It is said that despite a diet adequate in calcium, stress can lead to relative lack of this mineral because of the buildup of lactic acid in the blood. This may be particularly so in those conditions where generalised muscular pain is associated with soft tissue injury. Lactic acid is said to ‘bind’ the calcium, making it difficult to assimilate.

Taking a glass of ultra-filtered calcium-enriched milk together with a daily supplement of calcium may help sleep to return to normal. (It should also be noted that all women require between 600 and lOOOmg of calcium per day between the ages of 30 and the beginning of menopause just to prevent the loss of bone mineral density which leads to the often painful consequences of osteoporosis.)

Foods rich in calcium include yoghurt, cheese and other dairy products, eggs figs, oranges, almonds and calcium rich vegetables such as cauliflower and broccoli.

The most readily absorbable natural sources of calcium are soft-boned fish such as sardines and salmon.

If you consume large amounts of sugar rich foods, excessive amounts of flour or alcohol you are likely to be low in dietary magnesium which is essential for calcium absorption. Magnesium-rich foods include sea salt, kelp, seeds of all kinds,nuts, beets, spinach, dates and prunes. According to some nutritionists magnesium oxide supplements taken a half hour prior to going to bed have replaced the sleeping pill for many insomniacs.

Of the B group vitamins the one said to be most influential in helping sleep is pyridoxine or Vitamin B6. This vitamin is said to have sedative effect on the nervous system. It appears to be essential for the normal functioning of the brain, and for maintaining the level of magnesium in the blood. When B6 is deficient, the amino-acid tryptophan is not used properly by the body. This has particular relevance to chronic pain patients where the levels of serotonin or 5 HT are known to be depressed in some with chronic pain. The taking of L-tryptophan has been associated with both promoting natural sleep and a natural anti-depressant and has been shown to increase the brain levels of serotonin.

To treat insomnia Vitamin B6 is usually taken in doses of 25-50mg daily.

Pantothenic acid, another of the B group of vitamins has also been linked with insomnia. This is a key vitamin in the conversion of fats and sugar in the body into cellular energy. The dose of this vitamin to promote natural sleep is lOOmg per day.

The vitamin B12 has also been used by orthomoloecular psychiatrists to treat depression and insomnia. It should be given only after a test for B12 deficiency is carried out. Supplements of 25 milligrams daily may then be of help in sleep disorders.

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‘Imagine that you’re standing, in the very early morning on a beautiful beach, standing quite alone on that beautiful beach in the pastel stillness of that beautiful beach.

‘Now imagine a wide sweep of fine, pale sand. A clear, blue sea with waves forming, curling, breaking and washing up the beach in curves and scallops of lacy white foam, receding to leave the sand wet and glossy.

‘Imagine a deep blue sea on the horizon shading into paler colours. The sunlight is glinting on the water, the clear brightness of the sky is reflected in the wet sand as the waves recede.

‘Imagine it vividly, still in the cool of the morning so that everything is bright. The colours are so clear and you can feel a cool breeze against your face.

‘Further, imagine some grey and white seagulls are fluttering down to float ever so lightly on the water, out beyond the breakers.

‘Imagine everything looking so fresh, clean and new. The sound of the water, the breeze and the fine clean sand — the bright clear colours. You are now walking along the water’s edge — along the wet sand which is hard, and yet comfortable under your feet. As you walk along the wet sand, you feel the water occasionally washing over your bare feet.

‘You begin to feel exhilarated. You begin to feel joy and exhilaration. It’s such a clear, fresh morning. The colours are so clear and bright. You walk along with the cool air in your face and the waves sometimes washing in a sweep of lacy foam over your feet and then receding.

‘You feel that your body is healthy and light and you walk along with a fine, swinging stride feeling exhilarated and optimistic. You feel the future is great, the exhilaration is quite a vivid, physical feeling and you are intensely aware of the beauty of the sea and the beach and the sky as you walk along.

‘It becomes a very vivid, and very complete, real and total experience.

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Fine gold electrodes are inserted into the spine through an incision over the vertebral column. At first these are connected to an external computerised electrical stimulator while it is assessed for accuracy of location in the spinal canal and different stimulation methods are tried.

When it is found to be successful the patient undergoes a second stage of the operation in which a battery powered electronic stimulator is implanted under the skin of the patient’s chest or abdomen. After this has been done the patient uses a powerful radio device to send messages to the stimulator and direct the current being delivered, its strength and pattern of stimulation.

The success of such treatment varies according to which surgeon is reporting his, or her, success. But there is a certain degree of scepticism about the procedure from some of the innovators of the technique who have subsequently stopped performing it. Unfortunately, one of the major complications of the treatment is infection in the location of the fine electrodes — in the spinal canal. This usually leads to the removal of the $5000 stimulator unit which cannot be reused on other patients. Another unfortunate problem is the unexplainable loss of effectiveness which occurs in a previously helped patient — typically within the first six months of treatment.

A second opinion Those who are offered this form of therapy should always seek a second opinion. At best, it is an uncomfortable operation, at worst it is potentially harmful and fraught with postoperative problems.

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These are drugs which are not specifically developed to treat pain, which are used to enhance the pain relieving effects of the analgesics. They include the antidepressants, tranquillisers and some muscle relaxants.

Analgesics

These can be divided into simple and mild pain killers and narcotic or opiate based and potent pain-killers. The narcotic drugs are all developed from the age-old knowledge that the opium poppy produces a natural and extremely potent pain killer and euphoria producing substance — opium, from which can be derived other substances such as morphine and heroin (diamorphine).

Steroids

Cortisone-like drugs, which are often injected into joints or into inflamed areas, have a limited role in chronic pain treatment.

The major side-effects of such drugs, when taken in high dosages, are a reduction in the body’s natural capacity to fight off infection or inflammation, a softening of the bones (osteoporosis) and in some cases extreme weight gain and stretch marks.

The intra-joint usage of such drugs is sometimes associated with weakening of the muscular tendons and the tissues surrounding the joints.

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