Pain is like "a pig on ice".

I have Hoosier teacher, antique dealer Richard Oxenrider to thank for this expression. The double predicament of both chronic pain patients and pigs stuck on ice is that of those clutched in the dual dynamics of gravity and immobility. Trust me, I have seen it more than not. With pain patients, not pigs on ice. But I can imagine the later, spread-eagle d, panicking, the ice groaning beneath them threatening a cataclysmic crunch followed by a bone-chilling dunk. How to extricate the chronic pain patient from their predicament is the common question not well answered by either surgery or drugs, which tend to immobilize even more. Motivated movement toward the saving shore is the answer. Or as George W. said to his soldiers rowing him across the Delaware toward the encamped Hess ions, "Pray to God...and keep rowing toward shore."
So breaking the plane of inertia is important in both instances.

IMPACT:
What appears to be working more and more" first visit" at Stroger/Cook County Hospital Pain Clinic is Scalp Acupuncture. It seems to have the impact to shock those hardy enough to bear it in a direction away from the paralysis of pain. We (my interns and I) always have them move the offended area as soon as the first few needles are retained. I was taught to jump-start the treatment from the Middle Burner area, then go to the equivalent scalp somotope, usually the hip and back or neck and shoulder. Then get the patient mobilized immediately while gripped with the distracting pain in another part of their body. Sometimes my interns or I will add an opposing needle for stronger stimulation. (The jab and move, stimulus/response tactic is one I also saw my friend, Master John Howard also use with ASP Auricular Darts in his Battlefield Acupuncture Seminars.)

Follow-Through and Combination Punches
In boxing, follow-through and combinations add power to the attack. I learned this first-hand from Nappy, our Italian boxing coach at Notre Dame. The same seems to hold for stuck pigs and stuck"Energy and Blood" (the latter is the source of pain in Chinese Medicine). What this translates into during our weekly pain clinic shifts is making sure that patients have a combination of therapeutic activities they can do at home to support any movement they have made away from pain's grip, and toward more function. This can include teaching them Sujee Korean Hand Therapy, Sotai Corrective Exercises, and or Medical Qigong Movements to secure and reinforce any progress made away from pain and toward healing. This tactic of follow-through/combinations is, I believe, what keeps hospital-based acupuncturists from succumbing to the slippery slope of heroic vs. holistic therapy, designed to empower rather than enslave those in pain.