Pain is essential to our survival. It functions like a burglar alarm to let us know when we are in danger of damage to our tissues. When the brain gets a signal from sensory organs in the body that it interprets as danger, it lets you know by having you experience pain. Sometimes, however, the burglar alarm system stays on all the time and then your brain has you experience chronic pain. This is not useful to you and causes suffering. Nearly 100 million adults in the U.S. have chronic pain. The causes of chronic pain vary. This post will focus on non-drug treatments for chronic pain. The next post will focus on drugs for treating chronic pain.
At the outset, let me be clear that none of these treatments cure or eliminate chronic pain. They may decrease pain and/or improve one’s ability to function in spite of the pain, but chronic pain rarely goes away. We must treat it as a chronic disease, similar to the way we manage other chronic diseases like diabetes or high blood pressure.
Non-Drug Treatments
Non-drug treatments have the advantage of benefit with little or no risk. You are better off if you can get by without having to take drugs for your chronic pain.
Physical Therapy
Physical therapy works particularly well in people with chronic pain from arthritis or chronic low back pain. Improving muscle strength can help stabilize joints. Improving core strength and flexibility can help back pain from any cause. Physical therapy is also helpful in people who have pain from fibromyalgia. Physical therapy, like most other treatments I will talk about, is rarely used alone, but as part of a more comprehensive treatment plan.
Chiropractic Manipulation
Chiropractic manipulation seems to work as well as but not better than physical therapy for the treatment of low back pain and neck pain. There is no evidence that it is helpful for other types of chronic pain.
Acupuncture
Acupuncture, when administered by a licensed acupuncturist, has been shown to reduce chronic pain and improve function. It is definitely worth a try as part of a management plan for treatment of chronic pain from any cause. Here is a link to an acupuncture clinic in St. Johnsbury, Vermont.
Yoga
Yoga incorporates physical movement and muscle strengthening with breathing and meditation. It has been shown to improve chronic back pain and pain from fibromyalgia. It also has been shown to improve mood and a sense of wellbeing. Yoga postures and exercises must usually be modified for people with chronic pain. An experienced yoga teacher who teaches gentle yoga is essential. Otherwise injuries can occur. Here is a link to a yoga teaching center in St. Johnsbury.
Mindfulness Training
Mindfulness is a form of meditation, but also a way of being in the world. Mindfulness meditation both decreases chronic pain and improves your ability to function with pain. Remember that pain perception is controlled by the brain. Mindfulness meditation is one way to change the brain’s interpretation of pain signals so that it is less likely to decide that you are in danger. The most well-known mindfulness training program is called Mindfulness Based Stress Reduction (MBSR). Check the web to find a class near you. Here are links to mindfulness training programs in St. Johnsbury and Barnet.
Cognitive Behavioral Therapy (CBT)
CBT is a psychological therapy that has proved effective for several psychological conditions such as depression, but it has also showed benefit in the treatment of chronic pain. The main benefit appears to be in ability to cope with pain as well as decreasing behaviors associated with pain. Most counselors have training in CBT. That includes the behavioral health specialists at Corner Medical and Kingdom Internal Medicine.
Hypnosis
Medical hypnosis is really a form of guided meditation. It allows you to access the power of unconscious portions of your brain. Since these unconscious parts of your brain control your perception of pain, it makes sense that hypnosis can help chronic pain. The real purpose of the hypnotist is not only to make suggestions to your subconscious mind, but also to teach you how to do self-hypnosis exercises yourself. I used to do medical hypnosis (not so much now because of time constraints). I have witnessed a woman having a c-section with hypnosis as the only anesthesia! There are only a small number of people who can achieve that level of hypnosis, but almost everyone can get some benefit. The trick is finding a skilled medical hypnotist. Also, unfortunately, most insurers will not pay for hypnosis treatments. On the other hand, it is possible to teach yourself self-hypnosis. Here is a link to one self teaching program. There are many others. Try googling “self-hypnosis for chronic pain.”
Other Alternative Treatments
There are a number of other non-medical treatments for chronic pain that have not been well studied. Some people have found them helpful, though. These include Reiki, Therapeutic Touch, Massage Therapy, Tai Chi, and Aromatherapy as well as others. None of these things have any significant risk, so it’s fine to try any of them that strike your fancy. Some of these can be found at Steppingstones Inn in Lyndonville and Trail2Wellness in East Burke.
Your Treatment Plan
The best plan for treating your chronic pain is to combine more than one of these non-drug treatments. At Corner Medical, for example, our behavioral therapist works with people with chronic pain in a program that uses mindfulness training combined with some CBT techniques. We also have a chronic pain workshop that teaches several of these techniques. Not all treatments will work well for everyone. It is important to individualize your treatment based on what works best for you.