Your next step to avoid chronic pain. Click on that area of your body, using the navigation buttons in the left column. A lot of the common causes responsible are included under a common site affected.


There is information to help you assess yourself,in partnership with your health professional. There is material to help you understand the diagnosis, so that you can better assess management advice your are given. There are instructions for self help and when to get professional help.

The emphasis is on holistic non-drug management, directed at causes rather than at just symptom control. The perspective is from my experience as a family medical practitioner in Australia, with major interests in musculoskeletal and nutritional medicine. I graduated in 1964 from Melbourne university and entered private practice in 1969 after hospital jobs in general medicine, surgery, paediatrics, obstetrics and anaesthetics.

The text links at the foot of this page, are to the first pages on each area of your body.


Chronic pain sometimes develops because of persisting tissue damage, and sometimes because early response was not appropriate or adequate. Some of the information on this site is to forestall this unfortunate development.

A number of vicious (self perpetuating) cycles can be involved in chronic pain. Muscles become tight,then sore from overuse. As with most parts of our body, nociceptive mechanisms (our pain brain) can get better at doing their job with continued practice. We get disabled, which causes emotional distress and this aggravates our discomfort.

We can interrupt all of these cycles, and reduce or eliminate chronic pain.

Hurt is not the same as harm. It often gives us warning in time to prevent impending harm, and helps us avoid future harm by the "once bitten twice shy" technique.

The pioneering work done in Vellore by Drs. Paul and Margaret Brand, showed the disasterous effects of lack of pain sensation in leprosy.

Despite this, in a lot of situations no harm is being done - and avoiding the discomfort may be causing harm. We can become unfit, stiff and end up with more discomfort as a result. Our mental state can be badly affected too, as we become more timid and avoid activities we could still enjoy despite the discomfort.

The way we are from day to day, feels "normal" to us. People often have no idea they have chronically tense muscles. Healthy fitness includes flexibility, strength and cardiovascular fitness, but flexibility is needed before we can optimize the other aspects.

I have emphasized attainment of flexibility by stretching, but this is not the only path to that end.

"The only place where success comes before work is in the dictionary."


In long haul situations, memory can become unreliable, modified by emotional turmoil. We whitewash memories to survive and function.

Recording activities and corresponding pain levels, may allow one to later "see the wood for the trees." I hand out an A4 sheet with one line per quarter hour through an average day. Your improvement may show in better function, even if pain levels are the same.
Fold each page over so you don't reread your entries - try to make each a fresh assessment.

If you can print things, you could use the "Brief Pain Inventory" to record your condition in a formal way a doctor might appreciate. See


Your name, e-mail and any other details will never be sold, hired out nor shared.

The American Society of Anesthesiologists Task Force on Chronic Pain Management has just updated its guidelines. (Anesthesiology. 2010;112:810-833) Their list of treatment types may be of use when you are considering new treatments for yourself.

They are ablative techniques, acupuncture, nerve blocks, botulinum toxin injections, TENS, epidural steroids, intrathecal opiate drug therapies, minimally invasive spinal procedures, pharmacologic management, physical therapy, psychological treatment, and trigger point injections




Holistic Doc's Pain Support Blog
Holistic Doc Blogs keep you up-to-date on interesting medical developements not covered on the Holistic Doc Pain Web site. Subscribe here.
About the author, Dr. James Rose mbbs fracgp
This is about getting on my soap box, and teaching stuff I know works.
contact and disclaimer page
contact and disclaimer page for holistic doc pain
coronary artery disease information and advice
Your first steps in sorting out different chest pain causes including coronary artery disease. The urgency of your need for medical attention is addressed.
Your abdominal pain diagnosis from details of your history
Your first step in sorting out your abdominal pain diagnosis, is to look for connections which may point to specific causes.
Is your knee pain in your knee but coming from somewhere else
knee pain is commonly referred from thigh and pelvic girdle muscle spasm. Self examination to distinguish this from knee arthritis, is described.
vascular headache distinguished from tension headache by self examination
Migaine is a vascular headache, mostly involving the superficial temporal artery. Occluding this artery with finger can stop your pain.
neck pain is a metaphor for disagreeable anything, for good reason - tension.
Neck pain can respond well to stretching exercises, plus attention to the teeth, jaw and tension, even if you have cervical spondylosis on x-rays.
Our shoulder joint is designed for long distance grabbing to prevent starvation.
To understand your shoulder joint problems, requires a good working knowledge of the anatomy here.
Upper back pain is to do with “posture,posture,posture.”
Your upper back pain may be referred from your neck, or due to poor workplace ergonomics.
Your Achilles heel pain pulling you up in your tracks?
Therre are three common reasons for heel pain. You can check these out by noting where you are tender.
lumbar spine, lower back exercises are about core stability
Notes on lumbar spine pain - functional anatomy, characteristics of some of the conditions responsible for this scourge of being upright.
Pain depression, anger and low self esteem - a nasty bit of work.
Pain depression, worse pain, worse depression - one of a number of vicious cycles in chronic pain. Helping break these is the motivation for this site.
Shingles pain starts before and can continue long after , the rash
Shingles pain is an example of neuropathic pain, due to damage to the nerves themselves, here from reactivation of latent VZ virus infection in the nerve.
Our sacroiliac joint, suspended in our pelvic girdle, solid and safe - mostly.
The large sacroiliac joints have very limited movement anytime, and most of what goes wrong reduces this further.
Sorry for using incomprehensible vocabulary on this site.
This pain word index is to try to make up for all the technical terms on these pages.
Fibromyalgia pain is widespread, intractable and responds to graded exercises.
With fibromyalgia pain, you're painfull and tender just about everywhere you push on yourself. You've got work to do on yourself.
Hand pain and numbness, carpal tunnel, forearm or neck?
Wrist, thumb and hand pain and numbness - disabling, but readily sorted out and amenable to effective treatment.
Mouth pain from stomatitis, gingivitis, aphthous ulcers -many causes.
Mouth pain is more likely to be caused by antibiotic treatment , than a throat infection.
The elbow pain anachronism - It's just not cricket, tennis or golf.
Elbow pain is a mixture of enthesopathy and referred phenomena, not epicondylitis, seldom elbow arthritis.
Ear pain when an earache isn't an ear ache, and when it is just that
You've ear pain, but your doctor says the ear's OK. Your child always has earaches. Here's information that may help.
Pelvic pain misery - unnecessary, don't put up with it
Pelvic pain diagnosis often requires both a gynaecologist and ultrasound specialist with particular interest in this area.
Limb pain - a compilation or maybe a compendium, of causes
General limb pain by cause, starting with lymphoedema
Our links page for you to peruse, with thanks.
Other useful sites, including my sister's drawing classes
If we have pain questions are bound to need answering
My attempts to answer some pain questions posed by readers of this site
Your upper arm pain comes from somewhere else
Upper arm pain comes from yet further up, from neck, shoulder or upper thoracic structures.
Menopause hormone imbalance herbal treatments
Menopause management, perimenopause pre to post
Scarce and essential vitamin-b12, commonly lacking
vitamin-b12 shots are commonly beneficial, not used often enough
Tired all the time? Chronic fatigue has many, many causes.
TAT for tired all the time - very common in my notes, very difficult to manage
Case histories to give a better idea of conditions
These case histories of real people may help you with your problems
Symptoms of hypoglycemia in non diabetic people
hypoglycemia is about endocrine failure, often from stress
thyroid medicine common mismatch disease symptoms v. test results
thyroid medicine harbours a silent epidemic of subclinical hypothyroidism, not picked up well by conventional pathology tests
dizziness - single word, a number of meanings, and conditions
Can you describe your dizziness with other words?
Frightening anaphylaxis, potentially deadly but treatable
The current epidemic of anaphylaxis - about children and peanuts, but not deaths
blog archives for holistic doc's pain support site
Blog archives for holistic doc pain
Food intolerances in a young child - case history
A young girl - with food intolerances ruining her life - common story
IV vitamin C is very valuable in many diseases
IV vitamin C article from The Journal of the Australian College of Nutritional and Environmental Medicine
A tooth decay free mouth is possible - start early.
Tooth decay is preventable and it's never too late for dental health
Alcohol, the universal sedative, maybe tranquilizer
What's behind heavy alcohol use
Polyarthritis - when multiple joints are affected by disease
Polyarthritis may be an early clue to diseases needing treatment now.
Self motivation - the only sort that works.
Unlike supersize me, self motivation is all from inside self consciousness
Are you overweight ? Diet help for ideal body weight.
No one enjoys being obese nor intends to be excessively so. This diet help page may offer some ideas for you.
The role of vitamin C daily allowance in health and illness
The important role of vitamin C in your nutrition, compared to your average rat
Surrogate markers (biomarkers) v. clinically useful outcomes
Take care not to be misled. Surrogate markers can do this.
pathological tests quote reference ranges - not "normal" ranges
Healthy or unhealthy dicotomy, using reference ranges with reservations
One sleep health disturbance is obstructive sleep apnea
Sleep health issues have enormous effects on general health, not just due to sleep debt.
Arterial hypertension, high blood pressure importance
Hypertension your personal call to action? Here's why it may be so.
Magnesium deficiency - suspect it, then do a therapeutic trial - treat it
Vitally important in our metabolism, so best not to have magnesium deficiency
Disease pathogenesis from the twinkle in your parents eye.
Where to tackle problems? Understanding disease pathogenesis chains of events.
Healthy lifestyle medicine - way to go.
Therapootics - sticky start on lifestyle medicine
Acute rheumatic fever in a 15 year old
A clinical record of acute rheumatic fever from the 1960s
Referred pain, from our back to the front of our body.
About confusing chest and abdominal referred pain patterns, without a sore back to point to their cause.
Experiences of the uncertainty principle in my clinical practice.
Clinical medicine illustrates the uncertainty principle. It's not an easy game.
Carl Pfeiffer on zinc deficiency - notes from 1984 lecture.
A ramble through zinc deficiency according to Carl Pfeiffer and subsequent literature.
Our prostate gland conditions, enlarged, inflamed or the site of cancer.
Information on prostate gland diseases, the causes and cures, science and hype.
Medical diagnosis, delving into the past and present for causes of illness.
Moving from story to diagnosis, a descriptive label isn't enough to understand what is going on.
Double blind trials for hypothesis testing - the ants pants?
Well conducted double blind trials avoid biased results from hopes and expectations of both patients and doctors.
Why pain and suffering? Like Julius Sumner Miller, here we ask "Why is it so."
Understanding why pain and suffering happen involves first acceptance then honesty with ourselves, without blame.
Strep throat or sore throat at the start of a viral URTI?
A Strep throat versus viral URTI sore throat differential diagnosis study
Stress effects on me the stressee (pinched from French.)
Misunderstanding stress can make one feel powerless. What presses your buttons?
Hunting out a compassionate medical care provider for yourself and loved ones.
Do yourself proud, accept only compassionate medical care. You're worth it, and so work to deserve it.
Functional medicine lab tests help us perk up. It's root cause medicine.
Best outcomes for us depend on information, so functional medicine lab tests give good feedback
Acid laryngopharyngeal reflux disease spotter's guide
Unpleasant come-uppins from our stomach, very irritating laryngopharyngeal reflux disease.
Gastro-esophageal acid reflux diagnosis
How to make an acid reflux diagnosis rather than coronary heart disease.
Wobbly? Ataxia technically, unpredictable error of movement.
Losing control is worrying but ataxia may be from curable causes.
Choosing supplemental nutrients wisely. Which, when, how much, why, why, why?
Some examples of use of supplemental nutrients, essential, beneficial, even damaging.
Immediate burns first aid avoids blisters
Urgent treatment needed - burns first aid methods
Skin burns, wounds and ulcers - your treatment guide.
Immediate first aid for skin burns, wounds, and what to do after that to encourage rapid healing.
Our outside (skin health ) reflects our insides - look at it and look to it.
Skin health isn't just skin deep, and skin care needs to involve protection of the skin flora
Cholesterol and all the fuss about it - an opinion.
Cholesterol research findings in humans, worth noting.
Sodium chloride salt, friend and foe (in excess or deficit.)
A defense of salt and a warning to have enough in hot weather.
Abdominal bloating from intestinal gases rather than fluid retention (ascites)
A dissertation on abdominal bloating, belching and flatulence.
More illustrative medical case histories.
People's case histories you may see yourself mirrored in.
DIY back check-up home study course available on-line
Is your back "out?" Learn how to tell, in easy steps, on-line.
My start in neck manipulation, which nearly ended badly.
A tale of progress to neck manipulation and later on to better techniques of mobilization.
More Cases from family medical practice.
More cases - histories of real people with real problems.
More Case histories from family medical practice
Further examples of vitamin B12 case histories
Gastro-esophageal acid reflux causes
Treatable, avoidable acid reflux causes, best way to treat GERD (GORD.)


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Ablative techniques are cutting out painful tissue, destroying nerves etc.
Nerve blocks are injections of local anaesthetic into nerves to deaden pain.
TENS is electrical current applied to skin, hence "transcutaneous - through skin."
Epidural steroids are cortisone injections into the cavity within the spine bones, around the outside of the nerves passing down in there (outside the dura.)

The theca and dura are two names for the same structure, the tough sac which contains the brain and spinal cord, and the cerebrospinal fluid they are bathed in. Intrathecal injections are through the dura into this fluid space.

Minimally invasive spinal procedures include using needle like instruments to suck out disc material, inject enzymes or cook discs (percutaneous nucleoplasty)

If you are interested in a home study course on examination of the spine, please send me your e-mail address by the contact form.