12. Fascia are fascinating!
In recent years, anatomists and physiologists expanded their knowledge of the connective tissues of the body. Far from just being a fill material or stabilizer for muscles and joints, the various forms of fascia are also conduits of nerves, lymph, and blood vessels, and extensively supplied with nerve endings, making this all-enveloping magical union suit our largest sensory organ for all our internal goings-on.
In a recent interview, fascia and movement researcher Robert Schleip (University of Munich, Germany) explained the involvement of connective tissue and pain: Immobility and stress can cause the tissue to become sticky and stiff, triggering discomfort or even pain. Blocked flow through the fascial system also increases depression. Early evidence shows good results for using foam rollers to decrease it. Dr. Schleip is planning a clinical trial of using hopping movements for mood improvement since he discovered this worked for himself better than jogging.
Stagnation in the body is now being investigated as a possible cause of inflammation and chronic diseases, with lymph drainage as a possible strategy to reduce chronic musculoskeletal and idiopathic pain syndromes (Jay Shah 2021). Both manual lymph drainage and the ancient practice of Qi Gong increase vascular perfusion and speed of lymph drainage, offering solutions for inflammation, sensitization, and other pathologies. A sedentary and unhealthy lifestyle leading to such stagnation changes cell behavior (Patricia Huston, 2022). Our connective tissue is like a sponge - if stagnant, it can be squeezed and rinsed clean, restoring tissue health and reducing discomfort.
Dr. Schleip recommends long gentle (!) stretching to encourage healing, with longer holds having more profound effects; 1-5 minutes have been tested, also 10 minutes, have been shown to reduce inflammation and change biochemistry, even reducing tumor growth.
11. Motion is Lotion!
Movement is The Key to Health. Recent articles in Consumer Reports and CR on Health recommend massage and movement such as Yoga as first-line pain killers (once your physician has checked you), for conditions such as back pain, Osteoarthritis, and Fibromyalgia - without side effects from medication. Also, a recent study found that a 30 minute stretching routine five times a week reduced blood pressure by 7 points (J. Physical Activity and Health 12:2020, cited in Consumer Reports for Health).
Our bodies want to heal - and they will, if given regular cues in form of structured touch and movement! Invest some time and effort into eliminating the causes of discomfort (including stress) rather than just reducing the symptoms. I've talked to a sciatica sufferer who keeps his condition under control with 90 minutes of movement a day. My nerve pain from cysts in my lumbar spine was reduced by dancing around the living room and also doing karate practices for a couple of hours every day; eventually, the cysts disappeared, probably worn away by all the movement and stretching.
At first, your body may complain a bit from the unaccustomed activities. Building up slowly and consistently will bring improvement, as will developing a habit, and listening to your body. Get your daily Vitamin M as in Motion!
10. Balancing Sturdiness and Ease Helps Scoliosis
The most common type of Scoliosis starts in early teen age, and is due to lack of support from postural muscles (and connective tissues) not having caught up with a growth spurt. Muscles responsible for axial elongation of the spine (standing tall), are too weak, and the torso collapses into a spiral, with areas of stronger muscles and connective tissue causing concave curves, and weaker areas bowing outward. The inequalities are exacerbated by unequal loading, since that feels more comfortable - for example carrying grocery bags in the hand opposite the stronger flank, or carrying a toddler on the stronger side of the waist. And it's a lot easier to lower yourself using the stronger hip - so it gets stronger and stronger, while the other side never gets a workout. This also happens in sedentary adults always leaning on the same side armrest in their favorite chair.
Habitual unequal loading can also lead to Scoliosis in active adults. Repeating the same strong lifting or other strong movements over and over on the same side only leads to the same pattern of stronger areas spiraling around the torso as in the teenage-onset Scoliosis, but without the collapse into a slouching spiral but rather more of a stiff tilt of the torso.
In Yoga, we strive for balance between sturdiness/effort and ease/mobility. A body with only relaxed muscles collapses, while one with only high-toned muscles is stiff and cannot move. Muscles have to be trained both to relax and to brace or contract as needed. Strength comes from increased muscle mass (and springy resilient connective tissue adding support) built up through repeated signals to the tissues in form of exercises. Strength also depends on brain signals inducing voluntary movement, and maintaining postural or bracing muscle tone. The brain learns what the "maintenance normal" is for the various muscles - thus with Scoliosis, we are not aware of the unequal tensions...and it takes time to re-program the patterns.
Reducing Scoliotic curves requires physical strengthening of weaker areas and stretching and relaxing contracted ones - and acquiring a habit of self-monitoring to correct habits of collapsing and unequal working. Yes it's an effort, but persistence pays off! No more pain, more strength and resilience, and better fitting clothes! And ageless graceful movement and mobility is not half bad either.
9. First Brace Yourself, Then Load
For both people lacking condition and those with Scoliosis, lifting a heavy load risks injury due to weaker areas collapsing. It does not feel very good either! I found that out when I was learning personal training, and my (thirtyish, muscular) coach handed me (fiftyish, thin, scoliotic) a thirty pound sand sack for jogging around the parking lot. I could almost hear the "Oufff" of my spine and rib cage as my weak spots struggled to contain the pressure of the weight.
Handling heavy loads needs training a) postural muscles and connective tissue, and b) coordination of core muscles with limb stabilization and movement. Postural muscles are designed for stamina, to hold up your body weight for a long time (standing in line, or sitting unsupported at the computer, with a tall spine for hours...). Well developed connective tissue helps to hold things in place without muscular effort (think strapping tape). And as martial artists and dancers know, bracing your abdominals and locking on your shoulders turns the body into a unit, which is then able to create a strong movement force safely.
Our bodies are trying to be efficient. If a structure is not used, the body will start to take it down, to use the resources elsewhere. Use it or lose it! Conversely, using a body part regularly gives it the signal for shoring up the structure. After a long illness, I could sit unsupported for maybe 2 minutes until my back started aching with strain. Gradually increasing sitting times, and drawing myself up (with a bit of stretching) over and over built up my stamina; now I can sit without a back rest for literally hours without pain (of course taking little unobtrusive stretching breaks).
Movement training can help engraining the "brace first, then load" sequence. Lift your tummy before picking up the sacks of groceries! And of course with Scoliosis, you want to pull your weak side to center as part of the bracing (which you can do after practicing your rib lift every day), and make sure your weaker shoulder is tucked onto the torso before pushing or pulling with that arm.
An ounce of prevention is preferable to a pound of cure!
8. Yoga for Scoliosis Expanded
One important aspect of changing posture is self-awareness - you have to feel where your bits are in space and in relation to each other in order to be able to call them into new alignment. I keep developing more exercises to cue the brain and muscles to find and correct asymmetries - more ways to practice means more information for the system!
Strengthening the weak areas is still the most important task for counteracting the collapse. Stretching the tight areas helps balance the sides of the body, and again gives cues to the brain to reprogram the postural holding patterns. Once the postural muscles are able to lift and the weak side muscles can stabilize, manual therapy can help to mobilize stiff areas of spine and ribs. Doing this too soon would deprive the body of its attempts at stabilizing. It tries to do the best it can by holding on where it is able - which is the tight areas that are already on the map in the brain! The weak areas' muscles are not very accessible to stabilizing commands, since disuse decreases their presence on the body map in the brain. Part of strengthening is not just building more muscle fibers, but helping to get more nerve fibers online, and so goosing more of each muscle into action. And of course feeling the muscle contracting then helps activate more of the brain map for that area, a positive feedback loop!
Targeted Yoga poses for symmetry and overall torso stability, and doing Qi Gong with the intention of strengthening those weak areas as well as repeating movements with good posture to establish the habit, have helped me reduce my scoliosis as well as help with shoulder and knee problems (weak area limb joints are unstable too, not just the torso). It takes some effort and patience - but the self-empowerment is worth it.
7. Yoga for Scoliosis - Learning to Support Your Spine
I was diagnosed with Scoliosis at the age of 13, after back pains brought me to the orthopedist. He told me I had a shorter right leg, and prescribed adding 1/4 inch to my right heel, plus (fortunately) PT to strengthen my weak-muscled torso. The PT helped some, but did not offer specific exercises to target the weak spots, and to stretching tight spots, or to mobilize the stiffened spinal joints. Also, no advice was given how to improve posture and prevent further troubles in daily life. Now that I've learned much more, I've found ways to make sitting and standing safer for my spine.
At least, the long-ago back strengthening, and an active life, reigned in the back aches, and prevented worsening of the curvatures. But I did not like the built-up heel, and soon went back to wearing flats. Instead, I got into the habit of compensating for the short leg by putting my weight on it in order to level my hips, and so help to keep my spine straighter. Of course, this did nothing to improve my posture otherwise - and many decades later I had osteopenia in that less-used left thigh. And I ended up with painful muscle imbalances in the twisted hips, and again back discomfort which woke me up at night.
Discovering classic Yoga got rid of the back aches very quickly, and untwisted my hips enough that I had to have my (again) built-up shoe lowered. I loved it so much that I started teaching Yoga, with focus on older adults. Still, I was stuck with a noticeable curve in my lower back, stiff ribs, and slumped shoulders. Learning more core and spine awareness and gaining strength and mobility in taking Pilates-based PT and Yoga for Osteoporosis finally helped me to undo more of the dysfunctions, and improve my health. And then adding Dr. Fishman's targeted muscle strengthening was the final element.
Mild to moderate Scoliosis tends to appear in slender children with thin muscles and soft connective tissue, often when they have their teenage growth spurt (and think it's "cool" to hang around with a wet-noodle spine). It breaks my heart to hear them being told to "watch if you grow out of it" - and if it gets worse, there's the possibility of putting immobilizing hardware into the spine. In older sedentary adults who get into the habit of always sitting leaning on the same elbow, or standing leaning on the same cane, the sideways shift is blamed on advancing age, so you "have to live with it". Not true. Clinical trials by physician and Yoga teacher Loren Fishman have shown that both in teens and adults, a few minutes a day of targeted exercises, done consistently over months, reduce the curvatures significantly. One especially diligent lady actually reversed her Scoliosis, developing a curvature to the other side! Balancing muscle tensions is the key.
Fishman, Loren M.MD, 2024. Isometric Yoga-like Maneuvers Improve Adult Scoliosis. A Non-randomized controlled study. Topics in Geriatric Rehabilitation 40: 3-8.
6. WHAT'S MANUAL LYMPH DRAINAGE?
Lymph Drainage is a gentle technique, mostly moving tissues at the skin level, but it has powerful effects.
You can optimize your immune system with a full-body Lymph Drainage 4 times per year, or during and after pregnancy.
MLD also reduces allergies and rejuvenates your face and neck with a LymphLiftTM of the head and neck.
Injuries and surgeries heal faster due to reduced swelling and tissue damage.
Experience shows that 1-2 Lymph Drainage treatments a week before surgery, and daily, then more widely spaced treatments starting about a week past surgery (with your surgeon’s permission) reduce swelling and bruising, and speed up healing up to 6 times, with reduced scarring.
The technique focuses on the hair-thin lymph ducts just underneath your skin surface that help return liquids, protein, and fats to your blood circulation via scattered lymph nodes that serve to filter out debris and germs on the way to your veins. While there is no heart-like pump for lymph, the tubes themselves have muscled walls that contract to push the lymph fluid towards the heart. They are attached to the skin via thin fibers to hold them in place, so can be stimulated by pulling on the skin.
Manual Lymph Drainage can speed up lymph flow up to 10 times! This helps to drain sinuses, decreases local inflammation, clears out debris from injury, pushing invading bacteria towards the lymph nodes where they are dispatched by resident immune cells, and decreases edema (excess fluid in the tissue), resulting in improved tissue health. This speeds healing and reduces scar tissue build up.
Plan your appointments together with your surgery for a faster recovery! You can purchase a 3-pack of sessions for $200. For more information and to schedule, please call 352-281-1048.
5. TRIGGER POINTS - WHAT A PAIN IN THE LEG, AND NECK...
Janet Travell MD, White House physician to President Kennedy, and her colleague David Simons called trigger points "the scourge of mankind" since they cause so much suffering and pain, though they are not otherwise dangerous. If you have nagging, clangy aching or pain in your musculoskeletal system, it may be due to Trigger Points.
What is a Trigger Point?
It’s a palpable, pressure sensitive knot or lump in the belly of a muscle in the middle of taut bands. The lump, which may be as small as a pinhead or as big as your thumb, consists of strongly contracted muscle tissue, which stretches the rest of that muscle strand to the maximum (the taut bands leading away from the knot). The contraction in the trigger point is so strong that it cuts off its own circulation, causing oxygen starvation and accumulation of metabolic wastes, which in turn irritate the tissue and cause pain signals – setting up a vicious circle which perpetuates the trigger point. This is why it won’t go away if the muscle relaxes, the way a muscle spasm (charley horse) would.
Janet Travell MD and David Simons MD have found, over 50 years of research, that trigger points can occur in all muscles, and cause a large percentage of all pain and other discomforts such as stiffness (up to frozen shoulder), headaches, muscle weakness, dizziness, numbness, and even heart arrhythmia.
What causes Trigger Points?
Both sudden overwork (weekend warriors beware!) and prolonged overwork or immobility (computer users!) with muscles in shortened positions can lead to Trigger Points. Stress, illness or nerve irritation may make it more likely that trigger points form, or become more painful, as in the case of Fibromyalgia sufferers.
What are the symptoms?
Trigger points can exist in a latent state, causing pain only if pressure is applied to the knot or the muscle is stretched. Most often, trigger points cause dull, nagging pain and reduced muscle strength. If the muscle is asked to contract strongly or repeatedly, excruciatingly sharp pain results, which can appear far from the site of the actual trigger point through connections of nerves and fascia (for example, a knot in a hip muscle causes such “referred pain” down the leg in a Sciatica-like pattern). Nerve and fascial connections can also initiate satellite trigger points in other muscles, which will recur even if treated until the prime instigator has been found and eliminated. Stress and anxiety increase overall nervous system arousal and thereby signaling to muscles, leading to increased tension and pain in trigger points.
Trigger Point Treatment possibilities
A trigger point can be temporarily soothed back into latency with non-specific treatments such as rest, heat, or non-specific massage. Permanent relief results from dissolving it with repeated specific treatments – Trigger Point Therapy (point-specific massage), Positional Release, or repeated gentle stretching of the muscle. The latter may not be possible for severe cases. Forced stretching will damage the already maximally lengthened muscle fibers, irritate the nerves surrounding the knot even more, and so worsen the problem. Of course, overworking a muscle again can cause a new trigger point to form, so in case of work-related repetitive strain or postural problems truly permanent improvement requires change in activities. Treating trigger points can much improve quality of life for people with fibromyalgia or chronic myofascial pain. Also, it has been found to be helpful (and indeed essential in severe pain syndromes) to decrease overall stress and anxiety with mindfulness-based practices (meditation, breathing exercises, Yoga, Qi Gong…) and thought pattern retraining (cognitive therapy).
Recommended Treatment Plan
Massage of trigger points improves circulation and may result in a dramatic release of the knot with the first treatment – though usually, entrenched points may need a series of applications for permanent improvement, which can be combined with learning postural changes and gentle preventive stretching. Depending on the number and severity of trigger points, I would recommend at least two follow-up massages after the initial assessment and treatment; I also recommend you learn the basic trigger point technique for “touch-ups” between professional treatments, which will speed up healing, as well as giving you control over your pain when it wakes you up in the wee hours! On average, trigger points need about three weeks of professional and self-treatments; severe cases like frozen shoulders may take four to six weeks to resolve if treated diligently, and in cases where long-term stress-tension habits are an issue, pain can recur for many months. The key is not to get discouraged when stress or other factors cause flare-ups – knowing what to do to break the pain cycle helps to remain patient until fully recovered.
Clair Davies, with Amber Davies, 2013, “The Trigger Point Therapy Workbook”, 3rd ed.
Clair Davies, 2006, “The Frozen Shoulder Workbook”; Oakland: New Harbinger Publications.
J.G. Travell and D.G. Simons, 1992: “Myofascial Pain and Dysfunction: The Trigger Point Manual” Vol.2, 2nd ed., and
D. G. Simons, J.G. Travell, and L. S. Simons, 1999: “Myofascial Pain and Dysfunction: “The Trigger Point Manual” Vol. 1, 2nd ed.; Baltimore: Lippincott, Williams, and Wilkins.
D. Wise and R. Anderson, 2011. “A Headache in the Pelvis. A New Understanding and Treatment for Chronic Pelvic Pain Syndromes.” Occidental, CA: National Center for Pelvic Pain Research.
Devin J. Starlanyl and John Sharkey, 2013, Healing through Trigger Point Therapy; a guide to fibromyalgia, myofascial pain and dysfunction. North Atlantic Books, Berkeley, CA.
4. ZERO BALANCING - LIVE LIFE IN BALANCE
Feeling out-of-sorts, or trying to adjust to a major life change? Zero Balancing can get you back on an even keel.
Zero Balancing is a guided or facilitated meditation to help you perceive wholeness. It is a gentle form of manual therapy which facilitates good alignment of body and mind with structured touch - careful traction and pushing of limbs, and contact of certain points of joints, bones, and sometimes muscles. It was developed by Osteopath Fritz Smith, MD to “provide a holistic body-mind therapy that amplifies each person’s experience of health and vitality on all levels”. Zero Balancing is “a hands-on body/mind system of therapy designed to enhanced health by balancing body energy with body structure”. It tunes the fascial system, so that physiologic responses to touch and pressure facilitate healing and integration by the client. “Zero Balancing helps to create a wonderful feeling of inner and outer balance, alignment and organization” (www.zerobalancing.com; youto.be/scB6NiYTvi8).
The name “Zero Balancing” was adopted from the exclamation of one of Dr. Smith’s patients that she felt she had been “balanced to zero” or neutral (as on a mechanical scale with both sides evenly balanced).
After a health history and discussion of the client's goals, an average session lasts about 40 minutes, with the client first sitting, then lying face up on the table. A few minutes are spent after the session to walk back and forth to experience and integrate any changes in posture and body feeling; changes continue for 2-3 more days. It is recommended to avoid any strenuous or jarring activities on the day of the session (horseback riding, skiing) and reduce workout intensity by 25%, without adding anything new.
To find out if Zero Balancing works for you, it is recommended to have 3 sessions within 3 weeks. You can purchase a 3-pack of sessions for $195. Call 352-281-1048 for more information or to make an appointment.
3. BENEFITS OF YOGA
Yoga combines mindfulness-based stress reduction with training for balance, core strength, posture, as well as stretching muscles, connective tissue and nerves - all necessary to keep tissues well-nourished and mobile, and the whole body comfortable. Dr. Andy Harbin in his TEDx talk said "movement is not what we do, it's what we are" - from cells to organs to the whole person, waves of activity keep our metabolism going. A well-designed Yoga class will carefully stretch and strengthen the whole body, resulting in a feeling of well-being. It's adaptable to anyone's abilities - my oldest chair Yoga client is 93!
Dr. Tim McCall lists 75 health benefits for Yoga practice - practicing meaning doing some poses every day (or almost daily). Once established as a habit, it becomes an oasis of calm and health in your day. I can tell when someone has adopted the practice: they start saying things like "I'm going to do my Yoga" - they own it!
Since Yoga philosophy recommends an attitude of non-violence to one's own body, what you can do with YOUR body (without pain) on THIS day is YOUR Yoga. No forcing or straining, work with what you are offered today.
In our sedentary times, postural collapse is often visible already in children: head forward, upper back hunched with shoulders turned forward, scoliosis (often in girls), knee misalignment, collapsed foot arches. Body weight hanging on ligaments instead of being carried by muscles and connective tissue deforms joints more and more, leading to pain and dysfunction (swallowing, breathing and digesting with a scrunched chest and stomach is not easy).
Rehab specialist Loren Fishman MD (et al., 2014), found a 40% reduction in scoliosis curvature in adults after 6 months daily Yoga practice, and 60% curvature reduction in adolescents. Strengthening and working on symmetry consistently help to avoid back pain and surgeries.
Yoga's detailed attention to structural balance and alignment is the antidote to computer neck or text neck, low back pain, foot pain, and shoulder dysfunction. Also, it tones the Vagus nerve, helping us back into rest and digest mode after a day of relentless hurry-worry. And it has been found to be better against back pain than pain killers - with no side effects!
Give Yoga a try - it's adaptable to any age and level of ability. If you can breathe, you can do Yoga!
2. YOGA FOR BONE HEALTH - with Dr. Fishman's method
Dr. Fishman selected the exercises for spine safety in Osteoporosis and Osteopenia Isometric muscle work stimulates bone building and strengthens muscles. Postural awareness and strengthening improves balance and coordination as well as posture.
During class, poses can be modified to the student's abilities, using chairs and blocks as supports.
Yoga Vs. Bone Loss?
Physician and long-time Iyengar Yoga teacher Loren Fishman MD developed a series of Yoga poses specifically to stimulate the body’s bone building cells. In clinical trials over the last 13 years, participants practicing his 12 poses daily for 6 months showed significant bone density increases in spine and legs; improvement of hips varied, from little to considerable. Also, bone quality (functional architecture) appeared improved, without incurring any serious injuries.
Dr. Fishman’s publications on Yoga and Osteoporosis:
Fishman LM. Yoga for Osteoporosis – a pilot study. Topics Geriatr.Rehabil. 2009. 25(3):244-250.
YI-Hsueh Lu PHD, Bernard Rosner PhD, Gregory Chang PhD MD, Loren Fishman MD. Twelve-minute Daily Yoga Regimen Reverses Osteoporotic Bone Loss. Topics Geriatr.Rehabil. 2016. 32(2):81-87.
Calcium supplements alone do not improve bone mass or architecture - the body needs signals in form of gravity and pulling on muscles to know where to lay down more material (Form follows Function). Also, falls are a major cause of fractures - pills do not imrpove coordination and balance, but Yoga, Qi Gong or Tai Chi do!.
Together with Anusara Yoga teacher Ellen Saltonstall Dr. Fishman designed a 40-hour training for Yoga teachers, to help more people.
(For more information, see section on Osteoporosis at Dr. Fishman’s website www.sciatica.org).
Osteoporosis affects 55 million Americans; a sedentary lifestyle has been shown to be a major factor in developing the disease.
The most commonly used medication for osteopenia and osteoporosis – Fosamax – is associated with common gastrointestinal and gastroesophageal pathology, osteonecrosis, slowed healing, atrial fibrillation, and pathological fractures – actually causing spontaneous fractures, which the medicine is taken to prevent!
Also, falls are a major cause of fractures; medications do not improve balance and coordination…Yoga does!
The classes include standing and floor poses (Yoga exercises each have names to help remember them). Most poses have less strenuous versions for beginners, more challenging ones for intermediates, and the full, classic poses which are the most preventative for bone loss.
Yoga for Bone Health has been found to be very safe – Dr. Fishman’s patients and study participants have had no serious injuries in over 100,000 Yoga hours. He recommends that patients with severe bone loss (lower than -3.5 score) take medications and start careful Yoga. Most medications inhibit the cells that take down bone; since Yoga stimulates their counterparts, the cells that build bone, it does not interfere with the medications.
Please move mindfully and do not force a pose – none of this is supposed to hurt! We are trying to move into poses carefully and then use vigorous isometric muscle use to stimulate the bone building cells as much as possible.
The greatest chance of a Yoga injury is from over-enthusiasm! So please follow instructions, and at the same time, listen to your body.
1. Peripheral and Trigeminal Neuralgias (Shooting, Burning Nerve Pains)
In its March/April issue, Massage and Bodywork Magazine published an article by pathology teacher and massage therapist Ruth Werner on Tic Douloureux (facial nerve pain). I read this article with especial interest since I have had tic douloureux type pains frequently over the last 30 years (not every day, thank goodness). As you can imagine, I have tried to find actionable and background information for all these years. I would like to share some of my results, since conventional medicine has no consistently effective solution for nerve pain.
Many factors can cause and aggravate these pains, even within the same body: Injuries with nerve compression, irritation by nearby blood vessels, herpes, and autoimmune conditions such as Multiple Sclerosis in which the isolating nerve coverings deteriorate. There is not much doctors can do for nerve pain other than surgery and strong medications, but there are lifestyle changes and manual and topical treatments that can help improve the overall condition.
Something that I don’t understand is that medical texts talk only about trigeminal neuralgia. ALL NERVES can develop tics douloureux!!! (Tic is a twich or spasm, and douloureux means painful in French). Mine are mostly in the longer peripheral nerves off the sciatics in the legs, but also around the hips and onto the abdomen, on the back, down the arms onto the hands and fingers, though my very first one at age 8 and second one at 18 were from the neck up the side of the head. The peripheral pains became a sometimes completely incapacitating nuisance with an autoimmune flare-up at age 29. Since then, I have been reading extensively to try and find help.
Zero Balancing faculty member Judith Sullivan recommends that Trigeminal Neuralgia can be self treated and soothed by lightly stroking across the hair behind the ear 15-20 times (supposed to be upward, but a postherpetic pain client of mine did it downward and found it to be effective too) as this calms the origin of the trigeminal nerve.
Tellington Touch (gently moving the skin in circles, starting at the nerve root and moving towards the painful area (over and over) can calm the nerve by moving both fibers and fluids (see below at "movement").
Topical Arnica oil or Topricin lotion soothe skin nerves. Apply gently from the nerve root at the spine towards the painful area, then lie down and rest quietly.
Gentle repetitive movements can help to reduce pain and distract the nervous system. This moves out inflammatory substances and brings in nutrients, as well as taking physical pressure off nerves by pulling on fascia (probably that's why Tellington Touch can be beneficial). As a practitioner in the office, I use acucups to lift tissue, petrissage over the spine with as much shear as possible if I suspect impingement there, and arnica oil which calms nerves. But you have to sneak up on the painful area (maybe not even touching it until calmed) from proximal to distal.
Regular exercise reduces inflammation and increases Nerve Growth Factor production. I seem to be doing best with 90-120 minutes of movement a day. Avoid compressing nerves for lengthy periods (sitting!), so releasing tight fascia and muscles is helpful (I'm a Yoga teacher...and my best client). Note that contraction knots in the hip muscles (Trigger Points) can cause a sciatica type pain down the leg, which is relieved by releasing the knots).
Eating an antiinflammatory diet is helpful (I’m an MT not a dietician so I recommend clients do research, and ask their MD about this). Check out Dr. Mark Hyman's and Dr. Terry Wahls books for lots of good information. I’ve had quite good success with eating ginger to quiet pain (yep - I peel a slice and VERY slowly chew it until gone).
And of course stress must be kept low (working on this one now...), and sleep and rest planned into your day.
It is a very frustrating condition. The only way forward seems to be with self-empowerment, finding useful tools to be able to have a life, and then applying them consistently. Getting the frequency of the attacks reduced is a huge relief, and reducing the severity at least most of the time makes it less traumatic for the sufferer and their family.
