Monday, December 28, 2009

Mirror Visualisation Therapy part 2

This video continues with an explanation of the theory behind mirror therapy and its applications.

Mirror Visualisation Therapy part 1

Dr Ilan Lieberman looks at the history, evidence and practical applications of mirror therapy. Recommended.

Thursday, October 29, 2009

Last post for a while - keeping it real.

I won't be posting for a while so I thought I'd give my thoughts in this post.

The House episode on mirror therapy was great in that it helped spread awareness of a non drug way of dealing with pain. However it's important to keep things in perspective. Mirror therapy is not a quick cure or the perfect treatment. It offers, in my opinion, a tool to add to others things that work for you. There is ongoing research which shows that some people can get a great result. It really helped me. In my opinion it has a better chance of working if you get it right. I would have much preferred to have been guided by a physiotherapist but there was none here at the time I began who knew about guided imagery and mirror visual imagery. In Australia now there are many therapists who have been trained in this area. NoiGroup has exceptional training for professionals in Australia and throughout the world. Their website has excellent resources for patients and professionals. David Butler and Dr Lorimer Moseley explain about this new treatment and the new understanding of the part the brain has to play in pain in free video on the NoiGroup site.. Dr Moseley and his team have a new website Body in mind which I recommend you visit and keep visiting. I recommend that you read the article Guided motor imagery is effective for longstand complex regional pain syndrome.

There is great cause for optimism with so much research current. It pays not to put all your chickens in one basket and not count on one thing, one drug one therapy as a fix. Looking out for ourselves, making a list of what helps, eating well, being mindful, remembering to breathe and keeping it real seems to me to be a good way to go. Stay safe and remember to take care of you.

Wednesday, October 28, 2009

Mirror therapy - the importance of getting it right. - my observations.

I did mirror therapy this morning again for my ankle and discovered something.
I sat as you saw in the video with the mirror between my two feet. I moved my foot as I had done before but had this strange sensation, similar if not the same, as the sensation when I moved my painful foot and not my good foot whilst looking at the mirror image of my good foot.

I realized that I did not have the mirror positioned exactly centrally to my body. I also noticed that it was at an acute angle (smaller) instead of at right angles to my body. When I realigned the mirror all went well and no "strange sensation". It appears to me that the positioning/angle of the mirror such that the hidden foot is in the same position as the mirror image of the good foot is important in using this therapy and that having the position contry to the image could be causing a mismatch somehow.
I speculate whether the distance from the mirror might also be important.

If someone thinks videoing this might help others to understand please post a comment and I'll video what I did.

Body in mind - Dr Lorimer Moseley interviewed on ABC Science.

Dr Lorimer Moseley was interviewed yesterday by Annabel McGilvray on ABC Science radio broadcast. The importance of his new research is evident by the item listed in "just in" on the ABC News website.
Phantom limbs make impossible moves.

Check out Dr Moseley and crew's new website Body in Mind  


There is an excellent post about CRPS on Body in mind here.

Saturday, October 24, 2009

Mirror therapy improves motor function as well as reduces pain.

In the previous posts here and here you saw me using mirror therapy for severe foot pain and loss of function. You will have noticed that I mentioned that before doing the mirror trick I could not move my toes, nor could I raise and lower my foot. After continuing the movement trying to move both feet (good foot while looking at the mirror image of it and the painful, injured foot hidden behind the mirror) eventually I was actually able to move my toes and to raise and lower my foot. This remarkable improvement in motor function was after only a short time of doing this treatment.


I injured my ankle on Wednesday. Today, Saturday, I can walk normally although with some discomfort. There is still some swelling and bruising but much improved. My treatment has been mirror therapy a few times a day, laser acupuncture on Wednesday and Friday in the area of injury and Yamamoto New Scalp Acupuncture. The YNSA specifically is to address autonomic dysfunction. 

Body in mind has posted a comment by Dr Lorimar Moseley on a recently published letter in the New England Medical Journal. In the post he says, "it would be nice to see if pain reduction and motor improvement are related". 

Well in my my case with this injury, function definitely improved with mirror therapy. I went from couldn't move toes or foot to being able to move them. I  suspect that my inability to move my toes was because of pain. Mirror therapy eased the pain but also gave me visual input which created the illusion that my injured foot was moving. I don't pretend to understand this. I just know it works for me and for that I am very grateful. Before having this tool with which to help myself this would have been a different, much worse outcome for me involving ongoing extreme pain and loss of function for a long time.

Thursday, October 22, 2009

Mirror therapy for foot.

In this video I use mirror therapy to ease pain and improve movement in my painful right foot.

Another accident - mirror therapy helps again

Yesterday I turned my ankle on a tree root on my way along my favourite beach track. I landed hard hearing a crack as I went. The pain was extreme and immediately my blood pressure dropped as nausea etc set in. Fortunately the crack was no more than a twig I stood on in an effort not to fall. The sound was the same as the crack last time when I tore my knee tendons and broke cartilage so the memory made me afraid I'd done some serious damage. However the incident caused sufficient pain and shock to immediately bring about a return to autonomic dysfunction. As soon as I got home I took vitamin C in the hope of preventing a return to other Complex Regional Pain Syndrome. In the few hours between the fall and seeing my doctor the pain escalated to the extent I had great difficulty putting my foot to the floor. My doctor used laser acupuncture on the area and Yamamoto New Scalp Acupuncture to help calm the autonomic symptoms.

I was in extreme pain again and really struggled on the trip home. I was very nauseous from the pain and at a loss what to do as I lay on the bed with my leg raised. I struggled to bear the pillow under my foot. I could no longer bear to move my toes or move my foot up and down. I was told this was because of swelling but I had my doubts.

Still convinced this was not CRPS but just my injury I remembered that I'd eased acute mouth pain using my version of mirror therapy. I had nothing to lose so sat on the side of my bed and positioned myself so that I could only see the mirror image of my good foot. This time I used the recommended method of moving both feet in the same way. I knew I could not wriggle my toes on the injured foot so that is what I watched myself doing in the merror. I tried to move the injured foot's toes in the same way. To my amazement I was able to curl them a little. I continued do this for about 30 seconds and then tried to move my foot up and down while I watched my other food doing this. Again amazingly I was able to move my painful foot, not as much but I moved it. I continued for about 30 seconds. Then I put my foot on the ground while watching the mirror image of my good foot doing the same. I did this only for a few seconds.
When I lay on the bed the pain was less intolerable and I could more comfortably rest my foot on the pilows.

I repeated this a few hours later and again this helped reduce the pain.

Today I did the mirror trick again. It helped again and I can now place my foot on the floor and walk with the aid of a crutch.

The pain went from extreme to bearable with mirror therapy.  Whether this pain has been wholly from the injury or from CRPS  from the injury I don't know. What I do know is that mirror therapy helped. I'll make a video shortly to show you what I did and will continue to do.

I will have Yamamoto New Scalp Acupuncture again tomorrow and next Monday and Wednesday. I'm really hoping that this will again correct the dyautonomia that has returned.

My husband and I are going to Vietnam in 9 days. I was getting fit, walking heaps and planning a short trek in the Highlands above Sapa near the Chinese border. This is a bit of a setback but I am confident I can recover by then using mirror therapy and with my GP's laser acupuncture and remarkable YNSA.

Monday, October 19, 2009

Happiness Institute - overcoming the tyranny of when & shape your future now.

This is today's Monday morning email from the Happiness Institute.
I subscribe.

In short - "you are not your past and you can shape your future".


Here you will find not just ideas but strategies to put them into place with relevant links. 
Dr Sharp's last sentence says it all.
"So there it is; the past is history, tomorrow's a mystery, today is a gift...that's why they call it the present."

Ramachandran - On your mind

This TED talk is one of my favoutites.

Sunday, October 18, 2009

Taking bio-feedback for pain relief to the next level.

Body in Mind tweeted about this video from TED talks.
Neuroscientist Christopher deCharms is helping to develop a new kind of MRI that allows doctor and patient to look inside the brain in real time -- to see visual representations of brain processes as they happen in order to help treat chronic pain with a kind of biofeedback. Being able to visualize pain can help patients control it.

Body in mind - Lorimer Moseley and team's new website

Lorimer Moseley and team focussing on clinical neuroscience and the role of the brain in health and disease in their web site Body in the Mind

Look to the left for a link to great information about CRPS..

In my garden today.
I'm sharing some photos I took today with my new camera a Panasonic Lumix DMC TZ7. It's small, light weight and has a great 12x zoom.


Far out on the horizen you'll see a whale watching boat.
In the next photo I've zoomed in.


Click on the image for a better look.

Friday, October 16, 2009

More people talking about mirror therapy

Diane Jacobs twittered about this. Diane has some very interesting tweets. Neuroplasticity is the ability of the brain to re organize itself. The brain creates new neural pathways which allow  it to compensate for injury etc. Recently the TV series House demonstrated this by using mirror therapy to stop phantom limb pain. 


There has been so much interest shown since this episode that CNN did a feature called

Brain mirror therapy CNN interviews Dr Sanjay Jupta.
This follows on from an earlier report For amputees an unlikely painkiller: mirrors. 
At the Walter Reed Center for Veterans mirror therapy is now offered routinely. Dr. Jack Tsao, a Navy neurologist with the Uniform Services University says"this treatment has the potential to benefit amputees worldwide, and the best part is, no special training is required to do it. He gives interested parties instructions over the phone or by e-mail."

Thursday, October 15, 2009

More evidence of the effectiveness of mirror therapy.

Anesthesia Dolorosa is one of the most dreaded complications of neurosurgery and is considered to be non-reversible.  It occurs when the trigeminal nerve is damaged by surgery or physical trauma in such a way that the feeling sensation in part of the face is reduced or eliminated entirely while the sense of pain remains.  


The blog An Anesthesia Dolorosa Miracle tells the remarkable true story of how a husband and wife worked out a way using mirror therapy to relieve and finally stop the extreme pain of this debilitating condition. This is really worth reading especially the great explanations with attached photos. 

Wednesday, October 14, 2009

The Happiness Institute free webinar "Create the best job in the world - for yourself".

This might seem like an odd post for my blog however stress of job loss, having to change our lives and redefine who we are is very real to people with chronic pain especially CRPS/RSD. If in the workforce or planning a return this could suit you.If this webinar isn't for you it may help someone important to you. Remember happiness changes the brain in ways that are helpful.


The Happiness Institute in Sydney, Australia is now offering a series of free webinars. The last one was on "resilience", having the skills to cope with stressors in life. This one will be offered again so I'll post about it then.

This webinar Create the best job in the world - for yourself, is about maximizing the happiness and satisfaction the participants can gain from the time they are working

Presented by Professor Tim Sharp participants will learn how to:

- clarify your priorities, discover your purpose and paint a positive vision of the future
- approach whatever you do with enthusiasm and interact with whomever you need to work with positivity
- identify your inner strengths and attributes and utilise these effectively to enjoy what you do more and to be more  successful
- and finally, be resilient, bounce back from adversity and stay on track once you've planned out your path 

Wednesday, November 11 at 5.30 - 6.30 EST (that's Sydney, Australia time)
This world clock will help you find the time difference.

This is now over however this link will take you to a very good document Resilience - maintaining the happiness through the hard times
and for therapists this is a great resource Building resilience - using positive psychology to get through tough times. (slide show)

Monday, October 12, 2009

Interview on Charlie Rose with Dr V S Ramachandran

Charlie Rose presents an interview with V S Ramachandran in which he discusses among other things, mapping of the brain, treating phantom pain and stroke symptoms using a mirror, autism and the mirror neuron system.


By using a mirror image of a normal limb to convince the brain that everything is OK, V S Ramachandran, a United States Neurologist, in 1998, managed to relieve phantom limb pain.

Since then research has shown that Complex Regional Pain Syndrome and other chronic pains can be relieved by looking at the mirror image of the corresponding painful body part.

In Australia there is a great deal of interest, with mirror therapy becoming more widely accepted as treatment for chronic pain, in particular for the treatment of Complex Regional Pain Syndrome.

In 2004 thirteen chronic CRPS Type I patients were given two weeks each of a hand laterality recognition task, imagined hand movements and mirror therapy. The results upheld their hypothesis.

In 2006 at Oxford University in the UK, Dr Lorimer Moseley was involved in a much larger study . Their conclusion was that Motor Imagery using mirrors reduced pain and disability in patients with Complex Regional Pain Syndrome Type I or phantom limb pain, but the mechanism, or mechanisms, of the effect were not clear.

Dr Moseley and David Butler have written an excellent book which examines this novel approach to pain management, "Explain Pain". The Neuro-orthopeadic Institute of Australasia, NOI Group, was formed to support therapists here, in the USA and in Europe. If interested go to
the left of this blog and click on the link under crps/rsd related articles.

In the UK doctors, such as Dr Candy MacCabe of the University of Bath's School for Health, and Dr Ilan Lieberman, a Consultant Doctor specializing in Pain Medicine and Anesthesia at the University Hospital of South Manchester in England, have been able to alleviate the pain of Complex Regional Pain Syndrome using a simple mirror box.

In 2003 D MacCabe first described the use of this therapy for CRPS Type I. She showed that mirror visual feedback (MVF) relieved pain significantly, and normalized temperature changes in the affected limb. In 2006 in the Netherlands, a trial treatment of patients with Complex Regional Pain Syndrome Type I with mirror therapy was conducted with the aim to improve arm-hand function. The hypothesis of this study is that mirror therapy stimulates cortical representation of the upper extremity. The functionality of the upper extremity is expected to improve more than with only conservative therapy.


This "cortical" model of pain suggests that the brai's image of the body can become faulty, resulting in a mismatch between the brain's movement control systems and its sensory systems, causing a person to experience pain when they move a particular hand, foot or limb. 

Researchers believe that this kind of problem could be behind a host of pain-related disorders such as Complex Regional Pain Syndrome and repetitive strain injury. 

Look to the right of this blog for links to research under "mirror therapy links".


Making a Mirror Box for Treatment of Phantom Limb Pain

This video shows how easy it is to make your own box. mirrorboxtherapy.com and noigroup.com have collapsable boxes for sale.

Remember you can also use just a mirror so long as the problem body part is hidden behind the mirror and you can see the mirror image of the good part.

Thursday, October 08, 2009

Mirror therapy trial - currently recruiting

house s06e03 mirror box

The Utube video which was previously posted here has been removed as it breaches copyright in Australia.

It showed an episode of "House" in which in which Dr House successfully treats phantom limb pain using mirror box therapy.

Sunday, September 27, 2009

ABC Unleashed interviews Norman Doidge about "The brain that changes itself"

Dr Norman Doidge, psychiatrist and psychoanalyst from Columbia University discusses neuroplasticity of the brain and his book "The brain that changes itself". He tells us that "neuroplasticity is not a theory. It is a fact." He says that this is cutting edge material and up to now, no government is utilizing this knowledge to help develop health policies. This should not be trivialized. It's time for "out of the box" thinking.

Although this video only briefly mentions neuroplasticity and its part in pain it is well worth watching. The implications for benefits for us go well beyond management of pain and are relevant for all.

Saturday, September 26, 2009

My experience with Yamamoto New Scalp Acupuncture Part II

In my last post My experience with Yamamoto New Scalp Acupuncture Part I I wrote that I've had remission from Yamamoto New Scalp Acupuncture. That was in March 2008.

Three weeks after gaining remission I had an accident in which I ruptured my knee ligaments and broke cartilage. The acute pain and shock immediately caused a return to CRPS symptoms including dysautonomia. This was devastating for me but I held the thought that if I could gain remission once then I could hope to gain it again. I've decided to wait till I recover from this knee injury before I try again.

This is now a repost of my post on 1st June 2009.

Last Friday (29 May 2009) I had the first in a new series of Yamamoto New Scalp Acupuncture. This time the treatment is specifically to try and bring about remission from CRPS/RSD. I'm going on the presumption that the treatment brought remission last time, it should work again.

Immediately I noticed a calming, relaxing of mind and body. I believe this is because the parasympathetic nervous system is activated.

I have the second treatment today(1 June 2009). At this time I have pain lower right quadrant, upper left quadrant and right wrist pain. The upper left pain is caused by inflammation in the intercostal spine area. I 'm also massaging that area with sesame oil followed by a warm heat pack twice a day. Since Friday the pain has eased a little. I'll blog about this as it will be a record for me about the effectiveness of this treatment.


Five treatments over three weeks later.
Those who read my posts regularly will remember that I have been having a series of treatments of Yamamoto New Scalp Acupuncture in the hope of for a second time going into remission from CRPS/RSD.

I've had 5 treatments and am again amazed by the result. At first it was just muscle spasm and a general sense of calm that I noticed. With this went a slight reduction in pain. Each time I'd notice the same thing. The truly amazing thing for me is that I now am not having signs of dysautonomia. This means I am not sweating inappropriately, my heart and blood pressure are normal, my skin is not hypersensitive etc. CRPS pain is gone. I do have other pain due to things such as arthritis from bone changes due to injury. This is annoying but not overwhelming as CRPS can be at times.

This is the second time I have had this treatment that has resulted in remission from Complex Regional Pain Syndrome. Early last year I had remission for several weeks after treatment with Yamamoto New Scalp Acupuncture. Then three weeks later I had an accident in which I ruptured my ligaments and tore cartilage. I had severe acute pain which caused an immediate return to CRPS symptoms.

I plan to be careful and not risk take as I think that I will remain in remission if I can avoid another initiating event.

This is truly an amazing result.

Thursday, September 24, 2009

My experience with Yamamoto New Scalp Acupuncture. - Part I

The first time I had Yamamoto New Scalp Acupuncture (YNSA) was November 2007.
This is a repost of a post I made on 3/3/08.

I've been having Laser Acupuncture for a couple of months. This was releasing muscle spasm, easing symptoms and was calming. However on this visit I'd had a headache for three weeks. I take Vitamin B2 to prevent migraine so this was breakthrough headache, not as bad as acute migraine. My GP was decisive and said that Yamamoto Acupuncture would be best. I was very nervous as I'd heard needles are not advised for people with CRPS. My scalp on the headache side was hypersensitive as was the whole side of my head. He placed one needle on the non painful side and I felt nothing as he inserted the needle, but it was a different story on the headache side. I really felt the needles on that side and was concerned that the pain caused might have made things worse.


This was not the case and withing 30 minutes the headache had gone. It returned briefly later that afternoon and then was gone and did not return.

My next experience with Yamamoto New Scalp Acupuncture was about four weeks ago. I'd made two small cards which involved cutting and fine motor work with my hands. I have a stiff and thick right wrist from the wrist fracture which led to CRPS. I have limited movement in my wrist because of the severity of the fracture which resulted in permanent disability. Fine motor activity appears to cause irritation to the nerves of my right hand/wrist. This is what happened in this case. I had difficulty closing a fist, holding things, squeezing a peg etc. My nerves were firing and my perception of feeling changed in my fingers and hand. The pain traveled quickly to my elbow. Soon my shoulder became painful. Very quickly old pains returned.( You may remember I've mentioned before that sometimes old pains suddenly return.) By the time I went to the doctor I was in a great deal of pain in my right wrist, elbow, shoulder, right leg, foot and left shoulder, back and my chest. My doctor said it was inflammation and that the median and radial nerves were involved and issues stemmed from C1 to C7 in my back. Not being a medical person, I wasn't sure I understood what he meant but I was prepared to trust his recommendation to use YNSA . I'd read about its use and knew it works for neurological problems.

Although I noticed relaxation immediately, I had no miracle cure. However later that evening I was able to hold things with less pain. By the time I saw the doctor a few days later I had noticeable improvement in my hand, but that was not all. The old remembered pains had retreated. Imagine hurting from head to foot and then the pain retreating back first form the extremities. I've been having two treatments a week. Between each treatment I seem to do something which irritates the wrist again so I get better and then slide back a bit. Right now all of the old pains have gone. My hand is painful when I do certain things with it eg turn on a tap. I've irritated the nerves in my hand today by using a pair of scissors. This will always be a problem due to the nature of my injury. The CRPS involvment is the ongoing pain and symptoms and spread of pain to other areas and resurfacing of old pain.

After the fifth treatment the CRPS symptoms had stopped.


But there's more!!!!


Just over a week ago I went to the City. I walked up a hill and was surprised at having no tachycardia, shortness of breath and crushing chest pain. I walked up two long flights of stairs. Usually I struggle. Again no tachycardia etc.

Later that day a poor gentleman was hit by a taxi right in front of us. I saw him fly through the air and we were first on the scene to call for help and administer aid. I had no adrenaline rush, no symptoms, no sweating, feeling feint etc. I was calm. This is how I used to be before CRPS. Those who have followed my journey will know I cannot take medicines because of cardiac complications from a hyper sensitive sympathetic nervous system. Suddenly I d no sympathetic nervous system response. In fact I was very calm.

When we came home I checked my blood pressure. It was normal. I stood up suddenly and took it again. No difference. Usually my blood pressure drops about 20 points when I stand from sitting. My blood pressure appears to be normal and no wild swings.

This weekend I again walked up hills and stairs with no problem. At present my blood pressure and cardiac response have appeared to be normal for a week and a half. This is nothing short of amazing.

What this means is that right now my sympathetic and parasympathetic nervous systems seem to be responding normally. I had come to think this would never be the case and adjusted my lifestyle accordingly. I was not expecting this to happen. The only thing that I am doing differently is Yamamoto Acupuncture. I am continuing treatment and will post again soon about how this is going for me.

Remember this is a repost from 3/3/08

The road to remission from CRPS/RSD.

As many of you will know I am now in remission from Complex Regional Pain Syndrome. Over several years I've used non drug ways to deal with pain and symptoms.

The most significant discovery for me was mirror visual imagery or mirror therapy. I used this to treat single sided pain and flair up of pain and symptoms. It really works. It not only eases and finally stops pain but it also stops other symptoms such as muscle spasm, improving temperature and sweating problems etc. I was able to regain strength and balance and able to do more physical therapy for longer periods. Mirror therapy paved the way for my recovery.

Other things helped calm the sympathetic nervous system. Please refer to my recently posted list, things such as mindfulness meditation and controlled breathing.

However I had whole body CRPS which involved general disturbance of the autonomic nervous system. So I was dealing on a daily basis with pain and the usual CRPS symptoms of temperature changes, hypersensitivity, muscle spasms etc, and I was also experiencing significant cardiac symptoms of atrial fibrillation, crushing chest pain with any exertion, very labile BP with occasional loss of consciousness. Although mirror therapy made a remarkable difference and provided me with the tools to help myself each time I had a major flair, I still had dysautonomia and pain and symptoms to some degree every day. In other words, even though it was a huge help it did not provide remission from CRPS/RSD.

In November 2007 I had my first ever treatment with Yamamoto New Scalp Acupuncture. I am in remission now and have been for three months due to treatment. My next post is a repost of my first experience with YNSA.

Wednesday, September 23, 2009

Oxygen derived free radicals are possibly the mediators of mechanisms leading to some of the neurological symptoms of CRPS

First suggested by Sudeck in 1942, Dutch researchers' studies supported the theory that oxygen derived free radicals are possibly the mediators of mechanisms leading to some of the neurological symptoms of CRPS. They found
  • high oxygen supply with tissue hypoxia in CRPS extremities;
  • a diminished oxygen availability to the skeletal muscle tissue affected by chronic CRPS;
  • and several deficiencies in the skeletal muscles of CRPS sufferers
Studies in Holland have centered around free radical scavengers as treatment for CRPS. There are many ongoing studies with DMSO, NAC in Holland.

This is supported by research in Israel serum and salivary oxidative analysis in complex regional pain syndrome.

Free radicals are atoms or groups of atoms with an odd number of electrons and can be formed when oxygen interacts with certain molecules. Once formed these highly reactive radicals can start a chain reaction. Their chief danger comes from the damage they can do when they react with important cellular components such as DNA, or the cell membrane. To prevent free radical damage the body has a defense system of antioxidants.

Antioxidants are molecules which can safely interact with free radicals and terminate the chain reaction before vital molecules are damaged. Although there are several enzyme systems within the body that scavenge free radicals, the principle micronutrient (vitamin) antioxidants are vitamin E, beta-carotene, and vitamin C. Additionally, selenium, a trace metal that is required for proper function of one of the body's antioxidant enzyme systems, is sometimes included in this category. The body cannot manufacture these micronutrients so they must be supplied in the diet.

Vitamin E : nuts, seeds, vegetable and fish oils, whole grains (esp. wheat germ), fortified cereals, and apricots.

Vitamin C : Ascorbic acid is a water soluble vitamin present in citrus fruits and juices, green peppers, cabbage, spinach, broccoli, kale, cantaloupe, kiwi, and strawberries.

Beta-carotene is a precursor to vitamin A (retinol) and is present in liver, egg yolk, milk, butter, spinach, carrots, squash, broccoli, yams, tomato, cantaloupe, peaches, and grains. (NOTE: Vitamin A has no antioxidant properties and can be quite toxic when taken in excess.)

Research now shows that we can substantially affect the level of anti-oxidants in our bodies by eating fresh fruits and vegetables.

Google "antioxidants for crps" to learn more.

Remember the research about vitamin c's ability to prevent CRPS after some orthopedic surgery!

Preventioning development or complications of CRPS after surgery.

This post is featured in How To Cope With Pain's September blog carnival.

This is of particular interest to me as had this information been known at the time of my wrist fracture in 1998, this simple, inexpensive treatment could have prevented my nines years of pain.

Researchers at Centre Hospitalier, Rue Marcellin Berthelot, 02 000 Laon, France found that the incidence of reflex sympathetic dystrophy was five time times lower in a group give vitamin C orally for 45 days from the start of the fracture. They considered that this supported previous observations and lent credibility to the value of vitamin C administration as a prophylactic measure to prevent the occurrence of reflex sympathetic dystrophy in patients who undergo surgical treatment of a displaced fracture of the distal radius.


In July 2007 the Journal of Bone & Joint Surgery reported that Drs Zollinger, Tuinebreijer, Breederveld and Kreis, Department of Surgery, Red Cross Hospital, Beverwijk, The Netherlands had conducted a randomized, controlled, multicenter dose-response study into whether vitamin C can prevent the development of Complex Regional Pain Syndrome in patients with wrist fractures.

The study concluded that Vitamin C reduces the prevalence of complex regional pain syndrome after wrist fractures. A daily dose of 500 mg for fifty days was recommended recommended.

Monday, September 21, 2009

Another look at my list of what works for me to help reduce pain and symptoms of CRPS/RSD.

With CRPS/RSD I have learned to take one day at a time. Many things have helped in in my journey to wellness.

Having breaks between major flare ups is a blessing and an indication that I'm on the right path. Here are some of the things I've found to help with pain and symptoms.

I am a sufferer not a professional. These things work for me about which I am very thankful. If you think something may help you check first with your treating practitioners.

Friday, September 18, 2009

Graded more on limb laterality, motor Imagery, and mirror therapy

Neuro Orthopedic Institute of Australasia has some excellent resources. Click on the links in order to gain a better understanding. Just remember you don't need to believe mirror therapy will work. It's a real, not psychological treatment and creates measurable (with MRI) neural pathways.

Thursday, September 17, 2009

Dr Ilan Lieberman explains how to do mirror box therapy. Recommended

Dr Lieberman talks about various exercises and the ideal method to use when doing mirror therapy. He emphasizes bilateral movements and the importance of pacing.

Find out about your medicines.

The National Prescribing Service of Australia (NPS) has a new website offering. The new medicine name finder works by giving you the active ingredient when you type in the name of your medicine.
  • Step 1 - Type in the name of your medicine.
  • Step 2 - Note the results
  • Step 3 - Now you know your medicine name you can
Print your search results to take to your doctor or pharmacist
Get a down loadable medicine list and note your details
Search for consumer medicine information

While there check out the very good "tools and tips" to the upper left of the site.

Australians should note the free "Medicine Line" number -1300888763
I've used this service when I was taking medication. If you have a symptom you can tell them what medication and natural remedies you use. They look at side effects and possible interactions and advise accordingly. It's an excellent service.

The other number to note is the 24hour medihelp line 1800022222

Monday, September 14, 2009

Pain - the invisible illness

Although some with chronic pain have visible signs such as walking aids, braces etc, most to all intents and purposes look no different from anyone else. This can be both a blessing and a curse. I know that we don't want our pain to be visible to others, but at the same time, the fact of having pain can make every day things so difficult and we'd like others to realize.

I'm in remission now for over 2 months but the memory is vivid. I wrote this short poem I'll share with you.

Wishing and hoping and planning,
Not dreaming.
Watching and waiting and pacing,
Not scheming.
Each time I go out,
Hoping there is no one about.

Wishing and hoping and planning,
To make it.
Watching and waiting and pacing,
Can't take it.
A trip to the shop
Should not be so hard to cop.

But when each day comes
I know I'll be strong
So you won't see

That I'd rather be
Wishing and hoping
And planning and dreaming
Racing , not pacing
I'd be pain free.


Sunday, September 13, 2009

Online courses - keeping the brain active.

There's now so much evidence to support the importance of retraining the brain to help with chronic pain. It's also important, I believe, to keep our brain active. (Let's not also forget the benefits of distraction from pain.) Playing games and puzzles is good. I've read that it's better to vary the activity to keep the experience fresh. Doing new types of things such as studying a language can provide a good brain workout. I'm going to Vietnam later in the year and am trying to learn some Vietnamese. It's been a while since I studied but I'm enjoying being able to take things at my own pace.

I think there's a lot to be said for on line courses as a way of keeping our brains active. I think being able to take things at your own pace is one of the advantages of online courses.
Some online courses that might also challenge are an online accounting degree or an online psychology degree.

NOI Group mirror therapy support.

This simple, quick and effective drug free treatment for chronic pain is gaining momentum world wide. In Australia there is professional training in methods of mirror therapy. Here the NOI Group has ongoing product development to support the mirror work. Watch the Noi Group pod cast of mirror box therapy.

Saturday, September 12, 2009

No one explains mirror therapy better than Neurotropian. - recommended

Matthias Weinberger has the blog Neurotropian. He is a Physiotherapist extraordinaire in my opinion, is passionate about the new science of pain management and promotes awareness and educates in this brilliant blog. Matthias is also a very talented photographic artist. I encourage you to bookmark his site and visit often. I go back and read his posts several times as there is so much information and good sense in them.

Neurotropian blog has a series of invaluable posts about
"mirror therapy". Mirror therapy has been proven to create new neural pathways, retraining the brain, important for those with CRPS. I recommend you watch the video of Ramachandran before Mirror Box Therapy Part I.

  • Mirror Box Therapy Part I describes how easily the brain can be changed by vision. Click on rotating spiral to show you how. He presents the science of "Somatosensory maps being re-modeled so that the pain is gone (forever)" because the brain is restructured. Please note that from my observation, if pain returns as soon as you stop mirror therapy, there may be an ongoing pathology or mechanical problem which needs addressing. Note the fantastic results with Iraq veterans in Walter Reid trials.

  • Mirror Box Therapy Part II talks again of the brain's plasticity. With his gift for making the difficult seem simple Mathias helps us understand just how our brain can change in ways that benefit us.
  • Mirror Box Therapy Part III talks about the virtual body in the brain and distortion of images. In my case if I've had pain for a long time my image of my body part becomes distorted eg I become convinced that my leg is swollen. Measuring shows me that it's not but in my mind it is. Mirror therapy stops the pain and returns the image in my brain to normal. Again this section is interesting and explained in such a way that it is easy to understand.
  • Mirror Box Therapy Part IV specifically talks about CRPS and mentions the limb laterality left/right recognition problem. This is the best explanation I've found about this. In previous posts I talked about Noi Group's Recognize program. I think the cards they now have would have been much better for me as I have a big problem with recognizing left and right hands. This post is devoted to feedback from the body to the brain and is most important. I recommend you take time and read this section.
  • Mirror Box Therapy Part V has some really good links. Hubmed is brilliant. I've bookmarked a number of other links thanks to Neurotopian.
  • Mirror Box Therapy Part VI - as the expression goes "from pain to possibilities". This section is just fascinating. Read it and bookmark "Neurotopian" in your favourites. I'll be checking regularly and hope at some point there will be the opportunity to get updates by email as you can with Blogger.
  • Mirror Box Therapy Part VII covers frequently asked questions. It provides answers about side effects, lengths of sessions, where to get boxes and what to do.

Friday, September 11, 2009

Cheaper mirror boxes - 20% off.

I noticed that Mirror Box Therapy website has mirror boxes on special at the moment.
Only problem is that the discount seems to be for three boxes only. I think this is aimed more at therapists than patients. This then, I expect, would result in a reduced price for patients buying from therapists. However I applaud any effort to reduce the price for patients and promoting this brilliant way of reducing pain.

A little about antioxidants.

Free radicals are atoms or groups of atoms with an odd number of electrons and can be formed when oxygen interacts with certain molecules. Once formed these highly reactive radicals can start a chain reaction. Their chief danger comes from the damage they can do when they react with important cellular components such as DNA, or the cell membrane. To prevent free radical damage the body has a defense system of antioxidants.

Antioxidants are molecules which can safely interact with free radicals and terminate the chain reaction before vital molecules are damaged. Although there are several enzyme systems within the body that scavenge free radicals, the principle micro nutrient (vitamin) antioxidants are vitamin E, beta-carotene, and vitamin C. Additionally, selenium, a trace metal that is required for proper function of one of the body's antioxidant enzyme systems, is sometimes included in this category. The body cannot manufacture these micro nutrients so they must be supplied in the diet.

Vitamin E : nuts, seeds, vegetable and fish oils, whole grains (esp. wheat germ), fortified cereals, and apricots.

Vitamin C : Ascorbic acid is a water soluble vitamin present in citrus fruits and juices, green peppers, cabbage, spinach, broccoli, kale, cantaloupe, kiwi, and strawberries.

Beta-carotene is a precursor to vitamin A (retinol) and is present in liver, egg yolk, milk, butter, spinach, carrots, squash, broccoli, yams, tomato, cantaloupe, peaches, and grains. (NOTE: Vitamin A has no antioxidant properties and can be quite toxic when taken in excess.)

Research now shows that we can substantially affect the level of anti-oxidants in our bodies by eating fresh fruits and vegetables.

Google "antioxidants for crps" to learn more.

Thursday, September 10, 2009

What is the oxygen, free radical connection with CRPS?

First suggested by Sudeck in 1942, Dutch researchers' studies supported the theory that oxygen derived free radicals are possibly the mediators of mechanisms leading to some of the neurological symptoms of CRPS. They found
  • high oxygen supply with tissue hypoxia in CRPS extremities;
  • a diminished oxygen availability to the skeletal muscle tissue affected by chronic CRPS;
  • and several deficiencies in the skeletal muscles of CRPS sufferers.
Studies in Holland have centered around free radical scavengers as treatment for CRPS. There are many ongoing studies with DMSO, NAC in Holland.

This is supported by research in Israel serum and salivary oxidative analysis in complex regional pain syndrome.

Wednesday, September 09, 2009

If you have chronic pain it's important to remember to breathe.

Oxygen, or lack of oxygen is involved in chronic pain pathways. Substance p is one of many neurotransmitters involved in clinical pain syndromes such as Complex Regional Pain Syndrome. Neurotransmitters transmit information across synapses. When released neurotransmitters either help or hinder electrical impulses along nerve fibers.

Substance p's relationship with oxygen deficit is well known. Oxygen deficit triggers the release of substance p. Experiments have shown that decreasing tissue oxygen concentrations increases release of substance p. The amount of substance p is relative to the level of hypoxia or put simply, the lower the amount of oxygen, the higher the amount of substance p.

It is already known that tissue hypoxia and an increase in skin lactate levels occur in Complex Regional Pain Syndrome. Oxygen free radical scavengers such as vitamin C reduce the pain of CRPS and bring about local oxygen homeostasis, inhibiting the release of substance p. Topical capsaicin (made from chillis) cream inhibits the release of substance p by increasing oxygen delivery. I use capsaicin cream, however some research has shown that there is no difference between placebo and capsaicin cream. Both reduce pain. (I'll write about placebo in another post.) This, in essence, is merely a simplified explanation. Majid Ali's "Oxygen view of pain" explains more.

Dr Majid Ali recommends what he calls limbic breathing which he describes as a "vigorous type of breathing with a long out breath". My physiotherapist and my integrative medicine doctor also recommend a the type of breathing where the out breath is longer or twice as long as the in breath. This type of breathing, I believe, activates the parasympathetic nervous system bringing about a sense of calm and thus helping us to better
cope with pain. Now I also realize that this style of breathing has the added benefit of encouraging increased oxygen intake.

For chronic pain sufferers it's important to remember to breathe.

Sunday, September 06, 2009

Vitamin B2 (Riboflavin) has been shown to prevent migraine.

Migraine is believed to originate from inflammation of blood vessels in the brain. Theories about the exact cause of inflammation range from nervous system malfunctions to an imbalance of certain chemicals in the brain.

I've had migraines for over 40 years. When I was told I could no longer tolerate medications my specialist told me about this study. He suggested I take B2 at the recommended dosage in the trial. However I've found that 150mg per day prevents migraine for me. If I forget to take it for 48 hours I get a raging migraine. My doctor also said that if I get a headache or breakthrough migraine then I should sip dark grape juice. Dark grape juice is Riboflavin or vitamin B2. This actually lessens the intensity of a migraine and settles the nausea. However prevention is the way to go for me. .

Remember always to check with your treating professional before trying something new. Sometimes things such as vitamins do not go well with other things people take.

A study using vitamin B2 (riboflavin) to prevent migraine - published by Pub Med- investigated the effect of high-dose riboflavin on migraine frequency, duration, and intensity.

Participants suffered fewer migraines and those they had were of shorter duration.


Friday, September 04, 2009

YNSA points for CRPS/RSD

To the left of this blog I've created a section for links to research. At present there are links relating to Yamamoto New Scalp Acupuncture. Today I'd like to draw your attention to a link to a website ynsacupuncture.
This site offers a clear description of Yamamoto New Scalp Acupuncture and how it compares and is different from Chinese Scalp Acupuncture.

Of specific interest are these two pages which mention points used for the treatment of
Regional Pain Syndrome -
For the upper extremity
and
Complex Regional Pain Syndrome -For the lower extremity

If you are interested in this treatment I encourage you to read the research and case studies.

Yamamoto New Scalp Acupuncture

"Medical Acupuncture", a Journal by Physicians for Physicians in Vol 15#1 has a report on Affectiveness of New Scalp Acupuncture (YNSA) for relief of Pain of the Locomotor System: an Open, Prospective Topometrically Controlled Study by Thomas Schockert, MDPublish Post
Professor G√ľnter Schumpe, MD
Claudia Nicolay, MS.


What is remarkable about this study and gives credibility is that it "was performed purely for scientific reasons and did not receive financial funding from any source".

This study was undertaken because it has been observed that immediately after Yamamoto New Scalp Acupuncture (YNSA) treatments, many patients experienced long term absence of symptoms.The trial examined results after a single treatment with the aim to examine the speed of relief and length of time the relief lasted.

"YNSA seems to be a therapeutic method capable of erasing pain memories rapidly and sustainably."
"New research findings on so-called pain memory (the new science of pain I have mentioned before), which is generally established in patients with chronic pain, provide reasons why a single, short-term application of YNSA can effect elimination of symptoms lasting (in this trial) up to 382 days."











































Thursday, September 03, 2009

This makes interesting reading.

On the topic of prescribing drugs this post at PsychCentral makes interesting reading, "A How-To Guide To Getting Doctors To Prescribe Your Drug".

Misbranding of pain killers - can it risk lives?

September, 2009 the Guardian in the UK had an article about the major US Drug Company Pfitzer. "Record lawsuit punishes misbranding of painkillers."

The biggest criminal fine in US history reflects the seriousness of this offense.

Some of the medicines linked to the scandal are the pain killer Bextra," the anti-psychotic drug Geodon, as well as the antibiotic Zyvox, and a treatment for epilepsy, known as Lyrica."

In 2004, the Sanfrancisco Chronicle reported that a division of this same company, Pfitzer, the world's largest drugmaker, has agreed to plead guilty to two felonies and pay $430 million in penalties to settle charges that it fraudulently promoted the drug Neurontin for a string of unapproved uses"

"In a written statement, Pfizer said the illegal practices took place before Pfizer acquired Warner-Lambert in 2000.

"Pfizer has cooperated fully with the government to resolve this matter, which did not involve Pfizer practice and employees,'' the company said. "Pfizer is committed to compliance with all health care laws and FDA requirements and to high ethical standards.'''

Note Pfizer said in 2004 that it was "committed to high ethical standards".

Heaven help us if they weren't so committed!

This is another massive betrayal of trust. Patients have no choice but to trust their doctors. Doctors need to feel that what they are told about the drugs they prescribe is the truth. Doctors need to feel that they can trust this information provided by drug reps and at conferences etc is accurate and appropriate.

All this is making non drug treatments seem even more appealing.


Saturday, August 29, 2009

Are genetic factors contributing to development of CRPS/RSD?

Not enough is known about predisposition to conditions such as Complex Regional Pain Syndrome. CRPS patients are left with chronic pain, vasodysregulation, and other symptoms. The predisposing factors are unknown. Genetic factors undoubtedly contribute, and are just beginning to be identified.

Researchers at Massachusetts General Hospital ( MGH ) have found the first evidence of a physical abnormality underlying CRPS. They reported four CRPS patients also diagnosed with the classical or hypermobility forms of Ehlers Danlos syndrome (EDS), inherited disorders of connective tissue. They hypothesized that "EDS might contribute to the development of CRPS.

Springer Link, published an article about Japanese research "Headache and first degree family history of headache may be a risk factor for complex regional pain syndrome".
They investigated whether or not headache and family history of headache were risk factors for CRPS. Their results suggested that headache and first-degree family history were risk factors but suggested further studies with larger numbers be carried out.

It seems that pilot studies are undertaken with promising results but little follow up is undertaken. It is my thought that there appears to be a hit or miss approach to research and not enough of which is publicly funded.

Pub Med published this Netherlands study which looks at Familial occurance of complex regional pain syndrome.
They concluded that patients with familial CRPS developed it at a younger age and have a more severe characteristics suggesting a genetic predisposition.

Parc Promoting Awareness has a copy of an abstract from Stanton-Hicks, Cleveland "Complex Regional Pain Syndrome in Identical Twins". Please scroll the page in the link for this abstract. They state that this is the first reported case of CRPS with identical twins. Milly, if you read this post you'll realize how important this is. I'm giving you the link to Cleveland Clinic.
I recommend you contact them and share your information, or at least pass this suggestion and information on to your doctors.



Identical twins with CRPS/RSD

A visitor wrote about twins with RSD. In the next few posts I'll be looking at genetic and predisposing factors for developing CRPS.


Saturday, August 22, 2009

Byron Zone

I made this slide show. I thought I'd share where I live with you.

Kissed by the first rays of the morning sun, Byron, a shire of splendour, on the rim of an ancient shield volcano, is a meeting place of peoples and cultures. A 1000 year old midden at The Pass in Byron Bay is testament to the traditional ownership by the Arakwal Aboriginal people who remain custodians of this land.

Since its discovery by Captain Cook in 1770, Byron Bay has morphed from working man's town to play town. The surrounding towns and villages that make up this unique shire are also captivating, each with its own special charm.

More than just one town, this is Byron Zone.

Friday, August 21, 2009

What works for me with symptoms of CRPS/RSD.

With CRPS/RSD I have learned to take one day at a time. Many things have helped in in my journey to wellness.

Having breaks between major flare ups is a blessing and an indication that I'm on the right path. Here are some of the things I've found to help with pain and symptoms.

I am a sufferer not a professional. These things work for me about which I am very thankful. If you think something may help you check first with your treating practitioners.

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