DR. TUNKEL'S APPROACH TO HELPING THOSE WITH CHRONIC PAIN:
Q. What is acute pain vs chronic pain?
A. Acute pain is the pain that occurs at the time of or shortly after an injury and lasts until the injured tissues heal or the pain sensation is suppressed by medications.
Chronic pain can occur with ongoing tissue injury but is often pain that persists even after there is healing of the injured tissues and is not well-suppressed by medications, especially in the long term.
Q. How can pain persist in an area even after the tissues completely heal?
A. There can be changes in the ‘wiring’ of the brain and spinal cord (the Central Nervous System or CNS) that continue to signal that there is pain in that area. There can also be changes in the tissues in and around that area that provoke the experience of pain, also mediated by the CNS. Oftentimes, this ongoing, chronic pain can change, spread and even worsen over time.
Q. What does “Healing Pain Naturally” mean?
A. Chronic pain can be helped by treating the pain ‘naturally’. The approach used by Dr. Tunkel is based on facilitating the inborn abilities of the body/mind to heal itself. (Although acute pain can be suppressed with medications, the inherent healing process can also be optimized by the use of ‘natural’ methods).
Q. What types of natural methods are ideal for ‘Healing Pain Naturally’?
A. The purpose of all modalities used by Dr. Tunkel is to facilitate the natural healing process. For example, increasing one’s awareness of the body’s position and movement within a relatively pain-free range can help ‘unlearn’ unhelpful habit patterns and encourage healing. Other modalities he often uses, such as manual medicine and medical acupuncture, not only facilitate the healing process but also help decrease local triggers of pain, thus facilitating postural and movement therapies.
Q. Are there other treatments incorporated by Dr. Tunkel?
A. Yes. These can include instruction in breath work, relaxation and meditation methods as well as nutritional and other lifestyle counseling and other passive treatments such as vibration and light therapies.
Q. How does Dr. Tunkel choose the best combination of healing modalities?
A. The collaboration of the patient and Dr. Tunkel helps create a therapeutic plan based on the needs and goals of the patient. They work together as a team to help maximize the realization of those goals.
Q. Why not use opioids?
A. Of course, the number one reason that many physicians are reluctant to prescribe opioids is the opioid epidemic. Nonetheless, opioids can have their place for short term use. When pain is initially caused by tissue damage, opioids can help reduce the initial experience of pain at the level of the brain and spinal cord (the Central Nervous System or CNS). However, opioid receptors on the neurons in the CNS become ‘tolerant’ of the opioids by creating increased numbers of receptors. This requires a series of escalations in the dosing of the opioids. Gradually, they become less and less effective, and can even cause “hyperalgesia”, where opioids can actually cause an increase in pain. Of course, the use of opioids may also lead to opioid dependence and addiction.
DR. TUNKEL'S VIEWS ON 'NATURAL' HEALING APPROACHES:
Q. Are there differences in the way alternative modalities, such as manual medicine and supplementation, can be used?
A. Yes. The two main approaches are using natural methods to facilitate the body’s inherent healing capacities and using them to create a specific remediation of one or more symptoms. Dr. Tunkel relies primarily in the former approach. However, there are circumstances where a specific symptom modification is intended, though this then acts to facilitate the innate healing process.
Q. Does Dr. Tunkel use the terms “Healing Energy” or ”Spiritual Energy”?
A. He usually uses the terms ‘inherent healing capacity’, ‘inborn wisdom’ or ‘innate intelligence’ of the individual or body/mind. This presumes the body/mind is endowed with self-healing capabilities.
Q. What does lifestyle counseling or intervention mean?
A. Probably better to use a phrase like ‘activities optimization’ or ‘optimizing activities of daily living’ (i.e. optimizing ADL’s). Dr. Tunkel wants the positive changes of active therapies not just during a period set aside for these by the patient, but to integrate them into their ADL’s.
Q. What are the differences between passive, educational, and active therapies and approaches?
A. Passive modalities are ‘hands-on’ approaches that are delivered to the patient by Dr. Tunkel. The patient’s participation requires only their in-office cooperation. Educational and active modalities are more ‘experiential’ in nature. They require patient engagement both in-office and outside as well. They usually emphasize the focus on somatic awareness.
Q. What is ‘somatic awareness’?
A. Body awareness (aka somatic awareness) practices are based on paying greater attention to the feelings of one’s bodily sensations. These are very natural sensations that most people do not attend to in their daily lives. They seem to have been underemphasized by many Western cultures and are only now being given greater attention. This is in part through increased interest in somatic awareness that is seen especially in Eastern philosophical and psychological approaches to human optimization.
A parallel phrase that is sometimes used is “living in the body”.