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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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

Surprising effective ways to relieve back pain

What is the most common disability world wide? What most commonly causes workplace absence?

Would you be surprised that it is low back pain?

What is the most common disability world wide? What most commonly causes workplace absence?

Would you be surprised that it is low back pain?

Pain in the spine, including the neck and back, affects 85% of people at some time. I’ve had it, my husband has had it, and likely you have too. Low back pain causes $7.4 billion in lost revenue from lost or decreased workplace productivity. Add to that the health care costs and it exceeds $100 billion.

Let’s explore  what causes back pain, and what we can do about it, focusing on non-drug non-surgical methods.

 SURPRISING EFFECTIVE WAYS TO RELIEVE BACK PAIN -WATERCRESSWORDS.COM

 

 

BASIC POINTS

This post will explain some of the treatments which are backed by medical studies and recommended by medical experts.

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 back 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.

doctor holding a patient's hand

I do not recommend you pursue any of the treatments mentioned in this post without first consulting a qualified health professional about your condition.

What causes back and neck 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.

a human skeleton
The spine connects the head to the rest of the body. It extends from the skull to the pelvis and legs, and along the way attaches to the shoulders and rib cage.

Some cases are due to serious but treatable conditions like

  • Infection
  • Major injury, causing broken bones (fractures) or more severe injury to the muscles and nerves.
  • Cancer of the spine, which may have started somewhere else in the body and spread to the bones, called metastasis.
  • Various forms of arthritis- degenerative, rheumatoid, psoriatic
  • Disorders of the intervertebral discs, the soft jelly like cushions between the bones of the spine, the vertebrae
  • Fibromyalgia– a disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues. Researchers believe that fibromyalgia amplifies painful sensations by affecting the way your brain processes pain signals.

 

Managing pain in the neck or spine

The first step in treating back pain is to identify the underlying cause and treat that appropriately, which might involve anti-inflammatory medication, antibiotics, surgery, chemotherapy, radiation, and/or injections.

But sometimes pain persists after these treatments, or none of those treatments are appropriate or effective.

Medications for back pain

Patients often expect, and doctors have traditionally turned to pain relieving medications starting with the non prescription drugs like acetaminophen (Tylenol) and the anti-inflammatories called NSAIDS. A muscle relaxer might be added if muscle spasm is present. If those are not sufficient, the next step was often narcotics or opioids.

But we know that the benefit and effectiveness of these drugs do not always outweigh the side effects and risks so we look harder at non-drug methods to relieve pain. And studies comparing them indicate they can be as effective if not more so than drugs.

More about this at my related post

7 overused drugs

 

 

Integrative medical treatments for back pain

 

Lifestyle changes

Back pain sufferers should start by avoiding or modifying activities that cause or aggravate back or neck pain .

  • In  the workplace- more frequent breaks, limits on lifting, a different chair, adjusting the height of a desk or computer monitor or keyboard.
  • At home- changes in performing chores like vacuuming, mopping, gardening, laundry.
  • Smoking may not cause back pain, but use of tobacco seems to increase the risk of developing back pain. Another good reason to not start or to stop if you already start.     7 surprising reasons to be smoke free
  • Excess weight also contributes to back problems,maybe by putting more stress on the spine, or by limiting physical activity. Losing those extra pounds or kilograms may decrease pain. Obesity and pain- you can lose both this year

 

sign says NO smoking, wilderness area
When walking, wear proper shoes; and NO smoking.

 

 

Physical activity/Exercise for spine pain

All guidelines for back pain treatment encourage continued physical activity rather than bedrest, and agree than any activity is better than nothing.

a bed in a room
Rest in bed only for severe pain and for short intervals.

Some of the frequently recommended activities include

Meditative movement therapies are exercises that include body movement or positioning and focus on breathing and relaxation. Examples include Tai chi and yoga.

Other types of exercises which involve a combination of stretching and strengthening, as well as aerobic conditioning. This includes Pilates and other exercise, walking, jogging, dancing, swimming, and many sports.

jogging trail sign
Get up and move more.

When using any exercise to treat back pain you should consider working with a certified instructor who is aware of your condition. Don’t do any positions or movements that cause or aggravate the pain.

 

 

 

 

 

Topical therapies

    • Heat and/or ice applications
    • Hydrotherapy or aquatics – the use of water or an aquatic environment (includes exercise in water)

 

 

 Manual therapy

  • Massage
  • Spinal manipulation, osteopathic or chiropractic

 

 

Acupuncture/Acupressure

Acupuncture, a staple of traditional Chinese medicine, which is becoming more popular in the Western world, uses very fine needles to stimulate various pressure points around the body and re-shift the body’s balance of energy. The practice is also thought to improve blood flow and increase levels of the body’s natural pain-relieving chemicals. Acupressure uses the same principle with pressure instead of needles.

 

 

An acupressure mat (affiliate link)

 

 

Dr. Michelle Ramirez explains more about  acupuncture and its uses at this link.

A look at acupuncture

 

 

 

Mindfulness based stress reduction/CBT(cognitive behavioral therapy)

Does the way you think affect pain? Apparently so. Studies show that “mind-body” approaches that reduce stress and enhance relaxation can reduce functional limitations and distress from back pain.

WebMD explains how this works-

“Cognitive behavioral therapy (CBT) is a form of talk therapy that helps people identify and develop skills to change negative thoughts and behaviors.

CBT says that individuals — not outside situations and events — create their own experiences, pain included.

And by changing their negative thoughts and behaviors, people can change their awareness of pain and develop better coping skills, even if the actual level of pain stays the same.”

Managing Chronic Pain: A Cognitive-Behavioral Therapy Approach

 

 

 

 

 

The North American Spine Society offers

10 Tips for a Healthy Back

feet in sports shoes
Don’t let back pain keep you from  being active and enjoying life.

 

 

 

 

 

 

 

 

The product links in this post are for illustration only, and do not imply endorsement.

Please share this post on social media and follow this blog.

In a future post I will talk about how to manage other types of pain, and use of non-drug treatments for other conditions.

exploring the HEART of health with you.

    Dr. Aletha  

 

 

 

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Encouraging Hearts and Home
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This affiliate link can help you get fit at home on your own terms. I am enjoying working out with the Aaptiv trainers. Give it a try.