Drug-free ways to cope with chronic pain

Pain is supposed to be a good thing: it warns us of an injury, infection or serious illness. However, it’s isn’t so helpful when it never goes away .

Chronic pain — which can last from a few months to an entire lifetime — comes from many causes, from migraines to cancer, and can linger years after an injury or illness. It can disturb sleep, cause depression and anxiety, zap the libido, strain relationships and can even affect memory and cognitive functioning. It’s a top cause of disability, and it robs sufferers of quality of life.

Usually, the first defense against this menace is medication, but drugs alone often aren’t enough and they carry risks for side effects ranging from stomach upset to addiction. Today, more people are turning to complementary and alternative medicine (CAM) therapies as part of their pain management plan.

While different therapies work for different conditions and types of pain, research is showing promise in many areas. Here’s a quick overview of some of today’s non-drug therapies.

Ways to ease the pain

Acupuncture. Science is slowly catching up with this ancient practice, though experts still haven’t figured out why inserting needles into the skin helps to ease conditions like fibromyalgia, back pain and injuries. Some experts think acupuncture blocks pain signals or stimulates the body to release its own pain-numbing chemicals. Studies have shown that patients receiving acupuncture reported less pain when being treated for migraines or injuries than people who were on standard treatment plans of prescribed medications. Even where the gains were modest, a big plus was a lack of side effects.

Some studies even suggest it doesn’t have to be exact — even if the needles aren’t placed precisely along meridians (or “energy pathways”, according to Chinese tradition), patients can still see benefits. When done properly, there should be little or no discomfort to the procedure. (For more information, check out our previous articles Acupuncture – real or fake – reduces back pain and Acupuncture relieves arthritis pain.)

Massage therapy. Ever wonder why you instinctively reach for the hurt? While scientists aren’t quite sure how touch works, they do know it helps to reduce pain. For instance, a study published in the the Journal of Alternative and Complementary Medicine found that a single deep-tissue massage session (like Swedish Massage) caused a drop in the hormone arginine vasopressin (AVP) — a hormone which raises blood pressure and constricts blood vessels (which in turn increases agitation and pain). In addition, massage or light-touch therapy decreased the body’s production of cortisol, a hormone the body releases due to stress which is also associated with increased pain.

While the study supports previous findings about the link between pain and massage, experts aren’t sure how much is needed or even which kind. (For more information, see The healing benefits of massage.)

Some other therapies involving touch, known as biofield therapies, have a spiritual base — but there isn’t much evidence yet about their long term effectiveness.

Therapy. No, the pain isn’t in your head… but dealing with it can lead to depression and anxiety, both of which can decrease pain tolerance. One particular approach, cognitive behavioural therapy (CBT), is useful for treating chronic pain because it helps people identify the thoughts and behaviours that add to their stress. For instance, chronic pain can make people worry about losing their job or their relationships. Through CBT, patients can learn to challenge these negative thoughts and behaviours and replace them with more positive ones.

CBT also offers patients coping skills like relaxation techniques to relax tensed muscles, plans to cope with flare ups and problem solving skills to use in stressful situations.

Other therapies seeing some success include relaxation therapies, hypnosis, guided imagery and mirror therapy to treat phantom limb pain.

Physiotherapy. When you hurt, the last thing you may feel like doing is moving but exercise boosts energy levels and improves mood, both of which can help people cope with chronic pain.

However, exercise isn’t always so easy. Physiotherapy has been proven to help with conditions like back pain, osteoarthritis and injury. Physiotherapists can help you set up a therapeutic exercise program to increase mobility, flexibility and strength to support an injured joint or muscle, for example. They can also use pain relief techniques like acupuncture, muscle release, electrical stimulation and ultrasound to get you moving again. (For more information, see Physiotherapy: What to expect.)

Yoga and Tai Chi. These exercise regimes have won praise for reducing the pain associated with conditions like fibromyalgia, arthritis, migraines, neck pain and back pain. They also help built muscle strength, increase flexibility and improve sleep — yet they’re gentle and easily adaptable for people with a variety of health conditions.

In addition, the soreness experienced after these exercises also prompts the body to release its natural pain killing opioids.

Meditation. It offers the benefits of stress relief, relaxation, peace of mind and a better awareness of one’s body all rolled into one. Experts note that meditation isn’t about learning to ignore pain; rather the techniques may change the body’s perception of pain. Meditation can also help people manage their response to pain by controlling the anxiety of anticipating it and dealing with it. Like other relaxation techniques, meditation can help people lead more active lives.

Laughter. A good laugh is good for your health, especially the release of endorphins — those “feel good” chemicals that improve our moods, fight stress and naturally reduce pain. Some experts like laughter yoga founder Dr. Madan Kataria, even note that pretending to laugh can offer the same health benefits.

You don’t need an expert for this one. A funny book, video or movie will do the trick, or you can opt for something a more structured like laughter yoga. (For more information, see Laughter is the best medicine and Bring more laughter into your life.)

Music therapy. Recent research proves it’s as good for the body as the spirit. One 2008 study proved musical therapy — which involves engaging in musical activities guided by a certified professional — helped treat chronic pain in people with serious illnesses like cancer, AIDS and pain disorders. Musical therapy improves not just pain, but also reduces stress and anxiety. After listening to music for 25 minutes, 80 per cent of participants reported their move had improved — not to mention gains in movement and verbal skills. (For more information, see Music therapy.)

Electrical stimulation. Using Transcutaneous Electrical Nerve Stimulation (TENS) as a pain reliever is still controversial, but some studies suggest its effective for treating both acute and chronic pain from cancer, burns, phantom limb pain, joint pain and pain in the shoulder, back and neck (to name a few). With this approach, electrodes are attached to the skin near the site of the pain and a low-voltage current is transmitted from a battery-operated unit. These electrical pulses are thought to work on the nerves and nerve pathways that transmit pain, though experts don’t know exactly how — or if — it works.

While the procedure can sound dubious, the Arthritis Society notes that it’s safe and electrocution isn’t a risk. However, a lot more research needs to be done to determine its effectiveness.

Supplements and herbal remedies. They’re becoming more commonplace, but it’s still a matter of buyer beware, experts warn. Some studies have shown that some supplements may help to treat certain conditions — like glucosamine to treat osteoarthritis in the knees, capsaicin to dull pain and fish oil supplements to fight inflammation.

However, there’s a lot of conflicting research about their effectiveness, plus they can have their own side effects and contraindicate with prescription medications. Talk to your doctor or pharmacist before you buy to be on the safe side.

Tips before you try it

– Do your research. What works for one person or condition may not work for another. Find out which therapies have shown some success for your condition and be sure to check out any risks or safety concerns.

– Talk to your doctor. Experts warn you should always discuss changes to your treatment plan with your doctor first — he or she can help you weigh the benefits versus the risks, and even help you find a reputable practitioner.

– Find a reputable practitioner. Unfortunately, scammers give CAM therapies a bad name. Look for the practitioner’s qualifications or license on display, and know how to spot a con — like a practitioner who wants you to stop taking your prescriptions and discourages you from seeing your doctor.

And perhaps the most important advice of all: have realistic expectations . Alternative therapies don’t work for every person or every condition, and they may not be as effective as you hope. Effective treatment plans for chronic pain often involve many steps, many experts and a lot of time and patience.

Sources: The Arthritis Society, Canadian Pain Coalition, Intelihealth.com, MayoClinic.com, MedicineNet.com, Time Magazine, U.S. National Institutes of Health, WebMD

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