10 Things I learnt From 10 Days With Diane Jacobs

Across the end of March and the start of April I spent 10 days straight with Canadian physiotherapist Diane Jacobs, who was in Australia to teach her DermoNeuroModulating (DNM) workshop, which I attended.

Twice.

The first event was held in Noosa, Queensland. It was hosted by Robin Kerr at her recently sold practice, Alchemy in Motion.

The second event was held in Melbourne, Victoria. It was hosted by me at the lovely Parkville hotel The Larwill Studio.

Each event started with a 3 hour lecture by Diane, which covered the theoretical foundation of her work, and was then followed by 3 full days of teaching the manual techniques and clinical reasoning outlined in her book.

I also spent a few days before and after the Melbourne workshop hosting Diane – we went to the zoo, some local pubs and restaurants as well as the Shrine of Rememberance and the National Gallery of Victoria. She even got to have lunch with my mum!

I thought the course was fantastic, overall one of the best courses I have attended, and definitely the best manual therapy course I have attended.

50 Years Is A Long Time

Diane is the same age as my mum. I won’t say what that is exactly (not that I think she’d mind), but she has been in practice for almost 50 years.

Her first years were spent in a hospital setting, which almost turned her off the profession. In fact, she did leave for a short while, but she found her groove, and has never looked back (mostly).

I think anyone who has lived a life, worked thoughtfully and experienced many interactions with people is worth listening to and learning from, and Diane proved me right.

Not David Letterman

In 2013, I took a visceral manipulation course. It was interesting, but implausible. I’d say that Diane’s explanations make more conceptual sense.

One of the benefits of the course was the location – it was in New York City, and while I was there I went to a recording of The Late Show With David Letterman.

His Top 10 lists were great.

I’m not sure I’m of that calibre, but here goes.

NEW YORK – APRIL 24: Dave reads the “Top Ten List” on the Late Show with David Letterman, Friday April 24, 2015 on the CBS Television Network. (Photo by Jeffrey R. Staab/CBS via Getty Images)

On Life

Life mostly works itself out over time. We worry about things we can’t control very much (like outcomes in manual therapy) and cause ourselves a lot of bother, but it mostly works itself out.

On Work

Being a manual therapist is a peaceful way to make a living.

On Not Knowing

It’s okay to not know something, and it’s okay to have a story that may be somewhat, or even entirely inaccurate, as long as you acknowledge it.

The first principle is that you must not fool yourself – and you are the easiest person to fool.


Richard Phillips Feynman 

On Listening

At the Noosa workshop, Diane asked the group if anyone had neck pain, as she was about to demonstrate techniques targeting the occipital nerves.

A man in his sixties volunteered, and she asked him about his pain.

What followed was a 40 minute implicit demonstration of how to listen to someone (not just a patient). Diane seemingly made him feel as they were the only 2 people in the room with her facial expressions, body language and most importantly, her quiet attention.

I really think we need to start considering listening as an intervention itself

Alison Sim

On Manual Therapy

It’s non-specific and n=1 and that’s completely okay.

Additionally, manual therapy can be optimal when it is used for certain presentations (and not very good at all when used for others).

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“For the treatment of pain, manual therapy is always OPTIONAL, but it can be OPTIMAL” – Diane Jacobs ~ So when is manual therapy likely to be optimal? According to Diane, when pain is: ~ ▪ Localised/discrete ▪ Changes with movement/position (ie mechanical) ▪ Changes with distraction ~ Manual therapy is not likely to help (resolve the condition) when: ▪ There are multiple sites of pain that are likely to be the result of central sensitisation ▪ Conditions like fibromyalgia and hyperpathia (basically anything which is highly centralised) ▪ Most (but not all) neuropathic pain ~ I think there is a dearth of research looking at indications and dosage for manual therapy, and as a result (and due to the non specific nature of manual therapy), a lot of research into effectiveness is poor and doesnt help clinical practice. ~ What are your indications for manual therapy? (if you don’t use it, don’t comment, as I know the arguments against, I’m interested in arguments for) ~ #integrativeosteopathy #osteopathy #physiotherapy #massage #manualtherapy #myotherapy #chiropractic #clinicalreasoning

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On Interoception

Often Diane would ask someone if they had pain in the region she was about to demonstrate techniques for.

One thing that really stood out was how she always wanted to get people aware and thinking about how their body felt, rather than the labels and diagnoses they’d been given.

“Does anyone have a sore back”

“I do”

“Tell me about your sore back”

“I had a disc injury”

“How does that feel?

On Beer

Dark beers are her favourite, but The Damned Pilsener by HopNation in Footscray was pretty nice as well.

On Lifespan

It’s mostly genetic.

People try all kinds of things to live longer, but it’s mostly down to genes, and maybe stress.

On Asymmetry

Asymmetrical structure is normal, common and completely okay.

Habitual asymmetrical use of our body is possibly a predisposing factor for mechanical pain.

  • Sleeping on the same side every night
  • Curling up in the same position on the couch all the time
  • Crossing arms/legs the same way all the time
  • Standing with your weight on one leg
  • Carrying bags/children on one side

Her rationale is that such sustained postures/positions/movements relatively tension and shorten the same neural tissues in the same way over time, impacting their fluid dynamics.

Better awareness leads to better use of our body, which leads to feeling better in our body.

On Diagnostic Errors

Everything is a type 1 error (when it comes to musculoskeletal pain diagnoses).

Most of the pain problems we see in clinical practice have been given structural or biomechanical labels.

Yet, often neither changes when the pain resolves.

Or on the other hand, many people walk around with these structural or biomechanical changes and experience no pain.

She is very comfortable with simply calling something “pain”, treating it conservatively and if it improves, not pursuing it further (she will refer for investigations if it doesn’t and she suspects pathology).

DNM: Just Another Acronym?

Manual therapy is full of acronyms and techniques.

Does DNM bring anything different to the table?

Yes.

DNM isn’t about the techniques, which are lovely, but often just rebadged osteopathic techniques.

DNM is about the clinical reasoning process in manual therapy.

It is about considering the role of the nervous system in pain.

It is about understanding what we can affect with manual therapy (nerves, the most excitable tissue in the body), and what we can’t (muscles, fascia and joints – at least not directly).

DNM was the first approach to manual therapy I came across that not only considered the skin (the only thing we can touch), but the physiology and potential therapeutic effects of treating the skin.

There are no rules for DNM techniques – it’s jazz, not classical music.

It’s not copyrighted.

It’s not a business.

It’s simply one woman’s interpretation of the literature on pain, physiology and manual therapy.

Your Body Is Not A Machine

Back of man with arms elevated exposing machine internals.

What a machine!

Food is fuel!

The heart is a pump.

The brain is a computer. Inputs. Outputs. Processing.

Analogies likening the body to a machine have been around for centuries, if not longer.

They exist in almost every culture.

They shape the way people think about their bodies.

They are wrong.

Your body is not a machine, and that is an extremely good thing.

Your body is a biological entity, which adapts over time to the stimuli it is exposed to.

Moreover, your body is part of you and you are part of your body – the separation is an illusion of the mind.

Let’s look at this a little more deeply.

Why Do We Use Machine Analogies?

In a word: simplicity (even I succumbed to computer based analogies in this post – my understanding is better now).

Even the most complex machines are computers are created by, and hence can be understood by humans.

When it comes to our body, our brain, our mind – we really don’t know that much.

We are learning at an astounding rate, but almost all research in human biology and psychology ends with the dreaded statement more research is needed.

So, to simplify things, we use analogies of machines. To the non-technical minded person, machines are complex, but we have an idea about them because of our interaction with them in daily life.

But, in the process of simplifying, we have made things too simplistic, and as a result, our explanations lead to incorrect ideas.

Incorrect Ideas Lead To Poor Health Behaviours

Many people are afraid of activity due to a fear that they will “wear out” their body.

You hear doctors described arthritis as “wear and tear” all the time.

This leads people to stop doing the very things that would improve their condition – exercise.

We see similar problems with the “hardware/software” analogies used (I have been guilty of this in the past).

When people are told their brain is like a computer, it is very limiting.

Computers cannot create.

Computers cannot feel.

Computers cannot express themselves.

At this point in time, computers can only do what they are programmed to do.

If we think our brain is like a computer, then it is becomes a tool for processing information, rather than the core of our experience.

Additionally, a computer can be reset. While we all love the idea of a clean slate (new diet on Monday, new year’s resolutions etc), in reality, everything we have experienced in our lives shapes us in ways seen and unseen, which affects what we do, think and feel going forward, which shapes us further, in a big, ever expanding circular fashion.

What Kind Of Analogies Should We Use Instead?

When it comes to adaptation, which is the hallmark of living organisms, I like to use examples from nature, like this tree from a Facebook post I made a couple of years ago.

I love how, despite the challenges of an unfamiliar, urban environment presented to this tree, it manages to adapt and thrive. This is true across all of biology. Species, both plant and animal, will do whatever they can to adapt to their environment in order to survive and reproduce.

From an evolutionary biology perspective, this is what our primary purpose of life is.

Now, as humans, we have higher aims – creation, expression, fulfilment, enlightment etc – but deep down, these biological imperatives are still there.

Instead of saying “the body is a car that needs servicing and alignment”, why not say the body is like a tree, it grows until maturity, then it endures good seasons and bad throughout its lifespan, but it adapts and survives?

Instead of saying “the heart is like a pump”, why not describe it as a river that keeps flowing to maintain it’s own health – sometimes it flows faster, sometimes it flows slower, but it still flows?

Instead of saying “what a machine”, why not say what an amazing person?

Why It’s So Important To Get This Right

Imagine if, instead of being told that her sore knee is because of wear and tear, a doctor tells her patient that her knee pain is because her nervous system is being protective of it. 

Imagine this doctor then tells her patient that to deal with the pain she needs to become more adaptable and resilient, and that she can do this by improving her flexibility, strength and endurance with exercise and activity.

Imagine if this doctor also told her patient that stress and fear makes her pain worse, and that she not only needs to become more physically adaptable and resilient, but more mentally as well, and that this is possible because even into older age, the brain and nervous system can learn and change for the better!

Conclusions

Medical and allied health practitioners need to lead the charge towards healthier attitudes towards bodies, pain, injury and ageing.

More needs to be done to build confidence in people’s health, especially in the face of pain and ageing – two big drivers of fear.

This can be achieved by stopping the use of machine based analogies and encouraging people to build strength and resilience in the face of pain, rather than retreat and avoid aggravation.

The evidence is clear: while short term rest in the case of tissue injury and post surgery is sometimes warranted, the sooner people resume activity, the better their outcomes.

We also know that expectations drive outcomes. This means more positive messages about recovery and less fear based mechanical analogies.

It’s time practice started reflecting the evidence, it’s been around for a while now.

Nick Efthimiou Osteopath

 

This blog post was written by Dr Nick Efthimiou (Osteopath), founder of Integrative Osteopathy.

This blog post is meant as an educational tool only. It is not a replacement for medical advice from a qualified and registered health professional.

 

 



 

 

How To Overcome Recurrent Pain

 I have a bad back.

People often say that when they come to me with recurrent low back pain.

You could replace back with knee, hip, shoulder, elbow or any other painful body part.

I’ve heard it all.

But I’m here to dispel the myth of bad body parts.

There’s Usually A Reason

It’s impossible to determine cause and effect in a complex system.

But when people tell me there was no reason for their pain, I dig a little deeper.

What usually emerges is that something had changed before the onset of pain.

Of course this doesn’t mean that change is the cause of their pain, only that something changed.

Sometimes this change occurs so gradually, it’s barely perceptible.

Pain Is Protective

Usually, we will feel pain before we have done anything serious – as in injury.

Pain is a protective output of the brain.

It is generally a good thing, that keeps us safe, but it can become a problem in and of itself.

When you experience pain it usually means that your brain is trying to protect you .

You feel pain in a body part, but your brain is trying to protect you as much as it is trying to protect your sore body part.

After all, you are what’s important to your brain. Without you, it ceases to exist.

The Recurrent Pain Cycle

Recurrent pain cycle

What we can see is a pretty typical cycle for many people.

The problem is, they never get better until something breaks that cycle.

As you can see, something is missing. Change.

If we could create meaningful and lasting change, maybe we would have less recurrent pain?

Resilience and Adaptability

Resilience is not about being strong, though that is a component.

Resilience is able being able to withstand a variety of stressors.

Adaptability is about being able to responds to a variety of stressors.

These stressors can be physical, psychological, environmental or whatever else.

How do we develop this?

Desensitise

Graded exposure is a psychological technique.

It involves exposing yourself to situations that scare you, in a manner that allows you to control your fear.

Over time, you become less fearful and can increase your exposure.

Often pain is associated with movements, social settings or other contexts.

By applying the principles of graded exposure to pain, we can desensitise your response to certain contexts.

Desensitising is the first step to breaking the recurrent pain cycle.

Optimise Your Senses

Having limited sensory input can affect pain.

Sensory input is the information your brain receives from nerves throughout the body. This can be from muscles, tendons joints and organs.

When the brain receives better sensory input, it can better interpret each situation and respond accordingly.

There are 3 main impairments to sensory input relevant to osteopaths:

  1. Past injuries that haven’t been completely rehabilitated
  2. Soft tissues and joints that are stiff and/or immobile
  3. Under-stimulation due to lack of use

Improving your sensory input improves your adaptability.

Yet, even with perfect sensory input, you can only adapt as much as your health allows.

Adaptability isn’t only a neurological attribute.  Or even a physiological attribute.

Adaptability is a human attribute.

Load: Progressively and Contextually

Loading develops resilience.

But, if you are not adaptable, then you can only load so far before you break down.

This is why we seek to enhance adaptability and resilience.

Loading about more than lifting weights.

It is about challenging yourself across a variety of environments, contexts, movements etc.

Remember, resilience is not only physical.

Resilience, like adaptability is a human attribute.

Humans are physical, psychological, emotional and spiritual.

It is important to development resilience across all the entire human spectrum.

Conclusions

Recurrent pain is a form of chronic pain.

People often don’t consider it chronic, because it isn’t constant.

To break the recurrent pain cycle, you need to identify why your pain is recurring.

Then you need take the necessary steps to change.

This can be hard, which is why you should get help along the way.

Only when you create meaningful change will your pain change in a meaningful way.

 

Nick Efthimiou Osteopath

 

This blog post was written by Dr Nick Efthimiou (Osteopath), founder of Integrative Osteopathy.

This blog post is meant as an educational tool only. It is not a replacement for medical advice from a qualified and registered health professional.

 

 



 

 

Brain Training That Works

Brain Training

Brain training has become popular in the last few years, but does it live up to the hype?

No. (1)

Unfortunately, playing games on your phone doesn’t do much for your brain, aside from make you better at playing those games. (2)

Does that mean you are doomed to suffer from declining cognitive function as you age?

Not necessarily.

There are activities which have demonstrated positive effects on both brain structure and function.

Despite what advertisers tell you, these are not found in your app store.

So what can you do to “train your brain” and make it (and the rest of you) healthier?

Learn A Language

Learning a language is one of the best things you can do for your brain, and your life.

Learning a language opens up your world, from business to social and travel opportunities.

The added bonus is that it reshapes your brain, improving both the structure and function, and potentially helping stave off Alzheimer’s. (3, 4)

In this case, apps can be helpful, but nothing beats engaging in conversations – you are challenged to think in a different language, which is fantastic for cognitive function.

What’s great is that whilst becoming fluent is great for the brain (and your life), the act of learning a language, even if you struggle, still yields improvements.

Learn an Instrument

Learning an instrument has similar effects on the brain to learning a language.

Both the structure of the brain as well as the function are affected positively.

It seems that in the case of musical instruments, the longer you have played them, the better. (5, 6, 7) This doesn’t mean you shouldn’t bother if you are “older”, it simply means, once you start, keep it up, the benefits are well worth the effort!

One of the more interesting findings made by researchers, is that playing an instrument can help mitigate hearing decline due to ageing as well!

This occurs because we “hear” with our brain. Our ears translate vibrations of the air to electrical impulses that our brains decipher as sounds, and it is thought that playing an instrument helps enhance “meaning” associated with sound, allowing better function when hearing.

Exercise

Exercise is probably the best brain training activity of them all, because it offers so many benefits not only to your brain, but body and soul as well.

It makes sense that moving is so good for our brain, given how much real estate in our heads is allocated to performing and controlling movement.

The list of studied effects of exercise on brain training includes:

  • Structural growth via increased signalling of various growth factors.
  • Improved memory and cognitive function.
  • Delayed onset of neuro-degenerative diseases.

So what’s the best exercise for your brain?

There is research on cardio exercise (running, cycling, walking etc) and strength training, but not much on complex functional movements.

I would hypothesise, that the best form of exercise for your brain is a circuit style workout that challenges you to move in 3 dimensions, pushing, pulling and carrying different loads over different levels – from the ground to standing.

Crossing midline (imagine a line vertically through your body, cutting it into two halves) movements are super charged brain boosting exercises (they use low level versions of these movements in neuro-rehab).

Examples of movements that cross midline:

  • Crawling
  • Skipping
  • Juggling (8)
  • Alternate single leg/arm movements
  • Rolling
  • Rotational movements

Of course, if this sounds too much, just get some vigorous walking in, the research is still positive – move it or lose it (brain function that is).

Meditate

Meditation has been getting a lot of attention from scientists lately.

Research is showing positive changes to brain areas involved in stress and pain, along with global improvements to brain structure and function.

A while back I wrote an article on mindfulness for pain management – the principles described in it are relevant to brain health too.

Whether you do focused meditation, pray or simply spend time quietly contemplating, it is a fair assumption to say that inward focused practices can all have a positive affect on your brain.

Drink Coffee

Not everyone responds to coffee positively, but if you respond well, enjoy it or are addicted to it (not the greatest thing mind you), then there is some positive news.

Drinking u coffee a day can be neuroprotective (9).

I’m not sure it makes your brain better, but it can help stave off neurodegenerative diseases, which I guess, makes your brain better simply by virtue of not getting worse.

Of course, coffee has adverse effects that are more pronounced in some people, so exercise good judgement when deciding whether coffee “works” for you.

Conclusions

Brain training apps don’t work to make you smarter or improve the structure and function of your brain.

In fact, not much can make you more intelligent, as psychologists have been trying for almost 100 years to do, with very little success.

There are many things you can do to improve your brain health and potentially protect yourself against neurodegenerative diseases.

Like all biological cells, the brain responds to stimuli, and if you use your brain for challenging stimuli, it responds positively, growing new neural connections, increasing in density and improving in function.

Ideally, you will have a coffee before you exercise with your trainer who speaks to you in a new language, followed by an evening meditation before you play your instrument of choice.

 

Nick Efthimiou OsteopathThis blog post was written by Dr Nick Efthimiou (Osteopath), founder of Integrative Osteopathy.

Integrative Osteopathy is an osteopathic practice located in the heart of Fitzroy North, within the reputable Healthy Fit gym. With a focus on education, manual therapy, and active rehabilitation, Integrative Osteopathy offers individual solutions to various painful problems.

If you liked this article, and would like to learn more about maintaining brain and body health throughout your life, call 0448 052 754 to have a chat with Nick, or, to make an appointment online, click here.

This blog post is meant as an educational tool only. It is not a replacement for medical advice from a qualified and registered health professional.

 



 

 

 

References

(1) Consensus on Brain Training

(2) Putting Brain Training to the Test

(3) Language Learning Makes the Brain Grow

(4) Growth of Brain Areas After Foreign Language Learning

(5) Effects of Music Lessons on Aging Brain

(6) Brain Structures Differ Between Musicians and Non-musicians

(7) Effects of Musical Training on Structural Brain Development

(8) Juggling Enhances Connections in the Brain

(9) Neuroprotective and Anti-inflammatory Properties of Coffee

 

Management Strategies For Chronic Itch

Scratch

Chronic itch is a frustrating experience. Sufferers of skin conditions like eczema know this all too well.

I know what you’re thinking. Why the hell is an osteopath writing about itch? Shouldn’t they stick to their scope of practice?

There are a few reasons:

  • We treat people manually, usually to exposed skin, so we often come across people with skin conditions who aren’t managing them well, or are suffering from a persistent itch.
  • Itching associated has a lot of parallels to pain. Both pain and itch are outputs of the brain and both can be caused by either peripheral causes (in the skin), central causes (in the nervous system), or a combination of both.
  • Many of the general recommendations surrounding itch are within the scope of practice of an osteopath to recommend.

If you suffer from chronic itch, it is important to consult with your GP, and possibly a dermatologist, in order to get a diagnosis of your condition.

Your itch/skin condition could be the symptom of some underlying pathology that gets worse because you tried to self-treat.

Itch Physiology

We’ve all had an itch that needed scratching at some point in our lives.

Whether it was after being bitten by an insect or due to social contagion – like yawning, we tend to scratch ourselves when we see others doing it – or some other reason.

For some people though, itching is a daily occurrence, and the desire to scratch is often so strong that sufferers of chronic itch cause damage to their skin trying to find relief.

It used to be thought that itching was a sub-group of pain, but it’s now understood to be a separate entity, though they share many similar traits physiologically.

There are different mechanisms of itch, which we can classify as peripheral or central, just like pain.

This is an important concept to grasp, because most medical treatments are only directed at peripheral drivers of chronic itch.

There are 4 classifications of itch:

  • Dermal or pruriceptive itch: refers to an itch that results from activation of itch receptors in the skin. This activation is often caused by histamine (which is also the main driver of hayfever).
  • Neurogenic itch: is an itch that originates in the central nervous system, where itch-mediating pathways are activated. This can occur with the spinal application of opioid medications, or more commonly in skin conditions, inflammation within or affecting the central nervous system.
  • Neuropathic itch: also originates in the central nervous system, but is caused by diseases of the nervous system.
  • Psychogenic itch: is related to illusional states.

When it comes to itch associated with eczema and other similar skin conditions, we want to focus on dermal itch and neurogenic itch, as these are the mechanisms involved.

Why does it feel good to scratch?

Normally, when we are exposed to a scratching stimulus, we withdraw, as we perceive it as either painful or unpleasant.

However, when we are itchy, we welcome the scratching sensation as relieving.

When we scratch an itch, there are multiple brain areas that are active, including areas involved in both pleasure and pain.

Both active (scratching yourself) and passive (having someone else scratch you) forms of scratching have been shown to relieve itch.

Interestingly, scratching nearby to the site of the itch also relieves the itch, suggesting a central inhibitory effect, rather than a local effect from scratching.

Chronic Itch Is More Than Skin Deep

Dermal/pruriceptive itch is mostly mediated by sensory nerves that are embedded in the skin called C-fibres.

There are two kinds of dermal itch:

  1. Histamine mediated.
  2. Non-histamine mediated.

Histamine mediated itching

This typically occurs when we are bitten or scratched, and there is a release of local histamines as part of the immune response.

This also occurs with conditions like hayfever.

With chronic itch related to skin conditions, this is often managed with topical steriods and over the counter anti-histamine tablets (the same ones you would take for hayfever).

Non-histamine mediated itching

This occurs in people with certain diseases (cancer, HIV/AIDS, liver disease) and as a side effect of certain medications.

It is also a big feature of the itch associated with chronic skin conditions, like eczema, though it’s not commonly discussed.

This type of itching is a massive issue – it’s difficult to treat and causes lots of distress for the suffer.

One key feature of this form of itch seems to be neurogenic inflammation. Mentioned above, this is itch that originates in the nervous system.

Setting off positive feedback loops, this inflammation is self perpetuating, as long as the stimulus is in place.

Topical treatments don’t work well for this, which is why many eczema sufferers get short term relief from creams, but in the long term may continue to suffer.

In order to get lasting relief, the root cause of the neurogenic inflammation must be addressed.

This could be down to a number of factors (or combination of), including:

– Dietary
– Gastrointestinal distress
– Psychological stress
– Environment exposures

Considering the systemic nature of most chronic skin conditions, and their relationship to other conditions (such as asthma and hayfever in eczema sufferers), it makes sense that there is an underlying physiological dysfunction that is common to all.

One such proposal is the relationship between cellular energy and inflammation. Cellular energy is needed on a constant basis for our cells to function and reproduce optimally.

It is increasingly apparent that bioenergetic function and inflammation are interdependent processes. (2)

This simply means, when cellular energy is low, due to lifestyle factors or illness, inflammation results.

Without addressing lifestyle factors that could be contributing to chronic inflammation, most sufferers of chronic itch related to skin conditions will not get complete respite from their itch.

How To Treat Itch

The best approach to resolving a chronic itch associated with a condition like eczema would be multi-modal and address all the causative factors.

  • Topicals as directed by a dermatologist, to provide symptomatic relief and manage flare ups.
  • Anti-histamines to address the histamine component of the itch (usually in eczema the two kinds exist in tandem).
  • Dietary modification: detection and elimination of dietary irritants, which can be determined by performing an elimination diet with the assistance of a dietitian other qualified health practitioner.
  • Supplements as directed by a health practitioner based on testing, to address any nutritional deficiencies (commonly Vit D and magnesium when it comes to neurogenic inflammation).
  • Meditation/mindfulness or relaxation to alleviate and manage psychological stress. Alternatively, go for a walk in nature, which has proven stress relieving effects.

Conclusions

Like most chronic conditions, there is no single cure-all for chronic itch, thus a multi-modal approach works best.

Whilst most medical approaches can work well for symptomatic relief, there is yet to be any treatment approach that delivers a change to the underlying pathology.

With this in mind, long term strategies to deal with neurogenic itch related to skin conditions should address factors related to both chronic lifestyle related inflammation as well as local skin irritation.

 

This blog post was written by Dr Nick Efthimiou (Osteopath), founder of Integrative Osteopathy.

This blog post is meant as an educational tool only. It is not a replacement for medical advice from a qualified and registered health professional.

 



 

References

(1) McMahon, S.B., et al, Wall and Melzack’s Textbook of Pain, Elsevier Saunders, Philadelphia, 2006

(2) Bioenergetic dysfunction and inflammation in Alzheimer’s disease: a possible connection.