Myopia is rampant in healthcare. There are more than 120 specialties and sub-specialties for medical students to choose which career path to take. Treatment for chronic pain follows this focused approach. Anesthesiology and Physical Medicine & Rehab are the two most recognized accredited pathways to pain management. According to the Pain Medicine Fellowship description at Johns Hopkins, “The pain fellow is expected to make more independent decisions with respect to pharmacotherapeutic and interventional management of pain patients as the training period progresses”. It goes on to say that trainees will become proficient within 1 year in 17 interventional procedures, e.g., spinal cord stimulation, epidural steroid injections, facet blocks. In other words, drugs, needles and devices are the main elements being used to manage chronic pain. A few weeks ago I received the June issue of Pain Medicine, The Official Journal of the Academy of Pain Medicine. And while Massachusetts and most of the country struggle with an opiate epidemic, attached to the cover was a marketing brochure for ZohydroER, a 12 hr hydrocodone (opiate) formulation that promotes its effectiveness while warning about addiction, abuse, and misuse. Enough said!
Solving the Rubik’s Cube of chronic pain is improbable using this narrow approach. This is supported by the fact that the US spends more than $300 billion a year in medical costs treating chronic pain, yet the chronic pain epidemic continues to spread. One of the comments to my last post, How the Stress-Response is a “Root Cause” of Chronic Pain, was “Ah, wish it was that simple: treating chronic pain is a complex endeavor”. This same statement could be said about infectious disease 100 years ago, yet clinicians who saw the problem from a different perspective created simple solutions such as penicillin and the Tetanus vaccination.
A few years ago, while serving as a health & wellness consultant of a large hospital system, I was researching ways to impact their multi-million dollar musculoskeletal pain problem. I came across reports of an IRB-approved clinical research study performed onsite at Chrysler with 96 participants with chronic back pain. Utilizing Somatic Functional Therapy (SFT) in twelve, 2-hr group sessions, 55% of those completing the SFT group program had complete resolution of their back pain, compared to 0% of those in the randomized control group. I was intrigued while at the same time knowing, from a current medical thinking perspective, that it was not possible given my experience in sports medicine treating over 10,000 patients with back pain.
I then, by chance, met the developer of SFT, Ramon Nunez, Sensei, at an employee health conference in Las Vegas where he was a speaker. (He prefers to use the title “Sensei”, meaning teacher, as he believes that education is key to resolving chronic pain and related illness). I knew right away that this was something that I wanted to know more about, and he challenged me to come to Michigan to see and experience SFT firsthand. So I flew out to Detroit, where the clinical research on SFT was being done at Henry Ford Health System. What I learned opened my eyes to what had been in front of me the whole time, and I began training in SFT. His insights provided the missing link to understanding the puzzle of chronic pain and a whole new way to help the millions suffering with chronic pain.
I attended a national convention composed primarily of health insurance executives. When polled as to who would provide innovative solutions to our health crisis, over 90% said it would not be doctors or health plans but people “outside” the system. It makes sense that the path Nunez, Sensei has taken has allowed him to see “the forest for the trees” when it comes to our Nation’s chronic pain epidemic. Instead of studying from only one perspective, Nunez, Sensei developed SFT over the past five decades through his study of several somatic (i.e. the body as perceived from within) and healing systems, including the Martial Arts, Traditional Chinese Medicine, Movement Reeducation and Integrative Medicine, as well as his clinical and educational expertise. In over 40 years as a healthcare practitioner, Nunez, Sensei has treated over 50,000 patients for pain and illness. As an educator, he has taught at major universities and medical schools and trained hundreds of students and practitioners.
His journey began in the early 1960’s. As a child growing up in a violent neighborhood, he wanted to be able to defend himself. So he became a student of martial arts (a somatic system), where he mastered both the ability to defend himself and to inflict pain. As he continued his training, he became a martial arts Sensei (i.e. teacher) and also learned to alleviate pain, as the role of Sensei often involves treating injuries sustained in class. Thus, he became an expert in many facets of pain: experiencing, preventing, inflicting, and relieving it. In Asia, traditionally, the martial arts master was the expert in treating pain and other ailments.
In my last post, I discussed how the stress response is a root cause of chronic pain. According to Nunez, Sensei, “the organism’s primary directive is to defend/protect itself. At the most basic level, all of an organism’s responses (the stress response, immune response, etc.) are self-defense. What we see as symptoms of disease, are actually the organism’s attempts at defending/protecting itself. Pain is your brain’s attempt to get your attention, not something to be ignored, suppressed or covered up by pharmaceuticals. Thus, the cause of the pain (stress/immune response) needs to be understood and addressed.”
In my upcoming posts, I will discuss more of the pieces of this puzzle, and how they fit together to form a comprehensive and logical explanation of the chronic pain phenomenon. More importantly, I will share how this explanation has held up to the scientific method of validation (Observation – Question – Form Hypothesis – Conduct an Experiment – Analysis – Accept or Reject Hypothesis). In other words, does this explanation for chronic pain make sense based on how the body works, and is the treatment based on this explanation effective? The hundreds of patients I have personally treated with Somatic Functional Therapy (and the thousands more by Nunez, Sensei) would say yes!