HCT For The Relief and Control Of Chronic Pain

Author: Traci Patterson, CH, CI – Founder and Director, Advanced Pathways

 

You are not your pain. You can make that statement a reality by utilizing the powerful protocol of Hypnosis Combined Therapy (HCT).  HCT can harness your ability to retrain neural pathways and develop new patterns in the brain and body, to help you reclaim control.

HCT is a combination of clinical hypnosis/hypnotherapy, biofeedback, light/sound therapy, neuroplasticity training, working with the limbic system, cell memory, and more. This protocol has given patients, on an international basis, the ability to dramatically decrease pain levels (many do gain remission), increase restorative sleep, decrease and control stress, anxiety and/or PTSD, and regain their lives.

Clinical trial evidence over the past 10 years, confirms that hypnotherapy treatments are effective for reducing daily pain intensity levels in people with chronic pain.

My own experience of living with chronic pain (Complex Regional Pain Syndrome) means that I have a real understanding of the impact it has on all areas of life. Chronic pain doesn’t just impact one area. It hits patients in ways that were never expected. The isolation, stress, anxiety, depression, and feelings of helplessness can be overwhelming. The good news is this can change. You can have the ability to change the way you experience your body and your life – to take control again.

When pain persists, your role in managing it becomes really important. What you think, feel and do on a day-to-day basis, has an effect on your pain. In order to change your pain state it is necessary to change your thoughts and emotional responses.

HCT is a powerful tool that helps you take back control over your pain and your life by enabling you to change your thoughts and emotional responses to both your pain and to external factors. This will assist you to retrain neural pathways and calm down the over sensitized state of your central nervous system, helping you lay down new templates of response in the areas of the brain responsible for determining the pain experience.

With HCT you will be able to promote and experience the healthy effects of positive energy in your life, empowering you to get back in the driver’s seat of your life once again.

What exactly is chronic pain?
Pain is considered chronic when it occurs for most days of the week and persists for longer than three months. It includes persistent pain that no longer has an identifiable cause where the original injury has healed, as well as pain that has an identifiable cause such as arthritis, fibromyalgia, TMJ dysfunction, cancer, diabetic neuropathy, shingles, multiple sclerosis etc. It also includes persistent pain that has no identifiable cause at all.

It is now estimated that over 100 million Americans suffer from chronic pain. Push the numbers out on an international basis and chronic pain is becoming an epidemic. The cause and treatment of persistent pain is complex, added to which is the enormous impact chronic pain has on a person’s ability to function effectively in the wider areas of family, social and work life.

Chronic pain and illness is debilitating, isolating and extremely stressful. There is no single approach or ‘magic bullet’ solution to treating chronic pain. Rather, it’s a matter of being in charge of your health management and decisions, choosing the right combination of treatment strategies and health care professionals to help you improve your health outcomes and the quality of your life.

How do we know that hypnosis can actually make a difference for pain?
There is physical evidence that hypnosis works to alleviate chronic pain, and medical imaging studies have shown that hypnotic therapy influences all of the cortical and neuro-physiological processes that underline pain. Current scientific research shows that hypnotherapy treatment causes both pain perception thresholds, and pain tolerance levels, to be strikingly increased.

Why use Hypnosis Combined Therapy (HCT) to treat chronic pain?
HCT is safe, drug free, non-invasive, evidence based and also works to support other medical and alternative therapeutic approaches you may be using in your multidisciplinary approach to healing. My own experience of utilizing a range of health options including hypnosis to gain long-term remission in my own journey with chronic pain (CRPS) is a valuable resource that I bring to patients. I can help you navigate those choices to find what’s right for you, so that you gain real improvements in wellbeing and quality of life.

Science has discovered that thoughts, emotions and physical movement create chemical reactions in our body, which either calm down our central nervous system or turn the alarm volume up. By changing your response to pain and the way you think about pain, you can in fact change your pain state. Plus, when we tap into previous memories of being healthy and happy it allows us to rebuild the neuro-net that our brain relies on and our cell memory.

How we focus our attention can have a significant impact on our experience of pain. Research has shown that being able to focus attention on a task, activity, or experience – or to distract yourself – reduces pain and distress for people in chronic pain. The more we can divert our attention from pain, the less signal we create in our pain pathways. The less signal in our pain pathways, the less pain receptors and sprouts our nerves create, and the less sensitive our nerves become. When engaged in or focus on enjoyable experiences, we increase our production of good chemicals (neurotransmitters), such as endorphins. And, as you know, these ‘good’ chemicals help to calm pain pathways even more. Because hypnotherapy is a state of focused concentration it can create and absorb you in a desirable and comfortable state, and your brain can start to pay attention to that instead of pain.

We also want to focus on the Vagus nerve and the importance it has in chronic pain. The Vagus nerve is one of the largest nerve systems in the body. The name Vagus is Latin for “wandering,” which describes the long and complicated path this nerve takes through the body and all of the different systems it comes in contact with. In some cases this nerve is linked to medical conditions such as low blood pressure, and in other cases doctors will stimulate this nerve to help treat disorders. Stimulating the Vagus nerve with something as easy as an abdominal breath can release endorphins, serotonin, and melatonin.

Biofeedback allows us to objectively monitor your heart rhythms and display the physiological level of coherence – an optimal state in which the heart, mind and emotions are operating in sync and balance, and the immune, hormonal and nervous systems function in a state of harmonious coordination.

Pain and the brain…
Pain is an output our brain makes to defend us. It is what alerts us to danger and it acts as a protective mechanism to make us stop and do what we need to, to take care of ourselves. Our brain decides if something is painful or not. This is hard to comprehend because we feel pain in parts of our body, therefore we believe the pain comes from those parts, but in fact pain is determined by the brain.

However, when pain is ongoing the body’s danger response to sensory input becomes over sensitized and the alarm system stays on red alert causing a process called ‘Central Nervous System Sensitization’; then fears, thoughts and beliefs become involved and start contributing to the chronic pain state. Chronic pain sufferers end up feeling as though pain has engulfed their life, feeling helpless and hopeless. The good news however, is that HCT can change that. It can help you break the chains that chronic pain holds you in, thereby letting in the possibility for change and new perspectives.

A Multimodality / discipline approach…
A multimodality approach is needed in order to address the different facets of physical and emotional health involved in the treatment of chronic pain. Once you decide to get involved in your own healing, as captain of your team, you will need to find the protocol and/or team that works best for you.

Clinical trial findings and MRI studies support the fact that hypnotherapy is a valuable tool that will support your ability to learn new ways of dramatically decreasing your chronic pain and dealing with the impact it has had on your life.

What the research tells us…
• The brain is plastic! The brain’s neuroplasticity means that it is not a fixed and final thing; it can change the way it works and the way your body responds to its messages. “Neruo is for ‘neuron’, the nerve cells in our brains and nervous systems. Plastic is for ‘changeable…modifiable’” (The Brain That Changes Itself, Norman Doidge MD, 2007).
• The neural pathways that take messages to and from the brain can be altered, and new paths can be created. The latest brain research shows that our brain has the ability to change its function and structure through thought and activity, but only when it is in a state of openness, creativity and freedom from stress. Because hypnotherapy helps you reduce the significant levels of stress that occur in your body as a result of experiencing ongoing pain, it creates the necessary open and creative space for your brain to begin changing its responses. (Neuro Orthopaedic Institute Australasia, August 2011)
• Thoughts are one of the most powerful influences on your mood and emotions. The way you think about yourself, your situation, and your future is extremely important in chronic pain, for a number of reasons. The more you can reduce your own distress with your thinking, the more you reduce your adrenaline levels, which in turn is good for desensitizing your nervous system. The more you can generate helpful thinking patterns that improve your mood, the more helpful neurotransmitters you are likely to produce, such as opiates. These are your body’s natural ‘feel good’ chemicals. When your body produces ‘feel good’ chemicals, they help to reduce the level of signal in your pain pathways. (CPA Australia http://www.chronicpainaustralia.org.au)
• Research has shown that being able to focus attention on a task, activity, or experience – or to distract yourself – reduces pain and distress for people in chronic pain. An important point about attention is that we all only have a limited amount of attention to allocate to various aspects of our experience. If much of our attention is taken up by a particular thing, then there is less attention to be allocated to anything else. (CPA Australia http://www.chronicpainaustralia.org.au)
• There is growing recognition that hypnosis is helpful for altering the thoughts and beliefs that contribute to the pain state.
• The findings suggest that self-hypnosis training for chronic pain has two primary effects (a) it creates a long lasting (possibly permanent) change in the way the person and brain processes pain information, so that they experience a decrease in ongoing daily average pain, and (b) provides skills that they can use on a regular basis to experience periods of comfort.
• New sciences such as New Biology, Quantum Physics, and Molecular Science, all recognize that human beings are a dynamic organic process. These scientific perspectives contend that it is not the individual parts, but the whole that provides for in-depth understanding. The human organism is not perceived as isolated or compartmentalized, but rather is studied as a living system. No longer an “it “ – an object – the human being is recognized as a dynamic ever-changing process, embedded in a field of relationships and information. (From Changing the Language of Body: from Object to Process article by Liz Koch). This relational field moves between your thoughts, emotions, and body and is intrinsically linked. Hypnotherapy works with the whole person in a powerful way that harnesses their mind, body spirit self to achieve healing and transformation.
• Researchers are not sure exactly how or why biofeedback works. However, there does seem to be at least one common thread: most people who benefit from biofeedback have conditions that are brought on or made worse by stress. For this reason, many scientists believe that relaxation is the key to successful biofeedback therapy. When your body is under chronic stress, internal processes like blood pressure become overactive. Guided by a biofeedback therapist, you can learn to lower your blood pressure through relaxation techniques and mental exercises. When you are successful, you see the results on the monitor, which encourages your efforts. (University of Maryland Medical Center)
• The limbic system can influence chronic pain. A conceptual framework is presented suggesting conscious and subconscious interpretation of emotional responses to events can impact all systems of the body generating or modifying chronic pain symptoms. The limbic system can directly modify the activity of the autonomic, immune, endocrine and musculoskeletal systems. Through these systems it is able to alter the activity in all other systems. It is important to note that multiple systems are being affected simultaneously. The end result is that pain may be felt in a specific region, which can be viewed in the context of current knowledge on pain physiology and the neuromatrix. (University of West London)

You can utilize HCT to break the chains from chronic pain. Doing so will help you to regain your life by dramatically decreasing your pain, increasing restorative sleep, decreasing and controlling stress, anxiety and/or PTSD, and empowering you to engage in a meaningful life again.

 

Outcomes With Hypnosis Combined Therapy by Traci Patterson

Hypnosis Combined Therapy (HCT) by Traci Patterson, CH, CI has proven to be an excellent drug-free, non-invasive, and evidence based treatment protocol that is providing positive outcomes for the patients diagnosed with chronic pain, fibromyalgia, neuropathic pain, chronic migraines, and Complex Regional Pain Syndrome (CRPS) [type 1 and type 2].  Yet it is not limited to these specific diagnosis.

The data in this report is specific to those clients/patients diagnosed with Complex Regional Pain Syndrome (CRPS); type 1 and type 2; that were treated with Hypnosis Combined Therapy (HCT).  The data is based upon all CRPS clients/patients that were seen over a one year period (June, 2015 – June, 2016).

Today, over 1 million people are diagnosed with CRPS (Complex Regional Pain Syndrome) aka RSD (Reflex Sympathetic Dystrophy) worldwide.  While staggering, patients are not being given the options of treatments outside the box that can help them such as Hypnosis Combined Therapy (HCT).  What we have found through research and tried methodology is HCT gives hope and restores chronic pain patients’ lives.

The majority of patients diagnosed with CRPS aka RSD are treated with traditional methods (i.e. NSAIDS, PT, OT, local blocks, regional blocks, lumbar sympathetic blocks, ganglion blocks, pain medications/opioids, spinal cord stimulators and even pain pumps), and most do not see long term or permanent relief.

At Advanced Pathways we are seeing clients/patients that have been diagnosed with CRPS from all over the world.  Those from the United States have been seen at some of the top facilities (Cleveland Clinic, Mayo Clinic, Scripts Medical Center, etc.) and by some of the top physicians including Dr. Chopra prior to coming to our office. These are individuals that have not been able to find relief from other treatment options (listed above), but they are able to dramatically decrease pain levels and regain their lives utilizing HCT.  Many have been able to get into complete remission.

The average starting levels are below:

Pain Level:      9.090909091   (Rated on a scale of 0-10.  10 being the worst pain imaginable.)

Sleep Quality: 7.272727273   (Rated on a scale of 0-10.  10 being the worst.)

Quality of Life:                      (Rated on a scale of 0-10.  10 being the worst.)

HCT Outcome Data – CRPS

 

The average ending levels following, “Week-Long Intensive”, with HCT:

Pain Level:      0.727272727   (Rated on a scale of 0-10.  10 being the worst pain imaginable.)

Sleep Quality: 2.363636364   (Rated on a scale of 0-10.  10 being the worst.)

Quality of Life: 3.363636364   (Rated on a scale of 0-10.  10 being the worst.)

HCT Outcome Data – CRPS 1

 

HCT is a combination of the following modalities:  clinical hypnosis, biofeedback, light/sound therapy, transdermal peptides (when appropriate), working with the limbic system, cell memory, and more.  This combination is evidence based while providing our clients/patients with the best outcomes possible.

We have found that it is critical to look at all aspects of the diagnosis and what the individual is dealing with (i.e. stress, anxiety, depression, insomnia, PTSD).  It is imperative that the individual is able to resolve all of the issues they are dealing with, or have the tools to decrease these in order to regain their lives.

Hypnosis as an adjunct to medicine allows one to decrease pain and enhance healing. Often, a person with chronic pain may feel helpless, lost, and victimized. Hypnosis gives the person greater self-control, which decreases the effects on the autonomic system that activates the fight or flight response. Self-control also decreases the level of stress hormones. Both the reduction in fight or flight, and the decrease in stress hormones, can lead to a significant decrease in pain.[1]

We work with the subconscious mind.  The subconscious mind is not just in the brain or the head. According to research completed by Candace Pert, Ph.D., a research professor in the Department of Physiology and Biophysics at Georgetown University, she states, “The subconscious mind is a part of every cell within the body. Every cell in the body has memory units. Each cell has over 6,000 receptor sites for proteins capable of interacting with signals and converting those signals into intracellular activity. Through molecular division, each cell divides into a daughter cell and the mother cell dies. The daughter cells replace the parent cells; however they still contain the cellular activity or memory of the mother cell. This cell replacement process occurs every three months, except in skeleton cells that divide every six months. With each division and replacement new memories can replace old memories, creating new behaviors from the cellular level.”[2]

Another key area of focus is working with the limbic system and the autonomic systems of the body.  We understand that the human body is made up of four significant vital signs:  heart rate, blood pressure, temperature, and respiratory rate.  Pain was added to this list of vital signs in 2000 by JCAHO.  As with other vital signs, pain impacts a number of functions such as emotions, behavior, long-term memory and olfactory senses. The limbic system influences these same functions.  Understanding how pain interacts in the limbic system and how it operates helps patients break the pain loop and move beyond chronic pain. “When we think the Limbic System responds”[3].

When the limbic system functions abnormally, numerous health problems can occur. Physical problems such as a lack of sleep, too much stress, or chronic pain, exacerbate the problems created by an out-of-balance limbic system. The results are devastating.  In some cases, depending on the external factors, these imbalances can result in post-traumatic stress disorder (PTSD). This is the essence of stress turning into distress.

Hypnosis works well with the limbic system, specifically the Amygdala and the Hypothalamus, to change the stress response. Hypnosis allows a focused concentration and relaxation, resulting in an increase in oxygen throughout the body’s cells. This increase in oxygen has a major influence on decreasing a patient’s autonomic response to stress. Dr. John Rowlingson, the director of the University of Virginia Department of Anesthesiology Pain Management Center, is quoted as saying, “The limbic system might explain why therapies that act primarily in the brain, such as hypnosis, biofeedback, and brain stimulation, work so well to control pain.”

Transdermal peptides mixture of BPC-157, TB-500 and MGF has been proven to break up scar tissue, decrease inflammation, and decrease nerve pain.

Hypnosis Combined Therapy – the research and science of the mind-body connection, knowledge of how brain mechanisms interact, and pulling this together in individualized treatment plans – is what makes it so successful.  Utilizing different techniques through HCT, patients are able to break the chronic pain loop, bypass devastating memories, decrease inflammation, and set a path towards hope and a new life.

If you would like more information on Hypnosis Combined Therapy (HCT) by Traci Patterson, CH, CI please contact Advanced Pathways.

 

 

[1] Temes, Roberta, PhD. (1999). Medical Hypnosis and Introduction and Clinical Guide. New York: Churchill Livingstone.

[2] Pert, Candace B. PhD (1999). Molecules of Emotion. NY: Touchstone Publishing.

[3] Siegel, Ronald D. PsyD, Michael H. Urdang and Douglas R. Johnson M.D. (2002) Back Sense. New York: Broadway Books.

 

New CDC Guidelines Effects on the Pain Community

By: Traci Patterson, CH, CI – Owner and Founder, Advanced Pathways Hypnosis

 

In the last month the Centers for Disease Control (CDC) handed down new guidelines pertaining to opioid prescribing and the National Pain Strategy (NPS) was implemented. These guidelines and strategies have left the chronic pain community reeling, discouraged and feeling left behind. This is the time for advocacy for all evidence and outcome based treatments to be available to patients.

At this time the majority of chronic pain patients are receiving inadequate care and are not receiving information on all treatment options. With the new guidelines that have been set in place doctors and insurance companies are now limiting access to medications that can keep patients functional. If these limitations are going to be put in place then pain patients need access to all evidence and outcome based, non-invasive, drug-free treatment options.

I am proud to be the owner and founder of Advanced Pathways Hypnosis. I was diagnosed with Complex Regional Pain Syndrome (CRPS) myself in 2007 and was fortunate enough to get into remission in 2013. I take what I learned through my journey with chronic pain and utilize that to help others regain their lives.

To make this situation even more horrifying, is the realization that the majority of patients do not have access to the appropriate treatments. It is a disgrace to know that medical professionals are being forced to follow the oath they took to do what is best for their patients, or to follow new guidelines provided to them by the government due to fear of losing their medical license. These same clinicians’ feel that their hands are tied because other treatments that hold much potential to bringing relief – such as integrative and complementary therapies – are not covered or paid for by health insurance companies. Therefore, these treatment options for the most part are not even discussed with the patients.

I understand the feeling like no one cares or is listening. There should not be so many roadblocks for people to have access to information on all viable treatment options and to receive adequate care. Society needs to stop minimizing the pain of which they do not understand or cannot see on display.

However, lashing out against rhetoric and society is not going to solve these problems. The community needs to come together to advocate for access to all viable treatment options. A message that is honest and real needs to be pushed forward to the doctors, universities, insurance companies and elected officials. Now is the time to push for more than medications. We need to push for access to treatment options that will create a real difference in the lives of those living with pain. Become empowered and unify.

Hypnosis Combined Therapy: A Breakthrough in Chronic Pain Treatment

By: Traci Patterson, CH, CI – Founder and Owner of Advanced Pathways Hypnosis

Millions of people from children to adults are affected by chronic pain, which is commonly referred to as CRPS/RSD, Fibromyalgia, cluster headaches, neuropathic pain, etc. The numbers are staggering and they continue to grow.

For the majority of individuals that receive these diagnosis traditional treatments do not relieve their pain or suffering. As a former CRPS (Complex Regional Pain Syndrome) patient myself, I can relate, because I went down the same path. It wasn’t until I found a protocol that encompassed the very nature of “Hypnosis Combined Therapy” that I got better, into remission, and this is a direct result of breaking the chronic pain loop in the Limbic System.

Chronic pain in any patient regardless of their age is a pain signal being sent out by a continual loop and it is tied into the Limbic System, an area in the brain. Therefore, by utilizing “Hypnosis Combined Therapy” which is a combination of hypnosis, biofeedback, neuroplasticity training, cell memory, working with the limbic system, etc.; the pain loop can be broken and the patient can start to regain their life.

As an instructor and hypnotist that specializes in working with chronic pain patients, my primary end goal is to help the patient’s sympathetic nervous system to get into a more balanced state and to break the chronic pain loop. The protocols that we have set up have been very successful in decreasing the fight and flight mode, allowing patients to break the pain loop, dramatically decrease their pain levels – if not get completely into remission.

I have found that the use of Hypnosis Combined Therapy with a week-long intensive is providing the best results around. Together, these key pieces are used to assist with dramatically decreasing pain (if not alleviating it all together), improving emotional regulation, learning, behavior, decreasing stress and anxiety, alleviating PTSD, and more. After five (5) days patients are regaining hope, health and their lives.

Hypnosis Combined Therapy (HCT) is safe, drug-free, non-invasive and has no negative side effects.

As a CRPS patient that got into remission utilizing a similar technique, this is the best approach I have found to break the pain loop. I call this incredible protocol, “Hypnosis Combined Therapy”.   The amazing part is that the treatment is quick and easy. One week and patients are seeing fantastic outcomes.

This treatment protocol is now available to bring relief to chronic pain patients without the use of medication or extensive on-going therapies. If you or a loved one is living with a chronic pain condition and would like additional information on Hypnosis Combined Therapy (HCT) please contact Advanced Pathways Hypnosis.

Info@AdvancedPathways.com | 714-717-6633 | www.AdvancedPathways.com

Fibromyalgia: Successful Treatment Option

     In 1987, the American Medical Association recognized Fibromyalgia as a true physical illness and major cause of disability.  Yes, we all know that this condition has been around much longer than this and in all reality there was an illness in the 1800’s called neurasthenia where people developed the symptoms of Fibromyalgia and Chronic Fatigue Syndrome.  Since the dawn of time patients have looked to their physicians for answers and treatments to alleviate their symptoms or put this condition into remission.  Instead they are told over and over again that there is no cure and are given no hope.
     I had a Fibromyalgia patient come to me to complete a, ‘one week intensive’ in August, 2014.  She had been surviving with the condition for 30 years of her life.  She had tried most of the traditional treatments and nothing worked to alleviate the pain/discomfort that comes with this condition.  For those of you that live with Fibromyalgia, you know it is very debilitating at best.  It took away her ability to have the quality of life that she dreamed of, it stole from her the ability to share precious moments with her family, stopped her from enjoying shopping or having the capability to do a full shopping trip, much less enjoying a concert or any other function dealing with large groups of people, etc.  When she came to me her average “Pain Level” was 9/10 and her “Sleep Quality” was 9/10 [0 being the best and 10 being the worst].  At the end of the week she rated her “Pain Level” at 0/10 and her “Sleep Quality” at 1/10 [0 being the best and 10 being the worst].  She was at a ‘0’ (zero) in all of the areas in her body from her head to her toes for the first time in 30 years.  She had her life back, she had the ability to start to pick up the pieces and to do the things that she had wanted to do for so long and more!
     Fibromyalgia is a medical condition known for chronic pain throughout the body, accompanied by tenderness around the joints, muscles, tendons and soft tissues. This causes those who are suffering from fibromyalgia to constantly feel tired, with aching bodies and sore areas that become more painful from contact. This condition can lead to a whole host of physical ailments that can make it difficult for people to go about their daily routines. The chronic aches and pains along with other complications related to Fibromyalgia result in a very debilitating condition.
     Too many patients hear the words that there is no treatment that can help them, there is no cure, or there is no hope.  Yes, the reality is there is no “cure” at this time, but at the same time there are treatments available that are non-invasive and drug-free that can significantly decrease pain levels and for many patients even completely alleviate their pain.
     Hypnosis Combined Therapy has the ability to break the chronic pain loop using hypnosis/hypnotherapy, biofeedback, light/sound therapy, neuroplasticity training, cell memory and etc.  This is the protocol that was utilized with the Fibromyalgia patient that I referred to above.  Today, she is enjoying a new life, pain free.  She is a whole new person!  She is spending quality time with her family, going to family functions, traveling, going to concerts, shopping with ease and has the energy to complete her tasks without thinking about it.
     “I went through a week of treatment with Traci in August, 2014, after being close to disabled for many
years. The treatment worked wonders, partly because of the nature of the treatment, but also because of Traci’s customizing each client’s treatment to their own interests and goals. Now, I’m fully functional and making up for the years’ worth of that I’ve missed…” Colleen G.
     Here is a link to an audio file of when Colleen called into a radio show that my husband was hosting:
     If you or a loved one is living with Fibromyalgia or another chronic pain condition please take a moment to visit  our website or contact us for additional information.  This is not a one off success story.  We are seeing these types of results on a weekly basis with Fibromyalgia patients, CRPS/RSD, chronic migraines, PTSD, and other debilitating chronic pain conditions.
www.AdvancedPathways.com  |  Info@AdvancedPathways.com
Telephone:  714-717-6633

CRPS Treatment Options: Why aren’t physicians discussing all options with their patients?

ByTraci Patterson, CH, CI – CRPS Survivor and Owner of Advanced Pathways Hypnosis

Treatment for complex regional pain syndrome (CRPS) also known as reflex sympathetic dystrophy (RSD) must be individualized.  No one treatment will work for everyone.  That being said it is very important that patients have access to information on all treatment options available.

Treatment methods are continuously evolving as research and clinical practice provides new evidence and insights, but most physicians are not staying up to date on the latest treatment options. For example it was once thought that sympathetic nerve blocks were a diagnostic tool and a curative procedure. This has been disproven over time yet most Pain Management doctors are still performing them regularly on CRPS/RSD patients.

The majority of the physicians out there will want to start with anti-inflammatory medications (NSAIDS), pain medications, Physical Therapy/Occupational Therapy, local/regional blocks and then move on to sympathetic nerve blocks.   If there is no improvement with these modalities the next conversation will most likely be about having a Spinal Cord Stimulator implanted, or a pain pump that delivers morphine directly to the nerves affected in the spine.

What happens to the patient when they are told by their physician there is nothing more they can do?  Do you just continue on large quantities of pain medications and continue down the slippery slope?  Or do you fight to find something that will help, a treatment that can possibly put this awful condition into remission?

I have been on both sides of this.  I personally was diagnosed with a very aggressive, volatile case of CRPS.  Local and regional blocks did not work on me.  My Pain Management doctor was dumbfounded when this occurred.  Thus we moved onto lumbar sympathetic nerve blocks (LSB).  I had 13 LSB, until the last one caused my adrenal glands to completely shut down.  This landed me in the hospital for a week.  Following this my Pain Management doctor stated we could no longer do any LSB.  His next step was talking to me about having a Spinal Cord Stimulator (SCS) implanted.  I was against the idea and had a really bad gut feeling about it, but I was told this was the last option I had to reduce my pain.  I went through with the trial and it went well.  Approximately 6 months later I had a Medtronic SCS implanted.  I had nothing but issues with it.  Every time I charged the battery it caused my affected foot to swell.  They could not figure out why this was happening.  The next step was to have the battery replaced with a non-rechargeable battery.  I underwent the surgery to change out the batteries in hopes this would correct any issues.  Keep in mind that with each of these surgeries I had to be admitted to the hospital to control my pain, even though they were supposed to be an outpatient procedure.  Unfortunately, the second surgery to change the battery did not help.  I then started to have issues with the paddle that was implanted.  Long story short, they had to explant the Medtronic SCS and implanted a Boston Scientific SCS. It was during this time that my CRPS moved into my back!  I had asked my Neurosurgeon if this could happen and was assured it wouldn’t – it did happen after all…  I had this one for less than 6 months when I lost the ability to control the stimulation.  Upon further review of the situation and my symptoms it was determined that I had a buildup of scar tissue on my Dura which could cause paralysis if the SCS was not removed.  In Feb., 2011 the last SCS was ex planted from my spine.  At that point I was told by my Pain Management doctor, who is highly regarded, that there was nothing else he could do except to keep me on pain medication.  He was ultimately throwing his hands up in the air!  This did not set well with me.  I was dumbfounded that none of my doctors (Pain Management, Neuro Surgeon, Neurologist or GP) had anything more to offer me.  I had to research viable alternative treatment options on my own.

This is what the typical CRPS/RSD patient goes through once they receive their diagnosis.  Yet, the reality is there are other treatment options out there as I found out.  Treatment options that allowed me to get pain free and in remission.

The big question should be why physicians, hospitals and universities are not better informed about viable treatment options for CRPS/RSD, neuropathic pain and other chronic pain conditions, and what can be done to get the information out to the doctors that are treating us?

Some current treatment methods:

  • Antidepressants and anticonvulsants. Sometimes antidepressants, such as amitriptyline, and anticonvulsants, such as gabapentin (Gralise, Neurontin), are used to treat pain that originates from a damaged nerve (neuropathic pain).
  • Corticosteroids. Steroid medications, such as prednisone, may reduce inflammation and improve mobility in the affected limb.
  • Bone-loss medications. Your doctor may suggest medications to prevent or stall bone loss, such as alendronate (Fosamax) and calcitonin (Miacalcin).
  • Sympathetic nerve-blocking medication. Injection of an anesthetic to block pain fibers in your affected nerves may relieve pain in some people.
  • Intravenous ketamine. Studies show that low doses of intravenous ketamine, a strong anesthetic, may substantially alleviate pain. However, despite pain relief, there was no improvement in function.

Therapies

  • Applying heat and cold. Applying cold may relieve swelling and sweating. If the affected area is cool, applying heat may offer relief.
  • Topical analgesics. Various topical treatments are available that may reduce hypersensitivity, such as capsaicin cream (Capsin, Capsagel, Zostrix) or lidocaine patches (Lidoderm, others).
  • Physical therapy. Gentle, guided exercising of the affected limbs may help decrease pain and improve range of motion and strength. The earlier the disease is diagnosed, the more effective exercises may be.
  • Occupational therapy. Mirror box therapy, and desensitization of affected limbs. Assisting with activities of daily living, improving range of motion and strength.  The earlier this is utilized in the diagnosis, the more effective it is.
  • Transcutaneous electrical nerve stimulation (TENS). Chronic pain is sometimes eased by applying electrical impulses to nerve endings.
  • Biofeedback. In some cases, learning biofeedback techniques may help. In biofeedback, you learn to become more aware of your body so that you can relax your body and relieve pain.
  • Spinal cord stimulation. Your doctor inserts tiny electrodes along your spinal cord. A small electrical current delivered to the spinal cord results in pain relief. (Always do your research prior to moving forward with the implantation of a SCS or pain pump.)

Alternative/Complementary Therapies

  • Calmare therapy. Non-invasive, drug-free treatment option. Many time ‘boost treatments’ need to be completed to stay pain free with CRPS/RSD.
  • Clinical Hypnosis. Non-invasive, drug-free treatment option. The utilization of hypnosis and a multi-therapeutic approach is proving to be an effective treatment option for CRPS/RSD.  Those patients going through a ‘One Week Intensive’ have been able to significantly decrease their pain if not completely get into remission.  Working with someone well versed in chronic pain, pain management, biofeedback, neuroplasticity training, etc. will give CRPS or chronic pain patients the best outcomes.

Some Pain Management physicians that I have spoken to have stated that they are treating their patients in the manner that they were taught (i.e while in medical school and residency…).  The outline they verbally gave me pretty much mimicked how I was treated and how thousands of other patients are treated with CRPS/RSD.  The stark reality is that new treatment methods are continuously evolving as research and clinical practice provides new evidence and insights, but most physicians are so inundated with the number of patients that they have to see in a day, charting and regulations that it is extremely difficult to stay up to date on the latest treatment options.  This is not an excuse but reality.

If we stop to think about this it does make sense.  Pharmaceutical companies spend millions of dollars every year in an effort to ensure that their information and medications are in front of or in the hands of doctors.  Durable medical equipment (DME) companies do the same thing.  As a matter of fact they go as far as making sure their products and services are well known at the university levels too.  The bottom line is that updated information on alternative treatment options must be circulated back to those physicians and facilities that are treating patients with CRPS/RSD and any chronic pain condition (fibromyalgia, neuropathic pain, chronic migraines, etc.).

Living with complex regional pain syndrome (CRPS) or any type of chronic pain is challenging, especially if you don’t have a proper treatment plan or access to all your treatment options.  Share information with your treating physician from reliable sources and don’t be afraid to ask about alterative or complementary treatment options that may be available.

If you would like more information on CRPS/RSD, alternative/complementary treatment options, or the author – Traci Patterson please contact us at:

Info@AdvancedPathways.com  |  714-717-6633  |  http://www.AdvancedPathways.com

References

1.McMahon SB, et al. Wall and Melzack’s Textbook of Pain. 6th ed. Philadelphia, Pa.: Saunders Elsevier. 2013. https://www.clinicalkey.com.

2.Ferri FF. Ferri’s Clinical Advisor 2014: 5 Books in 1. Philadelphia, Pa.: Mosby Elsevier; 2014. https://www.clinicalkey.com.

3.Borchers AT, et al. Complex regional pain syndrome: A comprehensive and critical review. Autoimmunity Reviews. In press. Accessed

4.Abdi S. Etiology, clinical manifestations, and diagnosis of complex regional pain syndrome in adults. http://www.uptodate.com/home.

5.Complex regional pain syndrome fact sheet. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/reflex_sympathetic_dystrophy/detail_reflex_sympathetic_dystrophy.htm.

6.Abdi S. Prevention and management of complex regional pain syndrome in adults. http://www.uptodate.com/home.

7.Complex regional pain syndrome treatment page. RSDSA. http://rsda.org/treatment/

CRPS: Diagnosis and Prognosis

By: Traci Patterson, CH, CI and Owner, Advanced Pathways Hypnosis

As an individual that was diagnosed with CRPS (Complex Regional Pain Syndrome) I know there are a lot of questions about how patients are diagnosed and from there what is the prognosis for those patients.  I’ve put together some information to try to answer some questions that I’m asked quite often.

DIAGNOSIS

Currently there is no actual ‘one test’ that will give a definite positive diagnosis of Complex Regional Pain Syndrome (CRPS) aka Reflex Sympathetic Dystrophy (RSD).

Instead to receive a positive clinical diagnosis of CRPS/RSD, pain specialists and doctors use the current BUDAPEST CRITERIA 2004, which was brought out during the International Consensus Conference in 2004. This new diagnostic criteria takes over from the one from the International Association for the Study of Pain in 1994 (IASP 1994). The pain specialist or doctor will discuss with you your medical history, symptoms you may be having and any signs or changes. They also may do nerve conduction studies, EMG, MRI scan, x-rays, bones scans, and/or a thermal study.

If there is no known injury or illness that contributed to the problems then the doctors and specialists would carefully check to see if there is no other treatable condition that has been missed.

The BUDAPEST CRITERIA 2004 states that for there to be a clinical diagnosis of CRPS/ RSD certain criteria need to be reached.

These are:

  •  There needs to be lasting pain which is disproportionate to the initial injury or illness.
  • The patient also needs to be experiencing at least 3 out of 4 of certain categories listed below. If you are positive in any of these categories you need to tell the doctor / specialist that is treating you.

Specific Categories:

  1. SENSORY – This means that you describe symptoms of increased sensitivity or hypersensitivity on your limb
  1. VASOMOTOR– This is when you describe temperature differences in your limb and / or skin color changes and / or difference in your skin color between the limbs
  1. SUDOMOTOR / EDEMA – You describe edema and / or sweating changes and / or sweating asymmetry
  1. MOTOR / TROPHIC – Reports of decreased range of limb motion and / or abnormality of a muscle or nerve that effects or produces motion (including tremor, weakness, dystonia…) and / or trophic changes (includes changes in nails, hair, skin…)
  • You must ALSO show at least 1 sign observed by the doctor or specialist at your appointment, in 2 or more of the categories below:
  1. SENSORY– Evidence of hyperalgesia usually following a pinprick and / or allodynia (proof of pain to a light touch and / or deep somatic pressure and / or joint movement)
  1. VASOMOTOR – Proof of temperature change in 2 limbs or more and / or skin color changes
  1. SUDOMOTOR / EDEMA – Proof of swelling or edema and / or sweating changes and / or sweating asymmetry
  1. MOTOR / TROPHIC – Evidence of decreased range of motion and / or motor dysfunction (such as tremor, weakness, dystonia) and / or trophic changes (skin, hair, nails…)
  • If there is NO other diagnosis that could better explain the symptoms and signs observed during a physical examination, and you meet the above criteria then you will most likely be diagnosed with CRPS/RSD.

PROGNOSIS

If you receive early treatment following the injury or illness there is a little evidence or research to say that there is a fair chance of recovery or ‘remission’ as CRPS patients know it. It has not yet however been proven during clinical trials and studies concerning early treatment. However, the prognosis will be different for each sufferer as everyone is considered unique and their symptoms although they will have a common trait, will also vary.

Occasionally people are left with unrelenting, agonizing pain and irreparable changes regardless of what standard/traditional treatment is given to them.  I can’t stress enough, that more alternative and complementary treatment options need to be given to CRPS/RSD and chronic pain patients.  This is a starting point.  There are non-invasive treatment options currently available for CRPS patients at this time, but the hospitals and physicians are not utilizing them nor speaking to their patients about them.  Clinical/medical hypnosis/hypnotherapy has been shown to be effective in significantly reducing pain [I utilized clinical/medical hypnosis to get into remission, and I currently treat CRPS patients with clinical hypnosis and a multi-therapeutic approach to assist them in significantly reducing their pain and/or getting into remission.] and let’s not forget about Calmare Therapy.

More research is definitely require to help understand the actual causes of CRPS, how early treatment affects it, why it progresses in some people and not in others… The list is endless as to questions about CRPS – this needs to change.

In a recent study from 2014, Van Velzen, G.A.J. et al. (See below) concerning the quality of life, they concluded:

“We conclude that loss of QoL in CRPS patients is due mainly to reduced physical health. A comparison with data available from the literature shows that CRPS patients generally report poorer QoL than patients with other chronic pain conditions, particularly in the physical domains.”

(* QoL = Quality of Life)

Many children and teenagers who have been diagnosed tend to have a good recovery. According to Edward C.T.H. et al (See below for study details)

“The prognosis of childhood-onset CRPS I seems less favorable than usually reported, and is comparable to the prognosis of the adult-onset CRPS I in view of a decreased quality of life and a large relapse percentage (33%) at long-term follow-up.”

In another study by Finniss, D.G., et al. entitled ‘Complex Regional Pain Syndrome in children and adolescents’, (See below) it was said that:

“Early diagnosis, referral and appropriate intervention are essential in decreasing pain, suffering and resorting function for children and adolescents with CRPS.”

There is still more research to do to learn as much as we can about Complex Regional Pain Syndrome (CRPS) aka Reflex Sympathetic Dystrophy (RSD).  At this time there is no one specific test that can be done to diagnosis this condition.  The doctors and specialists are doing the best they can to confirm Complex Regional Pain Syndrome (CRPS) based upon the BUDAPEST CRITERIA 2004.  No, this is not perfect but it is aiding is the diagnosis and treatment of patients.

Research is slow when it comes to CRPS both in the US and in other countries.  There is some research that has shown that early diagnosis and early treatment will aid in the recovery and subsequent remission, but no clinical trials / studies have been completed to prove this.

I have personally experienced, treated and seen patients that have had CRPS from 1 years to 10+ years get into remission utilizing different non-invasive treatment options including clinical hypnosis.  We have to have studies done on all types of treatments, all stages of CRPS patients undergoing treatment and the efficacy of the treatments.  I think that the outcomes would be eye opening when it came to the money spent on Spinal Cord Stimulators and some of the other traditional treatments vs integrative and complementary treatments.

It seems that there is insufficient evidence in many areas of the condition that are unknown or understood by the health profession on a worldwide basis. This is something that has to change in order to increase the outcomes for CRPS patients.  That is the exact reason why Advanced Pathways Hypnosis is taking the steps to initiate data collection and a clinical study on the outcome of, “Clinical Hypnosis Utilizing a Multi-Therapeutic Approach with CRPS Patients”.  Please keep your eyes open in the near future for further information.

REFERRED TO RESEARCH / STUDIES / TRIALS