Interview with Dr. James Fricton – Part 1

Originally posted on ProHealth.com on
January 2, 2017

Interview with microphone
Dr. James Fricton is Professor Emeritus at the University of Minnesota, Senior Researcher at Health Partners Institute for Education and Research, and Pain Specialist at the Minnesota Head and Neck Pain Clinic. Besides being the current President of the International Myopain Society, he has been on the board of the American Pain Society and American Academy of Orofacial Pain. Melissa Swanson interviewed Dr. Fricton about his career, his Campaign for Preventing Chronic Pain and his romantic thriller self-help book, The Last Scroll.

Your career path began as a dentist. What led you to the field of chronic pain?

Fricton: I had always wanted to be a dentist since fifth grade. I went to college with the goal of pursuing a career in Dentistry. My interest in chronic pain came on during the 1970s, when there were many major societal changes including the Vietnam war, opening U.S. relations with Asia, introduction of acupuncture, and growing interest in natural foods, holistic health and well-being. These changes piqued my interest in acupuncture while in Dental School. During my third year in Dental School, I spent two months visiting the only academic-based acupuncture program in the country at UCLA. It happened to be part of a new program at UCLA called the Pain Control Unit; it was in the School of Psychology and was run by a faculty physician, the late Dr. Richard Kroening. He encouraged me to come back to UCLA and become a medical resident in Anesthesiology with a focus in Pain Management.

Thus, after Dental School, instead of going into any traditional dental specialty program such as orthodontics or oral surgery, I then decided to move to Los Angeles and take this residency position at UCLA. I started the first residency programs in head, neck, and orofacial pain management and completed the program in 1980. It was exciting to explore and learn about pain and the many medical, dental, alternative and complementary treatments for pain The use of integrative care of blending traditional medical care with complementary care strategies such as acupuncture and yoga has been the focus on my career. I completed my training and was appointed as a tenure track faculty position at the University of Minnesota. For past 30 years, I have been a Professor at the University of Minnesota, a researcher and educator at HealthPartners Institute for Education and Research, and a head and neck pain specialist at the Minnesota Head and Neck Pain Clinic. I have published several academic books on pain and over 100 clinical and scientific articles focused on prevention and treatment of chronic pain. There is much clinical and scientific knowledge that people need to know about their own daily lives to help them live a life without chronic pain– a good life. I try to use this knowledge and principles when I care for my patients and the work I do.

How did you first learn about chronic pain? Would you share your college roommate/yoga story?

Fricton: We all have serious pain at some time in our lives. My first major pain was in college as a young student. I injured my back while volunteering at a day care center and playing with children. The pain was severe and disabling. I could not get out of bed for a couple of days. It raised many questions about my physical health and my future. I went to student health and they indicated surgery was not possible, I was too young, and that I needed to learn to live with it. Then, synchronicity popped up. My college roommate at the time was taking a yoga program. This was 1972 and yoga was not common. Ram Dass, the former Harvard professor, left on a pilgrimage to India in the late ’60s as Dr. Richard Alpert and returned as a yoga teacher and a new identity. His 1970 tour of college campuses and his book Be Here Now established yoga as a lifestyle for a new generation including those at University of Iowa. I became one of those practitioners. When I did yoga, my back pain disappeared in about a week. I was blown away by the effectiveness of this supposed spiritual practice. However, I later learned that it was not only the calming of the mind and spirit that was so effective but also the stretching and strengthening of my muscles. I have been practicing yoga most days since then. This also piqued by interest in pain management before I even attended dental and medical school.

Currently as the President of the International Myopain Society (IMS), what is your mission? How does the Society help the chronic pain community?

Fricton: Chronic pain such as head, neck, and back pain is at epidemic levels around the world causing significant suffering, functional limitations, addiction, and missed work. As a result, chronic pain has become the highest-cost condition in all of health care with the use of high cost passive treatments such as medications, rehabilitation, injections, surgery, and implanted devices in an attempt to alleviate the pain. Yet, research has found that the majority of chronic pain is from the muscles and can be readily improved by activating the patient through training on self-management skills that improve muscle and joint function such as yoga, exercise, ergonomics, meditation, improving diet, sleep, and other lifestyle factors. The results in systematic reviews of self-management strategies suggested that they had better and longer term outcomes than passive treatments such as medication, therapies, and surgery. Thus, I felt there was a need to help all patients understand these concepts and how to change them to improve their pain. Therefore, my mission as President of the IMS is to broaden our understanding of preventing chronic pain. Thus, the IMS created the Campaign for Preventing Chronic Pain and Addiction to begin this process of helping each and every person learn how about their pain and how to relieve and prevent chronic pain.

What is the campaign for preventing chronic pain?

Fricton: To solve the chronic pain problem, we need a revolution in health care. We spend billions of dollars on advances in pharmaceuticals, devices, surgeries, and other innovative treatments for chronic pain, yet fail to deliver long-term successful relief due to the lack of engaging, empowering, and educating patients in these self-management strategies. We need to replace our current passive model of doctor-centered care with patient-centered transformative care. Thus, the IMS created the Campaign for Preventing Chronic Pain and Addiction to help each and every health professional and patient learn how to relieve and prevent chronic pain with transformative care, e.g. integrating training with treatment.

The Campaign has three goals:
Expand education on preventing chronic pain.
The campaign will distribute 3 types of personalized on-line Training Toolkits for consumers, for employers, and for health professionals to help people learn how to prevent chronic pain. Each toolkit includes:
Risk and Protective Factor Assessment
Personalized Self-Management Training Program
The Seven Realms Guide to Preventing Chronic Pain
Tools and other resources for chronic pain
Marketing and Seminars on Preventing Chronic Pain
Access to health coaching for chronic pain
Expand research on chronic pain.
The campaign will distribute on-line Research Toolkits to allow health professionals to participate in the Chronic Pain Research Network (CPR-Net), a practice-based research network. The Network will evaluate:
Efficacy of patient and provider training tools
Risk and protective factors for chronic pain
Better and safer pharmaceuticals and treatments
Innovative patient-centered treatment strategies
Expand advocacy for preventing chronic pain.
The campaign will distribute on-line Media Toolkits to spread the word to the public, industry, governments, and communities about the importance of preventing chronic pain and how it will transform health care for all.

What led you to creating the online course, Preventing Chronic Pain, a University of Minnesota MOOC education offering through Coursera?

Fricton: The on-line MOOC course at www.coursera.org/learn/chronic-pain was developed to help begin transformative changes to health care by focusing on a broader model of health care. When we use a broader human systems approach, we can better understand how individual risk factors in the cognitive, behavioral, physical, emotional, spiritual, social, and environmental realms of our lives can interact to perpetuate chronic pain and, if improved, can prevent it. The course was first offered in 2014 and now has had over 40,000 participants. The course evaluations showed that 91% of participants believed the overall experience was satisfying, 92% believed it met the objectives, 93% believed that it made a difference in their life, and 85% believed that it made a difference in the care of patients.

Selected comments from participants included; “This course is one of the most generous offerings that I have ever encountered. There is so much life-changing, life-affirming information available at no charge, to anyone who wants it; it is rare and amazing. I am VERY grateful for it.” “The learning experience has been tremendous!! Everyone should have this knowledge, especially those in the health profession.” “I loved this class and want to take it again!” “Absolutely fascinating and enlightening…This information should be part of every health care educational program!” “This course has really helped me to understand myself better and why I think, act and see the world as I do.” “I am eternally grateful for taking the time and energy to provide this beacon of knowledge to the world.” “I think this course is a wonderful gift, because pain is an avoidable part of our life. I have learned so many things.”

You have spoken and written that it is possible to prevent chronic pain. What do you think are the components to a patient’s success?

Fricton: Yes, I believe it is possible to prevent chronic pain. We need to understand that pain is our protector that tells us when something is wrong. Whether it is acute brief pain or persistent chronic pain, there are identifiable causes that if changed will result in relief. These causes are individual risk factors that occur in the cognitive, behavioral, physical, emotional, spiritual, social, and environmental realms of our lives and can interact to perpetuate chronic pain and, if improved, can prevent it. The mechanism for this modulation of pain lies in the concept of sensitization either at the tissue level or the brain level. As health care providers, we need to leverage this new research to accomplish both primary (before it comes on) and secondary (after it is present) prevention of chronic pain. This can best be accomplished through a transformative care model. This model of care integrates training with treatments. As doctors, we treat patients with evidence-based treatments such as medications, therapies, injections, and surgery. These treatments improve pain in many cases, but in nearly half of cases, patients do not improve. This lack of improvement is typically due to risk factors which are more under the patient’s control such as repetitive strain, ergonomic issues, stress, and emotional issues. When we train patients to improve these risk factors and strengthen their protective factors using modalities such as exercise, eating and sleeping well, and maintaining positive emotions, they get better faster. Thus, a transformative care model can transform both the patient and the health care system to improve their outcomes. In our clinic, we have health psychologists, physical therapists, and health coaches who work with patients to achieve their goals of pain relief. We are also incorporating online training to help patients identify and control risk factors that are causing their pain condition. Transformative care will eventually replace biomedical care for all chronic illnesses.

Everyone needs a Coach in their corner!

Originally posted Feb. 11th, 2016 on ProHealth.com

coach

By Melissa Swanson

I believe it takes a team to be able to fight fibromyalgia and its evil sidekicks. Each successful team has a great Coach who instructs or trains them in the fundamentals and directs strategy. I was blessed when I met Celeste Cooper. She became my teacher, my mentor and my friend.  Others have not been as lucky as me to have a Celeste to coach or advise them.

“When I was first diagnosed, I wish I would have had someone who understood Fibromyalgia. Someone that not only was living with Fibromyalgia but trained on how to help with the long list of questions I needed answered.”   Tami Stackelhouse

What can I do to manage the pain? How can I sleep? What medications/ treatments should I try? I feel so guilty missing out on so much in my daughter’s life. I just want to be me. What doctors should I see? What tests should I have done? I have been diagnosed with so many other syndromes/diseases. How do I treat them? Will it help my fibromyalgia? Will I get worse? These are just a few of the questions we have when we finally get our diagnosis.

It is easy to go online and research all of these questions, but how do you know what is reputable information?

Tami Stackelhouse is a fibromyalgia patient, an advocate and a graduate of the National Fibromyalgia and Chronic Pain Association Leaders Against Pain Scholarship Training.  She is also an author, coach, speaker, certified Fibromyalgia Health Coach and founder of International Fibromyalgia Coaching Institute.

What is a Fibromyalgia Advisor or Coach?  
A Fibromyalgia Coach is someone who is trained to provide support specifically for fibromyalgia patients. It’s a bit of a cross between health coaching and life coaching, with a focus entirely on helping clients live as well as possible with fibromyalgia.

Why do we need fibromyalgia coaches/advisors?
There are approximately 10 million (2-4%) Americans who have Fibromyalgia. According to PAINWeek.org,”There are 100 million people in pain.  There are 4,000 pain specialists. That’s 25,000 patients per pain specialist. There are simply not enough pain specialists to go around.”

“A novel study published in the American College of Rheumatology (ACR) shows that smaller micropolitan areas of the U.S. – those with less than 50,000 people – have very few or no practicing adult rheumatologists. In some of these areas, individuals have to travel more than 200 miles to reach the closest rheumatologist.”

It’s bad enough we have to find someone to believe us, but add the shortage of pain doctors to the fact that when you get an appointment with them, you get a whopping 15 minutes to cover all that you need to talk about.  We know that it helps to have good caregivers on our team. I have a GP, rheumatologist, neurologist, chiropractor, acupuncturist, myofascial release physical therapist and a pain management doctor.

None of them know how I really feel physically or emotionally living with fibromyalgia and its evil sidekicks.

“As a physician, I feel we so need people who are patients themselves, who are patient advocates and can guide and teach other patients self-care, what to ask their doctors and offering emotional support.”  Ginevra Liptan, M.D.  Author: Figuring Out Fibromyalgia

Tami Stackelhouse had been coaching clients since June 2009. A month after Tami published her book Take Back Your Life: Find Hope and Freedom from Fibromyalgia Symptoms and Pain, her one-on-one coaching practice was full. “It was the most awful feeling to have people email me saying that they had read my book and wanted to know how to work with me to get more help and have to turn them away. I knew I had to figure out a way to duplicate myself. There was no way I could help everyone if I tried to do it alone. So I decided to try teaching just a few people how to do what I do.” says Tami

In response, Tami created the International Fibromyalgia Coaching Institute(IFCI).  It is the first program tailored to helping those with fibromyalgia.

This past October, I joined eleven others from the United States and United Kingdom in the IFCI’s 16-week program.

We studied how to help clients come to terms with their fibromyalgia diagnosis, understand their treatment options, implement prescribed lifestyle changes, reduce fibromyalgia symptoms and navigate the often confusing medical system. The course consists of live and self-paced learning, mentoring and coaching practices.

What happens in a coaching session?

“Most of us know what we should do; it’s doing it that’s the hard part.” ~
Tami Stackelhouse

Coaching appointments are usually once a week, done over the phone and last typically 45 minutes. During coaching sessions, the coach and client will talk about any challenges that have come up since the last session and look at current habits, then focus on setting goals to incorporate healthy habits into daily life. Together, the coach and client will decide what to focus on. At the end of each session, the client will have one or two items to work on until your next session.

Does it work?  
Read what 2 of Tami’s clients say about their coaching experience.

“I’m really so pleased to be able to have regular coaching sessions and work on my health/healing with someone who understands and can give spot on advice! I think it will make a big difference! — and I won’t have to try to be accountable just to myself (doesn’t really work a lot of the time) phew!” — Eleni, Australia

“Working with Tami gave me hope for healing for the first time in years. My fibromyalgia has been very chronic throughout my life, and Tami’s gentle way of listening and supporting me helped me realize how much discomfort I had been tolerating. With her guidance, I’ve been able to acknowledge my challenges and build a support team that is helping me with the special care I need for well-being and peace of mind.” — Christine

On January 31, 2016, the International Fibromyalgia Coaching Institute celebrated with graduating its first 12 students. They are living with Fibromyalgia, ME/CFS, Myofascial Pain Syndrome and many more of the
co-morbid/co-existing conditions, and they are ready to start their new career
in doing what they love to do most ~ helping others who live in chronic pain.

These trained coaches/advisors have “been there and done that”.
“Coaching exists to help people find a better quality of life.”

~ Jan Chambers


Melissa Swanson is a chronic pain patient, advocate, and author. Through her Facebook page, she offers positive encouragement, medical information, resources, and support to 16,000+ fibromyalgia and chronic pain patients. In addition to her own blog, Melissa has been published in “Living Well with Fibromyalgia” and the NFMCPA “Advocate Voice.” She’s a graduate of the 2014 Class of Leaders Against Pain Scholarship Training sponsored by the National Fibromyalgia & Chronic Pain Association and a member of the Leaders Against Pain Action Network.

You can find Melissa at:
Facebook: www.facebook.com/survivingfibro

Blog: www.fibrowarriorslivinglife.com

Twitter: MelissaSwanso22