor prescribed pain medications and time off. On leave, Dave filled the hours by catching up with his favorite sports teams and drinking a few microbrews to relax.

Then his mother died suddenly. Dave began drinking more and more. His back pain was intensified by the stress of grief and sorting out his mom’s affairs, and he requested more pain medication.

Fortunately, Dave’s doctor practiced whole-person health. “What’s going on?” he asked. Dave was otherwise healthy, and his physical therapist had reported the injury was healing well.

That simple question was enough. Dave broke down in the office talking about his mom. Then he and his doctor created a mind-body approach to his physical and emotional pain. It included returning to work on light duty and scheduling some sessions with a counselor who was experienced in helping people with loss and grief.

Finally, Dave talked with his younger sister about how sad he was. As the older sibling, he had always filled the role of protector, never admitting to weakness. Talking with his sister allowed her to offer support for a change. Together, Dave and his sister worked on clearing out their mother’s home and preparing it for sale.

We can easily imagine a different path. Focusing only on the physical element of pain—Dave’s back—is one of the factors in many cases of narcotic overuse, with serious consequences.

Optimize pain treatment with mind-body approaches.
If you burn your hand on a hot stove, your first impulse is probably to cool the burn. You may wave your hand through the air to create a cooling draft or stick it under cool water. Then, you may try to distract yourself from the pain by watching a favorite show or talking with a friend. Using these mind-body approaches can calm your mind and relax your body.

The strategies we naturally adopt with acute pain can help with chronic pain as well. If you have been in pain for three months or longer, ask yourself, “How is my treatment working?” Communicate with your healthcare provider about what the options are.

Aaliyah, who has chronic migraine, used this approach. She scheduled a video visit to ask her doctor about her prescribed medication and ask about other options. She also asked about her use of non-prescription medications, which can lead to a condition called rebound headache.

Next, Aaliyah advocated for a mind-body approach. Using a migraine app to track her headaches showed that she tended to get one after being around a particular coworker, in a pattern often called the “let-down” headache.

Talking with coworkers about the problem helped her relieve some of the tension of working with her stressful colleague. She adjusted her workstation so she could stand and move around during meetings with this coworker, releasing stress.

Aaliyah planned to take a short walk after the meetings that typically made her tense up. She also spent a few minutes outdoors to get some sun and relax in nature. Eventually, she took the practical step of transferring to another team.

Aaliyah still has the occasional migraine and keeps her new migraine medication on hand. But the mind-body approach she took works far better for pain than medication alone.

Find the pain management that works for you.
A whole person approach is ideal for managing pain. Here are some evidence-based strategies to try.

Consider your biology.
Biological women have more chronic pain than biological men.2, 3 Research has shown several reasons for this, including hormone shifts over time, being victims of trauma and abuse, and tending to prioritize the needs of others ahead of their own.

Avoid foods that cause inflammation.
Inflammation in the body can worsen pain. On the other hand, an anti-inflammatory diet that includes plenty of whole grains, healthy fats, lean protein and berries—and yes, small amounts of chocolate and red wine—can reduce inflammation and thus help decrease pain.

Try a short meditation.
You may think you don’t have time to meditate. But neuroscience research tells us that becoming mindful for less than an hour during your day can help ease symptoms. In one study, patients who practiced mindfulness-based meditation or had cognitive behavioral therapy had less pain than those who did not add a mind-based practice to their treatment.4

Try a free, relaxing mindfulness meditation. Bonus: it includes a gorgeous nature video to help you reset mentally. You can use it for acute or chronic pain.

Be careful with tech.
The technology that surrounds us can cause pain. Have you ever experienced “text neck” or strained your arms, wrists, or fingers by typing too much? Erik Peper, Ph.D., is the author of Tech Stress: How Technology is Hijacking Our Lives. The book includes strategies for using technology without causing pain, including ergonomics that can help.

Taking control of your pain
No matter what type of pain you have, taking a whole-person approach can help you feel better. As we saw in Dave and Aaliyah’s stories, pain is much more than physical. Having a compassionate provider you can talk with about what else is going on in your life, as Dave did, and advocating for yourself, as Aaliyah did, can make an enormous difference in reducing or eliminating pain and creating the best health possible.

CHRONIC PAIN-
What Makes Some People More Vulnerable to Pain?
The emotional components of the pain experience.
Reviewed by Jessica Schrader

KEY POINTS-
The experience of pain involves both sensory and emotional components.
Psychological factors, such as anxiety and depression, make people vulnerable to the development of chronic pain.
Positive psychological factors, such as hope, acceptance, and optimism, affect the adjustment to persistent pain.
“One of the major reasons why pain becomes immortal in our bodies is how we feel in our minds.” –Haider Warraich

Pain is not a purely sensory experience reflecting underlying tissue damage (Melzack, 1996). Emotions, beliefs, and behaviors are vital parts of the human chronic pain experience. Negative emotions and limited emotional awareness contribute to greater pain and poorer adjustment (Lalkhen, 2021). Negative emotions stem from many sources including stressful life events, pain anxiety, attachment insecurity, and the experience of pain itself. The negative emotional aspect of pain can increase a person’s vulnerability to opioid addiction.

The followings are a list of psychological factors that influence pain perception. And they also contribute to pain relief and suffering (Allaz, 2015).

1. Stress
Suffering begets suffering. Our circumstances play a significant role. Unresolved acute stressors over the life course may be most relevant to persistent pain. Early stress in life can alter how the brain responds to stressors later in life and can sensitize us to trauma. For example, reports of childhood adversities (e.g., family conflict, sexual abuse, physical abuse) and adulthood conflict are higher in people with various pain conditions, including migraine headaches, irritable bowel syndrome, and fibromyalgia.

2. Poor mental health
Anxiety, depression, and anger are common in people with chronic pain. Anxiety and physical pain can amplify each other (Vadivelu, 2017). Distressed with chronic pain, a person may start to feel anxious that they have no control over their body. Their anxiety may increase their focus on the pain and intensify it. For example, problems with daily routines such as housework or gardening can trigger feelings of anxiety and fear, leading to avoidance behavior. The aim of therapy is to increase tolerance to trigger situations to reduce anxiety with each exposure.

3. Pain catastrophizing
Pain catastrophizing refers to the tendency to worry, exaggerate the seriousness of the pain sensations, and feel helpless about pain. Pain catastrophizing is associated with greater pain and maladjustment in acute pain, such as headaches and rheumatic diseases. People with trauma histories are more likely to catastrophize. Pain catastrophizing may communicate the patient’s need for support in dealing with both the pain and the emotional distress that goes with pain. Unfortunately, over the long term, catastrophizing may undermine patients’ support needs.

4. Attachment
Vulnerability in interpersonal encounters and high sensitivity to rejection associated with an inability to create trusting bonds are hallmarks of the insecure attachment style. The difficulties in creating interpersonal relationships can in turn contribute to the difficult construction of therapeutic alliance. A substantial body of research demonstrates that being insecurely attached to parents is a risk factor for maladaptive outcomes (Lumley, 2011). For example, evidence shows that an insecure attachment style contributes to high pain intensity and disability, to feeling pain as a threat, and to a higher degree of pain-related distress. Insecure attachment is also correlated to high levels of depression, anxiety, and catastrophizing and to a tendency to express distress in a somatic way.

5. Emotional awareness
People vary in the degree that they verbally and non-verbally express their emotions. The difficulty with awareness and expression of emotions relates to the frequently observed somatic expression of mood disorders. That is, emotional problems can be expressed through bodily symptoms. For example, evidence showed that anger inhibition predicted higher pain ratings at the end of the day, whereas anger expression predicted lower pain ratings, among women with fibromyalgia. Among people with low back pain, anger suppression led to increased pain behavior during a functional task. Many individuals manifest their anxieties and worries as physical symptoms such as abdominal pain. Somatization can be understood as a mode of communication of painful symptoms (grief or melancholy).

6. Positive psychological factors
Positive psychological factors, namely hope, pain acceptance, and optimism, affect the adjustment to persistent pain. Pain acceptance is defined as accepting what cannot be changed, getting involved in meaningful activities despite the pain, and decreasing ineffective struggles to eliminate pain. Acceptance requires that the individual continues the activities he/she values and maintains her personal goals despite the presence of pain. Evidence suggests that subjects with higher levels of pain acceptance experience substantially lower levels of pain, and distress.

In sum, psychological factors influence the perception of pain by affecting individual variations in sensitivity to pain. Reducing emotional hurt could be important for chronic pain patients.

ANXIETY-
Health Anxiety and Beliefs About Being Weak and Vulnerable.
When every symptom is a crisis.
Reviewed by Tyler Woods

KEY POINTS-
People with health anxiety often hold the dysfunctional belief that they are weak and vulnerable to disease.
Dysfunctional beliefs can be reshaped into adaptive beliefs through a process called cognitive restructuring.
By developing a more adaptive belief about being strong and capable of overcoming many illnesses, one can improve their health anxiety.
One day during your typical morning routine you notice what looks like a scab on the top of your hand. What is this? Well, there goes your morning. You suddenly aren’t that concerned about getting to work on time and you begin your careful inspection. You knew for certain you hadn’t scraped your hand at any point. Why else would you have a scab? Suddenly, the new diagnosis hits you. Skin cancer.

You can’t believe it’s finally happening. You had known for years you were doomed to eventually develop some type of melanoma. After all, as a youth, you spent most summers slathered in baby oil and frying yourself to a crisp.

Over time, the scab faded. But you notice a new symptom: upper back pain. Uh oh. So and so’s cousin’s first symptom of lung cancer was back pain. So, naturally, you throw yourself down yet another rabbit hole. And round and round it goes. You have barely moved on from skin cancer, and are already embracing a new imminent tragedy.

Of course, you didn’t end up having skin cancer. Nor did you end up having lung cancer. As usual, those seemingly catastrophic symptoms just sort of went away. But until they do, you are convinced that this is “it.”

What’s happening behind the curtain
This cycle isn’t anything new to you. If you have health anxiety, I am sure you are well aware of this pattern and your tendency to overreact to symptoms and bodily sensations. But you may not be aware that there is something profound happening underneath all of this.

Many people with health anxiety hold the core belief that they are weak and vulnerable to disease. It is as if you assume that any illness that comes your way, big or small, would be the thing that puts you straight into the grave. Core beliefs are the lens through which we see ourselves and the world around us. They influence how we interpret everything. If you believe you are weak and vulnerable to disease then, naturally, you are going to be terrified of all symptoms or bodily sensations because, if it is due to a serious disease, then you assume you are finished. It’s "game over."

Reshaping this core belief into a new, more adaptive belief
Let’s consider a new way of seeing your health. It is possible that you are underestimating your ability to overcome, manage or cope with an illness. Even if you were to get diagnosed (or have been diagnosed) with an illness, there are many reasons to assume that, in most cases, the illness would be treatable. For example, let’s say you are diagnosed with high blood pressure. This does not automatically mean you are going to die of a stroke or heart attack. Yes, of course, high blood pressure can increase one’s risk for a heart attack or stroke. But with changes in lifestyle and access to medical resources, this condition is manageable. In fact, thanks to science and the progression of modern medicine, there are a wide variety of options for treating the majority of health conditions.

I have seen many of my clients’ health anxiety improve drastically when they learn how to use cognitive restructuring to reshape their unhelpful beliefs (i.e., "I am weak and vulnerable to disease"). They learn how to identify what they once thought was "evidence" for this belief. They then begin to collect evidence for a healthier belief (i.e., "My body is strong and capable of overcoming most illnesses"). Through this process, they begin to slowly shed the old belief and form a new one.

Strengthening your new belief
What’s more, once the new, healthier belief is formed, it only becomes stronger over time. This is because our core beliefs, whether adaptive or maladaptive, continue to be strengthened through a process of reinforcement. Even though we often don’t realize it, we are selectively paying attention to the data in our environment that confirms the beliefs we already have.

This way of processing information can work for us or against us. Up until now, this process has been working against you when it comes to your beliefs about health. You have been searching for ‘evidence’ in your environment that you are weak and vulnerable to disease. It is time to retrain your brain to search for evidence for you being strong and capable of overcoming most illnesses.

The more you practice training your brain to notice this information in your environment on a daily basis, the easier it will become for you to begin processing information in this new way. You will begin to naturally notice evidence of you being strong and capable of managing or overcoming disease. Retraining your brain requires a lot of effort upfront but becomes much easier over time. It is well worth the effort.