The Free Flow Method: A Whole-Body Approach to Chronic Pain
Why does chronic pain keep coming back? Sydney acupuncturist Gavin Martin-Rentz explains the Free Flow Method: one root cause and five levers.
If you've lived with pain for months or years, you've probably been through the usual rounds. The GP, the scans, the physio, the massage, maybe a few rounds of acupuncture. Some of it helped for a while. Then the pain found its way back, or moved somewhere else, and you were left wondering what you're missing.
The Free Flow Method is the framework I use to understand and work with chronic pain: one root cause, which is obstruction to free flow in the body, and five levers we can use to clear it. It grew out of my own experience with chronic pain and illness, what I've learned since and what I see in the clinic every week. It's a living framework, so it keeps evolving as I learn more.
Below I'll explain where the name comes from, the two sides of the root cause, the five levers and how it fits alongside treatment.
Where does the name "Free Flow" come from?
It comes from a saying in Chinese medicine: tōng zé bù tòng, bù tōng zé tòng. It translates as "where there is free flow, there is no pain; where there is obstruction, there is pain." Picture a creek. When the water moves freely, the whole bank stays green. Put a log jam in the middle and things back up behind it and dry out below it.
In the body, the water includes blood flow, nerve supply, fascia, lymph and the signals of the nervous system. Obstruction can take many forms: tissue damage or injury, tight and stuck fascia, joint degeneration, impaired nerve function, lymphatic congestion, inflammation, or a nervous system that's stuck on high alert. When something is holding up the flow, the body tends to tell us about it with pain.
What is the root cause of chronic pain in the Free Flow Method?
The Free Flow Method sees one root cause of chronic pain: obstruction to free flow. In Chinese philosophy, everything contains yin and yang. Every sunrise has a sunset, every inhalation has an exhalation, and one can't exist without the other. Pain is no different. Flow can become obstructed in two ways, physical (yin) obstructions and functional (yang) obstructions, but they're two sides of the same coin.
Physical (yin) obstructions | Functional (yang) obstructions | |
What it is | Tissue and circulation obstructions, the things you can often feel or find | How the body functions and responds: the signals and regulation behind the tissue |
What it can involve | Myofascial restrictions, joint issues, old injuries, poor blood flow | An increased threat response, a dysregulated autonomic nervous system, overactive immune responses |
Neither side works alone. A tight, restricted neck sends more "threat" signals to the brain, which tends to increase pain. A body on high alert holds more tension, which restricts the tissue further. That's why working only on the sore spot, or only on the stress, often isn't enough.
You can read more about this in the yin and yang of chronic pain.
Why isn't treating the sore spot enough?
Because the place you feel pain is usually the tip of the iceberg. If the sore spot was the whole problem, most people with chronic pain would have found the right treatment and moved on. And you're far from alone: the Australian Institute of Health and Welfare report on chronic pain found that about one in five Australians aged 45 and over live with chronic pain.
The Free Flow Method starts from the idea that the body is an interconnected system, within itself and with the nature and world around us. So instead of fixating on where it hurts, we zoom out. What are the key obstructions in your life and body that are holding you in a chronic pattern of pain, and which levers will give you the most benefit for the least effort?
For more on this, see corrective vs symptomatic care.
What are the five levers of the Free Flow Method?
The five levers are the areas of life and body we can influence to restore free flow. We start outside the body and go deeper, layer by layer. Each lever has a yang side (how we act and function) and a yin side (the foundations underneath).
Lever | Yang side | Yin side |
1. External environment | Light, the seasons and your body clock (circadian rhythm) | Nature, grounding and environmental toxins, plus the people around you and whether they support or drain you |
2. Internal environment | Mind, mindset and emotions | Your internal ecology: patterns of moisture (dampness and dryness), temperature (heat and cold) and flow, shaped by diet, herbs, supplements and lifestyle |
3. Breath | Using targeted breathwork techniques to change or influence physiology in a specific way | Ensuring your foundational breathing habits are optimal and supporting you |
4. Nervous system | Retraining mismatched signals between your eyes, balance system and body-position sense | Regulating your baseline stress response: calming fight or flight and supporting rest and digest |
5. Fascia and structure | Moving better: stretching, mobility and targeted strength or rehab | Releasing specific areas of tension through self-treatment or with an acupuncturist or other practitioner |
You don't need to work every lever at once. The point is to find the levers that are doing the heavy lifting for you and start there. In my experience, the way you breathe from moment to moment has a far greater effect on your pain than any single breathing exercise, which is why the everyday habits matter so much.
I'll go through each lever in its own article in coming posts. To see how the levers play out for a specific condition, read how the Free Flow Method applies to migraines.
How does acupuncture fit into the Free Flow Method?
In the clinic, acupuncture works mostly on levers 2, 4 and 5 (internal environment, nervous system, and fascia and structure), and Chinese herbal medicine mainly on lever 2. For lever 5, the main local work is motor point release of the key muscles involved, alongside trigger point work and dry needling where it suits.
Levers 1 and 3 rely mostly on you, and in truth all five levers can and should be worked on outside of any treatment you're having.
My aim with the method is for it to do two things.
First, to sit alongside treatment so that you get more out of it than you would from passive treatment alone.
Second, to give you something you can follow without treatment, wherever you are in the world. If you do choose to add treatment with local practitioners, the method helps you work out which kinds are the best fit.
What does the research say about acupuncture for chronic pain? A 2018 individual patient data meta-analysis by Vickers and colleagues pooled 39 high-quality trials covering 20,827 people with chronic musculoskeletal pain, osteoarthritis, chronic headache and shoulder pain. Acupuncture did better than both sham acupuncture and no acupuncture for every condition, and the benefits lasted, with only about a 15% drop in the effect at one year. That said, I see acupuncture as one part of the picture rather than the whole story, which is where the other levers come in.
When people trial acupuncture for chronic pain, I suggest at least 6 sessions to see how you respond, though 12 can be a more realistic starting place for a chronic pattern. If you're improving, we continue to see how good we can get things, and some people then benefit from ongoing maintenance.
For timelines, see how long acupuncture takes to work and how often to come.
What can the Free Flow Method be used for?
The Free Flow Method is a holistic approach to pain relief and health in general. I use it as the lens for most of the chronic pain I see, from neck, back and knee pain to headaches and fibromyalgia. The levers stay the same, and what changes is which ones matter most for you.
The more complex and chronic a condition, the more important the other levers become. A pain pattern tangled up with exhaustion, for example, might need more from levers 1, 2 and 4. For simple injuries and pain, it's usually unnecessary to look beyond a lever or two, such as a desk-bound neck and upper back that might only need lever 5. It's also a useful framework for general health, even without any specific pain to work on.
You can read how this plays out in neck pain, lower back pain, knee pain, upper cross syndrome, fibromyalgia and migraines.
FAQs: The Free Flow Method
Q: What is the Free Flow Method?
A: It's the framework I use and teach for chronic pain and health in general. It sees one root cause, obstruction to free flow, which shows up as physical (yin) and functional (yang) obstructions, and it uses five levers to clear it: external environment, internal environment, breath, nervous system, and fascia and structure.
Q: What does "free flow" mean in Chinese medicine?
A: It comes from the saying tōng zé bù tòng, bù tōng zé tòng: where there is free flow, there is no pain, and where there is obstruction, there is pain. The method asks what's obstructing flow for you and what we can do about it.
Q: What are physical (yin) and functional (yang) obstructions?
A: Physical obstructions are tissue and circulation problems like myofascial restrictions, joint issues, old injuries and poor blood flow. Functional obstructions are about how the body responds and regulates, such as an increased threat response, a dysregulated autonomic nervous system or overactive immune responses. Like the yin and yang of a sunrise and sunset, they're two sides of the same coin and tend to feed each other.
Q: Do I need acupuncture to use the Free Flow Method?
A: No. The method is designed so you can follow it without clinic treatments, wherever you are. Acupuncture works mostly on levers 2, 4 and 5, while levers 1 and 3 rely mostly on you. Treatment can sit alongside it to help you get more out of each lever.
Q: Is the Free Flow Method only for pain?
A: No. It's built around chronic pain, but it's a holistic approach to health in general, and it's useful even if you don't have any specific pain to work on. The more complex and chronic a condition, the more of the five levers come into play.
Q: How many acupuncture sessions are needed for chronic pain?
A: I suggest at least 6 sessions to see how you respond, though 12 can be a more realistic starting place for a chronic pattern. If you're improving, we continue to see how good we can get things.
Ready to find out which levers are holding your pain in place?
If you'd like a whole-body approach to your pain, you're welcome to come and see me. I'll work out which obstructions and levers are driving your pattern and put together a plan with you.
If you'd like to try acupuncture for chronic pain in Sydney's eastern suburbs, come and see me at Acupuncture Grove in Bondi Junction. You can book online here or reach out with a question.
Also read:
Gavin Martin-Rentz is an AHPRA-registered acupuncturist and Chinese medicine practitioner at Acupuncture Grove, Bondi Junction, Sydney, with over 10 years in practice.
Acupuncture Grove services Bondi Junction, Bondi Beach, Coogee, Clovelly, Bronte, Waverley, Randwick, Maroubra, Double Bay, Watsons Bay, Vaucluse and surrounding Sydney suburbs.
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