Simple and effective ways to manage chronic pain -part 2 of a series

The most important ingredient in managing a chronic or persistent condition is having a therapeutic relationship with your physician and other healthcare professionals- physical therapist , mental health counselor, nutritionist.

In a previous post I talked about non-drug methods to manage pain in the spine-neck and back. You may want to review it now, but reading  this one first is fine. This post will focus on other painful conditions.

While people often discover methods to relieve pain that work for them, I am focusing here on treatments that are supported in the medical literature or recommended by knowledgeable professionals. For this post, I reviewed many articles which summarized current studies.

Finding trustworthy medical information

How do doctors know what works and what doesn’t? Since medical knowledge has changed since we went to medical school , how do we know what is current information?

We read literature pertinent to our fields on a regular basis, attend conferences, and talk to other doctors. But when we need a specific question answered , we do what you do-we Google it.

shelves in a library with adjacent computers
the Centers for Disease Control and Prevention (CDC) Library, located on the organization’s campus, in Atlanta, Georgia. The CDC collections span the field of public health. Print and electronic resources cover such topics as disease prevention, epidemiology, infectious diseases, global health, chronic diseases, environmental health, injury prevention, and occupational safety and health. The main library in Atlanta and selected branch libraries are open to the public. used courtesy CDC/ Emily Weyant; MSLIS; ORISE Fellow

One of the most frequently reviewed is PubMed listing  more than 28 million citations for biomedical literature from MEDLINE, life science journals, and online books. The service is free and anyone can use it. PubMed is a service of  the National Library of Medicine, the largest biomedical library in the world ,located in Bethesda, Maryland,

Another major reference is the Cochrane Library, a collection of databases in medicine and other healthcare specialties ; a fee is charged to use this service.

Basic points about complementary treatments for pain management

We should use medication and surgery when appropriate, but when these can’t be used or are not helpful, we can consider alternative methods, or what I and other doctors prefer to call complementary or integrative treatment.

This post focuses on symptom relief, not necessarily curative treatment.

Herbals and supplements are drugs and can be effective for certain conditions, but this post will discuss non-drug treatments only.

Many cases of pain improve spontaneously with no specific treatment.

Almost everything works sometimes.

There are few if any down side to any of these treatments. Used under supervision they are unlikely to have adverse side effects or result in long term complications.

The most important ingredient in managing a chronic or persistent condition is having a therapeutic relationship with your physician and other healthcare professionals- physical therapist , mental health counselor, nutritionist.

SIMPLE AND EFFECTIVE WAYS TO MANAGE CHRONIC PAIN-WATERCRESSWORDS.COM

Migraine

Migraine is more than just a bad headache; it is a disorder of the brain which causes pain as well as other common symptoms including nausea, vomiting, and sensitivity to light and noise.  Dizziness, numbness, and  loss of vision occur less frequently.

diagram of the human brain.
The major parts of the brain, including the pineal gland, cerebellum, spinal cord, brain stem, pituitary gland, and cerebrum are labeled. I photo courtesy of Source: National Cancer Institute Creator: Alan Hoofring (Illustrator)

Most people with migraine require some type of medication for relief, but non-drug treatments can supplement meds and can be helpful for prevention. Integrative treatments that work according to studies include

  • acupuncture
  • biofeedback
  • CBT-cognitive behavioral therapy
  • exercise
  • meditation
  • relaxation training
  • yoga

Fibromyalgia

I mentioned fibromyalgia in my post about back and neck pain, but  include it here  since it causes pain in other body areas.

Fibromyalgia seems to be a disorder of nerves which makes them super sensitive, leading to diffuse muscle and joint pain that can become disabling. Complementary treatments recommended include

  • Mind-body-guided imagery, hypnosis, biofeedback, mindfulness meditation , relaxation
  • Tai chi
  • Hydrotherapy, balneotherapy

Osteoarthritis of the knees (degenerative arthritis)

It is likely that arthritis in other joints responds to these therapies but there aren’t enough large studies to confirm.

  • Acupuncture,
  • tai chi
  • walking and  strengthening exercises
  • Balneotherapy-bathing in hot water mineral baths
people in a gym exercising
photo courtesy Amanda Mills, CDC.gov, Public Health Image Library

 

 

 

 

Tessa Frank  discusses how she became frustrated when increasing doses of opioids didn’t relieve her chronic pain, and what she’s doing now to manage her pain.

How I’m Managing My Chronic Pain Without Opioids

“While I no longer use opioids, I do use non-opioid prescription medications and a spinal cord stimulator to provide pain relief for my CRPS, complex regional pain syndrome, a chronic, debilitating neuropathic pain condition.

I’m also hyperaware of how stress triggers my increased feelings of pain, so to mitigate stress, I personally have found relief in meditation, relaxation and yoga among other approaches.” (excerpt)

 

 

 

 

If you didn’t read it earlier, here’s a link to the previous post about treating pain, along with a brief excerpt.

Surprising effective ways to relieve back pain

“Pain in the spine results from many medical conditions, ranging from minor to life threatening. Most cases are due to routine or excessive physical activity or a minor injury causing strain of the muscles, tendons, and ligaments, and will go away with no or minimal intervention in less than 12 weeks.”

 

 

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I am grateful when you like and share this post on social media.

Please consider helping support this blog by using my affiliates. You’ll find links in the side bars, on the home page, and on the resource page.

In a future post I will talk about  non-drug treatments for other conditions.

always exploring the HEART of health with you.

                       Dr. Aletha  WATERCRESSWORDS.COM-exploring the HEART of health

Most viewed post #5 -Driving Miss Norma- a book review

She did not write about cancer or fame- the two big themes of the trip for us. She did not write about the fear of dying or illness at all. Instead, she talked about life, living, and the things that brought her happiness

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The 5th most viewed post of 2017 was a book review. I think I was first attracted to this book by the title; it reminded me of one of my favorite movies, Driving Miss Daisy starring the late Jessica Tandy, Morgan Freeman, and Dan Aykroyd.

The plots are quite different but both stories are about an older woman and illustrated many of the same themes-family, friends, relationships, aging, illness, disability, and death. They both show how people do or don’t live life to the fullest.

Driving Miss Daisy was fiction but Driving Miss Norma is true, and her family keeps her story alive in this book and on social media. I’m glad so many of you  read this post, and are reading it now, and I hope you will  read the book.

Driving Miss Norma

One Family’s Journey Saying “Yes” to Living- a memoir

By Tim Bauerschmidt and Ramie Liddle

Harper Collins, 2017

(This post contains affiliate links.)

I first learned about Norma Bauerschmidt on Facebook when a friend shared a video about her. She was a 90 year old woman who decided to spend the last months of her life “on the road” travelling with her son in a motorhome. She was diagnosed with cancer but decided to forgo treatment so she could enjoy her remaining time.

I didn’t learn more about her until I saw this book.  I decided to read it, expecting a feel good entertaining read. The story turned out to be far more complex than the little I knew.

Driving Miss Norma - a book cover

Driving Miss Norma tells the story of Norma Bauerschmidt, a WWII WAVE veteran, wife, and mother. She was still in good health at 90 years of age, until she was diagnosed with cancer.

Her doctor recommended surgery to be followed by chemotherapy, and warned her the treatment and recovery would be long and difficult. She told him no, she would rather “hit the road” with her son and daughter-in-law and enjoy her life, seeing and doing things she had not had a chance to do before. And her doctor agreed, saying that is just what he would do.

Tim, her son, and Ramie, his wife, had already been living a nomadic life, travelling the country with their standard poodle Ringo in an Airstream travel  trailer they parked in campgrounds and  Walmart parking lots. They enjoyed travelling, seeing new places, meeting new people. They wondered how adding a 90 year old woman to their wandering lifestyle would work.

By the time they completed arrangements for Norma to join them, she was already frail, and as her illness progressed she needed even more attention and care. Tim and Ramie soon realized that this might be more difficult and complex than they imagined.

In the book, co-written by Tim and Ramie, they tell their stories also; the mid-life challenge of caring for aging parents, making end of life decisions and plans, and coping with parents’ death and  their subsequent grief. Having chosen not to have children, the role of caregivers was foreign to them, and one they had to painstakingly embrace and navigate.

By coincidence, Ramie had recently read the book Being Mortal  “a critical examination of end-of-life medical care.” Until then she had not thought much about the subject. But when she finished the book

Atul Gawande- Being Mortal-book cover
This book caused Norma’s daughter-in-law Ramie to being thinking about end of life issues in a new way

“I knew my life had changed. The way I looked at the end of life had been flipped upside down and backward. I knew now it was time to have those tough conversations.”

(I reviewed this book at this link)

As they travelled, Ramie began writing about their adventures and posting on Facebook to close friends and family. She thought that other people might also be interested so she started a Page, Driving Miss Norma. They attracted a handful of followers initially, as she expected.

up close look at a hot air balloon
Norma went on her first and only hot air balloon ride (complimentary stock photo from Pixabay)

But after Norma’s story was reported on the Good News Network, followed by a CBS Evening News Story , the Page began adding  followers by the thousands.

The were alarmed, even fearful, of what they perceived as an intrusion on their privacy. Until now, they had deliberately avoided media in their isolated lifestyle. Then they began noticing how Norma’s story was resonating with people in a way they had not expected.

“We had suddenly and dramatically found ourselves in the middle of an international conversation about the meaning of life, illness, dying and love. We were learning on the fly how to open ourselves to holding so much raw emotion.”

Her story opened their lives to new people and situations they never imagined would happen. Rather than being a burden, Norma’s growing fame became the vehicle for them to grow closer to her, each other, and a whole new set of friends all over the country and the world.

“We had the support of people all over the world and that was breathing new energy into our days. Here were so many people pouring out their deepest fears, losses, and desires to us. They told us of their caregiving struggles. They shared with us their innermost desires- to make peace with their recently deceased father, to tell someone “I love you.”

Throughout the story Tim and Ramie share about the places Norma visited (see map), people she met, from the common to famous, the foods she tried, sometimes for the first time, and activities she tried, also many for the first time, like riding a horse. They and the new friends they made shared food, fun, love, and laughter.

map of the United States
Norma visited all the sites marked on this map

But they also touch on the serious issues we all deal with sooner or later- aging, frailty, complex illness, terminal illness, end of life decisions, palliative care, death, and grief. They learned some important lessons about human relationships which they illustrate beautifully in their transparent writing.

“We learned how to greet people with open minds and open hearts…the lines that separate people into different boxes-religion and politics and race and age-blurred and faded and eventually disappeared. We got to see the truth in people, including in Norma: her glow, her tenacity, her joy, and her confidence.”

Tim and Ramie wrote the book after Norma’s death. They each took turns writing different chapters, and Ramie took all the photographs that illustrate it. But in a way Norma herself wrote the book, since it was the way she faced the final months of her life that produced the lessons her family learned and share with us in this book.

Norma kept a journal during their travels and after she died Tim and Ramie, with close friends, read it, and were somewhat surprised at what she wrote. Or rather, what she didn’t write.

“She did not write about cancer or fame- the two big themes of the trip for us. She did not write about the fear of dying or illness at all. Instead, she talked about life, living, and the things that brought her happiness:a sturdy wheelchair, mama and baby goats, a good hair perm, and her trusty sidekick Ringo.”

I feel sad that Norma’s trip did not bring her though my town so I could have met her. But there will be “Normas” in my life that I will meet, and perhaps someday I will be a Norma myself. When that happens I hope I remember the lessons this book teaches.

“Joy begets joy, love begets love, peace begets peace.”

You can continue to follow Tim and Ramie on Facebook where they are still

Driving Miss Norma

2 DOCS TALK reflected on Norma’s decision to forgo cancer treatment in this podcast

Do You Want a Long Lifespan? Or a Long Healthspan?

Driving Miss Daisy was  a Pulitzer Prize-winning play brought to television starring DRIVING MISS DAISY DVD

Angela Lansbury and

James Earl Jones .

Now available as a DVD or

watch online.

The Power of Meaning: Crafting a Life That Matters

 by Emily Esfahani Smith

“In a culture obsessed with happiness, this wise, stirring book points the way toward a richer, more satisfying life.”
To explore how we can craft lives of meaning, Emily Esfahani Smith considers an array of sources–from psychologists, sociologists, philosophers, and neuroscientists to figures in literature and history.
Drawing on this research, Smith shows us how cultivating connections to others, identifying and working toward a purpose, telling stories about our place in the world, and seeking out mystery can immeasurably deepen our lives.
She explores how we might begin to build a culture that leaves space for introspection and awe, cultivates a sense of community, and imbues our lives with meaning.Inspiring and story-driven, The Power of Meaning will strike a profound chord in anyone seeking a life that matters.
Support Independent Bookstores - Visit IndieBound.org

About the Author

Emily Esfahani Smith’s  writing has appeared in the Wall Street Journal, New York Times, The Atlantic, TIME, and other publications. She is also an instructor in positive psychology at the University of Pennsylvania, as well as an editor at the Stanford University Hoover Institution, where she manages the Ben Franklin Circles project.

Drs. Paul and Lucy Kalanithi reflected on their experience facing terminal illness in this review-

When Breath Becomes Air- reflections from Dr. Lucy Kalanithi

exploring the HEART of health through reading

Dr. Aletha