Successful Integrative Medicine Assessment and Treatment of Chronic Pain Associated With Breast Surgery
Many people experience neck and back pain at some point in their lifetime. Most often neck and back pain runs chronic episodic courses. It has been reported that a significant number of patients develop ill-defined pain problems after breast surgery. Wallace et al reported that 15% of women with breast augmentation and 9% of patients with breast reduction had persistent pain 1 year after their surgery in the entire breast, a specific area of the breast or arm pain.
Wallace et al’s survey questionnaire did not specifically inquire about neck or back pain. We present a retrospective report of 2 patients with breast augmentation and 1 patient with breast reduction who presented with chronic back and/or neck pain. They were seen at a US integrative medicine multi-physician practice that sees chronically ill patients who have failed standard medical therapy. All 3 successfully responded to a combination of integrative medicine assessment and integrative medicine interventions.
Most notably all 3 patients responded dramatically within minutes of intradermal procaine injected into their surgical breast scars (neural therapy), which appeared well healed. A literature search of PubMed (which includes Medline), EMBASE, AMED, and CINAHL revealed no previous reported cases of chronic back or neck pain treated with neural therapy applied to breast scars in the treatment of neck and back pain. This case series is also the first report of the use of autonomic response testing (ART) to identify scars associated with pain at a location remote to the location of the scar.
If these observations are confirmed by further studies using more vigorous research designs, there would be significant implications for public health and health care delivery via the nursing profession.
Background Information On Neural Therapy And A.R.T. ® Autonomic Response Testing
Chronic refractory medical problems are complex in nature. Our integrative medicine clinical successes in this area are the result of complex assessment and treatment processes. Describing all these processes in detail is beyond the scope of this article. The purpose of this article is to stimulate further research and attention to the described processes; it is not our intention to teach readers how to perform these processes for use in their practices. The following discussion will vary in detail regarding our assessment and treatment processes. Our main thrusts are pointing out (1) the possible significance of breast scars in neck and back pain; (2) the clinical effectiveness of scar therapy; and (3) the value of A.R.T. in informing clinical assessment and treatment. The effectiveness of scar therapy and the effectiveness of A.R.T. as an assessment technique have implications for nursing.
Neural therapy of scars
Neural therapy (NT) has been used frequently in Germany. NT was developed by 2 brothers who were physicians, Ferdinand and Walter Huneke. The injection of scars with preservative-free procaine “unblocks interference fields” produced by abnormal scars. Damaged tissue can generate chronic stimulation of autonomic efferent neurons resulting in chronic autonomic reflex activity such as nausea, vomiting, and pain. Whenever the pain or any other symptom is relieved immediately and completely after injection of the scar, this is called “the lightening reaction of Huneke.” All 3 of the herein described patients exhibited Huneke-like reactions.
In our institute, we have seen numerous patients present with upper back, neck, and shoulder stiffness and pain many months or years following a variety of surgical procedures of the head, neck, and chest including tonsillectomy, tooth scars, root canal scars, thyroidectomy scars, thoracotomy scars, shoulder surgery, vaccine scars, and breast scars, who respond significantly to NT of their scars. We have even seen dramatic improvement treating body piercings and tattoos.
Also, we want to point out that scar therapy can be accomplished by other means besides injections. In patient number 2, a rectal scar was treated by means of ear acupuncture, which resulted in rapid marked reduction of her low back pain. Strittmatter has written on scar therapy via ear acupuncture. A physical therapy colleague has observed pain relief by means of manual therapy of surgical breast scars.
Louisa Williams discusses a number of non-invasive methods of scar therapy in her book Radical Medicine, which is a compendium of holistic medicine. Future research will determine the most efficient and effective methods.
A.R.T. ® Autonomic Response Testing
A.R.T. is a form of applied kinesiology (AK). AK is a form of manual muscle testing in which an interpretation is made regarding the response (weakness, no change, or strengthening) of a muscle to manual testing. The interpretation informs the assessment of the patient and the prediction of positive, negative, or neutral responses to therapies. A.R.T. was developed by Dietrich Klinghardt, MD, PhD, and Louisa Williams, DC, ND. Many chiropractors and holistic/integrative medicine practitioners incorporate some form of AK within their practices. There are various forms of AK of which A.R.T. is one. AK originated with George Goodhardt Jr, DC. Some of the other forms are the Bidigital O-Ring Test developed by Yoshiaki Omura, MD; Neural Emotional Technique developed by Scott Walker, DC; and Contact Reflex Analysis developed by Richard Versendal, DC.
The various versions of AK use different muscle testing protocols and may provide different interpretations of the results obtained from muscle testing. The various methods of AK were developed by their originators to increase the sensitivity and accuracy of testing.
Schwartz et al recently published a negative experimental study of AK. However, the study lumped all forms of AK together, which would be similar to a negative study on penicillin and generalizing to all other antibiotics. Clearly, A.R.T. was not tested in their study.
Without A.R.T., scar therapy depends solely on trial and error. In our institute the success rate of helping chronically ill patients who have failed standard medical therapy has significantly improved with the addition of A.R.T.
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