Welcome Conor O’Flynn to the Body Balance Health & Physiotherapy Team

By | News

In other Body Balance Health & Physiotherapy news we would like to welcome Conor O’Flynn to the team!

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About Conor

Conor is a manual osteopath who was born and raised in Wallaceburg, Ontario. He studied Kinesiology at Wilfrid Laurier University in Waterloo, Ontario, earning a Bachelor of Arts. While studying at Laurier, Conor developed worked as a personal trainer and varsity strength coach for the university, discovering the need for an integrated fitness and therapy model.

After university, Conor earned a diploma in manual osteopathic practice (DOMP) from the National Academy of Osteopathy in North York. He returned to Waterloo and provided osteopathic therapy in both physiotherapy and alternative medicine clinics.

Conor’s therapeutic work focuses on musculoskeletal issues of all kinds. He uses manual (hands on) therapy techniques to restore balance and integrity to the body, removing the barriers to healing and recovery. He works hard to keep his techniques and practice up to date with current pain science and manual methods.

Conor is passionate about exercise, and bridging the gap between therapy and fitness. He prefers to gear his therapy towards an active recovery, placing the patient in control of their recovery process and transitioning to a healthy, vibrant life.

A lifelong athlete, Conor is a nationally qualified powerlifter. He’s competed at the national level in both muay thai kickboxing and grappling competitions. He is a prolific writer and is always looking to improve his fitness and therapy services.

Osteopathy and Chronic Pain

Osteopathy is an old therapy, going into its 144th year as a health practice in 2018. Though this might be viewed as a drawback – deeper roots to keep the profession stuck in the mud – it can actually work the opposite way. The long history provides perspective and allows for the old to be viewed on a spectrum with the new.

In the case of osteopathy, this means that the field has changed and will change dramatically. As it should. The original practice still makes up a large amount of what is considered osteopathic work today; manual therapy applied in an effort to achieve favourable outcomes and avoid more invasive interventions.

Viewed in this broad lens, the field is wide open to adapting to pain science as it changes and new evidence emerges. A 2016 article by Williams and Craig – titled “Updating the definition of pain” – provides many insights to apply as we move forward with manual practice.

Williams and Craig provide the following definition of pain, “Pain is a distressing experience associated with actual or potential tissue damage with sensory, emotional, cognitive and social components”(Williams and Craig, 2016). The incredibly important assertion that pain is an experience is a good start. That this experience may involve actual OR potential tissue damage is equally important.

In the case that actual tissue damage has triggered a nociceptive experience, osteopathy can provide manual care that seeks to parse, relieve, and re-integrate the areas in question. The goal is to remove obstructions to recovery and factors that feed into nociception, allowing the individual to once again feel like an integrated and functional unit.

In the case that there is only potential damage or perceived damage, osteopathic therapy can still be useful. A manual approach can be used to begin to restore confidence in an area of the body, provide novel stimuli which may interfere with nociception, and lay the groundwork for changing perception of the area through more active means, like exercise.

Through manual work and simultaneous discussion and education of the patient, the therapist can change both the objective expressions and the subjective perceptions which may contribute to the sensation of pain. We can guide the patient through the common narratives that often contribute to pain becoming or remaining chronic.

My own osteopathic work has been largely directed at realigning a patient’s focus as they navigate a painful experience. Often the instinct is to focus on the painful sensation and the things that one cannot do as a result of the pain. In my interactions with patients, I can help direct their attention toward doing what is necessary to improve toward a more functional state.

As pain experiences become chronic, the link between actual tissue damage and perceived pain weakens (Juch et Al, 2017). It’s important that the patient is able to form a therapeutic alliance with a practitioner they can trust. It’s more important that this practitioner helps to guide perception towards function and acceptance of pain itself rather than suggesting that a simple hands-on technique can “fix” the pain.

Manual Osteopaths are not among the professions allowed to perform diagnostics in Ontario. While at first this seems like a shortcoming, it does in fact put Manual Osteopaths in an interesting and unique position.

Rather than focusing on the diagnosis process and finding a label for the painful input, osteopathy is free to parse out the connection between tissue and pain that so many patients can get stuck on. Moreover, we can work on accepting conditions however they may currently present and set specific and meaningful goals with the patient.

This goal setting may not fit any other criteria beyond the patient, but that won’t matter. We can choose tasks that are meaningful to the patient, or on changing experiences currently affected by pain. This may be something personal and difficult to quantify in the clinic,but it may provide the patient with a tangible goal that they truly desire. This allows for the patient to feel a little empowerment, and in doing so removes reliance on the practitioner in question.

Osteopathic therapy is manual therapy. Manual Osteopaths work with their hands. Among the guiding principles of the practice, though, is removing obstacles that prevent healing. My hands may not be able to stimulate healing themselves, but they are more than capable of helping a patient feel better and liberating tissues to allow for better movement and experiences.

Through manual work, shared goals, working with acceptance and perspective, and forming an empowering therapeutic relationship with the patient, manual osteopathy is a useful tool in the treatment of chronic pain.

Williams AC, Craig KD. Updating the definition of pain. Pain. 2016; 157(11):2420-2423.

Juch JNS, Maas ET, Ostelo RWJG. Effect of Radiofrequency Denervation on Pain Intensity Among Patients With Chronic Low Back Pain: The Mint Randomized Clinical Trials. JAMA. 2017; 318(1):68-81.

 

The Opioid Crisis Leads Canadians to Seek Alternative Approaches for the Management of Chronic Pain

By | Body Balance Quarterly

Body Balance Quarterly (The BBQ)

The Opioid Crisis Leads Canadians to Seek Alternative Approaches for the Management of Chronic Pain

The Opioid Crisis

In December 2017, a Canadian news report released by CBC news made citizens aware of the rising number of opioid related deaths over the past year. Rising from 2,861 opioid related fatalities in 2016, based on the information reported to the Public Health Agency of Canada, it was projected that Canada was on track to see over 4000 deaths from opioid toxicity at the closing of 2017 (The Canadian Press, 2017). With the rising number of opioid fatalities each calendar year this has caused significant controversy among the Canadian Government, health care professionals, and citizens over the prescription of opioids and the use of these substances in the management of chronic pain.

In light of the unfolding opioid crisis, and the unveiling of the topic of ‘Chronic Pain’ among the recent news headlines in this edition of the Body Balance Quarterly we would like to offer our perspective on chronic pain. We will also discuss the latest evidence in support of alternative methods for chronic pain management.

What is Chronic Pain?

Pain is a complex phenomenon that extends far beyond a standardized feeling of discomfort and soreness. Pain is a subjective and emotional experience, which is characterized differently in every individual. In cases of Acute Pain that is felt following an injury, a signal of tissue damage is sent to the brain. In acute pain cases, the pain felt is typically proportional to the amount of tissue that has been damaged. When people experience pain after an injury, pain is believed to be a useful stage of the healing process as it promotes rest, which ultimately promotes healing. However, in cases of chronic pain the link between the presence of tissue damage and one’s pain levels becomes disconnected.

Until recently, the topic of ‘Chronic Pain’ has not been a hot topic of conversation among the general population. However, even with its increased prevalence in the news today with the current opioid crisis, the concept of chronic pain is still an idea that is not well understood by many. Chronic pain conditions include fibromyalgia, chronic regional pain syndrome (CRPS), spinal pain, and chronic low back pain (among many others). In cases of chronic pain, the pain experienced by an individual extends beyond the typical healing time of newly damaged tissue. In individuals with chronic pain the nervous system becomes hypersensitive to incoming signals causing the pain system to be ‘Turned up’, which reduces an individual’s pain threshold. This ultimately causes an individual to experience pain with tasks or sensations that would not normally be perceived as painful. This can have significant impacts on daily life as it causes increased attention to painful regions, reduced activity levels and subsequently activity tolerance, heightened stress response, poor concentration as well as sleep disturbances. Without intervention this can lead to a cumulative and chronic pain cycle leading to overall deconditioning which further amplifies the effects of chronic pain conditions (WRIISC, 2014).

So what can be done to break this pain cycle? Over the course of the past 5 years, an increased volume of literature has been devoted to the benefits of low – moderate intensity exercise, in the management of chronic pain symptoms. In a recent literature review Geenen et al. (2017) concluded that a general exercise and strengthening program has proven to be effective among individuals with chronic pain conditions in improving both pain severity and overall quality of life. However, self-initiated exercise programs were found to be less effective among this same population (Geenen et al. 2017). Numerous exercise interventions were included among this review from aerobic exercise, strength training and flexibility, to range of motion exercises, balance training, core strengthening, tai chi, yoga and pilates, which displays the wide variety of successful exercise options available (Geenen et al. 2017).

Mechanism of How Exercise Aids in Managing Chronic Pain Symptoms

‘Exercise is medicine’ has been a popular phrase among health care professionals and health advocates among recent years. In cases of chronic pain, exercise has proven to display many benefits in helping to manage chronic pain symptoms. Above we talked about how individuals living with chronic pain have a hypersensitive nervous system causing the pain system to be ‘Turned up’. The goal of exercise is to help retrain the pain system to be ‘Turned down’ by calming the nervous system and reducing its sensitivity to incoming signals. The human body is designed to move, and by introducing graded exercise and daily pacing strategies this can play a substantial role in the management of you or your loved one’s chronic pain symptoms.

Exercise helps to increase your energy stores, giving you a longer charge or battery life. This will help reduce your fatigue levels and make it easier for you to perform your daily activities. Aside from the benefits of pain reduction alone, there are numerous other health benefits that exercise has to offer, including but not limited to; decreased blood pressure and resting heart rate—ultimately lowering one’s risk of developing heart disease or stroke—improved sleep, weight loss, increased muscle mass, as well as improved psychological well being.

Among individuals living with chronic pain conditions, a common misconception is that exercise attempts will cause a flare up of pain symptoms, and therefore these individuals often rely on rest and relaxation to avoid worsening of pain symptoms (WRIISC, 2014). However, for successful long-term management of chronic pain conditions, a low to moderate intensity exercise program should be introduced. Here are some tips to consider with regards to exercising if you or a loved one has been experiencing chronic pain. Remember, although opioids may not be the answer for managing chronic pain, today’s evidence supports that exercise is!

Tips On Exercising Safely and Effectively for Chronic Pain Management

1) Contact your doctor first to determine whether or not you are ready for exercise and to begin exercising safely. It is very important to exercise with proper form and technique in order to prevent injury and training the wrong muscle patterns. If you are unsure about how to exercise safely follow up with a health care professional to get you started on a safe and individualized exercise routine.

2) Gradual exposure to exercise is very important to not ‘flare up’ the pain system. It is important to remember that in the beginning stage of exercise you may experience some worsened symptoms during or after exercising, however, if the pain is too severe that you feel you cause a ‘flare up’ you have likely done too much (Geenen et al. 2017). If you feel abnormally fatigued or have pain symptoms that are more significant than usual, take a break from exercising and return to exercise when your symptoms have decreased.

3) The effects of exercise often may take longer to display in individuals who are dealing with chronic pain (Geenen et al. 2017). Remember to be patient, by choosing a form of exercise you enjoy it will make exercise seem less daunting.

4) Gradually increase the exercise volume before you increase the overall exercise intensity. Once you are able to exercise daily, then slowly increase the difficulty of your exercise routine.

5) Include exercises that target all areas of the body, and all large muscle groups.

If you have a chronic pain condition and are ready to begin an exercise routine but are not sure where to start we can help! Body Balance Health offers numerous Health and Wellness programs to help develop an individualized exercise program for you to begin exercising safely. Check out our website or give us a call to see if Body Balance Health’s programs are right for you!

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Body Balance Health & Physiotherapy News

In other Body Balance Health & Physiotherapy News, we would like to welcome Conor O’Flynn to the Body Balance team! Conor is a manual osteopath who will be joining the clinic twice weekly (Tuesday’s & Thursday’s). Conor’s therapeutic work focuses on musculoskeletal issues of all kinds. Conor also has experience working with individuals who have been experiencing chronic pain. Osteopathy uses manual (hands on) therapeutic techniques to restore balance and integrity to the body by removing the barriers to healing and recovery.

 

Works Cited

Geneen LJ, Moore RA, Clarke C, Martin D, Colvin LA, Smith BH.
Physical activity and exercise for chronic pain in adults: an overview of Cochrane Reviews. Cochrane Database of Systematic Reviews 2017, Issue 4. Art. No.: CD011279.
DOI: 10.1002/14651858.CD011279.pub3

The Canadian Press. (December 18, 2017). Opioid deaths in Canada expected to hit 4,000 by end of 2017. CBC News. http://www.cbc.ca/news/health/opioid-deaths-canada-4000-projected-2017-1.4455518

The Government of Canada. (August 29, 2017). Apparent Opioid-Related Deaths in Canada in 2016*. Public Health Agency of Canada. https://www.canada.ca/content/dam/hc-sc/documents/services/publications/healthy-living/opioids-infographic-eng.pdf

War Related Illness & Injury Study Centre. (March, 2014). Exercise to help manage chronic pain and/or fatigue. Veterans Health Administration: Office of Public Health. https://www.warrelatedillness.va.gov/education/factsheets/exercise-to-manage-pain.pdf