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The Many Different Approaches to Pain

For many, pain is merely an unpleasant but rare experience, 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 and redness has faded.  Yet, pain is not bound to these temporary and inconsequential terms for all people.  Indeed, many suffer from pain stemming from injury or illness that does not fade with the passing of time.  Those who suffer such chronic pain know all too well how difficult and exhausting it can be to live with and try to manage that pain.  Even more frustrating than living with chronic pain can be attempting to find relief through treatment.  In many cases, medication does not sufficiently alleviate the symptoms of chronic pain, but perhaps only marginally improves quality of life while potentially putting patients at risk of 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 greatly minimizes 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 come to believe 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.  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. Passive therapies, on the other hand, do not require patients to actively move.  These include treatments such as acupuncture and massage therapy.3

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

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 pain management education it is possible to approach pain with efficiency, positivity and hope.  

 

References:

  1. https://www.theacpa.org/uploads/documents/ACPA_Resource_Guide_2016.pdf 
  2. http://www.aci.health.nsw.gov.au/__data/assets/pdf_file/0020/216308/Chronic_Pain_Management_Strategies.pdf 
  3. http://bodymend.ca/blog/what-is-the-difference-between-passive-and-active-physiotherapy/ 
  4. https://nccih.nih.gov/health/yoga/introduction.htm