Alternatives to Drugs for Treating Pain

Alternatives to Drugs for Treating Pain
From New York Times - September 11, 2017

Acute pain is natures warning signal that something is wrong that should be attended to. Chronic pain, however, is no longer a useful warning signal, yet it can lead to perpetual suffering if people remain afraid of it, the doctor said.

If the pain is not an indication that something is seriously wrong, you can learn to live with it, said Dr. Campbell, an emeritus professor at Johns Hopkins Medical Institutions. Too often, he explained, people with pain get caught in a vicious cycle of inactivity that results in lost muscle strength and further pain problems.

Throwing powerful drugs at chronic pain problems may only add to the problem because ever higher doses are often needed to keep the pain at bay. Knowing this, a growing cadre of specialists are exploring nondrug, noninvasive treatments, some of which have proved highly effective in relieving chronic pain.

The American College of Physicians recently issued new nondrug guidelines for treating chronic or recurrent back pain, a condition that afflicts approximately one-quarter of adults at a cost to the country in excess of $100 billion a year.

Noting that most patients with back pain improve with time regardless of treatment, the college recommends such remedies as superficial heat, massage, acupuncture or, in some cases, spinal manipulation (chiropractic or osteopathic). For those with chronic back pain, the suggestions include exercise, rehabilitation, acupuncture, tai chi, yoga, progressive relaxation, cognitive behavioral therapy and mindfulness-based stress reduction.

Drug-free pain management is now a top priority among researchers at the National Center for Complementary and Integrative Health, a division of the National Institutes of Health. A comprehensive summary of the effectiveness of nondrug treatments for common pain problemsback pain, fibromyalgia, severe headache, knee arthritis and neck painwas published last year in Mayo Clinic Proceedings by Richard L. Nahin and colleagues at the center.

Based on evidence from well-designed clinical trials, the team reported that these complementary approaches may help some patients manage their painful health conditions: acupuncture and yoga for back pain; acupuncture and tai chi for osteoarthritis of the knee; massage therapy for neck pain with adequate doses and for short-term benefit; and relaxation techniques for severe headaches and migraine.

Weaker evidence also suggested that massage therapy and spinal and osteopathic manipulation may be of some benefit to patients with back pain, and relaxation techniques and tai chi may help patients with fibromyalgia find relief.

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