48 Alternative Therapies to Help Lower Pain Levels

By Barby Ingle, Columnist

A year ago, I began this series of columns on alternative therapies for chronic pain management. There are so many different treatments, we presented many of them by letter – the 4 A’s, the 4 C’s, the 4 E’s, etc. This is my final column in the 12-part series.

In all, we covered 48 different treatment options. But we only scratched the surface. There are literally hundreds of alternative pain therapies and I've tried many of them myself. Many didn’t help me or provided only minimal relief. But I know of others who received great benefits from them.

This final month I am spotlighting trigger point injections, virtual reality, yoga and the yucca plant.

Trigger Point Injections

Trigger point injections can be beneficial in treating myofascial pain syndromes. That is when a patient has chronic musculoskeletal pain in specific parts of a muscle where a knot has formed due to inflammation. This is known as the “trigger point.” Steroids or analgesics (or both) are injected into the trigger point area to get the knot to release and the muscle to relax.

I have had trigger point injections done on my wrist and shoulder at various times. Although it was helpful long-term for my wrist injury, which occurred prior to my developing reflex sympathetic dystrophy, it was not as helpful with managing the RSD symptoms in my shoulder.

I could usually feel the muscle knots under my skin, but that was not always the case. I would also get a twitching response, which my doctor first thought was a sign of low calcium.  But after ruling that out, he realized that it was tight muscle fibers and inflammation.

There are risks with any type of injection. The injection or solution can cause damage to the skin and small nerve fibers, or cause infections and bleeding. If you think that trigger point injections could help, talk with your doctor first to find out if this would be a good option for you.

Virtual Reality

Virtual reality (VR) has been used in different forms of pain management since 1996. It operates under the theory that pain perception can be reduced by refocusing the patient’s attention away from their pain. Typically, that means wearing a headset or goggles that provide a 360-degree view while watching a realistic video or animated game.

AppliedVR in Los Angeles is developing a variety of virtual reality content to help treat pain, depression and anxiety. To give you an idea how it works, watch this promotional video by the company:

VR was first used to alleviate severe pain in patients treated at a burn center in Seattle, Washington. Since then, it has shown to be effective in treating acute pain in hospitals or when patients undergo lengthy testing procedures and need a distraction. I am hearing more and more from providers that VR can help lower the need for medication. 

VR is a fun activity that my husband and I have both tried. We quickly realized that it had therapeutic benefits and helped me to relax and keep my mind focused during long MRI’s and infusions. Like most therapies, the benefits of VR are usually short term. But VR is a promising field that is likely to improve as technology and personalized experiences are brought together in practice. 

Yoga 

Yoga is a mind-body exercise that uses controlled breathing, meditation and movements to stretch and strengthen your body. There are several types of yoga and people have been using yoga moves and thinking for thousands of years. The emphasis for all of them is on treating the mind and body equally.

Yoga can be used for pain relief for many types of chronic conditions, but patients must be cognizant of not pushing themselves into a flare by doing too much at one time. 

One study found that patients with chronic low back pain who took a weekly yoga class increased their mobility more than standard care like physical therapy. Other studies have shown that yoga is comparable to exercise therapy in relieving symptoms from arthritis, fibromyalgia and migraine. 

I have been using yoga in modified positions to strengthen myself. I don’t push myself too hard, because when I did I found myself in a pain flare. But when I go slow and easy, I find that it helps me build strength. For example, I will do the moves in a chair instead of on the floor and skip certain positions that may aggravate my pain. 

Practicing yoga has also helped with my mood, positive thinking and overall well-being. A typical yoga session lasts 45-90 minutes; mine are shorter, about 15-20 minutes at a time. Many people will go to a yoga class, but I do it at home using routines that I modified. Each session usually begins with deep breathing exercises that help me relax and lower stress levels. Then I use a series of yoga positions that are either seated, standing or laying down. Some positions are done quickly and others are held for a few minutes. If it starts to get too much for me, I stop or take a break.

At the end of the yoga session, I go back to breathing and mediation exercises to cool down. Be sure to modify your yoga to fit your needs. Doing some movement and breathing is better than nothing, even if it’s only a few minutes each day.  

Yucca

The Yucca is a plant with more than 40 species that typically grows in desert regions. It is used to make medicines for many conditions, including migraines, headaches, gastrointestinal disorders, osteoarthritis, high blood pressure, diabetes, vascular constriction, and more. 

Yucca medications are applied directly to the skin, made into extracts, or used in carbonated beverages. Some Yucca compounds have even been used in the manufacture of new medications. 

I first heard about the use of Yucca derivatives to treat pain while on a tour of the Desert Botanical Gardens in Phoenix, Arizona. That was where I found out that the Yucca can be used to treat sores, bleeding, sprains and joint pain. My husband is almost bald, and they suggested some people even use it for baldness. 

Researchers have found several Yucca compounds that are similar to anti-inflammatory medications.  Some of the chemicals in Yucca can also help reduce blood pressure or control cholesterol levels. For me, it helps reduce osteoarthritis symptoms by lowering the aching pain, swelling and stiffness I deal with. 

The Yucca plant is native to the southwest United States, where I currently live, as well as Mexico. Around here it is common for people to use the bark and root of the Yucca as a dietary supplement to promote joint health. There are even Yucca products on the market for treating pain in horses, dogs and other animals.

Be Open Minded

My alphabet series on alternative pain management is meant to spark ideas and discussion about treatments that you may not have known about before.  Before you try any of them, I encourage and remind you to talk it over first with medical professionals who are familiar with your past and present care. It is important to also remain open minded about your options and only do what you are comfortable with. 

There is no cure yet for chronic pain. So the more proactive we are in managing the symptoms -- even if we don’t get complete relief -- the better off we’ll be. Being positive, hopeful and creative in finding new ways to manage our conditions can help get our pain levels down.  

Want to see the rest my series on alternative treatments?  Here’s where to find them:

• The 4 A’s: acupressure, acupuncture, aromatherapy and art therapy.  
• The 4 C’s: Calmare, Chinese medicine, chiropractic, and craniosacral therapy. 
• The 4 E’s: energy therapy, electromagnetic therapy, equine therapy, and exercise. 
• The 4 F’s: faith healing, Feldenkrais Method, food, and functional medicine. 
• The 4 H’s: hypnotherapy, hyperbaric therapy, holistic living and herbal therapy.
• 4 Infusions: Ketamine, lidocaine, immunogoblins and stem cells.
• The 4 M’s: Mindfulness, magnets, massage and music.
• The 4 N’s: Nerve blocks, nitric oxide, neurotransmitter regulation and nabilone.
• The 4 O’s: oral orthotics, orthomolecular medicine, osteopathy and occupational therapy.
• The 4 P’s: Physical therapy, pain medications, prolotherapy and psychology. 
• 2 R's, a Q and an S: Quell, radiofrequency ablation, reflexology, sonopuncture

As I have stressed in all 12 articles, each of us is different, even if we are living with the same diseases. Your task is to find creative, effective ways to get the pain conditions you live with under control. I look forward to reading what worked and didn’t work for you.

Barby Ingle lives with reflex sympathetic dystrophy (RSD), migralepsy and endometriosis. Barby is a chronic pain educator, patient advocate, and president of the International Pain Foundation. She is also a motivational speaker and best-selling author on pain topics.

More information about Barby can be found at her website. 

The information in this column should not be considered as professional medical advice, diagnosis or treatment. It is for informational purposes only and represents the author’s opinions alone. It does not inherently express or reflect the views, opinions and/or positions of Pain News Network.

4 F’s That Can Help Lower Pain Levels

By Barby Ingle, Columnist

So far in my monthly series on alternative pain treatments, we’ve looked at 4 A’s (acupressure, acupuncture, aromatherapy, art therapy), 4 C’s (Calmare, Chinese medicine, chiropractic, craniosacral therapy) and 4 E’s (energy therapy, electromagnetic therapy, equine therapy, exercise).

I like my alphabet series because it offers pain sufferers a look outside the tool box for therapies they may not have considered. I know that insurance does not cover many of these treatments. And I know that nothing I am suggesting is going to cure anyone, but it may offer some pain relief. I suppose that’s the cheerleader in me -- keep going even if your team is losing and find a way to win.

Looking through the reader comments to my series, I found one from “Fred” that I liked:

"You read many commenters who say, 'I've tried them all, nothing works.' Wrong! There are hundreds, possibly thousands of potential alternative/complimentary pain modalities. Anyone claiming, 'I've done 'em all,' that person would have to be like 150 years old, given the time and dedication many require to show real effectiveness! NO ONE has done 'em all. There's always something left to try."

I want to thank Fred for his comment and to let him know that I agree with him. Far too often we say that we have tried everything and nothing works. But that doesn’t mean we should stop looking or trying.

The four F’s we’ll look at this month are faith healing, Feldenkrais Method, food, and functional medicine. Please contact a trained provider who can clear you before you try any of these suggestions, especially when it comes to movement and nourishment.  

Faith Healing

Faith healing is the practice of prayer or rituals that solicit divine intervention in spiritual and physical healing. This practice can include the “laying on of hands” and miracles.

I personally don’t know anyone who had a full recovery from divine intervention, but I did have a near death experience that taught me some important lessons.

I learned that I needed to have more patience with people and that human connection has a purpose. It helped me see my purpose in life and why I was here on earth. It didn’t take away my physical pain, but it helped me learn how to stay positive through it.

Many others have claimed miraculous recoveries through prayer. According to a Newsweek poll, 72 percent of Americans believe that praying to God can cure someone. I do believe it can happen, I just haven’t seen it yet.

In a report on faith healing, the American Cancer Society tells us that "available scientific evidence does not support claims that faith healing can actually cure physical ailments" and warns that "death, disability, and other unwanted outcomes have occurred when faith healing was elected instead of medical care for serious injuries or illnesses."

When parents have used faith healing instead of medical care, some children have died that otherwise would have been expected to live. Similar outcomes are found in adults who rely solely on faith healing.

I continue to say my daily prayers and remain a believer that all things are possible, even if I haven’t seen it yet personally. But I will continue with my other treatment options.  

Feldenkrais Method

The Feldenkrais Method is a type of exercise therapy devised and named after Moshé Feldenkrais. The method is claimed to reorganize connections between the brain and body, and to improve body movement and the psychological state.

I am a big believer in these techniques, used by Dr. Victor Pedro, who treats multiple friends of mine. I have seen them go into remission and remain well for years, although this treatment is not cost-effective for many.  

Supporters of the Feldenkrais Method claim it can repair impaired connections between the motor cortex and the body, which benefits body movement and improves their sense of well being. They also believe that it can be helpful with many pain conditions such as autism and multiple sclerosis. 

The Feldenkrais Guild of North America claims that this treatment option allows people to rediscover their innate capacity for graceful, efficient movement and that these improvements will often enhance function in other aspects of life. The treatment consists of repetitive movements with proper body alignment, done with or without a provider.

You can watch many videos online to learn and practice the Feldenkrais Method of exercise. Here is a sample:

Food

The food that we put in our bodies is one of the underlying causes of inflammation, which increases chronic pain. This is also one area that we have complete control over and don’t need insurance to cover.

I myself have used a low-carb, high fat diet – known as the ketogenic or paleo diet -- to help lower inflammation and lose weight. I thought the diet was going to be much more expensive, but it turned out costing about the same as what I was spending on my regular food budget.

I also discovered I was not as hungry or constantly looking for snack foods as I was when I was eating my regular “American” diet. We underestimate how inflammation plays a major role in chronic pain. Knowing what foods can increase inflammation can make a big difference in how we manage pain.

One of the things I have done with my diet is add some “super foods.” Several research studies have shown that the compounds in these natural foods can reduce inflammation and even block pain signals. Research also shows that super foods can increase brain chemicals, such as serotonin, which can stop depression and make you feel happier.

The super foods that you could add to your diet to deal with chronic pain naturally include burdock root, hot peppers, yogurt, fresh ginger root, cannabis, turmeric, fenugreek leaves, onions, strawberries, garlic, olive oil, and salmon.

For more information on the ketogenic diet, I suggest reading Quick & Easy Ketogenic Cooking by Maria Emmerich.

Functional Medicine

I believe functional medicine (FM) is the future of conventional medicine. In FM, the provider works to address the root cause of disease and views the body as one system, not a collection of independent organs to be treated separately. This type of care lets us focus on treating the whole body, not just the symptoms.

I have had providers who were specialists who only looked at one body part or organ and were not willing to consider that it was all interlinked. Finding providers who believe in FM was very important to me. Having this patient centered approach to my care helped me be my own best advocate and helped my providers do a better job getting me into a state of remission and controlled pain levels.

My providers spend time with me, between 45 to 90 minutes per visit. We go over my medical history, genetic vs. environmental aspects, and lifestyle factors. I love functional medicine because it helps support individualized treatment.

With the sharp increase in people who have one or more chronic illnesses such as diabetes, heart disease, mental illness, autoimmune disorders and  cancer, we need a system of care that puts the spotlight on everyone as a whole person.

The old way of practicing medicine is going out the window. We need to demand that all providers are on board with FM practices. We no longer want to be cookie cutter patients. We each need a unique approach to our care, and it is possible with better training for providers, research, and patient engagement.

Most providers are not adequately trained to assess the underlying causes of chronic diseases. Most can’t even adequately provide strategies such as nutrition, diet and exercise to treat and prevent future illnesses in their patients.

As patients we must push for FM and a more holistic approach. Finding a provider who is trained in FM involves them understanding disease origins, prevention, and treatment of chronic illnesses. With FM the unique genetic and environment of each patient is considered and an integrative, science-based care approach is employed using both traditional and alternative treatment options. As we focus on both internal (mind, body, and spirit) and external (physical and social environment) we will see greater improvements with our health, life and overall ability to function.

Do you have any suggestions? What alternative pain therapies have you tried that succeeded?  The more we share, the more others can see what they are able to do, what new treatments are available, and what old ones they may have overlooked.

Barby Ingle lives with reflex sympathetic dystrophy (RSD), migralepsy and endometriosis. Barby is a chronic pain educator, patient advocate, and president of the International Pain Foundation. She is also a motivational speaker and best-selling author on pain topics.

More information about Barby can be found at her website.

The information in this column should not be considered as professional medical advice, diagnosis or treatment. It is for informational purposes only and represents the author’s opinions alone. It does not inherently express or reflect the views, opinions and/or positions of Pain News Network.

The Four E’s That Can Help Lower Pain Levels

By Barby Ingle, Columnist

Continuing with my series on alternative pain therapies, I find it interesting that those who have not tried the treatments I cover are often the most vocal about whether they help or not. 

I want to remind readers that I am not suggesting that these are cures for any chronic pain condition, but more a way to possibly lower pain and stress levels, and increase daily activities. 

Also, please consider that pain can be bio-psycho-social in nature and may not always have a physical cause. I work with over 150 conditions in my advocacy work, and have learned that not all patients -- even with the same diseases -- respond to the same treatments. Most of the people I know that are in remission or have learned to lower or manage their pain levels are using multiple techniques and treatment options. 

The four E’s I will introduce you to are energy therapy, electromagnetic therapy, equine therapy, and exercise. 

Energy Therapy

Energy therapies, such as therapeutic touch and magnetic healing, are commonly referred to as bio-field therapies in the alternative medicine area. Supporters of these therapies believe “energy fields” flow through and around our bodies, and that when energy is flowing freely we have good emotional, physical and spiritual health. When the energy field is blocked, we become ill.

In therapeutic touch, also known as Rieke, attendants use their hands to find “blockages” and touch the patient at the blockage sites to remove the harmful energy, replacing it with their own healthy energy. In magnetic healing, the therapist places magnets at the blockage sites.

I tried an energy therapy session once and was actually in more pain when the therapist stopped than when she started.  I remained fully clothed and lay down on a massage table as the therapist moved her hands just above my body.  Because I have Reflex Sympathetic Dystrophy (RSD) and parts of my body are very sensitive, I choose the version with no touch. 

It didn’t work for me and I was told it was because the therapist didn’t follow my energy field properly. I was stressed the whole time, worried that she was going to touch me and how painful it would be. 

Energy therapy is mainly used to ease symptoms such as anxiety, fatigue, pain, nausea or vomiting. Some believe it even improves quality of life. Many people say that they feel more relaxed, calm and peaceful after an energy therapy session. I was afraid the whole time, so I didn’t get this effect. 

Some studies suggest that energy therapies work because the person experiences the focused and caring presence of a therapist, rather than a change in energy flow. More research is needed to understand the effectiveness of energy therapy, but if you are looking for a way to help lower stress and relax, this maybe a choice for you.  

Electromagnetic Therapy

Proponents of electromagnetic therapy (ET) claim that by applying low frequency electromagnetic radiation to your body that it can help lower pain levels, promote cell growth, improve blood circulation and bone repair, increase wound healing, and enhance sleep.

I tried this therapy for three months with an ET mat that I would lay on for an hour each day. The heat from the mat was relaxing and helped my circulation, but I can’t say that it worked any better than a heating blanket.

The practitioner who had me try the mat said that it could help with a wide range of symptoms and conditions, such as headaches, migraines, chronic pain, nerve disorders, spinal injuries, diabetes, arthritis, and heart disease. I think due to the increase in blood flow from the heated mat that I did get some temporary and slight pain relief.

The National Institutes of Health says there is a lack of scientific evidence about electromagnetic therapy and the American Cancer Society warns that "relying on electromagnetic treatment alone and avoiding conventional medical care may have serious health consequences." 

Equine Therapy

As the name implies, equine therapy makes use of horses (and sometimes elephants, cats, dogs and even dolphins) to help promote emotional growth. It helps to try it with an animal that can mirror human behavior. A horse is considered most effective because it can respond immediately and give feedback to the patient’s actions and behaviors.

Last year the movie "Unbridled" was released and it covered this type of therapy for physical and emotional pain. The movie is unforgettable and an uplifting story of redemption, healing, and overcoming some of life’s greatest obstacles. 

Equine therapy is usually offered for patients with attention deficit problems, anxiety, autism, dementia, delays in mental development, Downs’s syndrome, depression, trauma and brain injuries, behavior and abuse issues, and other mental health issues. 

The reason why eqine therapy has been recognized as an important area in the medical field is that some horse riders with disabilities have proven their remarkable equestrian skills in various national and international competitions. The basis of the therapy is that because horses behave similarly to humans in their social and responsive behavior, it is easier for patients to establish connection with a horse. 

I think this is an interesting concept when it comes to emotional pain. Although I haven’t done equine therapy myself, I have been intrigued over the years with the idea. That said, caring for a dog was hard for me and I can’t imagine taking care of a horse. 

Exercise

I think the word “exercise” has many different connotations for every person who hears it. Before starting any exercise program, precautions are needed to make sure you can do physical activities without further damage to your body. I have experienced unpleasant and painful exercise, which only served to make my pain worse. 

I have found that there are some exercises that are better for me than others. For instance, I can walk now for a few minutes each hour. That is more than I have done in years and I had to work my way up to it. Other pain friends can do a moderate program on stationary bicycles for 30 minutes at a time a few times a week. 

I have one friend who is doing full weight bearing activities. It causes her flares, yet she chooses to keep pushing her body until she reaches a crash. 

Please be sure to consult with a doctor before starting to exercise. Some studies suggest that moderate amounts of exercise can change your perception of pain and help you better perform activities of daily living.

It’s important to keep an open mind on what can help lower pain levels. There is no single technique or one size that fits all. From my own experience of living 20 years with chronic pain, I have explored many different options and done a fair amount of research before deciding if they were right for me to try. 

Using a multiple modality approach is often key to lowering pain levels. Nothing I have tried has been a cure, but many did help in some way.

Whether it’s one of the 4 E’s or a combination of treatments, I hope you find what helps give you a better life and that you will have continued access to it while we continue our quest for a cure.

Barby Ingle lives with reflex sympathetic dystrophy (RSD), migralepsy and endometriosis. Barby is a chronic pain educator, patient advocate, and president of the International Pain Foundation. She is also a motivational speaker and best-selling author on pain topics. More information about Barby can be found at her website. 

The information in this column should not be considered as professional medical advice, diagnosis or treatment. It is for informational purposes only and represents the author’s opinions alone. It does not inherently express or reflect the views, opinions and/or positions of Pain News Network.

The Four C’s That Can Help Lower Pain Levels

By Barby Ingle, Columnist

I hear more than ever from others living with chronic pain that they “have tried everything” and nothing helps. But there are always new pain therapies being developed or improved; some real, some placebo, and some researched more than others. 

I personally don’t believe that there is any one treatment that cures or fixes anyone, but there are many that can help take the edge off the pain we are feeling. I also recognize that some options are not right for some people or contraindicated for certain conditions. There is no one-size-fits-all treatment for chronic pain.

Last month we looked at four alternative therapies that start with the letter “A” (acupressure, acupuncture, aromatherapy and art therapy). This month the spotlight is on four therapies that start with “C” – Calmare, Chinese medicine, chiropractic, and craniosacral therapy. 

Calmare Therapy

Calmare is a relatively new treatment that is becoming more popular. I have tried it myself, and while it was not a long-term useful tool for me, I do know others who have received major benefit and relief from it.

Calmare Therapy, also known as scrambler therapy, is a non-invasive, drug-free solution for neuropathy and other conditions that cause nerve damage. I think of it as TENS unit on steroids. 

Duringtreatment, small electrodes are placed on the skin, which are connected by wires to a box-like device. Electrical pulses are transmitted to the body, like little electric shocks. This can help block pain signals in some people with certain types of chronic pain.

The provider I hear about the most having success with this form of treatment is Dr. Michael Cooney, a chiropractor practicing in New Jersey who sees patients from all over country.

Cooney wrote a guest column about Calmare for PNN a few months ago, where you can learn more about the treatment and how it works.

Chinese Medicine

When people think about Chinese Medicine (CM), many just think of acupuncture, but CM is more than just one modality. It involves a broad range of traditional medicine practices which were developed in China over 2,000 years ago, including various forms of herbal medicine, massage, exercise and dietary therapy.

One of the basic tenets of CM is that the body's vital energy (chi or qi) circulates through channels called meridians, which have branches connected to bodily organs and functions.

CM is being used more and more in American pain treatment as an alternative to Western medical practices. Only six states (Alabama, Kansas, North Dakota, South Dakota, Oklahoma, and Wyoming) do not have legislation regulating the professional practice of CM. 

Be sure to tell all your healthcare providers about any complementary health approaches you use, as it is important to give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care, which is important with more than a million Americans using forms of CM. 

The prices of traditional CM vary, depending on the practitioner and the region. Usually an initial herbal consultation ranges from $30 to $60, and follow-up consultation costs around $30. A month's supply of herbs may cost $30 to $50, but it’s a good value if it helps lower your pain levels, stress and helps regulate your neuro-inflammation.

Chiropractic

Chiropractic care is a harder subject for me. I have had positives and negatives with this treatment and with different practitioners. For the most part, my insurance has covered this type of care, but for many insurance policies it is not covered at all or it only pays for a few appointments a year. 

Chirporactic sessions can range from $34 to $106, depending on where you live, how many areas of the spine the chiropractor services, and whether more extensive exams are required.

This form of alternative care typically treats mechanical disorders of the musculoskeletal system with an emphasis on the spine, although I have had chiropractors adjust my hips, feet and shoulders. 

Chiropractic care is somewhat controversial with mainstream practitioners, including some who believe it is sustained by pseudo-scientific ideas such as subluxation and "innate intelligence" that are not based on sound research. In my own reviews of studies on chiropractic manipulation, I have not found evidence that it is effective long term for chronic pain, except for treatment of back pain.

However, chiropractic care is well established in the U.S. and Canada as a form of alternative treatment. It is often combined with other manual-therapy professions, including massage therapy, osteopathy and physical therapy.

Craniosacral Therapy

Craniosacral therapy (CST) takes a whole-person approach to healing, and the inter-connections of the mind, body and spirit. Practitioners say it is an effective form of treatment for a wide range of illnesses, and encourages vitality and a sense of well-being. Because it is non-invasive, it is suitable for people of all ages, including babies, children and the elderly. 

The intent of CST treatment is to enhance the body's own self-healing and self-regulating capabilities. This is done as the practitioner gently touches areas around the brain and spinal cord, which helps improve respiration and the functioning of the central nervous system. 

CST practitioners say it can help temporarily relieve a vast number of issues, including migraines and headaches, chronic neck and back pain, stress and tension-related disorders, brain and spinal cord injuries, chronic fatigue, fibromyalgia, TMJ syndrome, scoliosis, central nervous system disorders, post-traumatic stress, orthopedic problems, depression, anxiety and grief. 

Treatment costs range between $100 and $200 per session, and patients typically attend multiple times when chronic pain issues are being addressed. Some health insurance policies will cover CST.

Do I believe that CST will take pain away? No. But do I think it is a mindfulness tool that can help temporarily. Did it work for me? No, but it was worth a try since it is non-invasive. 

Again, I am spotlighting alternative therapy ideas that can help lower or reduce chronic pain.. Typical pain patients, including myself, find that it takes a variety of treatments to get pain levels low enough to consider it significant relief. The fact that they are treatments and lifestyle changes – and not cures -- is important to remember. 

I'd like to know if you've tried these methods and if they worked or didn’t work. The more we share our ideas and experiences, the better off others in pain will be in understanding different treatment options. 

Over the next few months I will spotlight more than 70 alternative treatments. Please only try what you are comfortable with and don’t put down others who are willing to try what they are interested in. 

Barby Ingle lives with reflex sympathetic dystrophy (RSD), migralepsy and endometriosis. Barby is a chronic pain educator, patient advocate, and president of the International Pain Foundation. She is also a motivational speaker and best-selling author on pain topics. More information about Barby can be found at her website. 

The information in this column should not be considered as professional medical advice, diagnosis or treatment. It is for informational purposes only and represents the author’s opinions alone. It does not inherently express or reflect the views, opinions and/or positions of Pain News Network.

Patients Say Non-Opioid Therapies Often Don’t Work

By Pat Anson, Editor

Pain treatments recommended by the Centers for Disease Control and Prevention (CDC) as alternatives to opioids often do not work and are usually not covered by insurance, according to a large survey of pain patients.  Many also believe the CDC’s opioid prescribing guidelines discriminate against pain patients.

Over 2,000 acute and chronic pain patients in the U.S. participated in the online survey by Pain News Network and the Power of Pain Foundation. Most said they currently take an opioid pain medication.

When asked if they think pain patients are being discriminated against by the CDC guidelines and other government regulations, 95% said they “agree” or “strongly agree.”  Only 2% said they disagree or strongly disagree.

The draft guidelines released last month by the CDC recommend “non-pharmacological therapy” and “non-opioid” pain relievers as preferred treatments for chronic non-cancer pain. Smaller doses and quantities of opioids are recommended for patients in acute or chronic pain.  A complete list of the guidelines can be found here.

“Many non-pharmacologic therapies, including exercise therapy, weight loss, and psychological therapies such as CBT (cognitive behavioral therapy) can ameliorate chronic pain," the CDC states in internal briefing documents obtain by PNN.

DO THE CDC GUIDELINES AND OTHER GOVERNMENT REGULATIONS DISCRIMINATE AGAINST PAIN PATIENTS?

“Several nonopioid pharmacologic therapies (including acetaminophen, NSAIDs, and selected antidepressants and anticonvulsants) are effective for chronic pain. In particular, acetaminophen and NSAIDs can be useful for arthritis and low back pain, and antidepressants such as tricyclics and SNRIs as well as selected anticonvulsants are effective in neuropathic pain conditions and in fibromyalgia.”

Most patients who were surveyed said they had already tried many of these non-opioid treatments and had mixed results, at best.

“Does the CDC really believe that a pain patient on long term opiates hasn't already tried everything else possible?” asked one patient.

“The CDC says don't do something but comes up with NO viable, realistic alternatives. Tylenol, etc., are unrealistic. Exercise is unrealistic when you are in too much pain to move! “ said another patient.

“Anti-anxiety meds are just as addictive. Over the counter pain medicines are not strong enough to cover the pain in a patient with chronic pain. And there are hundreds of pain patients who can't take NSAIDs because of an allergic reaction. Same thing with steroids,” wrote another.

When asked if exercise, weight loss or cognitive behavioral therapy had helped relieve their pain, only about a third of the patients surveyed said they “helped a lot” or “helped a little.” Nearly two-thirds said they “did not help at all.”

Over half said non-opioid medications such as Lyrica, Cymbalta, Neurontin, anti-depressants and anti-anxiety medications “did not help at all.”

Over the counter pain relievers such as acetaminophen and NSAIDs were even less helpful. Three out of four patients said they “did not help at all.”

“We must be mindful of the treatment options that the CDC guidelines stress over opioids,” said Barby Ingle, president of the Power of Pain Foundation. “For instance in my case, taking NSAIDS for an extended period (a little over 1 year) caused internal bleeding and ulcers which lead to being hospitalized, a surgical procedure, and months of home nursing and physical therapy that could have been avoided.

HAVE EXERCISE, WEIGHT LOSS, OR COGNITIVE BEHAVIORAL THERAPY HELPED RELIEVE YOUR PAIN?

“It is important to include a multi-disciplinary approach to care. We have to use non-pharmacological treatments and non-opioid medications in conjunction with more traditional treatments. Using chiropractic care, nutrition, good dental health, better posture, meditation, aqua therapy, etc., can go a long way in the management of chronic pain conditions.”

But the survey found that many of those treatments are simply out of reach for pain patients because they’re not covered by insurance.

When asked if their health insurance covered non-pharmacological treatments such as acupuncture, massage and chiropractic therapy, only 7% said their insurance covered most or all of those therapies.

About a third said their insurance “covers only some and for a limited number of treatments” and over half said their insurance does not cover those treatments. About 4% do not have health insurance.   

“I tried acupuncture and massage, paying out of my pocket, but neither helped. In fact, they hurt. I tried Lyrica, Savella, and Cymbalta. No luck. I do warm water aerobics three days a week WHEN I CAN TAKE MY OPIATES FIRST,” wrote one patient.

Although the CDC didn’t even raise the subject of medical marijuana in its guidelines, many patients volunteered that they were using marijuana for pain relief and that it worked for them.

DOES YOU INSURANCE COVER ALTERNATIVE TREATMENTS SUCH AS ACUPUNCTURE, MASSAGE AND CHIROPRACTIC THERAPY?

“Alternative medicine is needed. I am a huge advocate of medicinal marijuana, in addition to opioids to treat my disease,” wrote a patient who suffers from CRPS (Chronic Regional Pain Syndrome).

“If cannabis was legal and accessible, it would greatly lessen the need for prescription pain medication,” said another patient.

“I should be able to get the proper medical marijuana legally. I have tried it from a friend and it helps tremendously. However, I will not purchase it because it is illegal. I pray every day I can get it someday,” said a patient who suffers from lupus, arthritis and other chronic conditions.

The survey found patients were evenly divided on whether they should be required to submit to urine drugs tests for both prescribed medications and illegal drugs.

"In order to receive my monthly pain medication, I must submit to a urine screen and a pill count each and every month. I must (whether they work or not) agree to have steroid injections every few months. While I don't have any problem to submitting to urine screenings or pill counts, I do not like having injections that provide no help. I am trapped playing this game,” said a patient.

“99.9% of pain patients are responsible adults but are treated like toddlers who need constant supervision. Pain patients are sicker, fatter, and poorer because they are pumped full of chemicals and steroids. Forced to be experimental guinea pigs or forced to suffer if they say NO,” said another patient.

DO YOU THINK PATIENTS PRESCRIBED OPIOIDS SHOULD BE REQUIRED TO HAVE URINE DRUG TESTS?

"As both a chronic pain patient and a provider I get to view this issue from multiple perspectives. Of course opioids aren't the first line treatment for chronic pain, and when they are used they shouldn't be the only treatment. They are one part of a larger toolkit for managing chronic pain," wrote a registered nurse practitioner.

"There are many fortunate people who are able to manage their pain without medication, or even recover from pain completely using some of the wonderful new interventions we now have available. But there are large numbers of patients out there who have tried all the other medications and dietary changes and injections and PT (physical therapy) modalities and mindfulness. And they are still left with pain that only responds to opiates."

For a complete look at all of the survey result, visit the "CDC Survey Results" tab at the top of this page or click here.

Most Pain Patients Use Alternative Therapy (Video)

By Pat Anson, Editor

A large new study of chronic pain patients found that over half were using chiropractic care or acupuncture for pain relief, but many didn’t discuss their use of alternative therapy with their primary care providers.

Researchers surveyed over 6,000 patients in Oregon and Washington State who were Kaiser Permanente members and had three or more outpatient visits for chronic pain in 18 months.

The study, published in the American Journal of Managed Care, found that 58 percent of the patients had used chiropractic care, acupuncture, or both.

Over a third (35%) of the pain patients who had acupuncture never told their doctor, while 42% who had chiropractic care didn't talk to their providers about it. Almost all of the patients said they would be happy to share this information if their doctor had asked.

"Our study confirms that most of our patients with chronic pain are seeking complementary treatments to supplement the care we provide in the primary care setting," said Charles Elder, MD, lead author of the study and affiliate investigator at the Kaiser Permanente Center for Health Research. "The problem is that too often, doctors don't ask about this treatment, and patients don't volunteer the information.

"We want our patients to get better, so we need to ask them about the alternative and complementary approaches they are using. If we know what's working and what's not working, we can do a better job advising patients, and we may be able to recommend an approach they haven't tried,” said Elder, who is the lead physician for Kaiser Permanente's complementary and alternative medicine program.

The majority of the patients in the study (71 percent) were women, and the mean age was 61. Most suffered from back pain, joint pain, arthritis, neck and muscle pain, or headache.

The study was funded by a grant from the National Center for Complementary and Integrative Health.

A video report on the study that was produced by Kaiser Permanente can be seen here:

One-hundred million Americans suffer from chronic pain every year, and many of them turn to alternative therapies for relief. In fact, a new study shows that more than half of patients with chronic pain enrolled in a managed care setting use chiropractic care or acupuncture.