The Vast Field of Pain Management
For many of us, pain is merely an unpleasant but rare experience that is a temporary inconvenience stemming from a passing illness or slight injury. We might burn our hand on the stove on Monday, but by Friday the stinging has gone and the redness has faded from our skin. Yet, pain is not bound to these temporary and inconsequential terms for all. Indeed, a vast number of us suffer from pain stemming from injury or illness that does not fade with the passing of time. Those of us who suffer such chronic pain know all too well how difficult and exhausting it can be to live with and try to manage pain. Even more frustrating than living with chronic pain can be attempting to find relief through treatment. For many, medication does not sufficiently alleviate the symptoms of chronic pain, perhaps only marginally improving patients’ quality of life while potentially putting them at risk for the side effects of such medication.
Fortunately, there are a multitude of alternative therapies available to sufferers of chronic pain that may provide opportunity to further alleviate pain and potentially increase function. Chronic pain treatments can range from the more obvious routes of medication, exercise and surgery to more alternative treatments like acupuncture and pet therapy. All of these treatments, and many more besides, can be effective in alleviating the symptoms of chronic pain in some patients. Yet, according to the American Chronic Pain Association (ACPA), none of these treatments are nearly as important as chronic pain education. Indeed, the ACPA states that education and “active interventions are some of the best medicine for chronic pain because they engage the individual in learning and making positive changes to increase function and reduce pain.”1 Learning the extent to which pain is likely to be managed provides patients with attainable goals and destroys the potential for disappointment from unrealistic expectations. Providing education about a patient’s chronic pain to family and friends also provides a support system to the patient that will allow for better emotional care and more comprehensive medical care.
Without a proper education on their chronic pain and the variety of treatment types available to them, patients may feel they have no choice but to take potentially addictive and expensive medications for pain relief. Educating those who suffer from chronic pain on all treatment possibilities and the limitations of such treatments provides further opportunity for healing and may relieve the frustration of being limited to medication alone for treatment.
Therapies that are alternative to biomedical therapies like surgery and medication can be divided into three groups: psychological treatments, physical therapy and complementary alternative medicine (CAM) therapies. Cognitive behavioral therapy (CBT) is one of the more common types of psychological treatments for chronic pain sufferers. The goal of CBT for chronic pain patients is to help understand the thoughts and emotions that may arise as a result of dealing with pain for a long period of time. Many sufferers of chronic pain experience negative thoughts and emotions related to their pain. Experiencing persistent negative thoughts can cause patients to experience pain more strongly, according to the American Chronic Pain Association. Through CBT, it is possible for patients to gain skills to help them cope with negative thoughts and emotions related to their pain. Therapists treating chronic pain patients may utilize a variety of tools to help patients communicate where their pain is, how persistent it is and how it is affecting them emotionally. Pain maps and conversation guides may be used to help patients communicate more effectively than conversation alone.5 Improvement in sleep and behavior are just a couple of the potential positive effects of CBT on such patients.2
Physical therapy can be divided into two subcategories: passive therapies and active therapies. Active therapies involve muscle and joint movement and include treatments like exercise and stretching, sometimes with the help of a physical therapist. Also known as exercise therapy, active therapy allows patients to regain muscle strength and flexibility, which can increase overall function. Exercise therapy can be performed with a physical therapist or independently. In either case, the patient must actively move, which can be a daunting task for some sufferers of chronic pain.6 Passive therapies, on the other hand, do not require patients to actively move. These include treatments such as acupuncture and massage therapy.3 Acupuncture involves the insertion of small needles into points in the body. It is clinically supported as an effective treatment option for the alleviation of symptoms of a variety of diseases.7 For acute cases of pain, ultrasound can be used as a passive therapy. Ultrasound therapy utilized ultrasound waves at relatively low frequencies applied to parts of the body, most commonly in order to alleviate nerve pain.8
Finally, CAM therapies are generally utilized by patients in concert with other types of therapies, whether it be with medication, physical therapy, CBT or a combination of the three, to augment “traditional medical treatment.” 2 Though many CAM therapies may not be considered traditional, this does not mean that they are not scientifically valid. Indeed, a variety of CAM therapies have been scientifically validated. 1 For example, according to the National Center for Complementary and Integrative Health (NCCIH), “Recent studies in people with chronic low-back pain suggest that a carefully adapted set of yoga poses may help reduce pain and improve function (the ability to walk and move).”4 Yoga, of course, is not the only CAM therapy option available to patients wishing to pursue this path of treatment. Spinal manipulation is another popular CAM therapy. A physical therapist or chiropractor may administer techniques of massage, joint manipulation and spinal control to alleviate back, neck and head pain.9
A comprehensive guide to alternative therapies, as well as biomedical therapies, is available for free at the ACPA website. 1 Patients considering new approaches to their chronic pain are advised to first consult their physician before beginning any new treatment. Though not every therapy will give satisfactory results to every sufferer of chronic pain, with determination and education about pain management it is possible to approach pain with efficiency, positivity and hope.