X marks the spot- or does it?

Lady holding shoulder and neck with pained look on her face

It is a common misconception that the site of pain is the source of pain. Pain can be caused by a number of sources, including physical trauma, nerve damage, and illness. It is important to understand that the site of pain may not necessarily be the source of pain.

Those whom have seen a physical therapist be it an Osteopath, Massage Therapist, Physiotherapist and the like, you’ve most likely been given a body chart to mark ‘where it hurts’.

The majority of spots marked on the chart, are areas that ‘hurt’ and more often than not, it is due to referred pain. Except for joint issues and a problem with your deltoid, most ‘pain’ areas are actually referred pain coming from somewhere else.

Pain referral is a phenomenon where pain originating from one area of the body is felt in another area. It is a common occurrence in the body, and can be caused by a variety of factors.

The most common cause of pain referral is nerve impingement. When a nerve is entrapped, it can cause pain to radiate to other parts of the body. This can occur due to a variety of reasons, including tight muscles, scar tissue, or direct pressure on the nerve.

For example, a person may experience pain in the shoulder due to a pinched nerve in the neck. In this case, the source of the pain is the pinched nerve in the neck, but the site of the pain is the shoulder. This is why it is important to have a thorough medical examination to determine the source of the pain, rather than simply relying on the site of the pain as a diagnostic tool.

Pain referral can also be caused by pain from an internal organ. For example, pain originating in the gallbladder can be felt in the right shoulder. This is due to the fact that both the gallbladder and the shoulder are innervated by the same nerve.

Finally, pain referral can be caused by a “trigger point.” Trigger points are centralised points of tension within muscle tissue that can cause pain in other areas of the body. They are said to be ‘active’ when there is a sensation/pain without any pressure or palpation to the causative muscle. A tell tale sign that the pain sensations felt are from a trigger point, is when the sensation increases in intensity or is reproduced when pressed. Trigger points can be caused by poor posture, overuse, or trauma.

In all cases, pain referral can be a confusing and frustrating experience. If you are experiencing pain referral, it is important to seek medical attention to properly diagnose and treat the underlying cause.

In conclusion, it is important to understand that the site of pain is not necessarily the source of pain. Learning where the sensations are coming from, applying lifestyle measures to alleviate the issues, as well as manual/tactile therapies to help the true cause of the pain are necessary. This can be achieved with the release of overly tight tissues, decompressing spinal joints, relieving nerves and ultimately finding balance for the entire structure.

This is why when you go to a Massage Therapist, an Acupuncturist, a Kinesiologist and the like you may be receiving treatment in areas that don’t actually hurt. Be sure to ask questions and learn about your body. Learn what your body needs and how to prevent things getting into a state of pain and dysfunction again. And always seek a qualified, registered practitioner.



J, Travell; D, Simons; L, Simons. 2nd Ed (1999) Myofascial Pain and Dysfunction. The Trigger Point Manual. Vol 1 & 2. USA Williams & Wilkins.

E, Goodman. (2016) True to Form. N.Y Harper Wave.

I, Segal. (2008) The Secret Language of your Body. Vic Blue Angel Gallery.

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“V” – Vagus Nerve: The Vagus Nerve and the brain-gut axis explained

What is the Vagus Nerve?

The Vagus (wandering) nerve (Cranial Nerve 10 – CNX), is the longest cranial nerve in the body. It originates from the brainstem, the part of the brain that controls automatic functions that are needed for survival. It travels down from the brain passing through the neck, torso and abdomen to reach most body organs.

The Vagus nerve regulates the balance between two parts of our autonomic nervous system – the sympathetic nervous system (SNS) responsible for the fight, flight, freeze response and the parasympathetic nervous system (PNS) which enables us to rest and digest. This constant state of balance (homeostasis) between the SNS and PNS systems is facilitated by communication via vagus nerve signalling between the brain and internal organs and biochemical messengers in the bloodstream.

The Gut-Brain Axis:
The Vagus nerve connects the gut and brain via the Gut-Brain axis (GBA). It serves as a bi-directional “super-highway” along which approximately 80% of the information is sensory messages travelling from the organs to the brain (afferent fibres) ie: the vagus tells the brain what’s happening in your organs, and 20% is the response from the brain to the organs (efferent fibres) to regulate their functions.

The central and enteric (in the wall of the gastrointestinal tract) nervous systems, innate immune system, and gut microbiota all facilitate communication between the brain and the gut.

In the GBA the Vagus nerve innervates the tongue, pharynx, soft palate, oesophagus, stomach, gall bladder, pancreas, small intestine, and large intestine.

The Vagus Nerve influence on Digestion:

  • Digestion begins at the mouth: the vagus nerve increases salivation in response to the smell of food.
  • In the gut, the vagus increases gastric juices, gut motility (movement) and balances stomach acid, pancreatic endocrine and exocrine secretion (enzymes and hormones), hepatic (liver) glucose production.
  • Biochemical signals travel through the blood and via the vagus nerve. These biochemical messengers include neurotransmitters such as serotonin and glutamate, and gut hormones which communicate information from the gut to the brain. all of which play a vital role in sleep, mood, pain, stress and hunger. The neurotransmitters acetylcholine and GABA released in the brain, lower heart rate, blood pressure, and help your heart and organs slow down so that you can rest-and-digest.
  • When food is eaten enteroendocrine cells secrete gut hormones, which send signals through the vagus nerve to suppress appetite when we are satiated (full). If vagal tone is low we are less able to regulate appetite and food intake. A reduced ability to respond to satiety hormones contributes to weight gain and obesity.
  • The vagus nerve innervates most tissues involved in nutrient metabolism and has the potential to influence how nutrients are absorbed and metabolised.
  • Migrating Motor complex (MMC) is a 4 phase cyclical process in which the body cleans out the digestive tract. The MMC is triggered by the vagus nerve and takes place 3-4hours after eating during “fasting mode”. (MMC is interrupted by eating, so it is best to space your meals by at least 3-5hours for the MMC to do its job of moving waste).
  • The 4 phases of the MMC are:
    • 1: rest
    • 2: intermittent irregular contractions
    • 3: short bursts of regular high amplitude contractions
    • 4: rest

How do Microbes affect the Vagus Nerve?

  • Gastrointestinal microbes directly stimulate the end terminals of the Vagus and are a key influence in the cross-talk between the gut and brain.
  • Imbalances in the microbiome, including dysbiosis, pathogenic bacteria, fungi, parasites, viruses, leaky gut (increased intestinal permeability), IBS, and IBD, all cause inflammation which impacts the health of your gut and nervous system.
  • Nerve Signals from the microbiota maintain the intestinal wall. When the microbiome is imbalanced it affects the integrity of tight junctions which may lead to leaky gut, food intolerances, chemical sensitivities and inflammation.
  • Psychobiotics – probiotic strains known to influence the GBA, can improve the gut-brain axis and positively impact mood and behaviour.
  • Disrupted gut function can also change the microbiota’s composition or metabolic activity.

Common causes of Brain-Gut axis dysfunction:

  • Psychological stress and trauma – Activate the Sympathetic nervous system to purposefully down regulate all digestive secretions, gastrointestinal motility, detoxification enzyme expression, immune function.
  • When in a chronic state of stress, we are more susceptible to illness and it is more challenging to get and stay well.
  • HPA dysfunction and sustained cortisol activity can lead to increased dysregulation in anti-inflammatory pathways (ie: inflammation persists and can cause chronic inflammatory conditions).
  • Toxicity: Environmental, Chemicals, Smoking, Drugs
  • Injury/ Physical trauma
  • Disease/ Organ dysfunction
  • Diet: Nutritional Deficiencies; toxic foods; intolerances and allergens increase inflammation
  • Lifestyle: Poor sleep; insufficient rest.

What is Vagal Tone?

Good vagus nerve health is dependent on Vagal tone – the ability to switch between sympathetic nervous system activation in stressful events and to return easily to the parasympathetic state for regulating our nervous system.

Higher vagal tone means that your body can relax faster after stress, and can promote relaxation, sleep, digestion, and healing – you are more likely to recover quicker from injury, illness, and stress.

What causes Low Vagal Tone?

  • Prolonged overstimulation of the nervous system can result in becoming desensitized to chronic stress and over time this can lead to low vagal tone.
  • Low vagal tone has been linked to a variety of mental and physical health issues. including chronic inflammation, neurodegeneration, poor gut function – as it can stop your body from going into rest and digest; and autoimmunity.

What can I do to increase my Vagal Tone?

When the Vagus nerve is stimulated its tone increases (improves).

Below is a list of several ways to stimulate the vagus nerve: It is important to choose what is calming for YOU. Choose activities that enhance your state of relaxation, that you find calming and pleasurable as it releases oxytocin into your system, reducing stress and helping to improve mental and physical health.

  • Focus on your breathing.

When you breathe deeply and slowly it signals to your brain that you are not in danger, which allows your nervous system to switch into a parasympathetic state, lower cortisol and activate higher levels of GABA.

  • Start gently, slow breathing, observe your breath: In via nose, out via pursed lips – extend exhalation as long as possible.
  • Diaphragmatic Breathing: Breathe into your diaphragm allow your belly to rise, hold it briefly, then exhale slowly.
  • pranayama: Breathing exercises and patterns
  • alternate nostril breathing
  • gargling 1 minute 2-3 x/day
  • yodelling
  • singing loudly.
  • Humming
  • Laugh
  • Chew gum
  • Positive thoughts and Positive Self-talk: Reflecting on positive social connections improves vagal tone and increases positive emotions.
  • Looking at something beautiful
  • EFT; NET: Stress release techniques
  • Meditation
  • Spend time in nature, “nature bathing”
  • Far Infra-Red Sauna
  • Hot and Cold plunges
  • Cold Showers – (finishing your shower with a cooler water temperature is a gentle way to begin the gradual transition to colder water for longer)
  • Gentle Exercise

Diet and Lifestyle to support the Gut-Brain Axis:

  • Eat fibre: Eating fibre encourages the release of hormones that make it easier for the gut to send fullness cues to the brain via the vagus nerve.
  • Sunlight: Exposing the skin to a safe amount of UVA light can produce a hormone (melanocyte stimulating Hormone – MSH) that improves vagus nerve function.
  • Take Probiotics; Probiotics optimise gut-health. Specific strains of LGG may help the vagus nerve maintain GABA levels that have a calming and stress-relieving effect on our mood.
  • Sleep: Better sleep quality is linked to high diversity of bacteria, lower inflammation and better mental health.
  • Relieve neck tension and improve posture. Forward head posture puts more stress on your neck, thoracic spine and ribcage which affects breathing, diaphragm tension and digestion.
  • Identify and treat underlying drivers of inflammation including dietary triggers; bacterial, parasitic and viral infections.
  • Rebalance microbiome: supplementation with targeted probiotics
  • Reduce intestinal permeability with individualised nutrients and dietary changes
  • Support stress management
  • Reduce inflammation
  • Regulate the immune system
  • Correct nutritional deficiencies with diet and individualised nutrient supplement support.

For a Healthy gut – healthy brain connection the Vagus nerve pathway must be intact with high vagal tone. To be able to ‘rest and digest’ and support the gut-brain axis we have to be in the ventral vagal state. It is our state of safety and homeostasis, a state that our bodies should be in 90% of the time.

To achieve that we need good nutrition, a healthy microbiome, restful sleep, time in nature, nurturing social connection, a sense of purpose, positive mindset, good posture, slow breathing and time to relax.

Disclaimer: The information written in this article is general in nature and does not constitute medical advice. For individualised treatments and specific nutritional advice please see your qualified healthcare professional.

Tips to help with tension headaches

Woman touching pressure points on side of head in pain

All of us sometimes have “those days”. Ones where you have more to do than hours to do it. Where you relate to the song “Under Pressure”. Worst of all, ones where your head feels as if is it caught in a vice.

That vice like feeling is probably caused by a tension headache. It’s the most common form of headache, and it is estimated that around 7 million Australians have experienced them.

You will probably feel a dull aching pain on both sides of the head, and sometimes your neck. Muscles around the area may feel tight, tender or sensitive to touch, and movement may be restricted.

But there are things you can do to help.

Tips to help with tension headaches:

  1. Have a large glass of water. Hydration is important. Fatigue is a side effect of dehydration. Both fatigue and dehydration can cause headaches.
  2. Take a break. Make sure you take a break from your work every 30 to 60 minutes. That means getting up and moving around. The goal is to rest and reset. Look to getting movement through different muscle groups.
  3. Play ball. Grab your massage ball of choice (lacrosse/tennis/spikey), stand up straight and place the ball between your neck or shoulders and the wall. By bending your legs up and down, you can use the ball to gently massage the areas of tension. Just remember, keep those shoulders relaxed, your neck elongated, stand with your feet hip width apart and breathe.
  4. Get a massage: Your qualified massage therapist can target and soothe those muscles that are causing your discomfort.

There are also some steps to take to avoid getting tension headaches in the first place.

  1. Look at your triggers: Stress may not be avoidable, but the way we approach it impacts the way our body responds. If possible, avoid triggering situations. If you can prepare for them, do so by treating your body well.
  2. Sleep: As mentioned above, fatigue is a factor in causing headaches. Make sure you get enough quality sleep.
  3. Make Good Choices: You know the drill… exercise, limit caffeine & alcohol intake and give up smoking.
  4. Check your bedding. If your bed or your pillows aren’t giving you the support you need, it may be time to look to upgrade.

Wishing you all a pain free future.

Natural medicine for your health and wellbeing – explained!

Natural Medicine Week Collage

The Australian Traditional-Medicine Society (ATMS) – leader of the natural medicine industry recognises three primary types of complementary medicine: Ingestive, Bodywork & Massage and Chinese Medicine.

But first, WHY choose Natural Medicine?

Natural medicine offers a holistic and integrated approach to your health and wellbeing – it promotes the prevention of disease, rather than trying to treat it after it strikes. Natural medicine offers natural supplements and therapy’s that can assist the body in maintaining a state of health and wellness to promote wellbeing. Understanding modalities, such as Ingestive, Bodywork & Massage and Chinese Medicine, can help people work with their body’s to create an effective approach to their health.

WHAT is Natural Medicine?

Natural medicine refers to healthcare practices and therapies whereby trained natural medicine practitioners treat their patients for illnesses via natural methods and materials.

Clinical practice can be classified by three primary models: Ingestive therapies (including naturopathy and nutrition), Bodywork & Massage and Chinese Medicine, which includes associated techniques like acupuncture.

Ingestive covers any form of medicine consumed by the human body and includes the use of herbs and other plants – including oils and common spices. Many of the therapies have been around for hundreds of years and are often used to balance mind, body and spirit. Depending on the therapy, ingestive medicines may take various forms, including teas, tablets, essential oils, ointments, extracts, sprays and drops.

Ingestive therapies include:

  • Ayurveda
  • Herbal Medicine
  • Homeopathy
  • Naturopathy
  • Nutrition
  • Tibetan Medicine

Bodywork & Massage encompasses therapeutic techniques involving the body and aims to assess and improve areas of the human physics such as posture, skeletal and connective tissue (fascial) and muscle pain. All massage techniques are considered forms of bodywork and, covering a range of techniques.

Bodywork can take many forms including:

  • Aromatherapy
  • Bowen Therapy
  • Chiropractic
  • Clinical Hypnotherapy and Hypnosis
  • Counselling
  • Kinesiology
  • Lymphatic Drainage
  • Myofascial Release
  • Polarity Therapy
  • Osteopathy
  • Reflexology
  • Remedial Massage
  • Shiatsu
  • Traditional Thai Massage

Chinese Medicine is used to identify, treat, and prevent illness, with the underlying viewing of the human body and the mind as an interconnected energetic system. Chinese Medicine has the longest history of any medical system in the world, originating in ancient China and evolving over thousands of years to become a complete medical system.

Chinese Medicine include:

  • Acupuncture
  • Chinese Herbal Medicine
  • Chinese Massage Therapy

Want to learn more?

Join ATMS for Natural Medicine Week – a week-long celebration including hundreds of events and special offers, hosted by passionate natural medicine practitioners nation-wide. Find out more about the many different types of natural medicine which could improve your health and wellbeing at www.naturalmedicineweek.com.au.