APS Therapy for chronic pain

As far as I’m concerned APS Therapy (Action Potential Simulation) stands for Amazing Pain Solutions! A local GP recommended I investigate this therapy in late 1999 when I was going through a particularly intense period of pain. I trialled the electrotherapy device and decided to buy a unit for treating myself. Painmasters were not available at this time. Little did I realise that APS Therapy is a microcurrent therapy which is the type of current used in Painmasters. APS Therapy is not identical with the Painmaster as Painmaster patches need to be worn continuously whereas the electrodes for APS Therapy are applied for 32 minutes at the maximum each day. But APS Therapy has been instrumental in giving me wonderful pain relief in a couple of situations where Painmasters were not helpful enough.

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APS Therapy Unit Model MK 1.1 Purchased from APS Therapy Queensland.

For instance in late 2011, pain started to run down my right arm. At night the pain would wake me up. I eventually realised that my arm had been moving in a repetitive action as I used a small scythe to cut back long grass over large areas of our acreage. So I decided to switch to my left arm for this task but after a while that arm also started to become painful. And then everyday activities started to inflame the arms – just lifting dishes up out of the dishwasher, pulling watering hoses along the ground, opening or closing sliding glass doors, lifting shopping bags. At the time I was already on medication to calm down the nervous system as well as anti-inflammatory medication – however it was insufficient for preventing the pain which was now coursing down both arms.

So next I tried to rubbing Dencorub into my lower arms and around the elbows. As I did this I could distinguish large painful lumps and strings of nodules and various sore points. I stopped using any weights when I did arm exercises and changed to gentle arm stretches, I stopped all gardening, I stopped playing the piano, I stopped spending much time on the computer keyboard, I stopped loading and lifting shopping bags … and then one evening I went walking and was really swinging my arms vigorously to see if that would help but all I did was re-ignite the pain so that it kept me awake during the night.

At this point I started to go each week for a session of electroacupuncture. I noticed how and where the acupuncturist put the needles on both of my arms. At the end of each treatment the pain was significantly less however by about another 24 hours the pain was returning in full. It would be too expensive to go any more regularly to the acupuncturist but I realised that if I could get the same delivery of this treatment every day then my arms would have a chance of recovering. However I was not going to use 4 Painmasters, 2 on each arm, for reasons of cost and because I would need to wear them full-time and would need to bandage the ones around my elbows to prevent them lifting off.

So I pulled out the APS Therapy Unit. Each day I would apply the electrodes in specific points along each arm and I would do 16 mins on one arm and then 16 mins on the other – from the top of the arm to a site above the elbow, and from below the elbow to above the wrist. I would turn up the Treatment Level dial on the unit until it felt like the arm was tingling or buzzing and then I would lower the current down again, just below that tingling point, and keep it at that level. By doing this every day for a number of months, the pain gradually diminished and my arms ceased to be sensitive when doing the ordinary household tasks. However I have not allowed myself to go back to using the scythe in the manner I once did. I only ever use it briefly.

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The good thing about the unit is that it comes with an instruction booklet that gives guidelines about where to place the electrodes according to the type and site of the pain. If one needs more instructions on alternative sites for the electrodes one can visit impulse.apstherapy.com and click on the Contents. It is not as difficult to determine where to place the electrodes as it is to decide about the placement of Painmaster patches. It seems that it is possible to use the APS Therapy electrodes in quadrants … by this I mean that if my buttock is inflamed then I can place the electrodes roughly in a square at each corner of the buttock or the area bounded by the shoulder and waist. So it eliminates the problem of trying to find an exact location as is needed with Painmaster patches. Everything inside the 4 corners will be treated.

Elecrodes for APS

Of course there is the initial outlay of a lot of money to buy the APS Therapy unit. I paid A$2080 for the APS Therapy unit (model MK 1.1) in February 2000. And the electrodes (PALS Platinum Blue which are fairly pricey but necessary as other electrodes do not transmit in the same way) need replacing regularly as well as 4 x C batteries (the new Model MK 1.4 uses one 9V battery.) Very occasionally one may need to buy replacement cords. The life of the electrodes can be extended by putting a fine layer of water on the electrode surface before adhering it to the plastic sheet after every session. For the first 3 or 4 times the electrodes are fully hydrated and do not need this. But from then on I dampen each electrode carefully before I place it back on the plastic. I take the further measure of putting the 2 lots of electrodes back into the snaplock storage bag at the end of each session. Also the manufacturers recommend drinking at least 2 large glasses of water to flush out toxins after each session.

This brings me to another example of how APS Therapy has been more helpful than Painmasters. I get into more difficulty going on a holiday than most other times because I have created an optimal zone with specific seating and bedding in my own car and at home. Take me out of this zone and the pain flares up! So I decided to purchase the other lightweight model so that I could travel with less pain. This model is the APS MK 4, which cost me A$1960 in Dec 2013 from apstherapy.co.nz plus Customs Duty – as APS Therapy Queensland was no longer in business. There is a slight difference between my APS MK1.1 and APS MK4 – I need to watch that the treatment level does not continue to creep up after I have set the dial on the MK4 and changing the MK4 battery is fiddley as it is an awkward place. The APS MK1.1 also has a timer dial with settings of 4 mins, 8 mins, 16 mins.

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APS Therapy Model MK4 with lightweight carry case

I realise the APS Therapy unit is expensive and I would only recommend it to people who have chronic pain in multiple areas (See My Disclaimer) as it would be wiser to start with buying a Painmaster. Chronic pain sufferers would understandably want to trial the APS unit first and that may not always be possible.

After months of using the APS Unit I have made several important discoveries for treating myself

  • the lower the treatment level when the tingling in the body starts, the more substantial the pain condition in that site
  • it is better to keep the treatment level lower and extend the length of the session in that site than to turn the treatment level up
  • if the pain in one site has become extremely strong then I shift the electrodes around in one general area to get maximum pain relief e.g. first I might put the electrodes in a quadrant on the buttock with the black electrodes at the top and the red electrodes below near the top of the legs (for 8 mins), secondly I might do a quadrant on the lower back with the black electrodes on the left and the red on the right (for 8 mins), thirdly I might do the hips in 1 or 2 ways  as shown here from the booklet(for 8 mins), and fourthly I might do the first step again if that was the position where the treatment dial could only be turned up a small amount before reaching the tingling point (for the final 8 mins)

    From the User Manual p 32

    Examples of 2 ways of treating hip from the User Manual p 32

The one drawback for me with APS Therapy is that if e.g. I have strong pain in my buttock and I treat it in the method I described above, I then cannot go and do a lot of sitting as that will gradually undo the benefit of the treatment. (This highlights the marvellous capacity of the Painmaster to allow me to sit in a chair that would otherwise activate the pain.) It partly explains why I fell away from using the APS Therapy for a long time. I also did not benefit as much when I was first learning how to treat myself as I did not understand how crucial it was for the electrodes to be hydrated. And the other thing I have discovered is that the general rule of of starting most sessions by treating the spinal column first for 8 mins or more is wasted time in my case, time that would be better spent on the actual site of the pain.

So APS Therapy has given me wonderful peace of mind that at the end of the day I have the power to bring down the level of pain wherever I might be experiencing it, so that I can get a reasonable sleep. In general I use the Painmasters for lower back/buttock pain and APS Therapy on other sites – I still need to use specific medication for headaches. I can sometimes go without using APS Therapy for a number of months until pain re-asserts itself in some part of my body (besides my buttocks or head). But I can easily understand why this microcurrent therapy won a Gold Medal in 1998 for best medical invention at the International Invention Show in Geneva, Switzerland. How I wish the efficacy of microcurrent to treat pain would get the recognition it deserves throughout the medical profession!

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The portable lightweight MK4 (right) compared to the MK1.1(left)

 

 

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Mastering pain (part 2)

I have become so confident about the effectiveness of the Painmaster™unit that if I am not experiencing great pain relief then I know that it must be because I need to find a different place to put the electrodes (patches). For years I had constant pain in one site on my right buttock with pain extending from there down the right leg into the foot. So originally I could put the Painmaster on the same spots. I used a permanent pen to mark the spots until they were indelibly printed on my mind. (Refer to Mastering pain -part 1)

original position of small round electrodes

   

Nowadays it’s a much more complex issue as the pain has moved and keeps moving to involve other nerves and muscles. Different activities will cause certain areas to become inflamed, e.g., when I garden and do a lot of bending or when I sit too long at the computer. Going on holidays can become a nightmare because I’m sitting in all kinds of chairs which have varying degrees of softness/hardness and have varying angles for the fulcrum between my lower back/pelvis and my legs.The pain can completely flip over to the left side too.

The distributor for Painmaster in Australia and New Zealand has recently produced some great videos that show the versatility of the unit, for instance this video shows how hip pain can involve different areas and how one can move the patches to get the best relief for an individual’s specific hip pain. I want to share with you some of the different places where I put the patches when the pain moves but is still within the buttock and lower back region. I hope this encourages you to experiment with the Painmaster if you are not getting satisfactory results.

position 1
            position 3

position 2

The dominant images (below) from the Painmaster brochure and packaging shows 2 patches either side of the spine.It is probably the best position for treating pain which emanates from the vertebrae, a common place of damage and pain.

across spine   vertebrae pain          cropped image on Painmaster box

Another video produced by Painmaster Australia New Zealand shows the general principle for treating back pain. It also describes my preferred way of getting pain relief. I put one electrode on one side of the spine and the other electrode on the opposite side of the spine. In this way if I am getting a lot of pain around the spine I can calm the nerves and muscles separately on each side of the spine.

2 patches

This is also the set-up I use with 2 Painmasters when I am going to travel long distances on a plane whether the pain is already strong or not. (Painmaster recommends not using more than 4 units at a time.) It seems that my sacrum becomes jammed when I sit for hours in the same seat. I visualise the sacroiliac joints and position the patches close by and then determine where to put the connecting patches to the most painful spot on each of the buttocks. If the pain shifts slightly I can move the patches around until I can sense that the pain is diminishing.

sacroiliac joints

Keeping 2 electrodes over the left and right sacroiliac joints whilst varying the position of the connecting electrodes

electrode above waist

 

For good measure I include this diagram of putting one of the electrodes above the waist. I realised that the muscle running parallel to the spine was tight and painful when a very good massage therapist showed me its link with the strong pain I was experiencing in the top of my buttock.

 

Painmaster Australia New Zealand also provides a great video for placement of patches for lower back pain which might be more helpful than my explanation.

So if you are not experiencing good pain relief using a Painmaster …

  • even though you have read the brochure provided with the product,
  • even if you have looked at all the information and videos on the Painmaster website,
  • even if you have rung the help line – Call Us To Talk To An Expert –                          (in Australia) on 1300 558 252 

                          …  then don’t be afraid to experiment.

electrodes on two most painful points

 

 

 

 

 

 

put electrode where it really hurts

 

 

 

 

Of course I understand that feeling of anxiety about finding the optimum site for the electrodes as soon as possible. I can still get in a terrible mess with lower back pain, especially when I go on a holiday. I might try all the usual places trying to bring the pain level down but still be unable to make any significant impact. I prod all over the the soft and bony parts of the buttock trying to determine the worst places. Sometimes the pain needs to get very strong so that I can’t miss the chief offending spot and at last can set about obtaining pain relief.

I have never encountered another product that takes away the pain while one is actually engaged in the activity or position that is normally guaranteed to escalate the pain. So of course I am an absolute fan of the Painmaster!

But I do acknowledge that not everyone will get the pain relief from a Painmaster that they so desperately desire so I mention my Disclaimer again. I have not yet been able to find a way of using the Painmaster that makes a significant difference to the headaches I get, even though I know they are stemming from my shoulder and neck.(P.S. Don’t put Painmasters on your head! Or the front of the throat where the pulse can be felt!)

However I can assure you that I have found a couple of other ways to significantly alleviate chronic pain which may  help you. So this is not the end of my story …

Ignoring the pain

Recently an old friend came for morning tea and a chat. We talked about how it is possible to rise above pain if a person becomes engaged with something meaningful or creative. For some, a relationship lifts their thoughts above the pain, for others a connection with nature will surpass their awareness of pain in the body, while others are able to enter a world of creativity that blankets the world of pain. On a TV program I saw how scientists were interested in providing patients (suffering pain) with headsets and screens which enabled the patients to enter a digital fantasy world pursuing a goal through a series of challenges. The patients became so focused, so intent on the quest that they were able to forget the pain for a period of time.

I suppose the chief method for ignoring pain that I have employed over the years is reading. I love to immerse myself in a well-written true story which can temporarily give my mind rest from the insistent pain. Actually I have developed lots of techniques over the years – playing sudoku, listening to music, going for a walk, planning a speech, preparing an English lesson  – and you could probably compile a different list of your own favourite methods.

If I feel absolutely hemmed in with no ideas on how to ignore the pain I often go back to a phrase – ‘this too will pass.’ Time and again I have experienced the passing away of pain so this phrase is a very powerful reminder to me. I can tell myself to be calm as sooner or later I will find a way to lower the pain I am experiencing in a particular part of my body. It may take me months to achieve but I have had this happen in the past and I can find the way to make it happen again. For instance I remember a specific time when I was at my wit’s end:

  • In 1997 I had to stop writing as the pain in my writing hand was too intense. It was so bad that when it was absolutely necessary to sign my name I didn’t use my first name in full but reduced it to an initial plus the surname. I  found it difficult to sleep at night with the ache in my arm and so I developed a position of keeping that arm extended over my head and pillow all night which seemed to lessen the painful sensations. I decided I would keep writing with the other hand. I was never overly proficient with the other arm and gradually I felt that my right arm was also beginning to get a bad feeling so I stopped altogether. I could no longer play the piano. I still have diaries to remind me of that period of time – maybe 5 years all up. I found I needed to continue to make large arm movements (and overarm swimming was perfect) but I couldn’t hold my arms still, such as driving for long distances with both arms on the driving wheel, or lying flat on my back holding a book above my eyes to read. I could lift shopping bags but I couldn’t hold my arms still and carry the bags to the car  without aggravating the pain.
  • Eventually by paying attention to what worked and what didn’t and by not writing at all I managed to tone down the pain and these days I can write and play the piano but I only do these for short periods because I have a sense that within my arms there is a latent capacity for pain that could be re-activated if I do too much. When I feel tingles down the arm or a tightness or ache in individual fingers it is a reminder for me to pull back from whatever activity  is stirring up the sensation. It’s as if the body has a memory of pain in a certain place and it’s necessary to help the body forget the pain in order to recover.
irregular writing from holiday diary

irregular writing in a holiday diary

Ignoring the pain is different to thinking that if we (those of us who suffer chronic pain) take our attention away from the pain that the pain will actually improve. Our state of mind may improve if we ignore the pain but the pain runs its own course. I was dismayed when a doctor applauded me for going back to study as he felt that would take my mind off the pain and might even take the pain away!

We can deliberately ignore the pain for a certain period if we need to but there can come a time when the pain is too strong to be able to ignore. This is a time when it’s stupid to ignore the pain because it will increase if we don’t attend to it. My contention is that the sooner we register low levels of pain the better we will be able to redress it and stop it developing into a major episode. For example, the longer I am engrossed with designing something on the computer the more pain I will suffer in the shoulder/ neck/ head area the following day or longer – and not because I haven’t made all the ergonomic adjustments for working at the computer. But sometimes I choose to do this as I think something is very satisfying and worth the pain. Another example is the enjoyment I get from gardening – gardening sustains me more than it drains me and I find it hard to stop. Sometimes I misjudge whether it will only result in short term painful consequences or whether I have really stirred up extremely difficult shoulder pain again. Then I really regret that I didn’t stop the weeding earlier!

There are some people who might accuse us by saying,’You just need to relax!’ They imply that we have caused the chronic nature of the pain by being a very stressed, tense or anxious person. I think to myself, ‘I’d like to see you stay relaxed if you had this level of long-term pain. I too was a carefree person once!’ But it is true that becoming mentally tense can increase muscle tension which exacerbates the pain in the body – and that’s why we need to find out the kind of things that keep our own minds peaceful. The thing that can really tax my mind is that I go back over the day’s events trying to isolate what may have triggered more pain than I was expecting. Some days there just doesn’t seem to be any good reason.

So let’s ignore the simplistic advice about how better posture, a certain vitamin, a particular manual therapy, a new type of exercise etc. etc. will be the answer to our problem. Some people can even imply that we haven’t tried hard enough. I bite my tongue when really I feel like answering,  ‘Don’t you think I’ve tried all of that and more. If it was just that simple I would have recovered years ago!’

one way to soothe my shattered equilibrium

one way to soothe my shattered equilibrium

When I have done everything I know to keep the pain as low as I can and I still end up in a mess then I ignore thoughts of despair. I remind myself that I am still actually handling the pain, that it hasn’t overwhelmed me yet. I keep alive the thought that I will find a way to reduce that pain again. I calm myself with a nice cup of tea and I let myself switch off by reading a book. Or I allow myself to think of one step I can take next, one thing I can do to to feel I have re-gained control of what is happening – such as  ‘I’ll go swimming tomorrow’ or ‘I’ll switch the electrodes to another site.’ This way I manage to ignore fear and to keep hopeful that however bad it is at the moment another day will come when I will be so glad to be alive. And those days will be many.

Pain relief from manual therapy

Manual Therapists [physiotherapists, chiropractors, osteopaths, massage therapists, acupuncturists]  are genuinely intent on patients experiencing pain relief.  But patients with long-term pain need to realise that therapists can only relieve the pain – they cannot diagnose, fix or cure the whole chronic pain condition!

Therapists ask for and listen carefully to the current symptoms. They differ from most doctors in that they locate the area where the pain is stemming from and they work on the problem with their hands according to their specific discipline. It can really surprise me to find out that the source of my problem is in another part of my body. I often take a permanent marker and get them to mark crosses on my back so that when I get home I can see in the mirror where the offending sites are. Therapists also give valuable recommendations for managing the recovery from a painful episode – certain types of exercise, avoidance of certain activities, applying ice etc. Now that I have a proven way of treating pain with microcurrent therapy I still learn so much from them about the optimal site to place electrodes. This helps me to follow through on the pain relief I gain from an appointment. I highly recommend going to a therapist in times of dreadful pain as the information they supply will help you to manage your pain as much as the treatment they give.

I turned to a chiropractor in 1988 after my GP could not determine what was the matter with me and could only recommend paracetemol which seemed completely ineffective in diminishing the pain. At the time if felt like my right buttock and leg were on fire. In fact chiropractic treatment was the only thing that afforded me pain relief – not massage, not exercise, not tablets, not rest, not physiotherapy. It took years before it became clear that there was an underlying systemic condition and not just unrelated parts of my body breaking down. No wonder therapists would suggest conditions or injuries as they worked piecemeal on my body : whiplash, RSI, piriformis syndrome, sprained ankle, sciatica, stress, all-over muscle tightness, a very tight iliopsoas, tennis elbow and candida. This of course would lead to admonitions about having the correct posture, becoming more relaxed, changing my whole lifestyle, building core body strength, undergoing a course of dry needling, trigger point therapy or direct myofascial release, doing a detox, changing my diet, taking supplements, stretching and lengthening various muscles. I did all of this and more!

I should just say here that different therapists may describe my symptoms differently. Whereas the chiropractor may refer to the L5S1 joint, the physiotherapist will talk about the hip flexor muscle and pelvic girdle and the massage therapist might notice that the gluteus maximus is tight and another might talk about the need to strengthen weak abdominal muscles. I can always look up these terms under ‘Images’ on the internet to get a clearer idea when I get home from an appointment.

Appointments with therapists take time and money, and there can be one massage therapist, for instance, who really helps and another  who is useless. It will be a matter of trial and error. And money. There are additional things therapists may recommend such as taping a part of the body to immobilise it (absolutely the wrong thing for me!) or buying a foam roller (agony for my iliotibial band!) or a special BakBall (2 joined balls) to undo the nerve tension in my spine (too severe!). More money, appointments and frustration.

Examples of therapeutic aids that are ineffective for my condition

Examples of therapeutic aids that were ineffective for me

Here are some other things I spent my money on to no avail:

  • I really couldn’t tell if the Piezo  (needle-less acupuncture device) had any benefit.
  • Dry needling seemed to do nothing.
  • Cupping might have been slightly beneficial but I now steer away from glass fire cupping since I once got burnt – this meant I could not apply the electrodes to that area until the skin healed.
  • Ultrasound seemed to inflame the area and it took ages for the inflammation to subside.
  • Various back supports seemed to push into my spine at the wrong site and accentuate the pain.
  • Cranial osteopathy resulted in severe headaches.
  • Some acupuncture worked slightly and some was too strong and brought on headaches. A ‘course’ of acupuncture seemed to deliver pain relief in the lower half of my body but after I stopped treatment the pain simply regrouped and manifested itself with the same intensity. If I was able to have acupuncture every single day then perhaps …

Some things were worth the money:

  • I bought the Trigger Point Therapy Workbook to understand where pain might be radiating from.
  • A handheld Squirrel Massager for tight and aching muscles has been beneficial.
  • A new kind of tape – Kinesiology tape – which supports the problem area but does not restrict it.
Trigger Pont book and Squirrel Massager were beneficial

Trigger Pont book and Squirrel Massager are helpful for me

When I was still extremely confused about all the pain I was experiencing it was a physiotherapist who suggested that it was not normal for me to have such strong pain for the type of muscle tightness and joint restriction that kept recurring. I got a referral to a Pain Clinic in Auckland and this lead to an initial diagnosis of fibromyalgia. I now have doubts about this diagnosis but it was a help for me to understand that there was ONE actual syndrome to explain all the diverse ailments I was suffering.

In earlier years I would often feel frustrated and disappointed after a physical therapy treatment – either it stirred up the pain or it did not do enough to alter the pain. Now I have different and more reasonable expectations. Why should I expect therapists to make me better when doctors have not been able to? I have come to realise that I must not expect solutions to the pain but that I will probably get some pain relief which will gradually help me to pull out of a very strong episode of pain.

And nowadays I don’t enrol therapists in a detailed history of my chronic pain. I am the person who is most able to manage the different areas of my body that are involved.  I limit myself to the particular site that is giving me the most pain. I get as much information as I can from the therapist and then I go home and experiment with the Painmaster patches until I find the optimal site that will bring the maximum pain relief. See an earlier post on Mastering Pain.

Painmaster

Painmaster

You can also refer back to the Number 1 Principle For Reducing Pain which supports manual therapy if it brings you pain relief. Constant pain is the driver of chronic pain so if you can find any way to reduce pain by a therapist’s treatment then you are allowing your nervous system time to rest. It’s such a blessing to find a good therapist!

The most difficult thing about chronic pain

I found the most difficult thing about chronic pain was that it turned me into something I didn’t want to be. Perhaps my personality type would always have meant that I was going to be super-organised and highly motivated but chronic pain resulted in me becoming very tense and angry as I attempted to control factors that I thought would minimise the pain. I lashed out at those I loved most and this only made me feel guilty that I was not the mother and wife I had dreamed I would be. This grew into a deep sadness about myself. As time went on and the pain only grew worse I felt trapped as all my efforts to overcome it were useless and the medical profession seemed to be at a loss to help me.

When I look back at myself now I am amazed that I managed to do as well as I did. I know that inwardly I was putting my children’s and husband’s needs before my own while all the time I was longing for someone to come and nurse me. Perhaps the pressure to keep caring for my family kept me grounded. I simply did not have the choice to cave in to sorrow. And anyway I did so love them! I did so want to care for them!

Certainly by the time I presented at the first Pain Clinic – after about 18 years of increasing pain – I think was showing the psychological strain of trying to rise above my condition. I was confused about what was wrong with me and I seemed to be hovering perpetually on the edge of break-down.

stretched to breaking point

stretched to breaking point

 

Recently I watched a program called *The Secret World of Pain, a documentary produced in 2011 by the BBC program ‘Horizon’. The thing that most stood out for me were the last 2 pain sufferers. One was crying almost continuously, as if begging for pain relief. The other was holding back a lake of tears but when she experienced pain relief she opened the gates little by little so tears could flow.

In an instant I recognised myself and what can happen to humans who are subjected to relentless pain from which their minds are unable to rest. When you are the person in pain it feels as if you are being heroic by not crying too much and yet the tears you do release seem to be too much for others to cope with. I’m not talking about feeling emotional after only several months of pain – in 1989 when one side of my lower back and leg first became inflamed I was the very picture of optimism. I soldiered on with 5 young children, a husband whose work was demanding and a faith that God would help me sort it out.

But when the pain has gone on for ages, when the pain is often strong and causes sleep deprivation, when no treatment seems to alleviate it and others have exhausted their efforts to help THEN it is extremely difficult to maintain emotional equilibrium. I have cried in all manner of ways– sobbing quietly on my own, hysterical crying, a few tears filling the eyes or sliding down the cheeks, crying in the morning, crying in the evening, crying at anytime – even in cafes because I’ve been beyond caring how I look or how it makes others feel.

And then I stopped crying (well almost)! Because it didn’t change the pain. And sometimes it even made the headaches a lot worse. Also, why cry, when the people who love you can’t do anything more to help. It seems better to spare them some of the agony. But at the back of my throat there was a hurting sensation as if I was holding back a river of tears.

I didn’t want to have the pain but I didn’t have a choice. I simply had to learn how to be a loving person as well as carrying the pain at the same time. My secret is that God kept speaking to me as I would read the Bible in the mornings – somehow I was able to draw strength through spending time with him as my friend. It wasn’t that he spoke to me a lot about dealing with the pain, rather that he was able to concentrate my mind and energy on other thoughts, hopes and plans. I still felt like I was pleasing him and this gave my life such meaning and purpose. And by daily experiencing his close presence it didn’t feel as if I was alone while in pain or that he didn’t care about the pain.

Nowadays he has given me so much to alleviate my pain that I can never be grateful enough. And I haven’t lost the love of my family as I have seen happen tragically to others when they have been overtaken by the misery of constant pain.

There is a time to cry and a time to refrain from crying. There is a time to push through for medical help and a time to wait. But there is always a time for meeting with God. And God will give me what I need today to deal with this day.

Two pale-headed rosellas enjoying the blue berries on a dianella.

2 pale-eahed rosellas enjoying the blue berries on a dianella

Look at the birds … your Father in heaven feeds them day by day (Matthew 6:26)

 

*  The Secret World Of Pain, a BBC documentary which can be watched at

https://www.youtube.com/watch?v=75wkm9NTOb8

 

Microcurrent units

If you have discovered that Painmasters deliver the pain relief you need you might like to consider a more permanent form of microcurrent therapy. Here are 4 units I have some experience with: Micro 300, Micro 400, Micro 850 and MicroPlus.

different microcurrent units

different microcurrent units

In 2004 I went back studying after a very long break. I had no means of pain relief other than exercise and low-level medication. The few years in Auckland when I was able to purchase a continual supply of Painmasters had long faded away. I realised that attempting the course might bring about a nightmare of pain (mostly from the need to sit at computers) and so I went to the internet and typed in ‘micro current’ in the wild hope that there might be something out there that mimicked a Painmaster.

I was thrilled to discover on http://www.medcareservice.com a device called a Micro 300. This website no longer leads to the page on the Micro 300  device but the same unit can be seen at

http://www.3dhealthstore.com/micro-current-300.html

It was going to cost me more than $100 as well as postage from the U.S. It was a big event 10 years ago to order something online and arrange payment for it while living a whole ocean away from the source. I don’t know how many times I read and reread all the information on the site before I took the plunge – a plausible explanation was given on the website as to how microcurrent could address pain. When the case arrived I was nervous all over again in considering how to adjust the settings to achieve something similar to the Painmaster device. After reading the Micro 300 booklet I chose some settings and switched it on. After only a couple of days of experimenting I found the optimal settings and I was in business! All the different seats in lecture halls, tutorial rooms, library and cafeteria as well as computer chairs no longer seemed an insurmountable problem.

trying to make sense of technical specifications

wondering which technical specifications would match a Painmaster

When you remove the settings cover there are a number of choices to make. I can recommend the following selection however you could track some different settings to come to the optimal solution for your own pain condition. Just note that the MicroPlus has a second dial on the outer surface which I generally set in the range of 0.5 to 1.3 ( the lower end of the spectrum).

different settings to suit chronic pain

examples of settings that suit chronic pain

The Micro 300 model has now been replaced by the Micro 400 model. However Medcare Service no longer sells those models or posts to Australia. This forced me to search again and I found Llhasa OMS, a company which has always provided a very good service and you can arrange by email to have the unit posted to Australia. The units themselves come in hard black cases and mostly seem to be made in Taiwan even though they are sold globally. The case also comes with a battery and lead wires  as well as electrodes – I have not found these electrodes to be very durable. All the units have a small flashing light to show the battery is working.

The one which has become my main backstop is the Biomedical Life Systems Micro Plus which I have ordered from Allegro Medical – https://www.allegromedical.com– in the electrotherapy menu. I emailed them and they arranged to post it economically to Australia using DHL.

Lhasa OMS offers the Micro 850 (http://www.lhasaoms.com/Microcurrent-Units.html) at a very reasonable price. In many years of ordering I have only hit one snag  because there are 2 different models of the Micro 850, one offering a 10, 20, 40 minute length of current, another one providing a C(Continuous) 20, 40. The timer needs to be Continuous to address chronic pain so check this out when you email your order.

chronic pain requires the C (Continuous) setting on the Timer

chronic pain requires the C (Continuous) setting on the Timer

Of course whichever microcurrent unit you purchase there are still going to be occasional dramas and costs. You will regularly need to purchase new electrodes and lead wires as well as 9V batteries. You can try buying a recharger for a rechargeable 9V battery but I found that they never lasted more than 12 hours which was too troublesome. Eventually any microcurrent unit will expire after a few years of continuous use. The hard plastic cover for the settings and battery may also fall off.  Not to mention dropping the whole unit onto concrete floors! As a woman, I found I needed to dress in skirts or pants which ideally had a pocket so that the unit could rest in the pocket while the lead wires were threaded under the clothing. Although a microcurrent unit is a health device I always feel it is better to remove it before passing though airport screening and then reapply it before boarding. I just don’t want to make public explanations as to why I’m wearing something that looks like I’m wired to explode.

Purchasing the accessories can be time-consuming but here are a few tips for electrodes and leads if you don’t want to order them from overseas.

Alpha First Aid – in booths at Westfield shopping centres – sell the most common lead wire which fits into the Micro 400 and Micro 850

http://physioworks.com.au/online-store – under TENS Machines – sells electrodes.

http://whiteleyallcare.com.au sell PALS Valutrode Electrodes as well as less expensive AllCare Electrodes as well as the Lead for Allcare TENS (Product Code: ACTENLEADMK5) which is compatible with the Micro 400 and the Micro 850. The way to order to order these products is via www.myphysioshop.com.au.

By searching for a good price I have most recently ordered replacement electrodes from OPTOMO at https://www.optomo.com.au/category/tens-machines/

At the moment I have put the units into a cupboard and am enjoying the freedom of using Painmasters after a gap of 15 years (See  Mastering pain (part 1). No longer do I need to fiddle with settings, check the battery, purchase accessories online or deal with long wires bunched up underneath clothing. I can wear dresses! I can travel! I have proven to myself over and over that the level of microcurrent in a Painmaster – the original model provided up to 20μA (microAmps) and the latest model says 2.7 vDC @ 49μA  –  is a perfect match for removing the sensation of pain. I am so convinced about this Painmaster MCT patch that if I am not experiencing freedom from pain then I only need to move the patch to a slightly different place on my body. Maybe if I have strong pain occurring in a number of places – my shoulder as well as my buttocks – or if I cannot afford to use more than 2 Painmasters at a time, I will get out one of the above microcurrent units and use it in conjunction with a Painmaster.

Buying one Painmaster is a simple investment in finding out whether your pain responds to microcurrent. If it does then you can consider buying one of the microcurrent devices I have described.( Disclaimer) If it doesn’t work then you may not have the same kind of chronic pain as myself. But you have not wasted your money as it doubles as a device for sports injuries, for tennis elbow, for lower backs that ache from lots of lifting or for necks that ache from working at the computer…

Some doctors are sceptical that such a small current could make any noticeable improvement.

I am not saying that it cures chronic pain.

But I am saying that as long as I am wearing the patch in the correct site then it will render the pain negligible.

Doctors may want you to increase the settings on a microcurrent unit to milliamps in the belief it will give you a better outcome

BUT

 the use of a microcurrent for reducing pain is a surprising and wonderful example of how

less is MORE!

Exercise works

Exercise may be the last thing you feel like contemplating when your body is in pain. So let me tell you I would be one of the last people on earth to recommend exercise UNLESS I had found that it really reduced pain. Exercise on its own will never be enough but it can make significant inroads into your pain levels.

Strangely enough I can now remember the different types of exercise I have tried according to places I have lived. In Whyalla, South Australia I began with walking. I would get up before the children were awake and walk a number of blocks. My husband persuaded me to go to circuit classes at a local gym and there I found that the cool-down stretches made a big difference to the pain I was experiencing. This was followed by freestyle swimming at the Whyalla Recreation Centre. I would pay a babysitter to come at dinnertime and off I would go to swim a number of laps. By the time I got home the children were in bed, I would eat dinner and take some Mersyndol (Codeine plus antihistamine) – otherwise I would develop excruciating headaches in the night. I kept up with the swimming regime because it really reduced the pain in the lower half of my body. Much later I learned to swim with a snorkel and mask because this stopped the need to turn my head which brought on the headaches.

Some memorable backdrops to exercising have been

  • Mt Victoria in Devonport, Auckland, NZ.  Walking the dog on the circuit of this mount with panoramic views of Hauraki gulf and the green-blue waters of the harbour.
  • A small secluded beach near Whyalla. Watching multitudes of rainbows fragmenting in the sea around me.
  • A heated olympic outdoor pool in winter in Perth, W.A.. Getting there early to watch the rising mist as the pool covers were removed, breathing in the clean crisp air.
  • The bush pathways around Claremont, Perth.
  • The pathways around the New Farm Park, Brisbane which connect to paths along the Brisbane River.
local landscape whilst walking

enjoying the local landscape whilst walking

Somehow these surroundings have the added dimension of improving my mental state which can be overloaded with pain management.

Altogether, as well as walking, swimming and going to the gym, I have tried PUMP™, Pilates, Yoga, Jogging, Power Walking and Denise Austin aerobic videos – now replaced by other exercise DVD’s such as Increase Your Flexibility with Hun Yuan Tai Chi Chan Si Gong Foundation Exercises (see http://www.taichiacademy.com.au/products.php). Lately I have improved my backstroke swimming and I am currently learning more about Walkactive™.  (Learn about Joanna Hall’s method at walkactive.com)

I have found out for myself that Pilates and Yoga are too difficult for my body and instead of getting a nice deep stretch I can easily strain the muscles resulting in  a long episode of pain. Likewise jogging is too jarring for my body and can leave me with terrible headaches. Conversely ordinary gardening and housework are insufficient to bring about pain relief.

Another important tip I have learnt regarding myofascial pain is to stretch my muscles after the exercise not before. If you want to walk or jog or swim just start off at a slow to moderate pace and gradually build up speed and intensity. Then your body will be ready for deeper stretching at the end of your session.

Let me give you an example regarding the benefits of exercise. Twenty years ago I was attending a *fibromyalgia support group which a rheumatologist had recommended. A speaker talked about the idea of helping this condition by resting. It sounded quite attractive so I put it into practice.  I was running a household with 5 children, and my husband and I were preparing to go away for his long service leave. A few weeks had passed without exercise and I now felt I needed to clean the house  for my mother who was coming to mind the children. After a couple of very intensive cleaning days (barely sitting down) the bottom of one of my feet started to burn. Whenever I put my foot to the floor I experienced significant pain to the extent that I got myself some crutches. I was now forced to spend quite a bit of time resting on the bed. A couple of good friends came and helped with the chores til my Mum arrived. But the more time I spent lying down the worse my whole leg became – sometimes feeling a bit cold or heavy.

I realised that I needed to do something or I would not be able to go on this trip of a lifetime. So I began swimming in a heated pool at Takapuna (I hope those damp change rooms have been upgraded!). This was the best strategy – not to keep staying on my feet as that only made the pain in my foot worse but to keep the leg moving and active in another way. I kept this up for a few days more when my Mum arrived and thankfully I was able to get on that plane. [Years later I learned that the foot pain was stemming from the buttock/pelvis area and the swimming had mobilised that area.]

Obviously the lesson I learned from this was to KEEP on exercising, forget resting – and now if a certain part of my body gets stirred up I still need to keep it in motion but not with the activity that caused the area to malfunction. For instance I currently need to do gentle exercising of my shoulder but I mustn’t keep pulling out weeds as this caused the shoulder to flare up – admittedly we live on a large property and I have been pulling out thousands of weeds so that the land will return to native bush. I have also had to switch the arm I use for the computer mouse as that also fires up my shoulder even through it wasn’t the original cause.

Another lesson I have learned is to take medication with breakfast and wait an hour or so for it to take effect before I start exercising. And I exercise most days of the week.

Over the years I have settled into moderate exercise with many repetitions of the same movement for a number of different muscle groups, while maintaining a good posture. I suppose this is best described as exercises that tone and stretch. I am grateful in particular for  a DVD that provides 10 minute workouts to shape and strengthen the abdominals, the thighs, the buttocks and the arms & shoulders. I find that most exercises therapists recommend for me after treatment are already embedded in routines on this DVD.

Cindy Whitmarsh will be forever young to me. XXX

Cindy Whitmarsh will be forever young to me. XXX

All exercise DVD’s come with a disclaimer and I stress that I am passing on what works for me but you need to work out for yourself what type of exercising suits you best (Disclaimer). You need to find ways of exercising that you actually enjoy and that suit your own temperament or else you won’t be motivated to keep exercising. So don’t be afraid to gradually build up an exercise regime – it will give you pain relief and also stamina to cope with the condition. You may as well have the benefit of looking fit!

* Other doctors have since dismissed the diagnosis of fibromyalgia.

Chill out!

If ever I get into a dreadful episode where one part of my body will not stop ‘burning’ then I can switch off the pain for a while by applying an ice pack.

Ice can be used if you twist an ankle, if you get a bee sting, after chiropractic treatment and after some operations. Many health professionals recommend alternating ice and heat for inflammation and only applying them for short periods e.g.http://thephysiostudio.com.au/health-tips/ice-and-heat-application/ . 

An eHow article identifies whether heat or ice or both are suitable for different types of medical conditions – and quotes orthopedic surgeon Dr. Stephen H. Hochschuler that ‘ice should… not be used for patients who have rheumatoid arthritis, Raynaud’s Syndrome, cold allergic conditions, paralysis, or areas of impaired sensation’. This article also says that heat is most often used for chronic pain conditions such as arthritis. So be warned by my Disclaimer as I want to explain what has been an effective tool in reducing my pain but it is outside the above medical advice. 

It started when I did not have access to any of the electrotherapy devices I will describe in other posts. I could sit in my own special chair (which I dragged from home to many social occasions) and in my own special seating in the car to keep my pain levels low. But holidays posed excruciating problems with seating on plane flights (I would stand up when possible), in motels, restaurants and hire cars. Sitting in these would set up an unremitting burning sensation in one buttock and leg. When we decided to fly to Queensland for a family holiday I became absolutely desperate. How could I manage the pain so that I wouldn’t spoil the holiday? The thought came to me to use an ice pack so that I could numb the pain. In this way a campaign began to freeze my butt off!

The ice treatment worked so well that when I returned home I started carrying a small esky wherever I went. The esky contained several icepacks and an ice brick with a tea towel or two for wrapping up the icepack. The tea towel meant that the ice pack didn’t directly touch the skin (or else you can get an ice-pack burn!). And the more I did this, the less I experienced pain – which lines up with the one principle for reducing pain : the more pain relief you can provide the more the nervous system is damped down and the pain levels are lowered. It felt like I was helping the entire buttock area go to sleep and forget the pain. 

old styrofoam esky complete with ice pack covers

old styrofoam drink cooler complete with ice packs & covers

Ice is never going to be a complete remedy. Sometimes the pain in my butt has been too strong for the ice to control. But it is a good way to help stabilise the area and to use in conjunction with other tools. I had already noticed years ago when swimming in the surf and diving under the waves that the chilly water soothed my headache. Sometimes I will tuck an ice pack up under the base of the skull on one side or drape it round the back of  my neck and shoulders and this can mitigate a few headaches. If you’d like to try a safe alternative you could consider rubbing something such as Mentholated Ice Gel (widely available in supermarkets and pharmacies) around your neck and shoulder tops. Of course if you wake up one day and your neck is stiff and you can’t turn your head then draping a hotpack around the back of your neck is best. Don’t use ice in that situation.

As a matter of fact, heat is one of the worst things that can really ramp up the level of pain I am experiencing – such as working out in the garden for a couple of hours in high heat and humidity. I can almost guarantee that I will activate high-level pain when I have a spa (buttock-ache) or sauna (headache). One musculoskeletal specialist said that this reaction to heat is just another indication of how my myofascial pain is intertwined with my nervous system.

You probably don’t have this sensitivity to heat but you can still trial this ice treatment – but only do it for 20 mins – and track whether cold (or heat) alleviates your pain. I know that my first instinct years ago was to reach for a hot wheat pack so I wanted to mention this basic type of pain relief in case you have never tried ice.  You don’t need to adopt my  practice of constant ice packing but I can say for myself that it has never given me an adverse effect in all those years. It has actually helped me to chill out mentally too – my mind can switch off from the pain for a while.  Many is the time I have gone to bed not with a hot water bottle but with an icepack wrapped around my buttock!

NOT snug as a bug

Headaches are the hardest

I have accumulated a number of electrotherapy devices to reduce pain but I must admit that I cannot give unqualified support to these aids when it comes to chronic headaches. Thank goodness for the effective medication which I will describe.

I have been given various diagnoses such as cluster headaches, non-classical migraine, neuropathic pain, old whiplash injury, the C2 joint becoming locked, restrictive movement of head caused by postural weakness/ muscle rigidity/ joint stiffness in upper and mid-back, shoulders or neck which can disturb the occipital nerve,  hormonal fluctuations that causes rigidity of upper back which impacts on my neck, fibromyalgia,  aggravation of myofascial points in my shoulders …whatever!!!

My headaches are easily exacerbated by heat, by working on the computer, by sleeping on the wrong side at night, by chiropractic adjustment, by menstrual patterns, by expending a huge amount of energy, by turning my head whilst swimming, by travelling long distances, by emotional tension, by looking at electronic screens for too long, by lack of sleep, by BEING ALIVE!!!

a headache is starting

stuck on public transport when I need to get home to bed NOW!

I am interested to know that there is now a theory* that migraines involve neural activity which (if I understand this correctly) would fit with my whole condition so that the headaches are just one painful manifestation of nerve disturbance which I also experience in other parts of my body. A specialist explained to me that the overly sensitive nervous system is at the base of why the muscles, connective tissue and nerves become so aggravated.  Over time repeated episodes of pain lead to entrenched and faulty reactions in the body. Again, if I understand it correctly, this malfunction of the nerves works in conjunction with the malfunction of soft tissue around the skeleton to produce pain that perpetuates itself.

Older medications for migraine (e.g. Ergodryl) were not as effective at reducing the pain for me or took a lot longer to work and required more than one dose. Even then I would spend inordinate amounts of time lying in bed with a cold washer covering my left eye and that side of my head. Sometimes I would still need an injection to stop the vomiting and rushing to the toilet. As I write this I feel myself  re-living how the minutes passed so slowly as the pain kept jabbing into the back of my eye … the waiting and waiting for the driving pulsating pain to subside or be obliterated by merciful sleep.

 ### throbbing eye ### 

throbbing eye

jab#jab#jab#

Thankfully Sumatriptan has intercepted this torturous occurrence and within 45 mins of taking this medication I can feel the pain subsiding. Of course you cannot simply shop for this – it has taken years of pain and various treatments to arrive at the effective medication I now take – your headaches may not be identical to mine so keep  my Disclaimer in mind.

There is one thing I can recommend for the reduction of headaches for fellow sufferers – swimming! especially back-stroke!  as much as possible! It seems to work for me in 2 ways. 1. The constant coldness of the water on the back of the upper body and head dulls the pain and generally seems to calm the nervous system. 2. The repetitive but smooth action of the shoulders relieves the deep clenching of one of my shoulders and the tension in the spine of my upper body. I am not talking about tense muscles which massage can ease – yes the muscles are tight, but this is a lifetime of restriction which operates continuously on the structure and fabric of my body. An extra tip about backstroke – while moving through the water lengthen out the back of your neck by looking at your toes splashing but don’t lift the head, instead, tuck in the chin. Somehow swimming (every 2nd day)** tones the body so that it reduces the number of headaches I suffer. Swimming also provides greater alleviation of pain than having a deep massage – plus it is something I can do for myself! I hope  you can think of another activity that will reduce your headaches if swimming is not possible.

* http://www.ncbi.nlm.nih.gov/pubmed/11359360

** On alternate days I do different types of exercises that are more effective for the pain in my lower body.

### pulsing eye### Courtesy http://www.creativecolours.org/freebies.html

Mastering pain (part 1)

In 1995 my husband wanted me to come with him to France. Since 1989 I had virtually stopped sitting – because of strong pain radiating from my lower back into one leg. The trip from New Zealand via the US would involve unthinkable hours of sitting. And yet I said Yes! Deep inside myself I felt that God would make it possible. But how  would I handle the ordeal?

My mother wrote to say that I should go to a pain clinic to see if there was any other medical intervention available. This seemed unlikely as I had recently passed though a pain clinic at  a major hospital where they had told me I was already taking the appropriate medication and performing an exercise regime which should give me maximum pain relief! So I made an appointment at a private pain clinic. The new doctor first tried injections into the spine with no results. Nothing else he suggested provided pain relief.

With time running out he said I could trial a new therapeutic device that had been issued by an American company. He was offering it to patients who didn’t respond to other treatment to see whether he could recommend it in his practice. The device was called a  Painmaster™  which had two electrodes joined by a wire.  He suggested placing one electrode at the site where the nerve  exited the L5S1 joint and placing the other at the lower end of the piriformis muscle (which felt like a burning rock at the time).

old Painmaster brochure front

old Painmaster brochure front

In less than an hour the pain did not just get lulled, tricked, diverted, managed or become more bearable – the pain actually ceased! And the longer I sat on my rump the more the whole area felt comforted and soothed – way, way down. When I got onto that plane and sat there  hour after hour, I kept expressing amazement to my husband that my buttock felt so NORMAL.  After all those years, all that constant throbbing, all those tears, all the tablets, all that exercise, all the doctor appointments and all those physical therapy treatments I cannot explain how grateful I felt to God and to the people who had invented and produced the device.

I still could get terrible headaches but now I had found the way to take part in so many activities that involved sitting.  Of course I went back to the original hospital pain clinic and told them how the Painmaster  completely calmed the buttock area in the hope that it might lead to a more permanent solution for many others. I was staggered to be told that it was probably only something specific to my body – even though I showed the doctor the brochure which explained how the Painmaster set up an electrical microcurrent that addressed acute pain, sport and work injuries, and post-surgical rehabilitation in clinical studies.

I set about ordering Painmasters for myself to wear all the time. The original device only lasted for 3 days but it was reasonably priced at the time – about the same as one visit to a physiotherapist. If I did not wear the device then the pain would return. All that mattered to me was that it actually mastered pain.

However the trial supply of Painmasters eventually dried up, we moved back to Australia and I had to learn to manage the situation again – I will tell more about this later. Only recently in 2011 I was again facing a long flight from Australia to France and managed to hunt down the Painmaster makers by internet and they provided me with some upgraded samples that they were in the final stages of modifying. Once again the device performed perfectly and allowed me to be confident that I could manage the trip.

The new Painmaster has been launched from the U.S. (http://painmasterglobal.com) and is now being marketed in

On these websites there are medical articles which detail the science behind the effectiveness of the Painmaster for various types of pain and injury. I can only attest that this device has definitively been effective for the chronic pain I have suffered in a number of sites on my body (not my head).

new Painmaster packaging

new Painmaster packaging

It is not a big risk to purchase just one Painmaster to find out whether this type of microcurrent therapy will work for your own chronic myofascial pain (see my Disclaimer).  If you have tested it and it works then you will be able to consider purchasing more or trying another more permanent microcurrent device. If it doesn’t work then sooner or later you can use it for another painful situation such as a sprain.

In a future post – Part 2 – I will compare how well a few other therapeutic devices master pain. Don’t let a bad experience with some pain specialist master your thoughts.