Sit up with your knees bent and the soles of your feet together, holding the feet in place with your hands. Pull your knees up towards each other slowly. Once you have pulled your knees up as far as possible, begin to let them slowly fall back towards the floor.

• Leg extensions

Sit on the floor with one leg extended in front of you while the other leg is bent with the big toe pointing towards the opposite leg. With both arms together, reach towards the extended leg. Reach just until you feel a comfortable stretch. Reverse legs and repeat. Do this ten times on each side.

Remaining on the floor, spread both of your legs out in front of you. With both hands together, reach for your right foot, then in front of you, then to the left foot. Repeat this ten times.

• Toe touches

Sitting on the floor with both legs together and extended out in front of you, bend from the hips, trying to keep your back straight and your head up. Try not to bend your lower back. Reach for the lower part of your legs. Hold for a count of five and return to your starting position. Repeat ten times.

• Arm swings

Stand up with your arms extended out from your shoulders. In an even motion, swing your arms from side to side, twisting at the waist. Try to remain relaxed as you do this to get a smooth even motion.

• Arm circles

Standing, with your arms extended out from your shoulders, begin to move your arms in a circular motion. Do this ten times and then move them the other direction.

• Windmills

Standing straight with your arms extended out to your sides, bend down to touch your opposite hand and toe. Come back up and reverse your hand and toe. Do this for a count of ten.

• Standing side bends

Stand straight with your arms extended out to your sides. Bend towards your right side letting your right arm go down your side and touching your right leg around the knee or as far as you can go. Do this just until you begin to feel the stretch in your left side. Reverse and do to the other side.

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Again, these exercises should be done in a quiet place and at a comfortable temperature. The exercises can be split up at first with individual exercises being practised for a few days each. Since the exercise is usually practised with the eyes closed, a deep state of relaxation may be achieved. Thus, a good ‘waking up’ is needed from the state of relaxation. The simplest way is just to stretch your arms and legs, or to yawn and breathe in deeply, and to open the eyes, feeling refreshed and full of vigour.

‘Make yourself comfortable and allow your eyes to close. Then lift one arm a little, and just let it drop. Let it drop heavily, as if it were the arm of a Raggedy Ann doll, one of those floppy dolls or animals.

Choose one in your imagination. Choose a doll, an old loved soft teddy bear, a velveteen rabbit, a bean bag toy -or even a favourite pillow or blanket. Choose anything soft that you like. Lift your arm again a little and drop it, and let it rest there for a moment. Now think of your arm again. But don’t lift it in reality, just in your imagination. Lift it in your imagination and think that you are dropping it again. Do this while you breathe out. Go ahead. Let your arm go limp like a rag while you breathe out.

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The placebo is a time honoured way of presenting to a patient by a doctor of a sugar pill or coloured water said to have potent properties to heal or to relieve pain. It works because the brain produces natural pain-killers, the endorphins and enkephalins simply because the patient believes the treatment is going to be effective.

The effectiveness of the placebo in hypnosis in pain relief has been studied in low and highly hypnotisable subjects. In low hyp-notisable subjects, there is no difference in the effectiveness of hypnotism and a placebo, such as simply asking subjects to close their eyes and not react to given suggestions.

But in highly hypnotisable subjects, hypnotism is more effective than a placebo in pain relief — the placebo occasionally produces negative results.

The difference between hypnotism and a placebo is that hypnotism primarily acts as an analgesic and only secondarily as a sedative. There is no link between hypnotisability and the response to the placebo overall. Even unhypnotised subjects can respond to suggestions of relaxation. These can be of benefit in anxiety reduction, as in dental procedures where hypnotic ‘depth’ is not necessary as usually little pain relief is needed to help.

There is as yet no real evidence of a relationship between hypnosis and the endorphins. One study by Goldstein and Hilgard (1975) showed that hypnotic analgesia was not reversed by Naloxone, a drug which reverses the pain-killing effects of morphine in a dose which is effective in reducing the placebo response. So far, the study of internal systems for pain reduction and that of the natural morphine-like substances is still in its infancy.

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Procaine is thought to block the higher centres and pathways carrying pain. Effectiveness varies from one person to another.

It is important to stress that, unlike many narcotics and other medicines used in pain control, procaine does not seem to block the body’s own pain-fighting mechanism as stimulated by acupuncture, TENS, lasers, and so on.

This is important because it does not exclude the use of IV procaine with electrical and other stimulation allowing methods of pain treatment to continue hand in hand.

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