Tratamiento del Dolor por Osteopatía y Acupuntura

El alivio del dolor es una gran parte del trabajo de la mayoría de los profesionales de la salud. En mi profesión como profesional sanitario, el tratamiento del dolor es una de mis áreas de especial interés. Déjame contaros un poco sobre el dolor y cómo lo abordo.

Hay dos tipos generales de dolor:

  1. Dolor proveniente de alguna parte dañada del cuerpo («dolor nociceptivo»).
  2. Dolor generado por el sistema nervioso sin daño al cuerpo («dolor neuropático»).

¡Espera! ¿Cómo puede haber dolor sin daño? Bueno, aquí hay un par de maneras. Primer ejemplo: Es posible que haya habido un daño que ahora se ha curado, pero el sistema nervioso no se ha ajustado de nuevo a la normalidad. Segundo ejemplo: El sistema nervioso puede haberse sensibilizado por numerosos traumas físicos u emocionales previos, de modo que produce una respuesta de dolor a estímulos físicos menores. hay que tener en cuenta que todo el dolor se produce en el cerebro, aunque se sienta en el pie, en el estómago o en la cabeza. La diferencia es que en el primer caso está relacionado con un daño actual real y en el segundo caso no lo está.

El primer tipo de dolor (dolor nociceptivo) puede dividirse en dolor proveniente de la estructura externa del cuerpo como la piel, los músculos y las articulaciones («dolor somático») y dolor proveniente de los órganos internos del cuerpo («dolor visceral»). Este último puede ser confuso porque a menudo se experimenta primero en los músculos exteriores del cuerpo. El osteópata está excepcionalmente preparado para distinguir entre estos tipos de dolor, una distinción que es fundamental en su tratamiento.

Arriba dije que el tratamiento del dolor es una de mis áreas de especial interés. Eso no es exacto. Sería más exacto decir que el tratamiento de la persona con dolor es mi área de especialización. La diferencia es que, como terapeuta holístico, trato a las personas, no a los síntomas ni a los enfermedades. Al tratar a la persona, el síntoma desaparece o al menos mejora, lo que indica una mejora en cualquier trastorno subyacente.

Las disciplinas que practico, la osteopatía y la acupuntura, son excelentes para tratar a las personas que padecen el dolor. En mi experiencia, la osteopatía es el tratamiento de elección para la mayoría de los tipos de dolor comunes, mientras que la acupuntura a veces es preferible para ciertos tipos de dolor neuropático y algunos tipos de artritis inflamatoria. En este último caso también haría uso de mis conocimientos de fitoterapia.

Mis estudios formales me han equipado bien para reconocer condiciones que requieren tratamiento médico convencional o que serían mejor manejadas por otros profesionales de la salud. Por ejemplo, mi gran interés es ayudar a las personas con dolor crónico (dolor que ha estado presente durante meses o más), una condición en la que siempre hay factores psicológicos y de comportamiento involucrados. Cuando me di cuenta de esto, hice una curso de Master de tres años en psicología de la salud para poder ayudar mejor a estas personas. Sin embargo, no soy un psicólogo, y si hay problemas de trauma o depresión graves, conflictos emocionales profundos o adicción, entonces recomendaría a un profesional de la salud competente para este aspecto del cuidado de la persona.

Los Dolores Más Comunes

  • Dolor de columna (dolor de espalda o de cuello causado por lesiones menores o degeneración estructural)
  • Tensión muscular
  • Dolor de cabeza (por problemas de la columna cervical o tensión muscular)
  • Tendinitis (del hombro, codo, por ejemplo, codo de tenista, muñeca, rodilla, cadera y tobillo, por ejemplo, tendón de Aquiles)
  • Hombro congelado (capsulitis adhesiva)
  • Artrosis (de la cadera, la rodilla, el tobillo, el hombro, el codo, los dedos de las manos)
  • Dolor en el pie (por ejemplo, dolor plantar, dolor metatarsiano)
  • Ciática
  • Neuralgia braquial (dolor nervioso en el brazo)
  • Esguinces y torceduras
  • Dolor en la caja torácica
Copyright (c) Robert Hale 2022.
Foto de dominio público de Pikist.com. 

Robert Hale ofrece tratamiento para el dolor mediante osteopatía y acupuntura en Santa Eulalia, Ibiza. 

Treatment of Pain by Osteopathy and Acupuncture

Pain relief is a large part of most health professionals’ work. In my profession as a healthcare provider, the treatment of pain is one of my areas of special interest. Let me tell you a little bit about pain and how I approach it.

There are two general kinds of pain:

  1. Pain coming from some damaged part of the body («nociceptive pain»).
  2. Pain generated by the nervous system without any damage to the body («neuropathic pain»).

Whoa! Wait! How can there be pain without damage? Well, here are a couple of ways. First example: There may have been damage which has now healed, but the nervous system has not adjusted back to normal. Second example: The nervous system may have become sensitised by numerous previous physical or emotional traumas, so that it produces pain response to minor physical stimuli. Note here that all pain is produced in the brain, even though it is felt in the foot, or stomach or head. The difference is that in the first case it is related to actual current damage and in the second case it is not.

The first kind of pain (nociceptive pain) can be further broken down into pain coming from the outer body like skin, muscles and joints («somatic pain») and pain coming from the inner body organs («visceral pain»). The latter can be confusing because it is often first experienced in the muscles of the outer body. The osteopath is uniquely prepared to distinguish between these kinds of pain, a distinction which is critical in their treatment.

Above I said that the treatment of pain was one of my areas of special interest. That is not exact. It would be more accurate to say that the treatment of the person in pain is my area of expertise. The difference is that as a holistic practitioner I treat people, not symptoms or disorders. By treating the person, the symptom goes away or at least gets better, indicating an improvement in any underlying disorder.

The disciplines that I practise, osteopathy and acupuncture, are excellent at treating people suffering with pain. In my experience osteopathy is the treatment of choice for most kinds of common pain complaints, while acupuncture is sometimes preferable for certain kinds of neuropathic pain and some kinds of inflammatory arthritis. In the latter case I would also make use of my knowledge of herbal medicine.

My formal studies have well equipped me to recognise conditions which require conventional medical treatment or which would best be managed by other health professionals. For example, my great interest is helping people with chronic pain (pain that has been present for months or more), a condition in which there are always psychological and behavioural factors involved. When I recognised this, I took a three-year masters degree in health psychology in order that I may help these people better. Nevertheless I am not a qualified psychologist, and if there are issues of serious trauma or depression, deep emotional conflicts, or addiction then I would refer to a competent health professional for this aspect of the person’s care.

Most Common Pain Complaints

  • Spinal pain (back pain or neck pain caused by strains, minor injury or degeneration)
  • Muscle tension
  • Headaches (from spinal problems or muscle tension)
  • Tendinitis (of the shoulder, elbow e.g. tennis elbow, wrist, knee, hip and ankle e.g. Achilles tendon)
  • Frozen shoulder
  • Osteoarthritis (affecting the hip, knee, ankle, shoulder, elbow, fingers)
  • Foot pain (e.g. plantar pain, metatarsal pain)
  • Sciatica
  • Brachial neuralgia (nerve pain in the arm)
  • Strains and sprains
  • Pain around the rib cage


Copyright (c) Robert hale 2021.
Photo by Nick Youngson via Picpedia, reprosuced according to Creative Commons CC BY-SA 3.0 licence.

Robert Hale provides treatment for pain by osteopathy and acupuncture in Santa Eulalia, Ibiza.

Osteopathy – a general plan that is tolerant of our ignorance

One of my patients needed written clarification of the things we discussed at our first meeting. She writes:

Could please tell me again what your idea is of what is happening in my body to cause my symptoms? Also, what is your approach for treating this?

In my reply, as premises to the comments specific to her case, I made the following points:

  1. We don’t know everything (nor even a small part) about the way the body works, so we need an approach which is tolerant of our ignorance.
  2. In osteopathy, the working hypothesis is not as important as the general plan. The general plan says: «Be faithful to osteopathic principles and treat the patterns you find». The beauty of this is that it allows you to do useful work even if your working hypothesis may actually be wrong.
  3. Especially in chronic cases, chasing a single, clear «cause» is a wild goose chase. It is much more realistic and useful to think in terms of a network of multiple, reciprocal influences, each of which contributes to the maintenance of the whole (dysfunctional) system.
  4. The more you focus on detail, the less you appreciate the basic general patterns.
  5. As an osteopath I approach all problems in the same way (see number 2 above). The most important principle for the osteopath is to reduce at least one general kind of stress and strain from the body (the mechanical kind), so that the whole organism, unloaded a little, frees up some of its resources for healing.

This works.

Copyright Robert Hale © 2022. 
Photo by Paolo Melchiorre via Flickr, Creative Commons CC BY-SA 2.0 licence.

Robert Hale practises osteopathy in Santa Eulalia, Ibiza.

Manifesto


What follows is my osteopathic manifesto, which guides how I carry out my osteopathic practice. When you read it, bear in mind that I am mostly involved in treating more chronic conditions.

I believe in:

  1. Trusting your body’s intelligence. Your body is much more intelligent than my conscious mind. Your body arranges its internal economy to best accommodate a lifetime’s accumulation of trauma and stresses. I cannot tell it how to do that, in what time frame or in what order. I can only help to remove the strain and ensure that your body’s basic needs are met. This is sufficient and complete treatment. The body’s resources are then freed to heal rather than diverted to fight the strain.
  2. Slow, gentle treatment. The body, even under optimal conditions, responds in its own time. You cannot with impunity bend the laws governing biological processes. The best, longest lasting changes are the ones which happen so naturally they are often largely unconscious. They do not take place immediately, but in the days or weeks after treatment.
  3. Supporting the body’s efforts to heal. Stiffness, pain and inflammation are some of the body’s healing responses. Only medicine gone mad would want to smother them completely. A rational system of medicine, on the other hand, works to make them unnecessary by modifying the conditions in which they have developed.
  4. The unity of the organism. A headache isn’t only a head problem, a painful hip isn’t a only hip problem, a gastric ulcer isn’t only a stomach problem. The head, the hip, the stomach are not floating in space divorced from all else. Everything is a global problem.
  5. The only antidote to health problems is health. Also known as vitality. A vital organism responds quickly and efficiently to its health problems. If you have a lingering elbow pain, it is not (usually) just because something is “wrong” with your elbow. Either you are working it too hard for your body reasonably to endure, or your body is insufficiently vital to respond to the injury. The answer is not to treat the elbow, (then the knee, then the shoulder, etc.) but to rest the injured part and work to improve the body’s vital responses.

I do not believe in:

  1. Symptomatic treatment. Symptoms arise in areas of greatest strain. Strain accumulates in these areas because of distortions throughout the body. Treating only the symptomatic area may make it feel better temporarily, but only temporarily. And the overall strain will soon manifest elsewhere, too. So it is better not to treat the bits, but the whole.
  2. Heroic treatment. Things should not be forced with heavy clicks and crunches. A stiff area might be stiff for a good reason (see “Trusting the body’s intelligence” above). In any case, if something needs forcing, it is not ready for release. If and when it becomes ready, based on the body’s own priorities and time-scale, it will not need forcing.
  3. Single treatment cures. See “Slow, gentle treatment» above.
  4. Compartmentalisation and micromanagement. As I have mentioned, your body is intelligent (see “Trusting the body’s intelligence” above). To attempt to manage its every part and function would be presumptuous and ineffectual. It is far preferable to give general treatments rather than treating the minutiae of each painful part.

In conclusion, for those seeking a quick fix in one or two sessions, my place is the wrong place to come. The approach I propose may take longer than you might have envisaged. On the other hand it will be low risk, and it will produce deeper, longer-lasting results to your whole health.

Copyright © Robert Hale 2022.
Image: Photo by Jean-Etienne Minh-Duy Poirrier via Flickr.com of the Self-Repair Manifesto from Ifixit.com. Creative Commons CC BY-SA 2.0 licence.

Robert Hale practises osteopathy in Santa Eulalia, Ibiza.