Chronic pain management

Townsend Letter for Doctors and Patients, Jan, 2005 by C. Norman Shealy

At the same time, autogenic training has a very long history of great success. Indeed, Schultz demonstrated that 80% of "psychosomatic" diseases could be controlled with autogenic training. Widely used in Europe, but virtually unknown in this country, autogenic training is a self-hypnotic tool that is the foundation for much of our work. However, I added to this a great deal of imagery, some of the psychosynthesis exercises, Edmond Jacobson's concepts of progressive relaxation and a wide variety of Jungian and Gestalt-type exercises. This we called Biogenics[R]. (11)

Depression -- Virtually 100% of patients with chronic pain have depression. Often the depression was there prior to the onset of the pain problem. Through the years, we have used a very specific approach and can get 85% of depressed patients out of depression within two weeks without drugs. This includes the use of a Liss Cranial Electrical Stimulator, which by itself will relieve depression in 50% of patients. It has been clearly demonstrated to raise serotonin and beta endorphin levels. When we couple the Liss stimulator with photostimulation using the Shealy RelaxMate II[R] for deep relaxation, classical music and educational approaches, 85% of patients recover from depression without "side effects." Interestingly, when they go home about 15% of patients fail to follow through with the techniques they have learned so our long-term success with patients followed up to three plus years has been 70 to 72%. (12-16)

Counseling and Education -- Through the years, we have always done some type of individual counseling. However, some ten years ago we demonstrated that patients could do their own insight just as well as receiving it from a lecture or a private counseling session. This became the foundation for my book, 90 Days to Stress-Free Living.

Other Ancillary Techniques -- Massage, physical exercise and nutrition are all important components for management of chronic pain. For instance, we have demonstrated that 80% of smokers and 35% of nonsmokers are deficient in B6. Virtually 100% of patients with depression, which includes almost all chronic pain patients, are deficient in one to seven essential amino acids and 86% are deficient in taurine. These patients with chronic depression have abnormal blood levels of serotonin, melatonin, beta endorphin, norepinephrine and cholinesterase 92% of the time. Almost 100% of the time they are deficient in intracellular magnesium and all of them have a DHEA level that is either low or deficient.

Even in advanced rheumatoid arthritis, which has failed conventional therapy, and sometimes in advanced cancer, we have been able to help many patients bring their pain under control using these approaches. I have not personally found antidepressant drugs or any antianxiety drugs or antiepileptic drugs to be useful in the management of chronic pain. We have totally avoided the use of narcotics/opioids. (17,18)

In selective patients with back pain, we have found two significant problems: locked or degenerative facet joints or a sacral shear. A sacral shear is easily corrected most of the time with gentle and simple osteopathic manipulative therapy. In the facet joint syndrome, we simply do a temporary nerve block of the suspected facet joints and if this is successful on two occasions, then that joint can be safely denervated with an injection of 0.5 cc of 4.5% phenol and glycerin. We have a fifteen year follow up on hundreds of patients that had an excellent result with the initial approach. Some 80% maintain that long term. (19)