Rachel Richards

licensed massage therapist

east village, nyc

News: May 2016

A painful article on pain

A recent New York Times health article propelled me to express my concerns in this newsletter. The article is titled "The Pain Puzzle," and it was written by Abigail Zuger, M.D., a physician and infectious disease specialist. In the column, she describes her chronic elbow pain that began a few years ago when she developed tennis elbow from the repetitive motions of painting furniture. She uses phrases like "My elbow is killing me, and "I am ruled by my elbow." Zuger describes how her elbow pain has destroyed the happy, balanced, and efficient individual she once was. She sympathizes with her patients who come to her looking for prescription drugs that will relive their pain, and she relays her dilemma of knowing that opioids can do the trick, but that she is obligated to limit such prescriptions. I assume this is because opioids are very strong, addictive, and potentially harmful medications. Zuger herself abstains from taking opioids, but admits that, "...the hands-down single best treatment for my elbow is a drink."

It is apparent from reading this article that Zuger's main objective is eradicating pain and believes strong prescription medication is the only solution. "Anti-inflammatories ... might as well be cornflakes," Zuger writes. She also states, "Nonpharmaceutical approaches to pain treatment (Exercise! Stretch! Be mindful!) generally just don't fly." As evidenced by the title of the article, Zuger views pain as a puzzle, and is trying to find the missing piece.

I strongly disagree with Zuger on two main points. First, the key to alleviating pain in the long term is addressing the cause of the pain. For example, imagine you develop tendinosis in your shoulder. You will likely have pain, especially with specific shoulder movements that place stress on the injured tissues. One way to handle the pain is to drink alcohol or take drugs on a regular basis, both of which can have devastating long-term effects. Another option is to treat the soft tissue injury directly, improve your alignment, and develop new movement patterns to ensure the injury will not be repeated. This is accomplished by working with health care practitioners that specialize in treating the whole body, like massage therapists and physical therapists. This avenue of treatment not only eliminates pain, but also boosts your overall health by improving skeletal alignment, raising body awareness, enhancing immune system function, improving circulation, increasing flexibility, reducing stress, and improving mood, to name a few. I'm going with option two.

My other concern with the article has to do with the Zuger's description of pain as a puzzle. Pain is not a puzzle. It is, in fact, a mystery. Douglas Nelson, author of The Mystery of Pain, explains it well: "In a puzzle, you are missing something: once you locate the missing piece, the puzzle is solved. In a mystery, everything necessary to solve the problem is in front of you, it just takes a deeper understanding to come to resolution." Pain can be extremely complex, and as such, there is no one remedy that can solve the problem. Rather, many different factors can affect pain levels. Some examples are diet, exercise, sleep, hydration, stress levels, attitude, and regular visits with bodywork professionals. It is unlikely that any one of these factors will have a significant effect on pain, but the collective results can be life-changing.

Let us not be like Zuger, a self-perceived victim dominated by her elbow pain and endlessly searching for the magic cure, the missing piece to her puzzle. Let us instead acknowledge the mystery of pain, educate ourselves as to its causes, and address it with bodywork and various lifestyle changes. Don't become disillusioned by sitting with your pain and waiting for a cure to come to you. Realize that you have the power to make changes that will improve your pain and overall health. Start today!

Abigail Zuger, M.D., "Hard Cases: The Pain Puzzle," New York Times, April 12, 2016
Douglas Nelson, LMT, "The Mystery of Pain," Massage Magazine, April 2016

Make your mornings pain-free!

Do you have stiffness, aches, or pains when getting up in the morning? Learn how to sleep in a position that is comfortable and reduces stress on your body, so you can wake up pain-free. I will also show you the secret to avoiding pain and spasms when getting out of bed. Learn the best sleep position and how to get out of bed:


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