You have the option of purchasing a specially-designed device called the “CV-4 Still-Point Inducer” (See physical therapist for details) or obtaining two equally-sized sponge rubber balls to create a CV-4 Self-help Device for home use. You may wish to use two racquet balls or two sponge rubber balls such as the red, white & blue rubber balls children play with.

Place the two balls in the toe of a sock and then tightly tie the other end of the sock to keep the two balls in firmly contact with each other. In order to assure that the balls stay in contact with each other, place the first sock inside another sock, which is also tightly tied together.

INSTRUCTIONS

Lie down on your back either on the floor or on a bed. Put the CV-4 device under your head so that the entire weight of your head rests on the two balls. They should be under your skull in a symmetrical position from the midline of your head.

There is a slight horizontal depression in the skull just above the attachment of the main neck muscles. This level is slightly above that of the ear openings and is directly behind your eyeballs. Technically, this is near the top of the occipital bone below the lambdoidal suture. This is where you should be resting your head on the balls.

Allow the weight of your head to rest comfortably upon the device for five (5) to fifteen (15) minutes. You may shift your position slightly in order to maintain symmetry and comfort, but do so gently and gradually!

Repeat daily.

INDICATIONS

This is a good “shotgun” technique for helping tissue and fluid motion in and around the head, especially relaxing connective tissues throughout the body, and restoring flexibility of the autonomic nervous system response. It is beneficial for acute and chronic musculoskeletal lesions, including degenerative arthritis (wear & tear). It can lower fever as much as by four degrees (4) Fahrenheit. It can reduce brain or lung congestion, and dependent edema. It has been used to improve auto-immune disease, autistic behaviour of children, and anxiety.

This technique can benefit most individuals to some degree and is rarely harmful, if used with care.

THEORY

The Craniosacral Rhythmical Impulse (“C.R.I.”) is the rhythmical mobile activity of the Craniosacral physiological system. The structures of the Craniosacral system are organized around the meningeal membranes around the central nervous system. The Craniosacral system is intimately related to the function of the nervous system (most directly to the skull, spine and pelvis), related fascia, and other systems. Induction of momentary “still points” in the CRI is an effective technique for mobilizing the Craniosacral system’s inherent self-correcting abilities, which in turn can have profound beneficial effects throughout the body.

CONTRAINDICATIONS

The only contraindications are in situations in which even slight and transient increases in intracranial pressure are to be avoided such as where there is a risk of provoking a stroke or an aneurysm is present. Do not use this technique during the acute stages of a stroke or head injury!

ALTERNATIVES

If you are not achieving the desired or expected results from using a Still-Point Inducer device, consult with your therapist for alternative recommendations. You may need to initially benefit from hands-on therapy or become familiar with other approaches to help relax the body from the base of the skull.

Based on information provided by the Upledger Institute, FL

Fredric T. Samorodin

Physiotherapist Corporation www.integratedphysio.com

604-732-6323

TRAVEL TIPS

• Try traveling with a simple, rubber door-stop. It can stop intruders in their tracks. It’s inexpensive, light to pack and gives you the peace of mind to sleep well. The main door to your room usually has a good lock and peephole; some also supply a bar chain. But, if there is an adjoining room, that door usually has a fairly flimsy lock. The doorstop is especially useful in those situations.
• Try taping a foot-long piece of duct tape around a pencil to stick in your bag. It can fix so many things. If a strap on a sandal snaps or a purse handle breaks, it is duct tape to the rescue!
• Store all liquid products like shampoo, hairspray, etc. in zip lock baggies when packing. Many of these items can explode easily (some may explode from the high altitudes of flying) and the baggies will protect your other items.
• Foot problems are a painful part of the frequent-flyer lifestyle. Long hours of walking in airports, through convention halls or on uneven surfaces can lead to blisters. Band-aids often slip off toes and heels, so try packing thin moleskin instead. Buy the soft self-adhesive sheets at a grocery or drugstore, cut them into small squares and keep them in your purse or briefcase. If your shoe starts to rub, cover the area right away before it turns into a nasty blister.
• Make at least 2 photocopies of each and every travel document that you have: Driver’s License; itinerary, passport, etc. Give one set to a family member at home and keep one set in your purse or bag (separate from the originals). This is in case your originals are lost or stolen.
• If you are visiting a theme park/amusement park and you plan on riding the water attractions, pack extra dry socks for the family in a large zip lock bag. You can switch out the wet socks for the dry ones after riding.
• Bring a small flashlight. You never know when you’ll suddenly be “in the dark” and find yourself in unfamiliar surroundings. At night, keep your flashlight by your bed. A headlamp flashlight frees the hands for other actions as well.
• Do not flash your passport in public. Discreetly show important documents to officials only.
• Always bring a pair of flip flops (or thongs), or surf slippers. You never know when you may need some temporary “shower shoes.”
•  
• Take an inflatable travel pillow: when in flight, place the pillow under your chin to support your head if you nod asleep.  At your destination, place the pillow inside the pillow slip with “Mickey Mouse’s ears” pointing to the top of your head—you have just created a temporary contour pillow!

HOW LONG WILL IT TAKE?

There is no right answer to this question. You may receive relief within minutes, hours, days or weeks. One good rule of thumb starts by remembering just how long you’ve had your discomfort. If it’s been 10 or 20 years then you should be realistic in your expectations. Knowing that you’re likely to receive relief within a couple of weeks to a couple of months, from a problem you’ve suffered with for 20 years, it would be in your best interest to continue using the product for that period of time. Let your body set the pace of health restoration and be patient.

THE THREE WEEK RULE

Talk with your doctor, chiropractor, physical therapist, pain management clinic, etc., and they’ll tell you two things. First, that they don’t expect their patients to receive any noticeable relief for at least 3 weeks! Knowing this, and since our products are not sold as medical devices here in North America, you need to be just as patient in your expectations. The second thing they’ll tell you is that it’s very common, in fact likely, that your discomfort will appear to get worse before it gets better.

CAUTION TO THESE FOLKS

Pacemaker users; talk with the manufacturer of your unit. Do not talk with your doctor because they do not know how your unit was constructed; only the manufacturer does. ∑ First trimester pregnant women; talk with their doctor first. ∑ Medication users to keep the immune system down; such as people with organ transplants, as the magnetic products actually stimulate the immune system to strengthen it.

Because everyone’s body responds in its own way to magnetic field products, you may or may not experience some or any of the following during the beginning stage of use:

INCREASED DISCOMFORT

The body often retraces the action and processes that occurred previously, meaning that you may have to work back through the discomfort you experienced in the past. This is usually of short duration with relief beginning soon thereafter. It is suggested you continue to use the magnetic products, removing them for short periods of time and then replacing them until you have passed this stage. If discomfort persists, discontinue use (your problem may be so severe as to require a medical professional). Be sure to drink plenty of water to help flush your body of toxins should increased discomfort occur.

CHASING PAIN

After placing a magnetic product on an area you may find after a period of time the stressful area has moved! Move the product or add another to the new area. It’s not unusual at all to find that the origin of the discomfort is not the area where the major point of stress or discomfort is felt. This is common, particularly in extremities.

INDIGESTION

While your body is re-adjusting itself to “normal” it is recommended that during the initial time you begin using the Sleep System you do not eat a full meal and then immediately go to sleep on the mattress pad. You should wait approximately one hour. As your body becomes accustomed to the Sleep System, which is usually just one day to one week, this will no longer be a concern.

FOOT TENDERNESS

When using the shoe inserts for the first time it is recommended you begin using them with the smooth side up! The purpose of the bumps is to stimulate the reflexology points of your feet. Do not initially jog or take lengthy walks on them, until your feet have become accustomed to the magnetic insoles. It’s just like breaking in a brand new pair of shoes. Also, if you find your shoes are too tight when using the shoe inserts then remove the manufacturer inserts in your shoes. You won’t miss them and your feet will have a bit more space and feel great. If your feet feel a bit tingly-warm on the Magsteps, drink more water.

INCREASED FATIGUE

Again this is a common initial response which soon disappears within a couple of days to a couple of weeks. The body is working feverishly to cleanse itself, a detoxificadon if you will, and return itself to normalcy and to good health. Most of us believe we are in good health, its just that our bodies don’t agree with us! Should you experience a feeling of increased fatigue take comfort in knowing that very soon you’ll do a 180 degree turn and happily be enjoying a greater feeling of energy! Be sure to drink plenty of water to help flush your body of toxins.

FLUID LOSS

The insoles and Sleep System often help the body remove excess fluids. This is an added advantage to these products. Those who experience water retention and swelling may notice they urinate at an above normal rate for a short period. This too will pass soon. Do not reduce your intake of water. Everyone needs adequate water for the body to function at peak performance. Drink at least eight (8) glasses per day.

MEDICATIONS

When using the Sleep System in particular, this often enhances the effects of medications you are taking. If your medication would normally make you drowsy, have dry mouth, etc. or you’re using a time release patch, these medication side-effects may be exaggerated. DO NOT stop your medication but rather have your physician re-evaluate your dosages. You may very well need to take less than before. Many people have found that over-the-counter medications are no longer needed!

LESS SLEEP

Using a Sleep System often reduces the time your body needs to sleep. Be excited! Even though you’ll sleep less hours you’ll awaken more refreshed, more alert and ready to start your day with more energy. You’ll most likely find yourself able to get out of bed with less effort. This energy will carry you throughout the day and when combining the Sleep System with the shoe inserts you’ll find very little, if any at all, afternoon “blahs.

IS TOO MUCH ENERGY POSSIBLE?

You may wake a few times during your first night on the Sleep System but you’ll still feel refreshed and ready to go in the morning. This will pass after a few days to maybe a week. Stay with it. Be persistent. We’re all conditioned to saying things like “If I don’t get at least 8 hours of sleep I’m useless the next day.” Just imagine if you could drop to 7 hours or even 6 hours of sleep while feeling just as well rested or maybe better rested than before. Celebrate! You’ve just given yourself an extra one to two hours a day to do some fun things for yourself.

LACK OF SUCCESS USING THE SMALL STATIC MAGNETIC RELAX PRODUCTS (Silver foiled magnets)

In most cases, if you do not experience some relief or some positive change it’s probably because of one or more of the following:

• Time. Use for a longer duration. Use 24 hours a day (except while bathing).
• Misapplied. Replace in a different location. Reposition slightly if no response is noted after a day or two. Discuss this with the person who sold them to you.
• Inappropriate size. The product isn’t big enough to cover the area needing relief or you may need to “sandwich” the area with two or more magnets.

Again, talk with the wellness consultant (Fred Samorodin, IWC) who made the products available to you.

Fascial facilitation helps to reduce pain and re-align displaced and dysfunctional areas of the body. Chronic pain which has been present for more than six (6) weeks duration is most effectively helped by full body fascial facilitation.

Pain of acute onset seems to be associated with a specific event, for example, a knee or ankle sprain. Treatment carreid out only to the painful area helps to reduce pain, but may not reduce the possibility of re-occurrence! By treating the whole body, the local painful region will settle more quickly and the chance of recurrent pain will be minimized.

Chronic pain, although localized in a specific body region, is usually the result of many body areas being out of balance. After many years of research, full body facial facilitation has been found to be the best way to control chronic pain! Chronic pain in the body, is multilayered, like an onion. To localize the source of a shoulder pain (for example, requires a number of therapy sessions. It is for this reason that at least six treatment sessions are usually scheduled at the commencement of your therapy. The ideal treatment interval between treatments has been found to be one week.

Two or three sessions of full body fascial facilitation may be necessary before the therapist has some idea of the main problem causing the pain. During these early sessions, painful re-actions may occur. Facilitation wakes up unhealthy tissue! Unhealthy tissue does not wake up and say: ‘Oh, Joy and Peace in the World!’ Rather it wakes up and says, ‘Who told you to disturb me?!’ So after the first treatment or two, you may feel ten times worse or better!

Remember, that by being patient and waiting for the rest of the week between sessions, your self-healing mechanisms will be working twenty-four hours a day to restore your body to a state of wellness! Should your pain be too severe, contact your therapist and, if necessary, use some form of pain relief such as local heat, cold, or pain medication. The dormant, underlying tissue dysfunction must be woken up by facilitation for healing to occur. Once the ’sleeping tigers’ of dysfunction are stimulated, the body’s self-healing process will be started, usually leading to pain reduction and a return of the body to a balanced energetic state.

I have chosen these two conditions specifically because each contains within it’s possible aetiology a cluster of causative and potentiating factors and conditions which are remarkably similar. FMS and CFS(ME) also have a wide range of identical symptoms ranging from fatigue through impaired cognitive and memory functions, to muscular pain, digestive disturbances, headaches and sleep disturbance.1,2,3

By virtue of their ill-defined natures these conditions have become a refuge, one could say a dumping ground, for a host of undiagnosed and apparently undiagnosable health problems. The majority of medical practitioners seem either to be unaware of the reality of the causes, nature and appropriate care of such problems or are openly disbelieving as to their very existence. These are often patients dubbed ‘heart sink’ because of their emotional effect on the doctor, as the patient enters the room, yet again clutching a list of symptoms and requests for help.

All too often classified as ‘neurotic’ with their symptoms ascribed to ‘depression’, this is a truly miserable population of people, who often feel profoundly misunderstood by those around them (sympathy is finite and six months into such conditions it is often in scant supply from friends and family) as well as let down by the medical profession who is either disinterested, dismissive or perfunctory in its prescribing of antidepressant medication.

To have to endure this sort of emotional and social isolation as well, as the cluster of demoralising symptoms with which they are burdened, is clearly enough to depress anyone, and it is the experience of most practitioners and therapists involved in working with such patients that any apparent depression is usually a result, rather than a cause, of their problems. In the alternative and complementary health field a veritable industry has emerged which treats such problems with varying degrees of success using a range of approaches and methods - sometimes suitable and sometimes not. All too often what is on offer addresses such patient’s needs only partially, with predictably disappointing results.

There are no simple answers to conditions where causes lie in a mix of nutritional deficiencies, acquired toxicities, bowel dysbiosis, inadequate stress coping abilities, sensitivities and allergies, inappropriate or excessive medication, inadequate sugar control mechanisms, hormonal imbalances, poor posture and breathing dysfunction, current or past viral, parasitic, yeast or bacterial infections, impaired organs of digestion and elimination, emotional distress….. and more. There are certainly no magic bullets which can remedy a situation which may have taken many years to evolve.

These are a growing army of these walking wounded, the ‘vertically ill’ who are too sick to function adequately but are commonly not quite sick enough to become ‘horizontally ill’, actually bed bound, although this is all too often an outcome in severe examples.

Unless there is an underlying awareness of the true nature and causes of such conditions, and until there is a real understanding of the ways in which it is possible to offer encouragement for an abused and over-stretched immune system to begin to restore health, many forms of proffered help (orthodox or alternative) will succeed only in either masking or, at best, moderating the patient’s symptoms.

Understanding Homeostasis: Self-Healing

It is absolutely vital for anyone afflicted with a chronic illness to hold onto the fact that their body is a self-healing mechanism, that since broken bones mend and cuts usually heal, and that since most health disturbances, from infections to digestive disturbances, get better with or without treatment (often faster without !) that, in a healthy state, there must be in operation a constant tendency towards normalisation and balanced function. This is called homeostasis.

Homeostatic functions (which include the immune system) can be overwhelmed by too many tasks and demands, because of (perhaps) any or all of a selection of negative impacts including nutritional deficiencies, accumulated toxic material (environmental pollution, either as food or inhaled, in medication, previous or current use of drugs etc), emotional stress, recurrent or current infections, allergies, modified functional ability due to age or inborn factors or acquired habits involving poor posture, breathing imbalances and/or sleep disturbances and so on and on …

At a certain point in time the adaptive homeostatic mechanisms break down and frank illness, disease, appears and as homeostasis breaks down, a state of heterostasis emerges.4 At this time the body needs help, treatment, and this can take the form of either:

Reducing the load which is impacting the body by taking away as many of the undesirable factors as possible, by avoiding allergens, improving posture and breathing, learning stress coping tactics, improving diet, using supplements if called for, helping normalise sleep and circulatory function, introducing a detoxification programme, dealing with infections, and generally trying to keep the pressure off the defence mechanisms while it focuses on the current chronic repair needs.

Enhancing, improving, modulating defence and repair processes by a variety of means, mainly non-specific (described as constitutional methods, which will be explained further in later articles in this series)

Treating the symptoms: while making sure that what is being done does not add further to the burden of the defence and repair mechanisms.

Meet Fibromyalgia

Fibromyalgia (FMS) used to be called fibrositis (among many other names) and even now when the word ‘fibromyalgia’ is used in medical writing it is often accompanied by the word ‘fibrositis’. The similarities between Fibromyalgia syndrome, Chronic Fatigue Syndrome and Irritable Bowel Syndrome are listed below.5,6

In Fibromyalgia, Chronic Fatigue Syndrome and Irritable Bowel Syndrome the following similarities are found:

• Age Young Adult
• Primary Sex Female
• Prevalence Common
• Cause Unknown
• Chronic Yes
• Laboratory Studies Usually Normal
• Pathology None
• Disabling Frequently

In addition to these similar, indeed identical, factors, all these conditions are also frequently characterised by pain, fatigue, headaches, disturbed sleep patterns, anxiety, depression, numbness and tingling in the arms, hands or feet, bowel disturbances (diarrhoea and/or constipation on their own or alternating) all frequently affected by the weather, by activity and by stress and there are usually many painful and sensitive areas to be found on palpation in all of them. Irritable bowel problems will usually also be associated with palpable painful areas in the abdomen.

The Official Definition of Criteria for FMS7

The most commonly accepted definition (devised by the American College of Rheumatology in 1990) is that the person affected needs to show:

History of Widespread Pain

Pain is considered widespread when all of the following are present: pain in the left side of the body, pain in the right side of he body, pain above the waist and pain below the waist. In addition there should be pain in the spine or the neck or front of the chest, or thoracic spine or low back.

Pain in 11 of 18 Tender Point Sites on Finger Pressure

There should be pain on pressure (around 4kg of pressure maximum) on not less than 11 of the following sites:

• Either side of the base of the skull where the subocciptal muscles insert.
• Either side of the side of the neck between the 5th and 7th cervical vertebra, technically described as between the ‘anterior aspects of inter-transverse spaces’.
• Either side of the body on the midpoint of the muscle which runs from the neck to the shoulder (upper trapezius)
• Either side of the body on the origin of the supraspinatus muscle which runs along the upper border of the shoulder blade.
• Either side, on the upper surface of the rib, where the second rib meets the breast bone, in the pectoral muscle.
• On the outer aspect of either elbow just below the prominence (epicondyle)
• In the large buttock muscles, either side, on the upper outer aspect in the fold in front of the muscle (gluteus medius)
• Just behind the large prominence of either hip joint in the muscular insertion of piriformis muscle.
• On either knee in the fatty pad just above the inner aspect of the joint.

Children with FMS

Many children are also now being diagnosed with FMS, often starting with flu-like symptoms and then becoming chronic with sleep disturbance a major feature. Some children also display Attention Deficit Disorder (ADD) symptoms, fatigue, school and behaviour problems and commonly a tendency to allergies. Some FMS experts also find that such children frequently have very loose (hypermobile) joints.

How Many People are Affected by FMS?

Muscular pain which goes on and on for months or years is now very common, often causing sufficient disability to prevent people from working or functioning normally, in fact Fibromyalgia Syndrome (FMS) is now the commonest disorder seen by rheumatologists, after osteoarthritis and rheumatoid arthritis.”>

Dr.Don Goldberg, Chief of Rheumatology at Newton-Wellesley Hospital and Professor of Medicine at Tufts University School of Medicine, estimates that there are between three and six million Americans affected by fibromyalgia, mainly between the ages of 26 and 35 with the vast majority being women (86% females against 14% males according to many surveys).

Based on population size and surveys we can therefore estimate that between 750,000 and a 1.5 million people in Britain also have fibromyalgia.

In total it is estimated, by Professor Bruce Rothschild of Northeast Ohio Universities College of Medicine, that nearly 25% of patients seen at rheumatology clinics are actually suffering from fibromyalgia.8

How Disabling is Fibromyalgia (FMS)

100 out of 394 patients (that is 25.3%) with FMS (all female) and 12 out of 44 males (27) were shown in a recent survey to be sufficiently badly affected by the condition as to be unable to work; they were effectively disabled.9

Almost all the others surveyed claimed that their FMS affected their job performance very badly. In Canada a single insurance company, London Life, reported in 1989 that it was issuing monthly long-term disability payments to over 630 people with a diagnosis of fibromyalgia, involving a total of around a million dollars a month.

Historical Confusion of Names
Just as ‘fibrositis’ has become fibromyalgia, so has Chronic Fatigue Syndrome now replaced the former terms ‘chronic mononucleosis’ and ‘chronic Epstein-Barr syndrome’ of the recent past, and ‘neurasthenia’ and ‘nervous exhaustion’ of Victorian times.

There is still disagreement amongst experts as to whether CFS is the same as Myalgic encephalomyelitis (ME) or not, and it seems likely that this argument will run for some time. In these articles, wherever chronic fatigue is not related to a known disease processes such as diabetes or clinical depression, or simply to over tiredness through natural causes (e.g. overwork), the two names will be bracketed together as CFS(ME).

Some doctors insist that the psychological aspects of these conditions is the most important cause and they use the terms ‘masked depression’ and ’somatoform disorder’ to describe such conditions. This is strongly resented by those afflicted by CFS(ME) or FMS who see the psychological and emotional symptoms as being the result of their fatigue, pain and general ill-health and not as causes. CFS(ME) and FMS: are they the same?
There is also disagreement amongst experts as to whether or not ‘fibromyalgia syndrome’ and ‘chronic fatigue syndrome’ are not in fact the same condition.

Both CFS(ME) and FMS often seem to begin after an infection or a severe shock (physical or emotional) , and the symptoms are very similar. The only obvious difference seems to be that for some people the fatigue element is the most dominant while for others the muscular pain symptoms are greatest.

In other words for many people the diagnosis CFS(ME) and FMS are interchangeable terms, although there are certain symptoms (fever, swollen glands for example) which are found in a higher percentage of CFS(ME) patients than those with FMS, which sometimes make such a comparison less precise.

Symptoms Compared
One of the most interesting list of symptoms associated with FMS/CFS(ME) was that given to a conference on the subject by a leading San Francisco physician Carol Jessop MD in 1990.10 The number of patients she has seen and studied (over a thousand) makes this a comprehensive selection of associated symptoms, and is even more impressive since many of her patients are referred to her by other physicians thus making the diagnosis more likely to be accurate that is to say that both she and the referring doctor have agreed that these people ARE suffering from FMS or CFS(ME).

Common Symptoms Found in Dr Jessop’s Patients

• Chronic Fatigue 100%
• Cold Extremities 100%
• Impaired Memory 100%
• Frequent Urination 95%
• Depression 94%*
• Sleep Disorder 94%
• Balance Problems 89%
• Muscle Twitching 80%
• Dry Mouth 68%
• Muscle Aches 68%
• Headache 68%
• Sore Throat 20%

* Dr Jessop stated that this was a ‘reactive depression’ not a ‘clinical depression’ and that only 8% of her depressed patients had required prior medical attention for this before the symptoms of CFS or FMS emerged

Physical and laboratory findings
Dr Jessop reported the following symptoms and findings as well amongst her 1324 patients, average age 39, 75% of whom were female.

• Elevated temperature 10%
• Normal temperature 25%
• Subnormal temperature 65%#
• Low blood pressure 86%
• Yeast infections
• (tongue or mouth) 87%
• Tender thyroid 40%
• White spots on nails 85%*
• Tender neck muscles 91%
• FMS tender spots 86%
• Abdominal tenderness 80%
• Swollen lymph nodes 18%

# Possibly indicating under active thyroid function
* These white flecks are thought to relate to zinc deficiency

• 82% of 880 patients specifically tested had yeast cultured from purged stool samples.
• 30% had parasites in their purged stool samples.
• 38% were found to be deficient in magnesium using a three day loading test and two 24 hour urine samples.
• 32% had low zinc levels using blood tests (she believes sweat analysis is more accurate but this is not easy to use in an office practice)

Dr.Jessop stated that her patients reported that a number of classical disturbances and symptoms existed well before the onset of their CFS/FMS symptoms.

For example:

• 89% had irritable bowel symptoms before their FMS/CFS
• 80% had ‘constant gas’ or bloating before their FMS/CFS
• 58% had constipation before their FMS/CFS
• 40% reported heartburn before their FMS/CFS
• 89% reported recurrent childhood ear,nose, throat infections
• 40% had a history of recurrent sinusitis
• 30% recurrent bronchitis
• 20% recurrent bladder infections
• 90% of the females had premenstrual symptoms prior to onset of current illness
• 65% reported endometriosis before their FMS/CFS
• 30% had dysmenorrhoea before their FMS/CFS
• 22% had generalised anxiety disorders prior to their illness

Sleep problems were present in just 1% of her patients before CFS/FMS and over 90% after its onset.

As will be shown in subsequent articles, sleep is a key feature of this condition and restoration of normal sleep is vital in recovery.

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References

1. Yunus M. Fibromyalgia and other functional syndromes’ Journal of Rheumatology 16(sup 19)69 1989

2. Moldofsky H. Fibromyalgia, sleep disorder and chronic fatigue syndrome Ciba Foundation Symposium 173 Chronic Fatigue Syndrome p 262-270 1993

3. Goldenberg D. Fibromyalgia, chronic fatigue syndrome and myofascial pain syndrome. Current Opinion in Rheumatology 5:199-208 1993

4. Hans Selye The Stress of Life - McGraw Hill 1980).

5. Block S. ‘Fibromyalgia and the Rheumatisms’ Controversies in Clinical Rheumatology 19(1)p68 1993;

6. Goldenberg D. ‘Fibromyalgia and its relationship to chronic fatigue syndrome, viral illness and immune abnormalities’. Journal of Rheumatology 16(sup 19)92 1989

7. George Duna and William Wilke Diagnosis, etiology and therapy of fibromyalgia Comprehensive Therapy 19(2)60-63;1993

8. Bruce Rothschild Fibromyalgia : An explanation for the aches and pains of the nineties Comprehensive Therapy 17(6):9-14 1991

9. Goldenberg D Presentation to the 1994 American College of Rheumatology meeting

10. Fibromyalgia Network Newsletters : October ‘90 thru January ‘92 Compendium #2, January 1993, May 1993 Compendium, January 1994, July 1994. Available from Fibromyalgia Network 5700 Stockdale Hwy, Suite 100,Bakersfield, CA 93309-2554 USA

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A practicing naturopath, osteopath, and acupuncturist in the United Kingdom, with over forty years clinical experience, Dr. Chaitow is Editor-in-Chief, of the Journal of Bodywork and Movement Therapies. He regularly lectures in the United States as well as Europe where he instructs physiotherapists (Holland and USA), osteopaths (Spain and UK), chiropractors (Denmark, USA and UK) as well as massage therapists (Ireland, Sweden, USA). He is a senior lecturer by London’s University of Westminster on under and postgraduate courses in therapeutic bodywork and naturopathy.

In 1993, he became the first naturopath/osteopath to be appointed as consultant to a UK government-funded conventional medical practice. He lives and practices in both the UK and Greece. A prolific author, Dr. Chaitow has written over 60 books on natural health and alternative medicine.

It is inevitable that the stress and tension of life often contributes to temperomandibular joint disorders (TMD), however trauma or even “routine” dental procedures may lead to what Dr. Greg Goddard calls the “Overlooked Diagnosis”¹.

The problem is that a TMD may not directly reveal itself. The TMD may show up as:

• Tension headaches particularly in the temples but just as easily elsewhere in the head.
• Limitation of jaw movements ranging from a locked jaw in an open or closed position to a grating, clicking or popping jaw joint.
• The experience of having your head “in a vice”.
• Grinding one’s teeth at night that a dentist may address with a bite guard for nighttime use or the accelerated wear and tear on tooth fillings, dental appliances or the increased risk of cracking or splitting teeth.
• Facial, neck, shoulder and low back pains.
• Singing or speaking voice fatigue leading to vocal cord strain.

If you suspect a jaw disorder, you might want to consider receiving manual therapy from a health-care professional who is experienced in using bodywork principles and techniques developed by cranial osteopaths and bodyworkers.

Recently a business owner came to see me concerning a locked jaw. For the previous two or three weeks he had been unable to open his mouth wide enough to put in a spoon. Besides the pain, he ended up with a very limited diet, disturbed sleep and an aggravated dental condition of the gums. His concerned dentist sent him to a series of dental specialists, one of whom decided to refer him to me while another dentist used such vigorous examination procedures that the gentleman’s condition was actually aggravated.

After his first visit with me, the patient had enough relief in order to finally be able to fit a spoon in his mouth. After several visits not only was his mouth opening back to normal, but his neck was more flexible and his posture more balanced. This gentleman had gone through a particularly severe episode of the temperomandibular joint disorder.

As a healthcare professional trained in osteopathic techniques I have a good awareness of the strong positive potential to improve the symmetry of body posture and movement. I can use gentle manual therapy on the joints of the skull, the roof of the mouth, the upper neck joints, the tongue, and throat to help balance out postural malalignments. The relief of having physical distortions released from the bones and soft tissues surrounding the brain and spinal cord benefits the whole body.

Should you be experiencing a set of physical problems related to the preceding list ask your dentist or physician to recommend CranioSacral Therapy or Cranial Osteopathy. Canada has very few Osteopathic physicians. However a small percentage of Canadian physical therapists like myself and other health-care practitioners have incorporated the intricate work of cranial osteopathy into our practices. Such terms as as CranioSacral Therapy, Neuromuscular Release Therapy, CranioManidibular Therapy and Cranial Osteopathy, to name a few, offer some reassurance that we will:

1. Use gentle techniques
2. Work inside the mouth
3. Work with the total body posture.

Your efforts will be rewarded with benefits to your dental as well as general health.

1. Goddard, Greg, D.D.S. TMJ: The Jaw Connection - The Overlooked Diagnosis.

As a result of their finding, the researchers hope to study whether daily episodes of humming can reduce the risk of sinusitis in patients susceptible to upper respiratory infection (URI).

(Sinusitis, a common illness reported by 14 percent of the U.S. population, involves the inflammation of one of the paranasal sinuses, usually from URI.)

The researchers, who tested 10 healthy males, ages 34 to 38, found that humming sped up the exchange of air between the sinuses and the nasal cavity and increased the nitric oxide (NO) rate by 15-fold.

The researchers pointed out that proper ventilation is essential for the maintenance of sinus integrity, and that blockage of the opening between the two cavities is a central event in the development of sinusitus.

The authors note that the current test to measure the degree the sinuses are open is invasive and somewhat cumbersome to perform.

The study appears in the second issue for July of the American Thoracic Society’s peer-reviewed American Journal of Respiratory and Critical Care Medicine. July 26, 2002.

WHAT IS FIBROMYALGIA SYNDROME?

FMS (fibromyalgia syndrome) is a widespread musculoskeletal pain and fatigue disorder for which the cause is still unknown. Fibromyalgia means pain in the muscles, ligaments, and tendons ñ the soft fibrous tissues in the body.

Most patients with FMS say that they ache all over. Their muscles may feel like they have been pulled or overworked. Sometimes the muscles twitch and at other times they burn. More women than men are afflicted with FMS, and it shows up in people of all ages.

To help your family and friends relate to your condition, have them think back to the last time they had a bad flu. Every muscle in their body shouted out in pain. In addition, they felt devoid of energy as though someone had unplugged their power supply. While the severity of symptoms fluctuate from person to person, FMS may resemble a post-viral state. This similarity is the reason experts in the field of FMS and chronic fatigue syndrome (CFS) believe that these two syndromes may be one and the same. Gulf War syndrome also overlaps with FMS/CFS.

SYMPTOMS AND ASSOCIATED SYNDROMES

Pain - The pain of FMS has no boundaries. People describe the pain as deep muscular aching, throbbing, shooting, and stabbing. Intense burning may also be present. Quite often, the pain and stiffness are worse in the morning and you may hurt more in muscle groups that are used repetitively.

Fatigue - This symptom can be mild in some patients and yet incapacitating in others. The fatigue has been described as “brain fatigue” in which patients feel totally drained of energy. Many patients depict this situation by saying that they feel as though their arms and legs are tied to concrete blocks, and they have difficulty concentrating, e.g., brain fog.

Sleep disorder - Most FMS patients have an associated sleep disorder called the alpha-EEG anomaly. This condition was uncovered in a sleep lab with the aid of a machine which recorded the brain waves of patients during sleep. Researchers found that most FMS patients could fall asleep without much trouble, but their deep level (or stage 4) sleep was constantly interrupted by bursts of awake-like brain activity. Patients appeared to spend the night with one foot in sleep and the other one out of it.

Sleep lab tests may not be necessary to determine if you have disturbed sleep. If you wake up feeling as though you’ve just been run over by a Mack truck ñ what doctors refer to as unrefreshing sleep ñ it is reasonable for your physician to assume that you have a sleep disorder. Many FMS patients have been found to have other sleep disorders in addition to the alpha-EEG, such as sleep apnea, sleep myoclonus (nighttime jerking of the arms and legs), and restless legs syndrome. A newly discovered sleep disorder, upper-airway resistance syndrome, is also being evaluated for its association with FMS.

Irritable Bowel Syndrome - Constipation, diarrhea, frequent abdominal pain, abdominal gas, and nausea represent symptoms frequently found in roughly 40 to 70% of FMS patients.

Chronic headaches - Recurrent migraine or tension-type headaches are seen in about 50% of FMS patients and can pose a major problem in coping for this patient group.

Temporomandibular Joint Dysfunction Syndrome - This syndrome, sometimes referred to as TMJ or TMD, causes tremendous jaw-related face and head pain in one quarter of FMS patients. However, a 1997 published report indicated that close to 75% of FMS patients have a varying degree of jaw discomfort. Typically, the problems are related to the muscles and ligaments surrounding the jaw joint and not necessarily the joint itself.

Other common symptoms - Premenstrual syndrome and painful periods, chest pain, morning stiffness, cognitive or memory impairment, numbness and tingling sensations, muscle twitching, irritable bladder, the feeling of swollen extremities, skin sensitivities, dry eyes and mouth, dizziness, and impaired coordination can occur. Patients are often sensitive to odors, loud noises, bright lights, and sometimes even the medications that they are prescribed.

Aggravating factors - Changes in weather, cold or drafty environments, infections, allergies, hormonal fluctuations (premenstrual and menopausal states), stress, depression, anxiety and over-exertion may all contribute to symptom flare-ups.

POSSIBLE CAUSES

The cause of FMS remains elusive, but there are many triggering events thought to precipitate its onset. A few examples would be an infection (viral or bacterial), an automobile accident or the development of another disorder, such as rheumatoid arthritis, lupus, or hypothyroidism. These triggering events probably don’t cause FMS, but rather, they may awaken an underlying physiological abnormality that is already present.

What could this abnormality be? Theories pertaining to alterations in pain-related chemical transmitters (particularly substance P, nerve growth factor, serotonin, and norepinephrine), immune system function (e.g. abnormally elevated levels of cytokines that form the communications link between your immunologic and neurologic systems), sleep physiology, and hormonal irregularities are under investigation. In addition, modern brain imaging techniques are being used to explore various aspects of brain function. The body’s response to exercise, stress, and alterations in the operation of your autonomic nervous system (the one that operates in your peripheral tissues) are also being evaluated. Substance P and nerve growth factor are increased threefold and fourfold (respectively) in the spinal fluid of people with FMS, but researchers are working to figure out why these elevations exist. With regards to genetics, its role in FMS is also the focus of many investigations.

COMMON TREATMENTS

Traditional treatments are geared toward improving the quality of sleep and reducing pain. Deep level (stage 4) sleep is crucial for many body functions (such as tissue repair, antibody production, and the regulation of various neurotransmitters, hormones and immune system chemicals). Therefore, the sleep disorders that frequently occur in FMS patients are treated first because they may be a strong contributing factor to the symptoms of this condition. Medications that boost your body’s level of serotonin and norepinephrine (neurotransmitters that modulate sleep, pain, and immune system function) are commonly prescribed in low doses, such as amitriptyline, cyclobenzaprine and Celexa. Ambien, clonazepam, and trazodone are just a few of the medications that may be used to aid sleep. Ultram may help with the pain, although stronger opioids may be needed for treating moderate to severe pain. Muscle relaxants and other drug categories may be prescribed as well. Each issue of the Fibromyalgia Network newsletter contains information about new drug therapy options, as well as advice about how to make use of existing medications to minimize FMS symptoms.

In addition to medications, most patients will need to use other treatment methods as well, such as trigger point injections with lidocaine, physical therapy, occupational therapy, acupuncture, acupressure, relaxation/biofeedback techniques, osteopathic manipulation, craniosacral therapy, chiropractic care, therapeutic massage, or a gentle exercise program.

WHAT IS THE PROGNOSIS?

Long term follow-up studies on FMS have shown that it is chronic, but the symptoms may wax and wane. The impact that FMS has on daily living activities, including the ability to work a full-time job, differs among patients. Overall, studies show that FMS may be equally as disabling as rheumatoid arthritis.

SELF-HELP STRATEGIES

Lifestyle modifications may help you conserve energy and minimize pain. Learn what factors aggravate your symptoms and avoid them, if possible. Become informed about your condition by subscribing to the FIBROMYALGIA NETWORK newsletter. In this 16-page newsletter you will read about research findings as well as advice on coping with FMS. Most importantly, this professional publication contains regular input from the experts to keep you informed about new and novel treatment methods, as well as recommendations about how to incorporate them into your care. What you won’t find are advertisements or fluff that only serve to detract from the information you need! To subscribe click here, or call our toll-free number, (800) 853-2929. Other educational materials may be ordered from Fibromyalgia Network as well.

All information contained in www.FMNetNews.com is copyrighted by
Fibromyalgia Network, P.O. Box 31750, Tucson, AZ 85751 (800) 853-2929.
This site is provided for the purpose of assisting patients in understanding their condition.
Patients should always consult their physician for medical advice and treatment.

The Neurostructural Integration Technique (NST) is a dynamic and skilful professional bodywork technique, which activates the bodyís innate healing wisdom.  This results in a comprehensive reoranisation of the bodyís muscles, characterised by lasting pain relief and functioning plus an increase in energy levels.  The response is most often profoundly effective and sometimes miraculous.

NST is essentially a soft tissue therapy designed to release muscles and fascia in a manner, which is safe for all ages, from newborns to the elderly.  It is often called ìcontextual healingî, as its main aim is to reintegrate the body as a whole (e.g. ìrebootsî the whole system).  It is for this reason that there are no contraindications, essentially rendering the technique useful for a wide range of conditions from acute pain to chronic conditions.

A treatment consists of the use of sequences of specialised moved on the body, carried out in a very specific and systematic manner.  Ther is not forceful manipulation, rather a cross-fibre manoeuvering of muscle, tendon, ligament or nerve, using varying pressure and incorporating resting periods to allow the body to respond.  Treatment can be done either through clothing or directly on the skin.

Throughout the session the client rexperiences deep relaxation, essentially providing the body with a ìwindow of opportunity: to comprehensively reorganise itself via the natural activation of various nerve reflexes.

Substantial relief is frequently attained after the first three sessions; however a reduction in symptoms is most often noted after the first sessions.  Long term resolution is generally attained after the fourth or fifth sessions.  A session normally lasts 45 minutes to 1 hour.

It is common for individuals receiving this work to experience a wide range of reactions such as shifting body aches, hot and cold flushes, sweating and, at times, emotional releases, however these are a positive sign that the individual is returning to a better state of well being.

The real secret of why NST/Bowen works is because of its underpinning philosophy.  Put simply, the philosophy is that the body is a self regulating bioenergetic and biomechanical phenomena which will continue to regulate itslef for as long as it has the reserve energy necessary to sustain life, by the ongoing process of biological adaptation.

The body automatically reorganises itself under certain circumstances via an energy conservation mechanism, called biological adaptation, which is mediated through its most powerful programme of all-the survival response.

Development

The Australian bodywork genius, Thomas Ambrose Bowen (1916-1982), the original developer of the method, realised that the body would regulate itself and return to balance if the appropirate neurological and neuromuscular context was created so that it could.  There was never the question of if it could, this was implicitóthe fact that the person had life was evidence enough that it could!

He discovered that there is a particular cycle in the body (variously referred to in other methods as the Craniosacral system) which must be free to operate unimpeded, if the individual is to enjoy good health and balance.

Whilst he discovered that this cycle was perceptible at an energetic level, he was equally aware of its physical components namely the sacrum, coccyx, cranium and Temporormandibular Joint complex and the dural membrane, which connects them to make them a functional unit.

Over and above the importance of recognising the need for this system to remain unimpeded, was his emphasis and insistence on releasing the neuromuscular imbalances throughout the body, which have such a direct impact on the proper functioning of the cycle and consequently the health of the whole body.

It is this point alone which sets NST/Bowen apart from all other forms of Osteopathic, Chiropractic and Cranio-Sacral approaches.

In summary, he postulated that if all muscular imbalances  could be released that the body would regulate itself, and in this process pain and symptoms would vanish and energy levels would increase.  Furthermore, the problematic condition would not return, because it had been addressed at its origin.

Bowenís real brilliance however lies in the actual system he devised to enable this automatic systematic reintegration to take place.

He recognized that when the body was stimulated in a very particular fashion that the intelligence of the body would be alerted (as he put it) and the process of unraveling neuromuscular compensations (unwinding) would begin.

Depending on the extent to compensation in the body, this unraveling process could take anywhere from 5 minutes to 7 days at which time the body would go into a holding pattern.  A reassessment would be required to evaluate the client again, then another session carried out to restart the unraveling process once again if necessary.

In Practice and Application

In clinical practice, on average, it is common to receive reports from clients that they can feel the body going through the unraveling (unwinding) process for approximately 2ó4 days.

There is often a very similar pattern experienced with body aches which move from one location to another (e.g. shoulder to knee), some sweating, emotional releases which some clients, but above all, a very deep sense of relaxation and change taking place.  In addition many clients report noticing their symptoms leaving their bodies in the reverse order to which they arrived.

While this may appear to be just semantics, the distinction is very important to keep in mind.  NST/Bowen is synonymous with contextual healingóa lost art which is now having a resurgence in many forms, and gaining popularity with both practitioners and clients alike.  Another well-0known example of a contextual healing approach is homeopathy. Interestingly, many individuals have dubbed NST/Bowen as ìtactile homeopathyî.

Firstly, using a combination of neurological and energetic blockage points, an initial temporary natural sedation is applied to the body.  Then using specific rolling motions (called ìmovesî)  across designated muscle, tendon, nerve and ligament points, a three part integrated body balance is applied,  which is partly performed with the client in a prone position and then finished with the client in a supine position.  This is generally comprised of a combination of further blockage and release points.

The moves are unique to Bowen Therapy, resembling neither massage, shiatsu, acupressure, osteopathic, or any other therapyís activation, stimulation or releases.

Basically, the skin is lightly drawn over the designated points in either a lateral or medial direction, prior to executing the move.  After this, a little pressure is momentarily applied to the underlying structure, in the opposite direction, therefore finally crossing the structure (i.e. muscle, tendon, nerve or ligament) with a gentle pressure, back in the direction from where the skin was initially drawn.

Typically, the moves are executed without slipping, thus producing a gentel ìbumpî as the underlying structure is crossed.   In each session, the whole body will be treated commencing with a general body balance and progressing to specifics in line with what
issues the patient presents.

Conditions NST/Bowen Can Help With:

The question is often asked ìwill NST cure this condition or that conditionî?  The response is always the sameóNST/Bowen will cure nothing!  It is simply a process that enables the body to regulate itself, and throughout this process many symptoms disappear.

NST/Bowen is a contextual approach to healing and can be applied to any condition the human body is capable of manifesting.

The following list of symptoms frequently disappear in response to NST/Bowen Therapy:”>-

• Cranial, Temporomandibular Joint (TMJ) disorders.
• Head injuries and headaches including migraines
• Neck problems including whiplash, shoulder and arm pains.
• Back problems in both the lumbar and thoracic spine.
• Leg problems including hamstrings, knee and ankles.
• Sciatic and pelvic problems.
• Accidents and sporting injuries (acute or chronic).
• Musculoskeletal disorders, rheumatism, arthritis and fibromyalgia.
• Digestive, bowel and urinary problems.
• Respiratory problems including asthma, sinusitis, bronchitis
• Menstrual, reproductive and menopausal disorders
• Baby colic, gastric reflux and feeding problems
• Acute and chronic fatigue syndrome
• Stress conditions, emotional depression and learning difficulties.

Note that it is the experience of Fred Samorodin, RPT that the conditions noted above can respond to his use of various forms of bodywork including Cranio-sacral Therapy and/or NST/Bowen Therapy. There is no guarantee implied in this discussion.

While the above list of conditions are the most typical that respond to an NST or Craniosacral session, there are many other more serious condtions which respond favourably as well, e.g. Parkinsonís Disease, Multiple Sclerosis, Lymeís Disease, just to name a few.

Typically, results are extremely good, requiring just a few sessions to bring about some stability in the condition.  Current international statistics consistently verify that in general clinical practice 80-85% of symptoms disappear after 3ó4 sessions.  The remaining 15-20% of symptoms many require additional treatments (or advanced or blended procedures) to address core issues.  Many clients use NST/Bowen or Craniosacral Therapy preventatively.

Sessions are generally structured one to two weeks apart, depending on individual circumstances.

Fredric T. Samorodin, Registered Physical Therapist
604-732-6323

Acknowledgements to www.physicalogic.com

» Payment is due at time of service.

» Cash, cheques Visa or Mastercard  accepted.

» An initial session (45-60 minutes) is required of all new and clients returning after 12 months, or after recent significant health changes.

» Subsequent sessions are generally for 45 minutes while longer sessions can be benefitial in some cases and may be arranged.

» 24 hour cancellation notice is required or full fee will be billed.

» Subsequent sessions are generally one week apart.

» 5 sessions within two months recommended as a treatment program for chronic conditions. Plan ahead!