Breiner Whole Body Health Center

Dr. Johnston’s article Osteopathic Medicine for Relief from Chronic Pain was featured in Natural Nutmeg Magazine

Chronic pain is commonly defined as any pain, which lasts more than 12 weeks. Whereas acute pain is the normal sensation which alerts us to an injury or illness, chronic pain is one that persists, often for months or even longer.

Chronic pain can affect as many as eight of every 10 American adults. It can be caused by a musculoskeletal injury (involving the bones, muscles, or joints), nervous system dysfunction, chronic diseases, and autoimmune disorders.

Here are some of the most common causes affecting American adults today:


According to research1 from the University of North Carolina at Chapel Hill, no less than 84 percent of adults in the U.S. will experience chronic back pain at some point in their life. Often occurring in the lower back, the pain may be caused by an injury or develop progressively due to arthritis, osteoporosis, or normal wear-and-tear.

Back pain has become an epidemic in the U.S. and is today a leading cause of disability and lost productivity in the workplace. Common causes of chronic back pain include:

  • Slipped or bulging discs, typically caused by twisting or lifting injuries
  • Spinal stenosis, involving the narrowing of the spinal canal and compression of nerves
  • Compression fractures commonly associated with osteoporosis Soft tissue damage caused by strain or trauma to back muscles, ligaments, or tendons
  • Spinal fractures
  • Structural deformities such as scoliosis (the abnormal sideways curvature of the spine) or lordosis (the excessive inward curvature of the lower back)

Do You Suffer from Headaches?

According to research 2   50 percent of the adult population will report headaches during the course of a year, while more than 90 percent will report a lifetime history of headaches.

A chronic headache is one which occurs for at least 15 days per month for no less than three consecutive months. The most common types of chronic headache are:

  • Tension headaches caused by stress, fatigue, or sleeping wrong
  • Eye strain headaches caused when the ocular muscles become strained
  • Migraines caused by nervous system triggers or hormonal irregularities
  • Cluster headaches caused by the enlargement of blood vessels in the head


Joint pain is one of the leading types of chronic pain among American adults, typically caused by injury, infection, or advancing age. According to a report from the U.S. Bone and Joint Initiative 3, arthritis is the most common cause, affecting over 51 million Americans (or roughly one of every two adults).

Some of the more common types of chronic joint pain are:

  • Osteoarthritis, common in the elderly and usually affecting the larger joints
  • Rheumatoid arthritis, an autoimmune disorder which causes swelling of the joint spaces
  • Repetitive motion injury, common in athletes and people who do repetitive physical activities
  • Bursitis caused by swelling of the fluid-filled sacs that cushion the joints
  • Tendonitis caused by the inflammation of joint tendons


Chronic nerve (neuropathic) pain affects one of every 10 Americans, according to a study4 from the Mayo Clinic School of Medicine. This commonly happens when the nerves are either compressed, damaged, or exposed to drugs which strip their protective exterior coating (called the myelin sheath).

Some of the more common examples of chronic neuropathic pain are:

  • Sciatica, typically caused by nerve compression which triggers a shooting pain down the leg.
  • Diabetic neuropathy, often occurring in the hands or feet.
  • Carpal tunnel syndrome, commonly associated with repetitive motion
  •  Postherpetic neuralgia, a type of chronic pain which persists after a shingles outbreak
  • Trigeminal neuralgia, caused by injury to the trigeminal nerve of the face

Given the invasive nature of many medical interventions for pain, along with the growing opioid epidemic and addiction to pain medications, more people are seeking out natural approaches for managing their pain.

Osteopathic Medicine 

is a form of health care that treats the whole patient and addresses the underlying causes of pain and disease. It was discovered in 1874 by Andrew Taylor Still, MD in Kirksville, Missouri. He was a frontier physician who realized how ineffective and dangerous medicine and surgery were in his day. By spending time in nature and studying anatomy in extreme detail, he realized how the body’s structure and function were related. 

                                                                                                                                  The first Osteopathic school opened in 1892 in Kirkville, Missouri. Today there are 38 schools across the U.S., and over 100,000 osteopathic physicians in practice, with many in rural and underserved areas. Doctors of Osteopathic Medicine (DOs) complete 4 years of medical school and additional residency training, like their MD colleagues. They are licensed to practice medicine and surgery in all 50 states. In addition, DOs receive extensive training in osteopathic and anatomical structural diagnosis and treatment. Some osteopaths practice a gentle hands-on treatment called OMT (Osteopathic Manipulative Treatment). OMT helps to align bones and soft tissues and allows nerve, arterial, and lymphatic circulation to restore vitality and healing.

Osteopathic concepts are quite holistic in nature and emphasize the following principles: 1. The human being is a dynamic unit of function; 2. The body possesses self-regulatory mechanisms, which are self-healing in nature; 3.Structure and function are interrelated at all levels; 4. Rational treatment is based on these principles.

Cranial Osteopathy 

is a more advanced healing technique that involves gentle palpation and movement of the bones of the skull, the brain, the dural and fascial membranes, the sacrum, and the fluctuation and balance of the cerebrospinal fluid. This enables sutures between skull bones to be released and cranial nerves like the vagus, our major parasympathetic nerve, in charge of the body’s relaxation response, to become more balanced.

How Long Does an Osteopathic Visit Last?

A typical osteopathic visit may last 60-90 minutes on the first visit and involves a detailed medical and structural history from birth to the present of injuries, lifestyle factors like diet, exercise, emotional stressors, supplements, therapeutic stretching, relaxation breathing techniques, etc. Then gentle head to toe hands-on Osteopathic treatment is done to diagnose and treat imbalances in joint alignment, tissue texture changes, and tenderness. The goal is to alleviate inflammation and tissue congestion, which is the cause of the pain. By releasing fascial tension along nerves and lymphatic vessels and opening up venous and arterial circulation, proper oxygen and nutrients are restored to the tissues, while waste products are removed. This rapidly speeds up the healing, reducing pain, improving mobility, and restoring normal function and wellbeing. Also, the very relaxing, cranial-sacral part of the treatment helps to balance the sympathetic and parasympathetic “fight or flight” nervous system, allowing old injuries, shock, and trauma to be treated out of the anatomy very quickly.

I often describe osteopathy as “peeling the layers of the onion,” and tell clients that it may take up to 5-6 visits until more significant relief is experienced, for a pain condition that may have been present for over 10 years.  A classic example is an old injury, perhaps from childhood, like slipping and hitting the back of the head. There may be a concussion and whiplash that eventually healed in a few weeks. Then maybe 10 years later, headaches and back pain of a severe degree surface all of a sudden. All the tests, MRIs, and evaluations are inconclusive. Structurally what occurred was the energetic imprint from the shock of the injury is still stuck in the solar plexus, diaphragm, and the sacral bone. The dural membranes in the head and tailbone area can hold onto those kinetic forces that are blocking the normal flow of circulation in the body. Osteopaths can detect these subtle imbalances and treat them so the body can finally heal.

Various therapies work in conjunction with osteopathic treatment to aid in pain relief, including:

Laser Therapy

such as a Class IV infrared laser, can rapidly reduce pain and inflammation for chronic as well as acute pain from injuries and neuropathic pain. The laser energy is soaked up by the cell’s mitochondria, the energy production centers, and result in a cascade of healing events.


(pulsed electromagnetic field therapy) can also help with pain and healing injuries. Cells hold a charge across their membranes, and with injury and inflammation, that charge can be disrupted. PEMF works directly on the charged particles within the cell to reestablish proper membrane potential, and thereby brings healing and pain relief.  Even blood is positively affected by PEMF, as microcirculation dramatically increases.


can help in pain relief, in that pain itself is experienced in the brain. Neurofeedback is a specialized therapy where a patient’s brain waves are read with an EEG (electroencephalogram), and the patient can learn how to control dysregulated brain wave patterns through a feedback mechanism. Each case is individually assessed, and then a protocol is created to help with a variety of different neurological and psychological states, including pain syndromes such as Fibromyalgia, RSD/CRPS, and chemotherapy-induced peripheral neuropathy.

Hyperbaric Oxygen Therapy (HBOT) 

is a treatment that utilizes oxygen to enhance healing throughout the body. Patients are placed inside a hyperbaric oxygen chamber with an oxygen concentration of 100 percent; the pressure in the chamber is slowly raised between 1.5 to 2 times the normal atmospheric pressure. This allows more oxygen to enter the bloodstream and cerebral spinal fluid. Where oxygen concentration is increased, inflammation is reduced, and healing is enhanced. Research, as well as our clinic’s experience, has shown that HBOT has been effective for people suffering from Reflex Sympathetic Dystrophy (RSD), Chronic Regional Pain Syndrome (CRPS), fibromyalgia, and peripheral neuropathy.

Many of the medications used for pain can have harmful side effects to the stomach and liver, not to mention the addictive nature of opioid substances.

There are several good herbal and supplement options for managing pain and inflammation more naturally, without the dangerous side effects. Limiting processed and inflammatory foods and maintaining a balanced gut and microbiome is essential to supporting a healthy body. Detoxification and cleansing type programs can support the body’s inflammatory response by helping it to clear toxins and chemicals.

Helpful supplements for pain may include omega 3 fatty acids, turmeric, ginger, Boswellia, bromelain, glucosamine and chondroitin, magnesium, vitamin D, white willow bark, MSM, capsaicin, Vit B6, and cat’s claw.

Quite often, we use a combination of all these therapies when helping someone healing from pain. As pain is a very individual thing from one person to the next, the treatment approach needs to be tailored uniquely to each patient.


1. Arch Intern Med. 2009; 169(3):251-258.

2. The Lancet, Vol 7, Issue 4, P354-361, April 1, 2008.

3. Bone and joint

4. Pain Med. 2009 Apr; 10(3): 586-593.

David Johnston DO is a board-certified osteopathic physician in neuromusculoskeletal medicine and osteopathic manipulative medicine, and a Diplomate with the American Board of Integrative Holistic Medicine and holds additional certifications in cranial osteopathy.

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