text:
The "Whole Truth" About Resolving Pain and Opioid Dependency
By Stephen Rodrigues, MD
Stephen Rodriguez, MD is a pain specialist and author currently writing a book on resolving pain through physical therapy, accupuncture, and holistic methods in an effort to address the source of pain without the necessity of opioid pain killers. When finished, his book will be available at http://drstephenrodrigues.com/index.html.
The following is an excerpt from the book, currently in draft form:
This "high" effect that everyone talks about is not The Whole Truth.
If something is not The Whole Truth, it is a part truth and any statement that is not 100% Truth is a Whole Lie.
The whole truth is that pain medications for the treatment of muscular derived pain is a tragic mistake that was allowed by physicians who lost touch with reality. (In the 1960s)
The human body is perfectly designed to take care of itself. All we have to do is make certain that we take care of our daily requirements of nutrients, wellness, mindfulness, physical exercise, physical therapy, stretching and sleep hygiene. Then our bodies will be able to automatically restore.
If we do not keep up with our daily requirements we will become sick. Muscles demand a daily allotment of physical therapy. I also call PT, TLC.
If you get behind in your daily allotment of physical therapy – TLC, your muscles will store this need into a debt for future processing. This TLC debt will never go away until you pay your body back in the proper amounts and doses of TLC.
It's quite alright to take comfort medications while you are out and about living life.
Medications are not treatments for this pain.
Medications cannot touch this pathology of pain.
One of the worst medications you can give a human being is opium. Narcotics are opium derivatives which will alter brain chemistry negatively.
This "high" everyone talks about is not completely valid or fair. Opium in the brain drives neurotransmitters bunkers and once tolerance sets in removing the Opium Derivative will make you feel unhinged, sick, tired, sad, depressed, anxious, vomiting, projectile diarrhea with Flu-like misery. The opium derivative once habituated and tolerated by the brain alters yet "false balances" brain neurotransmitters so the patient will feel "normal" with a little sanity.
Restarting the Opium Derivative will nullify those signs and symptoms. This is not a "high," this is someone who wishes to feel "normal" again. An unstable unbalanced "normal" but "normal" none the less.
The idea of "high" is miscommunicated and a wive's tale. People simply want to be "balanced" in an unbalanced body.
Try taking any opium derivative for a few weeks and then stop the dose, you will then be able to "feel unbalanced and insane." If you have not already. I would not put my worse enemy through his ordeal. (well maybe a few people)
Not from the book:
Just to make this 100% clear for those who wish to escape from their painkiller plight. This info is the correct pathway to be cured.
The muscular system is the only location for recurring frustrating pain that everyone will experience in their bodies. Joints and nerves cannot cause recurring frustrating pain.
It's impossible for the skeleton or the nervous system to be the primary cause and location of recurring frustrating pain.
The treatment for muscular pain is physical therapy.
Physical therapy is the correct set are treatments for derived muscular pain.
Painkillers and surgery are the alternatives, not the primary or proper treatment.
The idea that surgery and or painkillers are the primary treatment is a fallacy, miseducation instigated by a few doctors in the 60's.
Physical therapy is on a spectrum from Yoga, stretching, range of motion and hot tub. I refer to this class of physical therapy as tender loving care, TLC.
Active tissue release, myofascial release, Chiropractic Care.
Dry and wet needling, trigger point injections and the like.
Sick, tired, beat up, and battered muscles will not tolerate not having enough TLC, and they will drive you crazy.
For most of those who mention that TLC or physical therapy options are not at their disposal – I would advocate for them to be placed back into the standard of care.
I'm certain that if you had a chance to be cured, you probably would choose the curative treatment and be freed from the opium derivatives.
These are all TLC Treatments which will attack and destroy the micro-scars embedded in muscles:
- Yoga
- Stretching on the floor or even in the bed
- Active Isolated Stretching
- Get a foam roller to work on your hip/back and abdominal area
- Swimming, Gardening, Zumba, Dancing
- Aqua-Therapy and Hot-tub Spa therapy
- Graston Technique
- Craniosacral Therapy & Core Synchronism
- Tai Chi and all the Martial Arts
- Reflexology and related options
- Acupressure
- Use self-trigger point release or acupuncture with your hands or a T-cane
- Try a Chi Machine
- Use Cupping
- Use Gua Sha
- Find a PT specialist who can perform "Spray and Stretch."
- Get help from a professional massage person
- Find a John F. Barnes therapist
- Zero Balancing
- Cold Lasers will stimulate healing also via heat generation. I have a Thor Laser that I use on occasion
- Teach yourself needles – as in Dry Needling or ask to be shown DIY needles
With Needles:
Get help from an Acupuncture professional.
Find a graduate of Gunn IMS, (Intramuscular Stimulation). I'm not on the Gunn's graduate list but have practiced IMS in my office for over 12 years.
Find a trigger point specialist who knows Janet G. Travell, MD or Edward Rachlin, MD.
Editor's Note: National Pain Report strives to share diverse information and points of view that hopefully helps someone resolve their pain. The content of our articles and associated comments should never be considered medical advice – as always, do your research and consult a healthcare provider when making decisions about your health and health care.
Amy at 5:45 am
I've been a captive to pain ever since childhood. I was not raised in a family that put value in anything but western medicine. Pills and surgery and invasive tests that gave no answers only more questions were what I lived with until my late 30's.
After a botched surgery to remove an endometrioma, (the 5th surgery I have had to that date), my body went into such a massive state of inflammation that by skin tore from the swelling. The inflammation was undiagnosed for 3.5 years. I went back to the GYN docs, to additional GYN docs (one told me it was all in my head), to GI docs (one fired me as a patient because he couldn't figure out what was wrong with me) to the Duke Medical Center for advanced testing with their GYNs and GI docs…all to come up empty.
I lost job after job due to the fact that I was disabled. Eventually, I was diagnosed with ankylosing spondolytis; a rheumatoid disease that destroys my spine and lower body joints. For a few years, I was able to function again…as long as I took mild chemo and massive immuno-suppressing drugs, but I never regained my ability to work and I still have 2 weeks of serious pain a month.
Throughout this time, I have tried changing my diet (5 times), doing physical therapy, taking up to 20 pills a day, and nothing has given me my life back. No one could put the whole picture of me as a patient together to create a total treatment plan.
Dr. Rodrigues broke that cycle for me. On our first visit, he described a scenario of ill health and inadequate treatment that fit my medical history almost perfectly. And he knew why my body had deteriorated to the level that it had.
He is the only doc that could tell me how to treat me entire body, not just throw more pills at me. His therapy combines all things in life: eating whole foods, stretching, yoga, sleep (quality sleep), massage, accupuncture, heat, accepting the fact that my thoughts had been incorrect and changing them, pilates, swimming and walking.
For the first time since 2009, my body is healing. No NSAIDS, no opiates, and I'm even able to wean off some of my pills (under me doc's supervision).
Why bother to tell my story? Why should you care? Because the fact is that we can not blindly trust our health care providers…in fact, we never should have. Ask questions at the doc's, find out how your body systems work, ask how your drugs work (and don't accept getting blown-off if they can't explain it to you), find out how your drugs interact with each other, approach surgery with caution…be your own advocate. And never just accept pain as part of life.
Mark Stewart at 7:17 pm
I was on my way to a frozen shoulder. My primary physician strongly recommended doing specific exercises myself regularly, or else I'd have the "opportunity" of 6 months of physical therapy having someone watching me to make sure I did them. The alternative if I did not would have been surgery. (My sister just underwent surgery for frozen shoulder.) I went to an acupuncturist and with three treatments he released my rotator cuff muscle and now have full range of motion of that arm, even several years later.
I have chondromalacia http://www.healthline.com/health/chondromalacia-patella which makes climbing stairs very painful. After several acupuncture treatments, I can now climb 4 flights of stairs 5 days a week. About once a year I get a treatment and I'm fine. I suffered 30 years needlessly.
I am an advocate of traditional medicine too (as my pharmacy can attest), but many chronic pain issues can be treated as Dr. Rodrigues suggests.
Deborah at 10:52 pm
THE WHOLE TRUTH. . . . . . Article by Stephen Rodriques He clearly stated @deborah
"I am not on your side" Comments Aug 18, 2016
My comment was a sincere thank you, to Dr Quintner..he provided excellent information and positive websites, which had renewed my strength and desire to hold on to my life.
As my constant pain leaves me beathless and struggling for relief and will to live.
For the record. . . I have severe chronic pain as do many others that read the articles from NPR. . .
I am appalled with
Dr Rodriques. . with his lack of compassion, understanding and negative attitude.
He is dogmatic in his views insisting that his research has yielded all the facts in treating all pain issues.
Sadly, after undergoing so many invasive and non invasive therapies.. that are in the whole truth article,
I have now sustained spine injuries and additional vertebrae fractures, with permanent nerve damage. My injuries are so severe and there is not any chance of rehabilitation.
This is my whole truth!!
I am struggling to hold on..
HJ at 6:32 am
You are probably right about the congenital hip dysplasia being an issue over osteoarthritis. I will definitely keep that in mind and someday when I'm in need, I'll be sure that the surgeon I speak with will be able to address my specific circumstances rather than looking at me as a "run-of-the-mill" hip replacement candidate.
I am very glad that you shared your story and I pray that you get some relief in the future. Sending warm wishes and hugs!
Therese at 4:38 pm
Thank you Jean, especially for saying I was courageous in sharing my story – that's something I rarely feel. It's funny, after I posted (and after picking my post apart, finding all the things I should have worded differently – this time worse than most) I spent a good portion of the day doing just what you advised not to. First, I cried at my own damn (pardon my language) story (as if I don't know it by heart), then I berated myself, over and over, for not going to a big city hospital, renowned for orthopedics, and filled in all the gaps with every horrible element I left out of the telling. I mourned the loss of adequate pain control, which has led to such a decrease in activity as to make the next revision much more pressing, and basically convinced myself that I simply couldn't go on. How prepare for yet another surgery when I can barely clean house or keep food in it?
But you are right. I did make the best decision I could at the time. I researched, I asked for advice and was told there was no need to go out of town for hip replacements. And who wants to travel hours away for their first major surgery? It is traumatic enough from home! My surgeon was kind and I thought competent and we had a good doctor/patient relationship. And now, I will have to do it again, ready or not, because, as you say, without taking that risk, there is little or no chance for improvement. I've already been told that I will basically never be "normal" again. But I'd be quite pleased to be able to go on my long walks. And it would be wonderful if my story did wind up helping someone else. I'll strive to have the courage to remain optimistic and follow through.
Therese at 1:35 pm
HJ, I should have added that I think it is the congenital dysplasia aspect that throws a monkey wrench into these hip replacements. I could be wrong, but I bet the many people you know who've had successful outcomes had straight up, "garden variety" osteoarthritis. Keep that in mind when you choose your surgeon and you'll be fine too!
Jean Price at 11:17 am
Therese…I'm so sorry you've had such a horrendous time, doing your best to regain a more functional life!! I can't imagine how hard this has been for you. Yet, I do know it's so very difficult when we don't experience a good outcome. And it's hard not to want to question both our decision AND the expertise of the care that ended up "making" us worse!! I've learned something very important about this issue, because I also was so much worse after my first lumbar surgery,..due to a major complication! The facts were…I chose an experienced.and competent Doctor. I made an appropriate decision based in my curiumstances of decreased strength and pain from the nerve compression of what was a "huge, mushy herniated disc". And the OUTCOME of the surgery, due to a complication, left me with a worsened condition, seen on the myleogram my doctor said as five times worse than before surgery! Sadly, OUTCOMES are NEVER controllable…they are dependent on many things out of the doctor's control AND the patient's control!! That's always the scary part of any treatment, especially surgery! It's laid out in our consent forms and part of reality! The decision to have surgery is really about being willing to RISK, to take a chance that the procedure will help us, and allow us a better life. We often look at the likelihood of possible risks to help us make informed decisions. Yet, it doesn't really matter what the statistics say are the possible complications…if you are one of the people who has a poor outcome!! It can feel like we made a poor decision or the doctor did something wrong, when that's usually not the case!! It's merely a potential consequence of the procedure! It does matter a great deal though, to realize we were taking that risk with hope of a good outcome, informed and willing, because our current situation was not what we considered livable!!!! And we DO make good decisions based on the information at hand at the time…because we can't know what the actual outcome will be!! If we did SOMEHOW know the actual outcome for ourselves, perhaps we wouldn't have chosen surgery…yet that's not possible and not part of the reality we had to face at the time! I believe we make good decisions for our care needs, and yes…having pain with the inability to function perhaps makes us more likely to take the risks associated with surgery. But why wouldn't we? Especially when we have exhausted other treatments to help. All this being said, I hope you and others can respect your decisions as sound, and have faith that you do a good job taking care of yourself! Our doctors mostly do their jobs well, too…within the scope of what they can control. Knowing this can free us to concentrate on dealing with what faces us now…and help us not spend our energy on questioning ourselves and our choices! It may make us less likely to risk in the future, yet I hope it would make is more likely to MEASURE and take the risks knowing neither we nor the doctors can totally control the outcome to give us what we hope for. Yet without taking that risk, we may stand little to no chance of improvement. Your story may help others, Therese…and your courage in sharing it is so appreciated! Bless you!!
Therese at 7:05 am
HJ, a very heartfelt thanks for your thoughtful response. This is the first time I have ever mentioned my circumstances. I was very apprehensive about doing so, and of course it was an "elevator version" as described in another article on this site. Like most of ours, I imagine, the whole story would encompass page upon page.
I will say that one hip has already been revised, ultimately making matters even worse. My entire body is indeed way out of whack now, as you mention, from compensating for it, and going in again causes more problems in and of itself. I remember reading in some random memoir not too long ago a sentence that really struck me and I find fitting: "The glass is already broken." I'm very scared to go through the other revision, knowing what it was like the first time, for many months afterwards, particularly in today's pain relief climate. It is vital to be able to work hard to recover properly. Also, I've been beaten down by my condition. I have had to fight so hard and I am meek by nature. I'm no longer at the top of my game, so to speak, as I was going in to the other surgeries, and I believe that's extremely important too.
An irony is that I did so much research beforehand (as well as exhausting all conservative measures), to no avail. At this point, I feel like I may as well have blindfolded myself and thrown a dart to make a decision. I think that's why I let Dr. Rodriguez get under my skin – he made it seem like there was still something I had missed.
Thanks again; this was a great comfort and I feel better about revealing myself. I know a lot of people have it so much worse that I half expected my situation to be disregarded, or (and I'm relatively certain not, but …) even attacked, probably a residual effect of the blaming of the patient in pain.
HJ at 5:15 pm
I have congenital hip dysplasia and was told that I would need hip replacement surgeries some day as well. I have seen many, many people do very well after these surgeries. I'm deeply sorry to hear that your surgery went poorly and your life has changed. I hear you and it's scary to hear it. I imagine that the surgery WAS in fact, necessary. As for Dr. Rodriguez, I think he loves his work so much that he'll unreasonably exclude the benefits of other forms of medicine. I have had muscle work done, and while there are often benefits, they are short term.
Frankly, I believe that there ARE dysfunctions that CAUSE our muscles to become strained. I have cervical spondylosis, for example. I regularly get trigger point injections, BUT, the muscular pain I have is a SYMPTOM and not a cause. My symptoms are repetitively… and helpfully… treated… but the underlying problem of cervical spondylosis remains and the symptoms return again and again.
With weight-bearing joints, I imagine that part of the problem comes from alignment. Doctors watch our gait — how we walk. I think we've learned how to walk in a way that balances us DESPITE our alignment issues that might come from something like hip dysplasia. It's a sort of domino effect, tho, because this adaptive weight distribution puts strain on knees or back… and we have other pains as a result. Treating the muscular pains can be beneficial but when the problem is our unique gait or stances, then the muscular problems return again and again.
What Dr. Rodriguez has forgotten is that we are more than muscles. As someone who has aggressive osteoarthritis, I'm acutely aware that underlying skeletal issues CAUSE muscular symptoms that are CHRONIC because the skeletal issues remain even after muscular treatment.
Please, don't doubt your treatment because of what Dr. Rodriguez has said. I'm sorry your surgery failed. It should have worked and it should have improved your life. And you didn't make a mistake in choosing it. Some day, I will likely make that choice. All I can hope for is that the surgery will go as planned and I will see the benefits that many other people have seen after their surgeries.
Dr. Rodriguez has blinders on. He'll say that we're the ones who are blind. He means well and he's passionate… but it doesn't mean that he's right.
Dr John Quintner at 1:40 pm
Dr Rodrigues, as you addressed your comment to me, with some reluctance I will respond.
"Allopathic providers who do not use or do not know:
Hippocrates, Ruiz, Helms, Rachlin, Gunn, Travell & Simons, Hackett, B.J./D.D. Palmer, Rapson, Seems, Gokavi, Baldry, Lennard, Burke, DiFabio and Pybus, Mann, Craig, Barnes, Chaitow et many many more.
are ignorant and nieve (sic). This is simply unfortunate and true.
The solution? Ask questions and or get those textbooks and needles."
I very much doubt that allopathic providers would be unaware of Hippocrates who, to the best of my knowledge, was not an advocate of the technique of "dry needling" innocent tissues.
The other names on your list include a number of past icons, who have obviously impressed you but whose contributions to the advancement of musculoskeletal and pain medicine have been at best minimal and at worst negative.
Chiding your colleagues as ignorant and naive for being unaware of this literature is absurd. Apart from Hippocrates, of course, no hidden wisdom is to be found in their writings. Alas, this is indeed unfortunate but true.
Dr John Quintner at 3:28 pm
Therese, as you must understand, "botched surgery" does not necessarily mean that there was no indication for the surgery in the first place. I hope that your hip surgery can be successfully revised. If not, I can only wish you well and hope that you can fully come to terms with your situation.
Stephen S. Rodrigues, MD at 1:44 pm
I cannot trust the group behaviors of the AMA, Am Board of Fam. Med, and HHS.
I'm certain that 95% of the member are honorable.
A scant few know what is going on and hiding the truth.
I'm certain that 99% their members have no idea of those authors I have mentioned.
Judge's findings in the second trial[edit]
On September 25, 1987, Getzendanner issued her opinion that the AMA had violated Section 1, but not 2, of the Sherman Act, and that it had engaged in an unlawful conspiracy in restraint of trade "to contain and eliminate the chiropractic profession." (Wilk v. American Medical Ass'n, 671 F. Supp. 1465, N.D. Ill. 1987). She further stated that the "AMA had entered into a long history of illegal behavior." And, she then issued a permanent injunction against the AMA under Section 16 of the Clayton Act to prevent such future behavior. However, she exonerated the two other remaining defendants, the Joint Commission on Accreditation of Hospitals and the American College of Physicians, and dismissed them from the case.
Judge Getzendanner also went out of her way to make clear what she was not doing:
The plaintiffs clearly want more from the court. They want a judicial pronouncement that chiropractic is a valid, efficacious, even scientific health care service. I believe that the answer to that question can only be provided by a well designed, controlled, scientific study… No such study has ever been done. In the absence of such a study, the court is left to decide the issue on the basis of largely anecdotal evidence. I decline to pronounce chiropractic valid or invalid on anecdotal evidence.
Stephen S. Rodrigues, MD at 1:37 pm
@ Cathy M
All you have to do is read up on myofascial pain and dysfunction.
If you leave out kneading all of your muscles any treatment will falter or fail.
Human muscles need to be kneaded for full and complete healing to take place.
Cure: Means you have addressed, understand, comprehend, aware, acting in your favor, preventive, proactive and at peace with all aspects your pain disease:
The cause, locations in the body, what to do in your favor, how to do, where to go to get help what not to do etc.
With muscular derive pain and dysfunctions, cure, means you are staying ahead of the stresses and strains of life and living, muscle titters and microscars.
See my FB pages or my website.
Allopathic providers who do not use or do not know:
Hippocrates, Ruiz, Helms, Rachlin, Gunn, Travell & Simons, Hackett, B.J./D.D. Palmer, Rapson, Seems, Gokavi, Baldry, Lennard, Burke, DiFabio and Pybus, Mann, Craig, Barnes, Chaitow et many many more.
are ignorant and nieve. This is simply unfortunate and true.
The solution? Ask questions and or get those textbooks and needles.
Therese at 2:35 am
Thank you Dr. Quintner. My hips became bone-on-bone at a young age due to dysplasia. The replacement surgeries were botched and took away my life as I knew it, seemingly in an instant. I still have not fully come to terms with this. Making matters worse, months ago Rodrigues MD placed an idea in the back of my mind that it all was completely unnecessary.
Dr John Quintner at 5:54 pm
"A few sinister evil doctors, in the AMA, twisted the value of all the evidence. They made the human evidence worth dirt and made the subject X-ray evidence pure gold.
By doing this, they turned the patient's cries for help out of pain into worthless data."
What an extraordinary claim! Does Dr Rodrigues have a shred of evidence to support the very serious accusation he is making against some of his medical colleagues? I hope that the American Medical Association carries out an urgent investigation into Dr Rodrigues' allegation of a conspiracy arising from within its ranks regarding joint replacement surgery.
Cathy M at 5:23 pm
I have to say this reminds me a LOT of the New Agers I encountered while working at a New Age magazine – totally convinced that any and all "failures" were the fault of the person who wasn't following a pure and healthy lifestyle! There was no recognition of genetic mishaps, accidents that permanently changed body parts, illness due to environmental toxins – nothing. It could all be cured by herbs and meditation – very high priced ones, most of the time. And anyone who said, "yes, but…?" was a heretic, not to be listened to. I got sick of it rather quickly.
Yes, the body wants to heal itself. Yes, some of these mentioned methods have good results for some people. But to "blame the victim" by saying those of us who use allopathic medicine are stupid and naive – that is both arrogant and offensive. Dr. Rodriquez – have all your patients who have been fully cured by your methods write up their stories. Let's hear about the actual results. I attended a low-back pain lecture with this kind of messianic fervor – and it was (not surprisingly) cherry-picked data. And no actual patients to confirm the man's assertions. And so are your statements, Dr. R…sadly – a twisting of a facts to make it seem like you have the whole truth.
Stephen S. Rodrigues, MD at 5:10 pm
@ Deborah
"Again, in my opinion, YES!! Dr R Please, don't be on our side.."
Knowing what I know today, I'm NOT on your side.
I was in a session with an attorney, an experienced medical judge, and a prominent retired FP doctor, I could not get them to "see" that Obamacare was a red herring. The beginning of the end of honorable and noble Physicians was seeded in the 60s.
If anyone thinks or believes that pain in the body is treated with knives and opium, I will just "makes me wanna holler and throw up my hands" in disbelieve.
"make me wanna holler and throw up both my hands" ~ Marvin Gaye
If you are not on the corrective side, you are on the wrong side!
Stephen S. Rodrigues, MD at 4:41 pm
There are no, zero, nada, zilch indications to remove viable skeletal component or tissues in an attempt to treat pain. (except in cases of cancer, infections or tumors)
1968 was the year that the idea of removing body parts to treat pain was etched into the pantheon of the worse crimes against humanity.
This was the year of the first joint replacement for pain in the leg. This event a opened pandora box of hell fire and brimstone which we are all living in today.
A few sinister evil doctors, in the AMA, twisted the value of all the evidence. They made the human evidence worth dirt and made the subject X-ray evidence pure gold.
By doing this, they turned the patient's cries for help out of pain into worthless data.
They made the patients MRIs pure gold.
They made invisible pathologies of pain worthless. They made the visible pathologies of pain pure gold.
They made performing procedures to treat the visible pathologies of pain based on the radiologic evidence pure gold.
They established procedures treating invisible pathologies of pain worthless.
They then had to bury, adulterate, miseducation, distorted and distract from all the corrective and curative procedures for the treatment of invisible pain pathologies.
This twisting of the eye, mind and evidence are a weakness of human beings. Then ultimate authority, AMA, instructed all physicians that pain had to be witnessed and validated by X-rays, MRIs, CT scans and blood test or the patient was feigning and or hypochondria. In this country feigning is distasteful, and hypochondriacs are weaklings, so it's easy to deny patients who have invisible pathologies of pain any compassion, loyalty, charity or grace.
What a unique, criminal, sinister, and genocidal minded scheme that is working correctly.
Working perfectly, means the original wicked seeds are too far buried underground for anyone to see or understand how it all began. What we are all feeling today is the huge cost of our health care, society, in the form of human carnage and sacrifices.
Deborah at 4:17 pm
Dr Quintner,
First and foremost, I so much appreciate your Compassion for all. The information you share is excellent.
Thanks for teaching me the difference between Fact and Faith:
Fact is when any ordinary doctor diagnoses illness in a report.
Faith is when good doctors like you, gives one the strength and hope to endure.
What a wonderful blessing and encouragement you are, I don't have words to thank you enough.
I will pray every day that God's blessings are upon you.
Maureen at 8:01 pm
Marlene, very well said! Thank you for putting it into that perspective.
I suffer severe nerve pain and am currently in a horrid place with it as my spine is once again collapsing, I'm awaiting a Neuro consult.
But without my meds… I'd truly be in severe depression by now also.
And I truly can't imagine life without the little bit the med helps me with in this condition. It keeps my head just above the water these days. Without it, I'd surely drown.
Dr John Quintner at 6:47 pm
Marlene, here are two websites from Australia where I am sure you will find reliable and up-to-date information:
Dr John Quintner at 3:06 pm
The American Academy of Orthopedic Surgeons (AAOS) provides patients with an excellent on-line resource that includes advice for those who may be candidates for joint replacement surgery: http://orthoinfo.aaos.org/topic.cfm?topic=A00375
If people are interested in alternative methods of pain relief following surgery, they will find such a discussion on the AAOS website: http://orthoinfo.aaos.org/topic.cfm?topic=A00649
Finally, as mentioned earlier in this thread, the final chapter on the theories of Dr Janet Travell has been written by one who actually attended a demonstration of her method of treatment and found it wanting: http://www.fmperplex.com/2013/02/14/travell-simons-and-cargo-cult-science/
But the myth lives on!
Marlene at 2:28 pm
I now see that all of your therapies are targeting "muscular" pain, which probably affects every person at some point in their lives. Your methods and your book may very well be all people with that type of pain need. Many, if not most of the people who have responded negatively, including myself, to your original article suffer from neuropathic, or nerve, pain. Most of us have tried just about every treatment recommended and probably currently include multiple modalities in our pain arsenal. Nerve pain, however, is a completely different animal that in the severest of forms, can ruin lives. I like the thinking that says we all need to treat our pain in percentages. Each of the suggested treatments can help our pain a certain percent, but some of us need more than that to participate in life. I'm certainly not saying that we shouldn't incorporate these treatment regimens, but when all of them combined still do not equal a high enough percentage to have any form of quality of life, we may need opiates to increase those percentages enough to get us out of bed, off the couch, back to work, etc. They should be used as a last resort, but when they change lives, they should be used. And used without guilt or punishment from naive doctors and narrow minded government.
Stephen S. Rodrigues, MD at 11:23 am
If you have been suffering from neck, back, hip, knee, or shoulder pain off and on for >10 years, and the doctor informed you that surgery was in order, these are the questions you must present to this specialist by asking, Doctor, "What …:"
What is a pain?
Where is my pain located?
Is surgery the best treatment option for my pain?
Is surgery the safest treatment option for my pain?
Can you prove without a doubt that my pain is in that location?
What evidence are you using to make this determination?
Will this surgery handicap me in any way?
Will this surgery disable me in any way?
What are ALL of my options for the treatment of my type of pain?
Do you know anything about myofascial pain and dysfunction?
Have you read any of Janet G. Travell's books?
Do you know anything about acupuncture, chiropractic care, myofascial release, dry needling, trigger point injections, prolotherapy or platelet rich plasma therapy?
Will this surgery cure me?
Why are you offering me a treatment that's not a cure?
What does "bone-on-bone" or "degeneration" really mean?
Does any part of the human body wear out to the point that it needs to be replaced with a man-made product?
Are you informing and educating me of the whole truth and nothing but the truth so help you, God?
Dr John Quintner at 5:39 pm
The National Center for Complementary and Alternative Health is understandably very guarded in its response to the important question that many pain sufferers have long been raising: "Are any complementary health approaches for chronic pain effective?"
"The currently available evidence is not strong enough to allow definite conclusions to be reached about whether any complementary approach is effective for chronic pain. However, a growing body of scientific evidence suggests that several of these approaches, including spinal manipulation, acupuncture, massage, and yoga, may help to manage some painful conditions."
In other words, should you decide to invest your money in any of these modalities of treatment, do not be surprised at the low returns on your investment. Moreover, contextual effects (formerly badged under the term "placebo") are likely to have played a large part in any reported positive outcomes.
Stephen S. Rodrigues, MD at 1:28 pm
What are these "Perfect Medicines" for the treatment of "pain in the body full of muscles" in the world of Hands-on Physical Therapy w and without needles?
● http://www.ncbi.nlm.nih.gov/mesh/68026201
● https://nccih.nih.gov/health/chiropractic/introduction.htm
● https://nccih.nih.gov/health/acupuncture/introduction
● https://nccih.nih.gov/health/pain/chronic.htm
● http://www.slideshare.net/pankajnsurange/triggerpointinjection
Mathew at 9:33 am
To: DR. JOHN QUINTNER and MELANIE GALBRAITH
May I congratulate you both for a truly comprehensive description of the numerous elements chronic pain patients confront with their Phyicians, the healthcare system, and ourselves. What a harmonious outcome looks like and how it can be achieved.
I absolutely loved the way you both broke it down to their singular elements.
Thanks to the National Pain Report for allowing you to pass along your work.
Dr John Quintner at 7:18 am
As a physician in rheumatology and pain medicine, I am extremely concerned by the amount of misinformation that has been conveyed to pain sufferers by Dr Rodrigues. With the permission of the editors of National Pain Report, I would like to direct interested readers to a blog on the website of the Australian Pain Society that was written by me and my colleague Melanie Galbraith (a physiotherapist and pain sufferer). The aim of our contribution was to provide a "travel guide" for the many people in pain who are finding it so difficult to understand what is happening to them and also to navigate our complex systems of health care: https://blog.apsoc.org.au/2015/05/18/this-train-is-bound-for-wholeville-a-travel-guide-for-the-perplexed/
Deborah at 9:56 pm
Unfortunately, I Have suffered great pain enduring many of the above mentioned treatments in this article, without a positive outcome.
Should one be concerned when a person is highly dogmatic in their views, and speaks of their personal opinions….as though… they are unquestionably correct??
Again, in my opinion, YES!! Dr R Please, don't be on our side..
I appreciate this opportunity to educate my self with diverse information, in hopes to address pain issues.
Bruce at 8:59 pm
Your muscle pain research sounds interesting. I have neuropathy. The nerves in my feet are dead. I have pain like you've never felt, not even for a brief moment in your life. The nerves can't be regenerated. It's not currently possible. The only things that help are gabapentin and opioids. I do not develop a tolerance to where the opioids 'no longer work'. They give me a blessed measure of relief from the searing, crushing, bones feel like they're broken – pain that I experience constantly. The nerves mimic every type of organically produced ailment – and more. Out of your mind, take your breath away pain. You have to experience it, doc. I hope you remain ignorant about this type of disease and never get it. While it might take longer to break down your massive wall of denial about its existence, once it did, you'd end up in the fetal position wishing you'd never been born, and wondering where you could get your hands on some oxycodone. And your reaction to anybody saying that medication is not the answer would be just as vile as ours. Of course, it's not the ANSWER, because there isn't one for nerve pain. And that would be the first thing you'd learn, and just because there's no answer for nerve pain doesn't mean you can wish it away like some child who doesn't understand something and wants it to disappear. You see, we're not allowed to do that. We no longer have choices. We just suffer and deal with mediocre minds like yourself, who make it infinitely worse on us, the weakest segment of society.
John Quintner. Consultant Physician in Rheumatology and Pain Medicine (retired) at 8:07 pm
Dear Readers. Do not despair! There is an effective and readily available antidote to counteract Dr Rodrigues' oft-repeated pronouncements. It may be found here: http://www.fmperplex.com/2013/02/14/travell-simons-and-cargo-cult-science/
Stephen S. Rodrigues, MD at 4:29 pm
In the 40s-80s, All so-called non-deadly pain problems we all will get from life and living which is located in the muscular system have matched solutions.
You have to believe that nature, the human body will automatically heal itself if given the right circumstances, elements, assistance, physical therapy and sleep which is the only way the human body can repair itself.
Palmer, Hackett, Travell, Simons, Rachlin, Gunn, Pybus et al ALL pieced together the solutions to eradicate the most miserable location of pain in the muscular system. See Myofascial Pain and Dysfunctions.
Please if you think I pulled this out of my brainwashed mind, think again.
Once I unlock steps with the unholy trinity; AMA, Wall Street and now the infected HHS, saw the power in the needles it was 18 yrs of discovery. I am very curious and an independent experimenter and inquisitive person. I simply followed the evidence based on the ultimate truth; The patient's word of mouth.
@Q the muscular system is the organ where the pain is located. The micro injuries embedded in the muscles try the pain signals. The micro injuries can coalesce to form bands, knots, tender points and the difficult to find the trigger point. The concept of the trigger point is a concept. The trigger point is not a structured pathology which can be only removed like the appendix. Besides pain is in the muscle that contains the micro scars and knots and tender points and possibly trigger points. Whether a trigger point is present or absent is irrelevant. The treatment plan of action stays the same, treat the whole muscle, region, quadrant, the whole person and their whole life. Because by the time these patients find someone to help them their entire being is not traumatized. This cellular and molecular structure have been corrupted.
What would've taken a few hands-on therapy sessions now will take dozens of intense treatment sessions
I use those celebrities as examples that no matter how much money you have you will fall into the trap. That means every American is susceptible to this deception and betrayal.
I also noted that you have fallen into blaming and shaming based on your personal biases and bigotries. Muscle derive pain is 100% invisible, and thus any assumptions made by an outsider would be a tragic betrayal of the divine spiritual being. You can't see this pain with the human eye or any technology. You can only feel this pain from within. You can't prove that you have muscle derive pain in a court of law.
The key to muscle derives pain is to catch it early and eliminated swiftly. Otherwise, it will dig deeper into the molecular structure of the tissues. It will even corrupt molecular and chromosomal structures. Muscle derive pain will destroy the ability of the muscles to act in your favor. I call this muscle failure. Muscles will fail like kidney failure one through 5. Once you get into stage 4 of 5 the therapies that you describe may not work especially if they're not offered to you in a customized, personalized manner.
Realize we have all been set up to fail.
@terri lewis
Everything you describe is everything that I do, in my office, all by myself along with the patient's help and the patient's helpers at home. Chronic, stubborn pain requires a pit crew who can apply lots of TLC lavishly and liberally to your mind body and spirit.
I have sent you information in the past and apparently you did not absorb it completely. If you like, I can send you a link to my book draft which has everything in it.
The concept of "quick fix" interventions for chronic pain is tragically distorted. Chronic pain cannot be medicated away, cut out with a knife, and will respond to any simple-minded minimal invasive or pain manager intervention.
Muscle derive pain will only respond to daily self-care, restorative care, Pro actions, lots of TLC and needling.
Every chronic pain patient has by default PTSD. All their new role transmitters have been mucked up plus all their muscle cellular structures have been mucked up. Once you enter stage 4 or 5 muscle failure, you need a master to customize and personalize your treatment regimen. Unfortunately, there are few Masters, and they are not taking insurance.
@elizabeth Chute
Ankylosing spondylitis is not an actual diagnosis. It is a descriptive diagnosis. A real diagnosis is one that has been proven and confirmed eradicated by the patient's testimony.
If you are living in pain with a term that a provider has given you that term is a sign or symptom, a subjective-objective and it is not an actual diagnosis.
I've discovered that in the past 30 years, physicians have cut corners in that they're using radiologic evidence as primary evidence. That's cheating. Radiologic evidence is not fresh vital accurate and up-to-date evidence. I call it dead evidence. The old dead evidence is forensic evidence. Forensic evidence is almost worthless as compared to the primary evidence which is the patient's testimony.
@kurt Matthies
"arachnoiditis, cauda equina syndrome, disc herniation with extrusion, spinal stenosis, scoliosis, facet hypertroph"
These are not actual diagnoses they are descriptions based on radiologic evidence. They can be proven they're simply subjective findings. A diagnosis is a guess which must be testable, treatable until it has been stabilized or eradicated and the patient has been restored to their normal state of well-being.
Every person in creation has the same molecular and DNA structures. Every person in nature is susceptible to the same diseases no matter where you are. In my book, there is no such thing as superstars. There are just stars. And each and every one of us is a unique star.
I will offer a follow-up post if you all would like to learn more about what pain and all of the treatment for pain that is in archives of medicine hidden from your views.
It is up to you to do the necessary research and study, open the mind, toss out the lies and rethink.
By the way, I'm the messenger and short cut. You will not be able to find any of this in PubMed — it ain't there!
Take the shortcut or take the longer 18 yr journey.
Jean Price at 2:56 pm
I have wondered if the treatment Dr. Rodriguez promotes works indefinitely, in his opinion?! Or if there is maintenance!? Or if patients are even followed to see how they are doing with pain after their sessions end?! Being a nurse in another lifetime and currently being a person with debilitating pain with a history of over twenty five years and counting…I've used and continue to use most every therapy known for pain, and even invented a few myself!! I HAVE been helped by pressure point therapy throughout my life with pain….like acupressure over trigger points by a physical therapist and/or self administered with a TheraCane device, myofascial releases, acupuncture… several different courses— plus therapies like, of course, a tens unit, massage ( which I'm unable to do now), deep heat and stretching, imaging, even laser therapy and a year long course of work hardening type exercises and stretches after two of my three/four lumbar surgeries!! And like I said….I WAS helped by this..UNTIL…ONE of these things happened afterwards….I got off the table, or walked to the car, or got in a car, or rode home…not drove, mind you, or got out of a car, or walked into the house, or sit down, or lay down in bed, or got up from bed!!! IN OTHER WORDS, the help/relief was temporary AND partial at best…the edge it took off never lasted! Even while I was still in the treatment course! Once I did seem to have better results with one acupuncturist, yet after three visits, the amount of relief plateaued and then dropped immediately when I stopped the every other day visits!! I have spent hundreds and hundreds of dollars on alternative medicine over the course of my pain life, so I was committed enough to do that, and I followed through the course…even when I was so bruised by the acupuncture and burned from the heat treatments I wondered if I was only a little better because something else hurt worse! I do believe in micro injuries (unseeable through diagnostic testing) in our muscle fibers, and I believe we have strains even when we use good body mechanics. With sleep issues, many of us never get to the healing stage of sleep…so it stands to reason these issues could contribute to our pain…as in be part of it, just like the help the treatments gave me was with only part of my pain, for a short while! My spinal cord was so stenosed that I had tremendous pain in the recovery room after c-spine surgery last year….when the pressure on it had been released…like a 40 on a scale of 1-10!! There was no muscle involved! Pure nerve pain! When a fragment almost amputated the nerve root in my lower back after surgery, it was the nerve pain that laid me low!! The muscle pain came from not walking correctly!! The bone on bone in my knee has CAUSED some muscle pain in my leg, along with bursitis, tendinitis, and ligament tightening!M. So, yes, muscles are part of the picture because their function is impaired by injury, disease, and pain itself!! But they are NOT the WHOLE picture..and seriously, once again, that's my biggest problem with Dr.Rodrigues' message! Plus his apparent opioid phobia and the fact his comments on other articles are always about his agenda and not the article! Or our real issues!! And I do hope he has a seasoned editor, I'd recommend that for his book!! And I hope they're well paid!! They'll earn it!!
Kathy-Jackie Kathleen Walker-Melcher at 11:51 pm
I did not start taking opiates until everything else failed. I've tried all of these "therapies","practices",biofeedback, hypnotherapy, acupuncture and pressure, magnets, copper, Supplements,trigger point, Myofasial release, tens units and other stimulater type therapy. These are just a few and I've done them multiple times (it might work this time). You seem to believe we started having some pain and immediately started taking pain pills. I use the therapies I've been taught and I still have to take my meds or I can not function at all. It is hurtful to me when people think I just jumped at the easy answer "opiates". It doesn't work that way. Those of us who need them, to have any quality of life, are at the end of our ropes. With no other options. And it is demeaning and demoralizing to have our suffering minimized. Yet I still read these articles and buy books that claim they can "cure" me. Yet they never live up to their claims.
Mathew at 10:47 pm
"Examples of irreparable harm or the traps that Michael Jackson, Whitney Houston and Prince fell into to their deaths." ~ Stephen S. Rodrigues, MD
Let's be absolutely clear on one subject sir. Celebrities, the Aristocracy of the United States are a class that is not subject to the same rules as the commoner.
I take offense to your use of their names in the same context as those of us who suffer everyday. Not to jump around on stage as 50 year old Michael Jackson did, pretending to be 25, but to extricate themselves out of bed daily.
Is there anyone here who honestly believes if Hillary Clinton or Donald Trump injured their spine, the CDC guidelines would apply to either?
Terri Lewis at 9:48 pm
I'm all about the neurobiology of pain. The brain is connected to the rest of our organ systems. Neuroinflammation is the nut we have to crack.
Sadly, we have few alternatives for pain intervention available to persons with chronic pain that are available to patients.
The DEA has a stranglehold on cannabis because it maintains no medical benefit even as the rest of the world is unraveling its' properties and possibilities. Just ask the Israelis.
Importantly, an ounce of prevention is worth a pound of cure, and many would not have experienced the injuries they are dealing with now had they had thoughtful preventive tools available to them prior to the event that injured them.
Some of us just have bad luck, bad genetics, etc.
We can't see biofeedback objectively unless we're hooked up to equipment.
That doesn't mean its' not effective. Same with EMDR which stimulates the 6th cranial nerve and produces a host of biological responses that are particularly impactful for PTSD.
Tai chi is an excellent methodology for low impact strength and balance training – to most of us it 'looks silly and can't possible do anyone any good.' Same with yoga, but we are unlocking its' benefits too. Cure? No. Restorative? Could be.
Meditation? Can't sit that long because it hurts. For some it is far better than SSRIs SNRIs and alcohol.
I do not know Dr. Rodriguez. His message is not particularly well communicated.
But because I know a little something about this topic, I am not willing to disregard the opportunity to figure out whether there are gems among the rocks.
I was introduced to myofascial release 2 years ago at an International Pain Conference during a very troublesome time with a frozen shoulder. I found a trained physical therapist who was skillful and scientific in her approach. Got very focused on the musculature of my shoulder and arm, its nerves, and how it was constructed.
Within 2 months, my locked up shoulder was moving properly and range of motion had been restored. @3 mos I did not know I had injured it. It saved me from a surgical intervention. I had to make a commitment to doing what I needed to do with what I had learned. It was not passive.
I see a number of alternative approaches utilized throughout my stint in Taiwan's rehabilitation system at the China Medical College, a large physician training organization.
I will also say, that the galloping intervention-generated injuries so common in western medicine are far less with Chinese medicine approaches.
I teach PTs, OTs, and Neurologists who are trained in both western and Chinese Medicine. They in turn teach me.
Seeing is believing folks.
Objective measures are important and we need controlled studies. Until we get them all we have are anecdotal reports. There is some movement in some quarters on this issue.
As patients it is frustrating to be told that alternatives are so limited or that magic bullets are available.
Under promise and over deliver.
Dr. Rodriquez might take this to heart.
Elizabeth E. Chute, Ph.D at 7:13 pm
I have been doing yoga, Pilates, meditation, etc. since before I was diagnosed with ankylosing spondylitis. Maybe because of this I have done well, but about 30 years ago I started taking 1-2 vicodin a day. This worked for about 15 years after which trazadone was added at night along with a muscle relaxer. I continued to do well and was active in life, earned a Ph.D. in sociology. However, as I started approaching 60 and had been teaching for about 15 years, my pain increased and I needed a patch in addition. You see, as you may not realize from studying static people, arthritis can get worse over time. I continued to exercise, but started breaking bones, developed arterial stenosis, and may now need a hip replacement. How does this fit into you model? I believe that exercise is a necessary component of good health, but I always needed pain medication in order to participate in it.
Dr John Quintner at 2:36 pm
Dr Rodrigues has for some time been a zealous advocate of the modality of treatment that goes by the name of "dry needling," and of the theory of "myofascial pain" originally espoused by the late past icons, Drs Janet Travell & David Simons. Their successors are still promoting their theory and practice through courses designed to attract health professionals of all persuasions.
Even today, physical therapists in the USA are fighting to have "dry needling" recognised as being within their scope of practice. Here is a link to their latest attempt: http://www.doh.wa.gov/AboutUs/ProgramsandServices/HealthSystemsQualityAssurance/SunriseReviews/PendingSunriseReviews
Let me quote from Dr Rodrigues' comments above: "The exact pathology within muscles which trigger all the pain signals are intramuscular micro scars."
The "inconvenient truth" is that such micro scars ("trigger points") have never been shown to exist (apart from in the minds of true believers).
My colleagues and I have refuted the theory of "myofascial pain arising from trigger points" and have drawn attention to the lack of scientific evidence that "dry needling" is an effective form of therapy. Why on earth should a therapist seek to damage to a muscle by inserting one or more needles when attempting to heal a non-existent lesion?
If readers are interested to follow the vigorous debate that took place a year ago, here is a link to a highly regarded website – Body in Mind: http://www.bodyinmind.org/trigger-point-evaluation/
My thanks are extended to Dr Rodrigues for his invaluable assistance in so effectively destroying the credibility of the myofascial pain theorists.
Kurt WG Matthies at 1:45 pm
Muscular pain is simply one aspect of a small set of pain syndromes.
For example, PT, exercise, needling, manipulation, massage, weight loss, and a dozen other "therapies" may be helpful in a simple cases of LBP, but your "Whole Truth" ignores other pathology that accompanies complex musculo-skeletal disease — arachnoiditis, cauda equina syndrome, disc herniation with extrusion, spinal stenosis, scoliosis, facet hypertrophy with associated osteoarthritis, and central pain developing from untreated pain in an opiophobic world.
Millions suffer from these complex cases, and require opioids as a part of their pain treatment plan to lower pain to levels that allow improved function and quality of life.
Many of us have already tried the remedies you suggest, and many others. If they are not effective, would you recommend suffering quietly as part of their treatment program?
Your "Whole Truth," Dr. Rodrigues, is full of holes and reads like the typical self-help books on pain that already fill bookseller's shelves.
Thank you for your contribution, Dr. Rodrigues, but trigger point therapy books were in vogue 30 years ago. They did little then to halt the pain epidemic and fell from popularity.
Yet, people new to pain will buy anything that claims to be a "cure" for pain out of desperation due to their suffering, as the medical profession turns from considering their patient's pain as an important metric, and fears treating pain from inaccurate information coming from medical authorities.
Stephen Rodrigues, MD at 10:37 am
NO one is a good message if their message bangs into a lifetime collection of incorrect and worthless knowledge.
It is very very difficult finding the words to describe the taste of a lemon. A lemon is a fruit and is the truth. To attain "The whole truth" of the lemon, you also have to experience its taste. The structure is easy to describe yet the taste sensations are impossible to put into words.
"Tradition physical therapy is not myofascial release."
This statement is right, yet it is not the whole truth.
The whole truth cannot easily be expressed in words and language. However, you can get very close by using very elementary level words and terms. Words pack power which can evoke ideas and concepts that are not grounded in the realities of how nature and the human body works.
The simple definition of pain; I need help with a problem.
The elementary definition of physical therapy; any treatment which applies a "force of effort," a form of energy, into the body.
The simple definition of the body: skin, subcutaneous tissues, nerves, arteries, veins, lymphatics, muscles and all the visible and molecular communications between those structures.
Untreated soft tissues will lead to sick muscles crushing the life out of itself, nerves, blood flow, immune function and mental awareness. Think CRPS, TN, and PTSD.
The simple definition of force and effort are energy; any activity which will move tissues into action, increase blood flow, or increase temperature thus stimulative in nature.
All of these terms, concepts, ideas and procedures all get mixed and muddled, and they should be avoided at all cost: traditional, physical therapy, myofascial, myofascial release, trigger point, and dozens of others.
The underlying logic:
The most common location of pain in the body is in the soft tissues. The only way to benefit the pain embedded in soft tissues is with physical therapy.
C. Chan Gunn, MD discovered the critical link between hands-on PT AND with Hands-on Needling of the soft, connective and muscle tissues as all forms of PT. The name he gives his method is IntraMuscular Stimulation(IMS). I use IntraMusculare MicroScar Stimulation, IMMSS to add a bit more clarity as to the exact pathology within muscles tissues triggering the pain signals.
As muscle tissues go through the 5 failure stages so does the increase in signs and symptoms and forensic evidence. As muscle tissues go through the breakdown process, there is a need to add more force of effort into the soft tissues which will activate innate healing which is the only way to treat soft and muscle tissue derived pain.
Stage 3 failure may not respond to manual or leverage labor.
Stage 4 may never respond to manual labor or leverage.
Stage 5 cannot respond or benefit from hands-on manual leverage labor.
Stage 5 is end stage muscle failure with internal cellular corruptions and can only respond to BLENDING all hands-on manual labor, thin and hypodermic IMMSS. PLUS the brain trauma, mental, emotional and social issues which are logical when any cancer-like illness is left to fester untreated.
So where do you believe you pain comes from and where is your pain located? The simple questions must have credible and reasonable answers.
Jean Price at 10:28 am
Terri…let's say everything Dr Rodrigues has to say is one hundred percent viable and truthful and proven and just short of a miracle! Who does this, how many are there, how can we find them, how much does it cost, how can it be paid for, how long is the treatment period (with maintenance, I'm assuming), do you have to have a referral, does he require documentation like medical records, are there pre treatment X-rays or tests he does, what are the potential risks, what are the alternative options, what are potential exclusions for participating, and last but not least…where did he receive his training on this and how did he research/determine it was such a powerful and all inclusive therapy for pain? Perhaps addressed in his book, perhaps not! My point here is…listening to alternative treatment options and alternative medicine isn't the issue here. Everyone I know is open to that!! Yes, myofascial releases, trigger point acupressure, massage, all that does have a benefit…and most will either get you to a plateau of some reduction in pain…or at least they are relaxing. Most of us have done some or all of these types of therapies. So I don't think his approach is that new…it's just more intensive AND it's exclusive of other therapies. To me, that's the problem! And the sad part is, for most…the relief of alternative therapies is temporary!!! Or it has to be ongoing, indefinitely!! Not financially possible for many! When you get in the car, ride home, and the pain is beginning to return already, it's hard to think more of the same is THE answer!! All these therapies have an end point, in my opinion and experience. And yet Dr. Rodrigues doesnt seem to consider his therapy like this..but rather speaks of it as THE ONLY thing that would help us. I find this inappropriate…especially from a doctor! And were I inclined to actually consider pursuing his care and these treatments, his use of the three celebrity overdoses as an example of the harm done by our doctors is a big red flag to me!! It tells me he probably hasn't a clue about how we use medication and how we live our lives! (I wonder if he even understands some of our patho-physiology!) Nor does he seem to truly understand how closely pain and functioning are tied together…not in our muscles…but in our lives! In all truth, how many have seen his name and skipped the whole comment before on articles? I have! You could be assured it wasn't going to relate to the topic…but rather HIS AGENDA! And I'm more interested in things to help my agenda…not his!!
Stephen S. Rodrigues, MD at 8:19 am
These are few true statements on the proper fundamentals of how nature and the human body works:
Over my 33 years in medicine of collected about many deadly medical errors which are contributing high numbers of treatment failures, waste, fraud, abuses, malpractices, mistreatment, meaningless pain procedures leading to the ultimate: doing irreparable harm to millions of Americans.
Examples of irreparable harm or the traps that Michael Jackson, Whitney Houston and Prince fell into to their deaths.
The most common cause of pain his life and living and all the contusions we work, war, running around for fun and play.
The human muscular system allows us to do all these things because it is a perfectly evolutionary designed active suspension system.
Human muscles take a beating, and they require rest, restoration, active awareness of their need for focused physical therapy.
Muscles cannot fully heal without restorative amounts of focused physical therapy.
Human muscles of the only organ system which requires constant awareness and ongoing personalized and customized physical therapy care.
Human muscles will only respond to the hands-on variety of physical therapy because muscles have to be pulled out, stretched out, kneaded out with particular force in your efforts.
Human muscles will fail to function properly, efficiently, accurately and consistently if they do not receive their regular doses of restorative hands-on physical therapy.
Human muscles which are our active suspension system will fail to be able to support you are physically, emotionally, fail to communicate with your brain accurately, failed to communicate with the other organ systems accurately and thus will fail to support the quality of life.
A perfect example of active suspension system failure is the overtraining syndrome.
Human muscle active suspension system failure can be viewed to fail in 5 stages.
Most all human organ systems will fail in a similar stage fashion.
Ignoring the early stages of muscle system failure will result in catastrophic amounts of pain, misery, mental and spiritual collapse.
The exact pathology within muscles which trigger all the pain signals are intramuscular micro scars.
Intramuscular micro injuries will only benefit from the force of effort apply with hands-on physical therapy.
Intramuscular microscars cannot be touched by medications.
Intramuscular microscars are so scattered, tiny and in infinite numbers of patterns that using a knife to remove these tiny scars would be considered malpractice.
Early human societies discovered a perfect tool to help the human hand apply precise locations of stimulating forced which will target the intramuscular micro scars without bothering other tissues.
Ancient Chinese Medicine Masters perfected the use of a thin filament needle a perfect tool invented by humankind.
C Chan Gunn M.D. of Vancouver was the 1st known physician who put this huge puzzle together in his book where he describes using the needle as in intramuscular stimulating tool.
Janet G Travell, David Simons, Edward Rachlin, Stewart Hackett and a few other physicians also realize that using a needle to stimulate intramuscular tissues was the perfect tool to treat muscle-derived pain.
In the many thousands of pages of Health and Human Services rules and regulations about how physicians should practice medicine in the best possible manner, there is a single line that states acupuncture is not to be used because it is experimental.
In actuality, this statement corrupts all aspects of any possibility of using a thin or hypodermic needles to cure patients who have muscle-derived pain and misery.
Someone put this restriction there because they knew how effective this therapy is at treating common everyday aches pains and stiffnesses.
They put it in this place as a barrier which in essence funnels patients into the operating room force sinister and criminal behaviors of surgeons and interventional pain management doctors.
Terri Lewis at 8:04 am
Our medical model takes a very passive approach to treatment.
If pain originates in the brain (I hate it when I hear that because it causes us to misunderstand the complexity of this disorder), then the solution to pain is to engage the brain to reteach or teach new methods for reframing individual pain responses.
That is what mind-body work does, and what the passive medical model cannot do.
We need to learn how to put these models together to integrate and measure effectiveness.
Tradition physical therapy is not myofascial release. Getting the language systems properly communicating across the professions is our first task.
I vote we listen to what that tale 'the blind man and the elephant' has to tell us about pain.
Cause we're not doing so great folks.
And for the record, I hate it when these word programs make substitutions based on algorithms that aren't useful. A little bit like pain management I think.
Terri Lewis at 7:54 am
Okay folks, let me be the devil's advocate and suggest that we not through out the opportunity to separate the wheat from the chaff.
What we have here is a clash of models, inartfully stated to be sure – but nevertheless there are a few gems to consider in this conversation.
First consider the models for care availble – medical model (insufficient, fails to account for adaptive functioning); multidisciplinary model (lack of providers, poor handoffs); interdisciplinary (everyone gets in the room and looks at the patient as a whole package); rehabilitative model (based on preserving and maintaining optimal function in the presence of injury).
I can categorically state without reservation that myofascial release is an effective tool for restoring function and reducing some forms of pain. Why? I've seen it at work, I've used it personally, I recommend it to others with certain kinds of problems and there is increasing evidence of its' ability to make a large contribution to improvement and pain reduction.
Let me remind you all that absence of evidence is not evidence of absence.
As for the rest of his practice claims, Asian cultures have used some of these techniques for thousands of years with great success. But they are adjunct to a body of practices that fall into the category of mind-body work – and western practitioners know very little about these practices because the medical model is our Bible.
And its' not working so well for us, just in case you haven't noticed.
We are learning a lot about a lot of things, including the role of glial cells in maintaining neuroinflammation. We don't yet know how or whether mind-body work will teach the body to change its' response to certain stimuli or to turn off certain patterns of responding.
Dr. Rodriguez may not be the best messenger, but let's not toss out this message just because we don't have the experience to understand it.
I have no conflicts of interest to report here.
So, just saying,
Mathew at 2:03 am
If something is not The Whole Truth, it is a part truth and any statement that is not 100% Truth is a Whole Lie. ~ By Stephen Rodrigues, MD.
Well Dr. Rodrigues, by your own standards, I believe I can say without equivocation that your article is "A Whole Lie". Far worse, an insult to the intelligence of those of us who would love to trade physical bodies with yours. I can assume that you cannot comprehend the amount of phyical energy it could possibly take to brush your teeth or that pain caused by an impingement to the spinal cord could be so extreme, that urination is only possible after 15 to 20 minutes of meditation to relax. A bath or shower? Forget it. That could take days of preparation.
The continuance of the physical body we can agree is a daily routine, that without exercise, the muscles will attenuate or atrophy.
Early in my life, I was an accomplished student of Isshin Ryu, a form of Marital Arts. It still remains a part of my life to this day, but after my injury to my spinal cord, it would be fair to say that other things took priority.
No one need argue that opium, the derivative of the poppy plant is the closest natural substitute to the bodies naturally produced opiate Enorphin. If the body is restricted from normal movment by an injury, then the bodies ability to produce natural opioids is also restricted.
It has always been my goal even though my illness does not currently have a suitable remedy, to maintain enough muscle mass as not to rely solely on my skeletal structure. For over a decade now, I have found opioids to be the supplement necessary to continue exercise and maintain muscle mass. I am turning 57 years old have lived with chronic pain for over a decade. My body is susceptible to inflammation caused by humidity and weather in general.
At 57, even if I were in perfect Dr. Rodrigues standards of health, I am not 20 anymore. Coupled with my degenerative condition, Last month I received the bad news from my doctor that he can no longer prescribe opiod based analgesics to me. After a year of success with him and hearing how impressed he is was, the carpet is now being pulled out from under me.
I now look forward to having to suspend my exercise, my walks with my wife, our trips we took together. I should note that this is my second Doctor in the past 5 years, the first submitting to the government's intimidation. My current Phyician was the last I could locate that would not submit to the lunacy of the CDC guidelines. Unfortunately for me and my wife, he has submitted.
Many thanks and appreciation to those Doctors and Nurses who submitted their comments below that demonstrated a logical grasp of reality and TRUTH!
Kurt WG Matthies at 12:16 am
Judy Foreman, in her excellent study of the pain epidemic that effects over 100 million Americans, A Nation In Pain (2014), tells us that a four year medical education in America includes, on average, six hours of instruction on the medicinal use of opioids.
Dr. Rodriguez must have been absent that day, hence, his "Whole Truth" about resolving pain and opioid dependency.
Scott Fitzgerald remarked that "there is no confusion like the confusion of a simple mind."
Unfortunately, many thousands suffer needlessly because of simplistic solutions to complex pain diseases when consulting similarly confused men and women in white coats who share the same ignorance of intractable pain, pain treatment, and "getting high".
Mark Nawrot at 12:06 am
I CANNOT believe the NPR carried this article on the site. It is insulting to chronic pain patients to be subjected to such unscientific drival. What about nerve damage? Is my bodt going to, heal itself of that? Even tho the HIV virus, the antivirals that treat, and the diabetes aquired from the antivirals are a given, and cannot be eliminated? I was on vicodan for the past 4 years, no increase of dose 7.5 tid, now that the Government has made it impossible for me to getan Rx fir it,, I have not had it in 6 months,,, gjess what I expeirienced NONE of the withdrawal symtoms the dr, I use lower case D on purpose, claimed that would happen. Is the dr trying to be the poster child dr for th DEA, CDC, and FDA ? The ONLY symtom I expierienced after not being able to use vicodan was PAIN.
Deborah at 12:06 am
This is my whole truth. I am appalled with this article. With all do respect… NPR I am thanking you in advance, for the many excellent articles presented thus far. I am, like many others suffering from chronic pain. Having exhausted many options for adequate medical care and now struggling to live each day with a emphasis on quality of life. We must unite and stand firm to bring about changes with regards to guidelines.
Stephen Rodriques MD..
Are you serious?? I feel you are using this forum for notaritiy and profit. Seems to me, you think this is your opportunity to kick start and promote a book in which you have yet to finish writing.. available @………index/HTML. However, my question to you….have you suffered prolonged dibilitating pain in your life?? I pray not..If you have, so sorry and maybe…you might mention that fact..so one might believe your are a compassionate human being..capable of feeling pain..
The way you present yourself makes me feel you might be a person with a god complex refusing to admit the possibility of error or failure, even in the face of irrefutable evidence.
You seem to be highly dogmatic in your views with your personal opinions as though they are unquestionably correct..
Perhaps, you have lost touch with reality.
This is my whole truth…
AF at 9:47 pm
I'm so happy to see the comments from physicians denouncing the author's theories. It's can tell you that I had years of physical therapy, with multiple techniques BEFORE EVER TAKING OPIOIDS. Some was helpful. Much wasn't. Even the most effective therapy was not enough, but I somehow managed to trudge along (this was much earlier in the course of this whole odyssey). It was only AFTER I started to get some relief that I really began to make gains with PT.
Robin Jewell at 9:43 pm
What kind of pseudo-scientific nonsense is this? Cupping? Needling? Chi Machine? I look to National Pain Report for articles about how to advocate for yourself and fellow pain patients, news about pain and pain treatments, and scientific information about illnesses and treatments, not pseudo-science fluff that denigrates those of us who live with pain daily.
Alyse at 7:32 pm
Oh my gosh….I really wish that I had never read this article! I thank God for all the comments
on this article! I felt like I was reading my death sentence! I am a 69 yr old female….I was diagnosed with CRPS/RSD in 2005 which was the result of two failed right knee replacements. I won't go into detail how I have suffered with AWFUL pain…life changes I never thought possible…and a continuing thoughts of
knowing if I were dead
there would be no more suffering! Would I take my life…NO!!! This disease has taken its own life in my body! But I must keep going since I fear the alternative! I read
National Pain Report for the need to know what is new in treatments…this article was so unnecessary…just one man with MD after his name thinking he holds all the answers! I may not choose to read anymore articles…but I just wanted to thank all for their comments…I still have hope that someday there will be no more pain! This so called doctor's article left feelings of hopelness!
Patrick T. Hennessey, MD, MPH, FACP at 5:56 pm
This "article" is self-promoting, self-aggrandizing garbage without a shred of factual basis. Allowing this to be published on this or any other site is a disservice to chronic pain patients and the legitimate practitioners who honestly care about, and attempt to help, them.
Granted, opioids are not the answer to all pain, but neither are physical modalities.
John Quintner. Consultant Physician in Rheumatology and Pain Medicine (retired) at 5:34 pm
I cannot understand how this guy has morphed into a "pain specialist". Usually I will congratulate anyone in my profession who is able to get a book on pain published, but in this case I will make an exception.
HJ at 4:01 pm
I cringed when I saw who the author of the article was.
I'd love to believe that this all will "cure" me. But here's what this is: A specialist who sees his treatment as a religion. The only religion.
The danger is when a specialist will not refer when referral is in the best interest of the patient. If I fail to get better, it would somehow be my fault.
Many of us have walked down the road you suggested. These are good adjunct therapies, yes.
I remember a particular relative of mine who has fully invested herself wholeheartedly in a specialty: chiropractors. I admit that there are good chiropractors out there, surely… but when a chiropractor says he can cure asthma, it's time to run… run in the other direction. This is the feeling I have about Dr. Rodriguez.
And frankly, I've conversed with him many times both here and on Facebook, and at times, I felt like his ideas were to be pushed down my throat and I was something "less than" because my doctors handle my care differently. I'm entirely frustrated by his assertions. I've determined that I'm the one living in this body, I have come to know this body I live in, and I'm not going to let any "doctor" shame me for not following advice I've tried in the past and found to have limited application.
It's not that these things don't help. They are far, far from the cure that Dr. Rodriguez proclaims them to be, and I will not deal with any more doctors who will not listen to me as their patient.
Marna Parker at 2:57 pm
Thought I was reading from an 1880's pamphlet. Oh, wait. Ya, fibromyalgia, degenerative disc disease, spinal stenosis, Psoriatic Arthritis AND rheumatoid arthritis. Gee, let's make my muscles hurt more, and not give me any medications for pain relief. Might as well give me a bullet. I agree that your "barking up the wrong tree"!!! Go play on Facebook and leave us chronic pain patients with a little less guilt for not being able to afford or do all of your treatments and classes. Or put yourself to good use and start preaching to the insurance companies to cover some of those alternate, temporary fixes.
Marlene at 12:49 pm
Joints and nerves cannot cause recurring frustrating pain
I was shocked when I read this article, and then when I got to this sentence, I thought for sure this was a hoax. Maybe an article from The Onion. I suffer from Ehlers Danlos Syndrome and Chianti Malformation. Someone should tell my ribs that they are incorrect for having pain due to slippage at the joints and shooting nerve pain from spinal cord damage. Apparently, they didn't get the memo. After decades of listening to physicians tell me the same thing (and utilizing a multitude of the above listed therapies to no avail), I used to get emotional, feel abandoned, frustrated and became clinically depressed. After the validation of my diagnoses and psychological counseling, I've learned to not take comments like these personally. So, for those of you who suffer from constant neuropathic pain, make sure other people's opinions, even and especially those of physicians, do not make you feel bad for taking medication that gives you a semblance of a quality of life.
Mel at 12:21 pm
WOW….just wow….
I am not only shocked that this is a DOCTOR writing this half hearted article, but it reads like an uneducated juvenile wrote it. Sorry if I seem a bit harsh, but I am not only a pain patient, but I am also a nurse, and have read dozens upon dozens of medical journals and the like. This does not read like an article written by a professional that has done any research regarding pain.
I won't go into all my arguments against what is said here, but I will bring up the fact that his statement "The muscular system is the only location for recurring frustrating pain that everyone will experience in their bodies. Joints and nerves cannot cause recurring frustrating pain." is completely FALSE, and a dangerous statement at that. I would like to see where he obtained such a shocking theory, his sources and research articles. I am sickened and saddened that National Pain Report would publish such a monstrosity, but I will acknowledge that the entire book may clear up some of my concerns. I will read it for sure. But until then, here is my main concern….
Its almost impossible in this day & age to get a physician to prescribe ANY pain medication, no matter where it { pain } "originates" which in some cases is a lifesaver when your at your wits end & suffering unimaginable pain. Articles such as this lend credence to the theory that only certain types of pain warrant opiates, which we are finding out more & more treat a variety of pain patients effectively.. An example is a woman who has fibroid tumors on her ovaries. Or someone who has spinal disc degeneration. We as humans are ALL different, our pain receptors are all different and we respond to treatments and therapy ALL DIFFERENTLY. For example, he touts using physical therapy and YOGA for muscular pain, I won't argue that at times this can be effective. But you tell that to someone who is out of shape, has ambulatory issues & or no financial means to access such treatments. I find it particularly cruel to not treat someone who is "suffering" because you feel that if they would jump on a Pilates board they could cure they pain. First & foremost we must TREAT THE PRIORITY. Pain is NOT NORMAL, its your bodies way of telling you something is not right. Ignore that, and you risk further damage, that may not be repairable. Yes you can become addicted, yes you can become tolerant, and if at all possible you should not use them on a regular basis. Again, that falls to the provider who MUST follow up on their patients. Regular appointments and through assessments of how the treatment is progressing….most physicians today do not even remember their patients treatment they have prescribed let alone follow up to check efficacy.That is a provider issue, not a patient issue. I can tell on many occasions doing rounds with a doctor and having to pull them aside and correct them on the patients treatment plan. Nobody is perfect but if you want to throw stones, ineffective treatment plans & follow up is a real core issue with chronic pain. Is does not take long to figure out who the drug seekers are vs someone who is truly seeking treatment and is willing to do alternative forms of therapy. Now I am not advocating for general purpose usage of opiates, not at all. But I am advocating for common sense here, and to put all pain patients in a this mold of opiates will not work for your type of pain scenario is just plain WRONG. I think Dr. Rodrigues is trying hard to put the cart before the horse, which sadly I see among many MD's today. Mostly because they fear that their licenses and practices are up for grabs by our government. That issue needs to be addressed much more so than the knee jerk response to throwing all pain patients to the wolves which is what is happening currently.. For a lot of us, taking opiate pain medication is just ONE in the arsenal of treatment for chronic unrelenting pain. Its not a choice but a requirement to get through our day to day lives.
IMO, Doctors are seeking a "release" of responsibility for treatment is the real issue here instead of standing up to our government and telling them STOP TELLING US HOW TO TREAT OUR PATIENTS! Because that is the true core issue here, whether it is out of fear of loss of practice or just plain insensitivity to their patients. Its time for MD's and all health care providers to stand up to the DEA & demand that they stop persecuting patients, doctors, pharmacies and others for giving their patients an alternative to HELL which living with chronic pain really is. You tell them up front the consequences of long term opiate usage, have them sign waivers that they understand & develop a plan of care with the patient acknowledging this plan. If they do not fullfill their end of the bargain, you slowly wean them off and discharge for non compliance. Period end of story.If your patient is complaint and you've tried every other treatment modality, than you have NO OTHER ALTERNATIVE then to treat them with opiates. PERIOD!
In addressing pill mills….Yes there are pill mills, & yes those folks need to be shut down and license's revoked. Nobody is arguing that, but they are not as prevalent as those in the government would like for us to think. I have NEVER seen or heard of a pill mill and I have worked in 6 different states throughout my career. I think the knee jerk response to shut down ALL opiate providers is a propaganda tool for what purpose I am unsure. But find a few drug addicts who have overdosed on grandma's codeine and wha la! You have your next episode on 20/20! The bottom line is here a DRUG ADDICT stole G MA's medicine and overdosed. Why should that affect the man who has fallen off a building in 08 on the job and has chronic serious back degeneration and pain & his opiate pain treatment? It should not…but today it does because that mans doctor has been persecuted by the government for prescribing long term opiates to his patients.
In conclusion, as a pain provider and a chronic paint patient, please stop making it appear that we are seeking band aids for something there is a cure for. There is NO cure for chronic pain, PERIOD. Only half hearted measures of treatment because our government has made criminals out of our providers. Now really….who are the SICK ones here????
Bonnye at 12:13 pm
I'm with you Maureen. In addition to Systemic Lupus, secondary Sjogrens, and Renal Tubular Acidosis; my bleeding and ulcerated bladder (from Interstitial Cystitis) certainly agrees with you as well.
I'm also quite tired of people (even Drs) who have never lived with chronic pain being so judgmental.
StevefromMA at 11:52 am
Maybe your good intentions help your patients but I'm with other folks here thinking of FM and similar disorders as central sensitization disorders only marginally helped by body treatments. Yoga, Barnes myofascial, acupuncture, etc., did not help me. There is suggestive data that a ketogenic diet might help FM and it's the only metabolism restart I can think of so I am strongly researching and considering it.
Would be interested in any comments or experience of folks here with this.
Jean Price at 11:44 am
Maureen….although I haven't researched the good doctor, I do have respect for the therapies he suggests…as ADJUNCT therapies, possibly even with the hope of stopping pain medications and other types of medications too…WHEN AND IF ABLE! Without those opioid medications, many of us would not be able to even consider his therapies! I have to admit I feel it is suspect when anyone swears ONE type of life style, or diet, or exercise, or medication, or physical therapy, or electrical device, or one type of ANYTHING is the end all and cure all for pain for all patients!! Especially the pain that we experience…daily, moderate to,severe, and life limiting! From what your wrote, Maureen, I gather it is more his enthusiasm speaking than any quackery! And the right kind of enthusiasm could be a huge help to us all! But, I also will admit my general displeasure in this article and the doctor's approach to pain medication!! It speaks of,once again, ASSUMING he knows what's best for everyone with pain….and yet has never seen us or had insight into our specific and oh so individual problems!! And his negative emphasis on pain medication makes me wonder if he understands pain and the resulting inability to function!! II once had a very experienced, committed physical therapist I worked with for literally years question why I was so reluctant to have the surgery recommended…because his months of one-on-one help and my months of painful commitment and a die hard attitude couldn't make my hip muscles "fire" and contract…they were useless due the nerve entrapment in my spine!! So I was walking entirely with my psoas and other abdominal muscles and creating many more problems! It was to be my third and fourth surgery on my back…and because on the first one I had learned the hard lesson that outcomes can be poor even if our decision was good! So I was trying with all I had NOT to go to surgery again. (FYI…I ended up marking an "s" on the calendar every day I wished I had gone ahead and tried surgery, and and "n" for no…and at the end of the month, I only had six no's…and I made my decision to go ahead with the surgery.). Again, to me this points up the issues we face…choosing the right therapy as individuals for our needs…at the right time…and having a wide range available to chose from INCLUDING medications, INCLUDING opioids!! I always have had a healthy respect for physical therapy…not the "fake and bake" type of hot packs and assisted range of motion exercises…although those have their place…but the real work of physical therapy…. exercising and strengthening, stretches and manipulation like trigger points and acupressure, and assessing any measurable improvements…all under the tutelage of an experience and motivated physical therapist. Ohysical therapy is not seen as acute care…therefore the physical therapists don't FIX us, but rather teach and guide us. Sadly, many use the acute care role of "expert" and if we don't get "fixed"by them, then WE become the problem, not our lack of function or pain!! We see this mindset in our doctors all the time! What we need instead is a partnership…where both people respect the other's opinions…and ALL options are presented, with the PATIENT making the care choice decisions…not the government agencies, insurance companies, pharmacies, and other doctors thinking their way is the ONLY WAY TO GO! All this being said, I would hope Dr. Rodrigues would reevaluate his stance and possibly consider WE might just have a point in using opioids medications ….sparingly and with a healthy respect SO WE CAN PARTICIPATE IN OTHER TYPES OF THERAPIES! And IF he does, then he just might receive more interest in his enthusiasm and expertise from all of us who feel now like shutting our ears to just one more person saying we don't need pain medications to help us function, to help us live life with some semblance of normality!! He might even decide to be a voice to help us rather than seem like all the others who are slamming us against the wall!! That would be so nice, wouldn't it!? I keep hoping someone will surface with support instead of judgements!! I'd imagine NPR will get a lot of hits on this article, but I wonder if they have any idea of the frustration it can cause us!?! Or care?!
Heather at 11:30 am
Wow. I really take this as offensive in a lot of ways. First off, not everyone is the same with the same conditions and at the same stages. It is not all muscular related either. It is muscular, bone, nerve, degeneration, deterioration, impingments, and the list goes on. Maybe for simple people with 1 or 2 no or ailments but not those of us with multiple autoimmune diseases-Ankylosing Spomdylitis along side of severe fibro with myafascial pain syndrome, osteoarthritis in my entire facets of the spine, bilateral AC shoulders with nerve Inpimgement in right, right hip with osteophytes and looking at possible hip replacement soon, left knee, both hands and carpal tunnel, DDD, multiple bulging disk in cervical and lumbar spine as well as bulge in thoracic with lots of osteophytes around it, kyphosis, lordosis, neuropathy, neuralgia, Rasiculitis, snapping hip symseome where hip pops in and out, IBS, Gerd, Esophogitis, chronic pain of course that never goes away and if it were not for small amount of pain meds trtjrj ould not be able to function. I use a cane now. I've done therapy 6 or 7 times and last time they told me my body was so compromised I was only allowed to do water therapy which was awesome. Lived and we bought a pool and it helps some. Use a TENs unit at times, ice and heat. 2 rheumatologist have told me I'm too complicated and last the point of treatment including Mayo. Waiting on 323rd as pain Dr believes I may have MCTD, Sjogrens, and Reynauds also. In 41 and a disabled nurse. I've been robbed of my life. I've tried and I just can't do it. Or breaks my heart as helping others is my calling but can't sit or srams for more the. 20 min or so without exxrucoatomg pain. No bending sroopomf squating or i will tip over and need help to get up. Csmt lodt more than 5 lbs. Camt cool do laundry uars work anything and everything I use to love to do. So my little amount of pain meds have never ever made me high what soever as I am a true pain patient. I will tell you they need to focus on some of the antidepressant out there that will knock you out dorb3 days with 1 dose. As Cymbalta and many others. In am Real, O am a pain Patient, I am not an Addict, so CDC and others Need to stop tako g away from those of us who have prod of disorders and diseases thru bloodwork, Xrays, MRI. CT scans, endoscopies and colonoscopies and many other test. An addict is someone who does not follow protocol or orders and takes more than ordered to get high or buys off the street. Whereas I Don't. I signed a contract and get drug tested every 3 months and tjats how it is. O follow the law and the rules. NO ONE SHOULD HAVE TO SUFFER BECAUSE OF NONSENSE AND BIG HEADED GOVERNMENT OFFICIALS AS ONE DAY TJEMSELVES OR A LOVED ONE WILL ENDURE PAIN AMD NEED HELP. SO EVERTONE PLEASE BE YOIR OWN ADVOCATE, STAND UP FOR YOIRSELF AND YOUR RIGHTS. KNOW YOUR DISEASES AND DISORDERS. END OF RANT. TIRED OF BS. MY question is what all you all going to do about the increase in suicide that is now rapidly occurring. Hide it and cover it up. On no they will test them during autosy and say of they had narcotics in their system, it was a drug overdose. Yep ladies and gentlemen this is what out medical word had become. How sad it is………
Sheryl Donnell at 11:16 am
When he says "The human body is perfectly designed to take care of itself. All we have to do is make certain that we take care of our daily requirements of nutrients, wellness, mindfulness, physical exercise, physical therapy, stretching and sleep hygiene. Then our bodies will be able to automatically restore." I immediately discount anything he is going to say from there on.
There are scores of women who were serious athletes, best nutrition in the world who would have died during child birth without a C section. His theory is blown right there.
What about a 2 month old who develops cancer, diabetes, or any other numbers of illnesses?
In fact, our bodies are mysteries. We don't always have a clue why one person gets ill and another doesn't.
Discounting the entire nervous system? Preposterous!
Whyou did you give him any more publicity?
Katie Olmstead at 10:47 am
I'm sorry. I don't usually post critical things in comments. However…I quote: The human body is perfectly designed to take care of itself. All we have to do is make certain that we take care of our daily requirements of nutrients, wellness, mindfulness, physical exercise, physical therapy, stretching and sleep hygiene. Then our bodies will be able to automatically restore.
Well, our bodies are imperfect. Things go wrong, terribly wrong. Our bodies are not perfectly designed at all. You can do all the TLC, the best diet, ideal weight, exercise regularly, even go to non-western practitioners, and still be in pain. Pain that may need narcotics so that one can live as normal a life as possible. This article rubs me the wrong way.
Curious what others think. I do or have done a lot of those good, healthy things, AND I take narcotics.
Bob Schubring at 10:01 am
Dr Rodrigues is missing the whole truth about the opioid receptors built into the human body. Those receptors bind to the hormone known as Endorphin. Endorphin is secreted by the human body.
So the whole truth about opioids, is that normal people are "high".
Ever notice the depressed funk into which people lapse, when hospitalized for 3 or 4 days and on bed rest?
Ever notice the similarities between bed-rest-induced depression, and opioid withdrawal?
What you were noticing is endorphin withdrawal.
A stagnant body stops making endorphin. Stops feeling euphoric from the endorphin. Starts craving endorphin.
So, here's the whole truth about exercise and pain.
Exercise hurts. And exercise creates endorphin that works exactly like opioids do.
So the first priority is to discover what structural problems (e.g. Town muscle or tendonitis) cause pain when the patient moves. Fix those problems. Or else, invent or discover some exercises the patient can do, without reinjuring the joint or muscle that is injured. Make sure the patient has some of their daily pain medication available to treat breakthrough pain that happens after exercise. Get the patient moving, and treat that pain with medication. As the patient begins making more endorphin, the pain diminishes.
Now pay close attention. This is the part where every bossy person gets confused and starts giving out harmful advice.
Opioids don't relieve anxiety.
If the patient is terrified of uncontrollable pain, the patient's anxiety will increase their awareness of pain. You have to proceed in a way that builds confidence. If the patient has more anxiety than pain, an anti-anxiety drug such as cannabidiol or alprazolam will get that patient less afraid. Some patients report major reductions in pain, just from using an anti-anxiety drug to help them relax. I am one of those patients…I developed a spasm in my lower back that recurred, frequently, after a car crash. Relieving my anxiety loosens the muscle. I go from a stabbing pain that makes it impossible to stand up, to a dull ache that I can ignore, depending on my level of anxiety. So I learned to stop feeling anxiety. One of the most effective tools for doing that, is to speak up and correct other people when they give me harmful advice.
All these foolish attempts to construct a religion around biochemistry and establish a secular materialist priesthood who "treat addiction", have failed. They were failures 102 years ago when the Drug War was first invented. They remain failures today.
Reiterating the high point. The opioids, like the body's own endorphin for which they substitute, moderate the feeling of pain. They do nothing for anxiety. That's a different bodily system entirely. To treat the patient's complaints effectively, recognize both sets of symptoms and treat both. Get the patient moving, and be certain to cause no further pain and anxiety in that process. The patient will learn to control their symptoms and will need less care than they currently need.
Kathy C at 9:55 am
More Snake Oil! This book might sell because it goes along with the current Ideology. "Muscles" indeed, maybe on some level, such as people who over exercise or develop a weekend injury this might apply, but it is absurd if give it some thought. It does not describe trauma injuries, Broken or damaged bones, joints, ligaments or nerves. The typical kind of "New Age" quasi religious nonsense. If he plays his cards right he can market this drivel on one, of the many InfoMercial channels on cable TV. This will go well with all of the other Expensive "Cure Alls" the gadgets, supplements, and the other nonsense directed at desperate people. There are lots of us who tried all of these Alternatives before even considering Opiods or Surgery.
The problem is there is no Science anymore, it is all equal now that Quacks have taken over. There is no tracking or even counting of the people who have had their wallets cleaned out, while attempting these "Cures. These go along just fine with the current Ideology of ignoring the negatives, while presenting an example of one person who thinks he was helped. The public has been duped into a false narrative that only benefits the Medical and Insurance Agencies. Of course just like everything else, there is no "Research". Certainly if this was a good idea there would be some Research to back it up.
Linda Mouat at 8:14 am
His hypothesis that pain originates in muscles is simply wrong. For instance, Fibromyalgia which centers around the nervous system and, of course, the brain. In this, the brain reads the nerves bringing pain signals, exaggerated. When sending out the brain signal that there's pain. The signal continues to circulate beyond the original need for it.
Another example, osteoarthritis of the spine and degenerative disc disease, the pain comes from the spine. When disc are degenerating, the bones from the spine rub on each other, trapping nerves and instability.
Kathy Childers at 8:10 am
It's impossible for the skeleton or the nervous system to be the primary cause and location of recurring frustrating pain.
I'm sure that this comment would be quite surprising to my neurologist who is currently treating me for Trigeminal Neuralgia (NERVE PAIN). By the way, people taking opioids for nerve pain do not get "high". At best, we get partial pain relief that allows up to be at least partially "normal".
I found this article misleading and insulting.
Maureen at 7:20 am
Dear Dr. Rodrigues,
I've read many of your posts and I used to be offended by them and your aggressiveness to get your message across to us.
I researched you and learned what your practice is all about and matched it with your writings. By now, I get you, and your message to us! I'm not offended anymore.
I even wish I were one of your patients getting that wonderful TLC you speak of.
I desperately need TLC.
But… I for one have experienced many of your suggestions along my journey. I've spent more years than I've wanted to in physical therapy. I know my body well by now. And what works and doesn't work for me.
I've always looked for a more natural way of healing.
I currently practice yoga and meditation, AGAIN, for my own reasons.
One of which is just to get out of the house and be with people!
It's soooo not easy for me. I have given up on it over and over. But here I am, trying again.
I go to 'yoga therapy for chronic pain' classes and I cry, it hurts to just sit or to stand let alone get into a pose or onto the floor. I bring blankets and pillows for comfort.
My classmates are now very used to me having to 'be still' quite often.
Some of them cry too. If anything, it's good to be in the same boat with others in one room for awhile.
In Sept. I am beginning private yoga classes (for free, the instructor really wants to try to help me. The thought of it is exhausting to me but I will give it a shot), because I still remain hopeful that one day it might truly help me… even just a little bit.
I eat a clean diet. I regularly use a TENS unit to release muscle tension.
I do my best overall. At this point in my journey… I have to spend a lot of time in bed trying to get relief.
Still, I suffer greatly. My spine is collapsing, again.
I despise having to be on pain meds. all these years. I've tried to be without them.
My pain levels bring me to a very dark place without them.
As many others here post…. I need them in order to do 'anything' outside of my bed. Often times, I can't even lie down without getting increased pain.
Pain wakes me up with a vengeance every single day. Life is difficult.
I'm well aware of the muscle (and nerve etc etc) damage that my injury and more so that my 4 spine surgeries have caused. I feel it every minute of my life.
And so my argument is this…While your writings are very informational, and I surely appreciate the doctor that you are and I understand your frustration with our community…
Please take no offense but… are you barking up the wrong tree?
I would imagine that 10/10 of us folks who live in horrible daily pain, who visit this site, simply cannot do what you suggest.
At least, not without an attempt at serious committed help/guidance from someone such as you holding us up along the way.
We are damaged beyond repair.
Or, our chronic conditions are intricate,complicated and too fragile.
And/or, we don't have the financial resources, or have a doctor like you to help us so willingly, to hold our hand and walk us through the treatment with hope of getting better in 'time'. Even if it took years.
If the promise is there…I would surely attempt it!
That would certainly be a slice of heaven to us.
So for me, the bottom line and my honest response is this…
while I appreciate your knowledge and your die hard commitment to help others/us, and I wish you nothing but good in life…
reading your column continues to personally frustrate me.