“Exploration leads to knowledge and understanding so the world can become a more mindful place.”
Written By: Jared E. Katz
Reviewed By: Paul Zeltzer, MD
Welcome to our 2nd Control Chiari Exploration! We are flying high as our ship is on a path for never ending intel to help deliver ease for a painful day. After a wonderful launch with our first Control Chiari Exploration (a research article/blog hybrid that empowers patients to further investigate pain management options that they never encountered).
Does Chiari cause pain? Does Daffy Duck slobber? YES! A persistent headache can often lead to severe debilitation where a Chiari patient fails to function optimally. Unwarranted stress stacked on top of chronic and severe headaches may also affect the cervical (neck) muscles, joints, and subsequent kinetic chain of the body. It is an extension of aches and pains that your body should never have to deal with. This is why it is imperative to seek treatment for chronic pain symptoms associated with Chiari malformation. Control Chiari is a pain management awareness movement that educates the community on a variety of pain management options that can be applied to the debilitating symptoms of Chiari malformation, as well as its comorbidities. Below are therapeutic modalities options which also serve as categories for Control Chiari;
● Botox Therapy
● Surgical Intervention
● Cognitive Behavioral Therapy (CBT)
● Manipulative & Body Based Methods
● Alternative Medical Systems
● Medical Marijuana
● Dietary Intervention
● Modification of Physical Activity
● Energy Therapies
● Mind-Body Interventions
● Social Support
● Medications e.g., painkillers/analgesics,
muscle relaxants, etc.
FIRST STOP; RESEARCH LAB! We will continue to explore scientific evidence that highlights the usefulness of our highlighted form of pain management. The Control Chiari category that we examine for this issue is Cognitive BehavioralTherapy (CBT), which typically focuses on easing the psychology of a patient. Cognitive Behavioral Therapy (CBT) is a noninvasive and interactive form of psychotherapy which has proved to be an immensely helpful tool in the treatment of anxiety and stress disorders. Much recently, researchers have also evaluated its valuable role in controlling the perception of chronic bodily pain. One study involving 61 patients revealed that well-structured CBT can potentially ease the chronic neuropathic pain associated with AIDS (acquired immunodeficiency syndrome). In addition, this form of psychotherapy is very beneficial for patients suffering from debilitating fibromyalgia. In a study discussing results from 13 different pain relief programs, CBT helped achieve considerable analgesia among patients diagnosed with the aforementioned pathology. In a large trial, a total of 118 patients participated, all of whom had been suffering from chronic pain. At the end of CBT sessions, a majority of individuals reported a significant decline in their pain intensity. Moreover, a number of participants also observed a drastic improvement in their functional limitations.
1 Evans S, Fishman B, Spielman L, Haley A. Randomized trial of cognitive behavior therapy versus supportive psychotherapy for HIV-related peripheral neuropathic pain. Psychosomatics. 2003 Jan 1;44(1):44-50.
2 Bennett R, Nelson D. Cognitive behavioral therapy for fibromyalgia. Nature Clinical Practice Rheumatology. 2006 Aug;2(8):416-24.
3 Beehler GP, Murphy JL, King PR, Dollar KM, Kearney LK, Haslam A, Wade M, Goldstein WR. Brief Cognitive Behavioral Therapy For Chronic Pain. The Clinical journal of pain. 2019 Oct 1;35(10):809-17.
NEXT STOP; CHIARIAN EXPERIENCE! As we travel through unfamiliar territory analyzing a new pain management option, we gather more intel from a member of our beautiful Chiari community. Our Control Chiari Exploration touches down in Kansas City and visits Jeannie, who explains, “I did an extensive CBT pain management program. I learned that my thoughts in response to pain can create a chemical response that literally increases physical pain. I had to stop thinking ‘there is nothing I can do and that my pain is unbearable and will never end.’ If you believe that you can do ANYTHING to help the pain then you can prevent the aforementioned chemical response. Even just reminding myself that I am doing SOMETHING, I am taking steps to help, i.e. laying in a dark room, can be helpful.”
Jeannie Scott currently lives in Kansas City, KS where she remains active with water aerobics, swimming, boating, hiking, and photography while continuing to manage her Chiari Malformation.
LAST STOP; SPECIALIST EXPERIENCE! Cognitive Behavioral Therapy is currently being performed in a number of treatment centers around the world by mental health counselors (psychotherapist or therapist) in a structured way, attending a limited number of sessions and mostly yielding beneficial results. Our Control Chiari Exploration touches down right near the rocky mountains and visits Dr. Le Certe who says, “People are not upset by events but by the view they take of them. Pain is an ‘event’ which is directly affected by the ‘view’ we take of it. Things which usually do not improve pain management include; 1)WISHFUL THINKING (I wish the situation would get better or go away) 2)HOPING (I hope this pain will someday improve) 3)PRAYING (I have faith in my doctors who will find a cure for my pain).”
Dr. Lance La Certe PsyD is a clinical psychologist in Aurora, CO. With more than 36 years of experience, Dr. La Certe specializes in Cognitive Behavioral Therapy (CBT), Pain Management, and Post Traumatic Stress Disorder (PTSD).
Conclusion! Let’s face it, living with Chiari is an ongoing battle. It is critical for more pain management research to be established because it will provide useful data for our community searching for answers. Intervention trials for CBT which specifically target the Chiari population, are non-existent. Cognitive Behavioral Therapy creates the idea that you can’t sit and wait. Don’t be negative. Don’t be a worrier. This will not empower a patient. However, if deemed useful for Chiari patients, such trials could be designed to determine its efficacy as a potential therapeutic for chronic pain. To reiterate, always remember that this CBT option is a suggestion and may not be for you, but it is always worth investigating first. For further information regarding Cognitive Behavioral Therapy (CBT), please visit the following websites:
3… 2… 1… Liftoff!
Please join us on our next Control Chiari Exploration.
ABOUT THE WRITER
Jared E. Katz is a writer, researcher, Traumatic Brain Injury (TBI) consultant, and brain health coach/advocate. Jared is not only a TBI and Chiari Malformation thriver, he is a motivator of the mind and the body where he constantly stresses human improvement. Jared currently serves as Executive Director and Founder of The Chiari Project, a 501(c)3 non profit organization that operates exclusively for educational, scientific, and charitable purposes. Also, Jared serves as Founder and CEO of PainLes, a health technology company.