Leading Integrated Healthcare

Muscle pain or spasm, and tendon pain

Pain from muscle tissue is perhaps the commonest type of pain of all. The muscles are the biggest users of blood and energy in the body and account for the vast majority of nervous system activity. The whole point of having a body is to move; and this is the job of the muscles. Such constant activity needs a certain amount of careful management!

Muscle pain caused by strain and sprain (actual tearing of fibres) is rare, but heals very readily unless there is some sort of impediment to this process. True spasm of muscle is extremely rare and occurs only in underlying bone injuries that the muscle attempts to splint, and in the disease tetanus.

Both muscles and tendons (non-elastic cords that join muscle to bone) are readily injured by repetitive strain or overuse syndromes – in which case the lubricating sheaths of the tendons can also become inflamed. Tennis elbow is a good example of an overuse syndrome – these days mostly caused by computer keyboard use. However, it is interesting to note that most overuse syndromes occur when one is under prolonged stress.

Muscle tissue can fatigue, or it can be inappropriately used and damaged. Fatigue is by far the commonest source of muscle pain, but the odd fact is that most muscle fatigue is due to unconsciously over-used muscle – that is, over-use of muscle is normally the result of stress and tension. To be more accurate, muscles – especially postural, torso muscles – are used to ‘brace’ parts of the body. This is in fact a basic biological survival function when the muscles are stimulated, but at the same time prevented from causing movement. For example if you are irritated, certain muscle groups will want to work to resolve the irritation. Similarly, if you are worried, the muscles will want to work to resolve the worry. This basic biological function is fine in Neanderthal man, but in modern life we are usually trying to resolve our problems without defensive or aggressive activity. However, this frustration in the body leads to muscle tension or bracing, which, if prolonged, will cause pain due to fatigue. This kind of problem is resolvable using muscular relaxation techniques, massage, bodywork such as osteopathy, pain-relief processes such as acupuncture, and of course, other more psychologically inclined stress-management activities, including Somatic Experiencing.

Here is a fairly accurate and popular – if not quite PC – analysis of this problem:

“Stress is – the confusion created when the brain overrides the body’s basic desire to choke the living shit out of some asshole who desperately needs it” (anonymous)


Dr Kaplan: Provocative Therapy

In December 2012, as result of a stress at work, I suffered from severe anxiety, fear, panic attacks, tachycardia and insomnia.These symptoms became increasingly severe and were associated with low self-esteem and loss of self-confidence. I consulted my GP who prescribed Citalopram and beta blockers for the tachycardia. The antidepressant did not suit me and I felt worse. I was then referred to Dr Brian Kaplan, to be treated with the ‘Provocative Therapy’. This treatment adapted by Dr Kaplan, is based on the principle that the therapist ask questions covering all aspects of the patient’s life, by exaggerating the meanings of it. During the 1 hour session, the patient experiences a strong reaction, triggered by the ‘Provocative’ input of the therapist. Initially, there is an increased fear with regression to the childhood, associated to strong emotions and sorrow, which may precipitate sobbing. Subsequently, this state is followed by a phase of self-analysis which is more constructive. The ‘provocation’ breaks the pattern of the patient’s own feelings of hopelessness and discomfort. In fact, there is an opening of the self-image and a critical strong desire for change, in response to the provocation, which can be at times, outrageous. I underwent 9 weekly sessions during which I progressively became free from fear. The anxiety and panic attacks reduced significantly and I started to know what I want from my life and became more positive and optimistic. At the end of the 9 weeks, I acquired my self-confidence and self – esteem together with a new approach in my life which initially appeared to me broken and rather useless. The 9 sessions – in my opinion – were sufficient to resolve the initial acute state with anxiety and I felt a person full of interest and happier.  It is more than one year since I started the ‘provocative therapy’ with Dr Kaplan and I have not had any relapse to the original symptoms and discomfort. I strongly recommend this this therapy as a novelty; this is medication- free and can produce resolution of the acute psychological/mental conditions, quicker than the conventional therapies. In order to be successful, it is crucial that the patient collaborates and has complete trust in the therapist. The scientific process of such a treatment is not yet known and /or clarified. However, a number of recent studies in Neurophysiology and Psychiatry have shown the importance of hexogen and endogen stimuli, which can triggers and induce changes in the brain in response to the external inputs, acting via the hypothalamic/endocrine axes. It can be suggested that some of these mechanisms may be involved in the therapeutic process of the Provocative Therapy, but a lot of work needs to be in hand.