I promised a series about pain, and a series you will have! In my last post, I talked about lifestyle changes that can help with managing pain. Chronic pain requires a long-term plan, and life-style change should be part of that plan. Although, I don’t know about you, but when I am in pain, I usually need some relief NOW. Some of that can come from medication, but what happens when medication isn’t enough? Lots of times the answer is more meds, but as someone who has given people narcotics and seen the dependence it creates without really improving quality of life, I have asked myself if it is really worth adding more. Not to mention the fact that I am always worried about whether I am contributing to the supply of narcotics on the street. Don’t get me wrong – thousands of people are able to get through the day because of their percocet, tramadol and oxycontin. It’s just – at what cost? That is where non-medication based therapies come in. The ones I talk about here are the ones that I see most commonly used successfully. Obviously the list of therapies is endless – I would love to hear your suggestions too!
Nerve Stimulation Based Therapies - There are several ways to help both new and chronic pains with electrical stimulation. the most famous way to do this is with a TENS device. TENS stands for transcutaneous electrical nerve stimulator. These devices send electrical signals to your nerves and help to control pain signals from them. How they do so is still up for discussion. A simple amazon search yields several options for TENS devices that are very affordable. They are regularly dispensed by pain management doctors and lots of people find lots of relief from them. Electrical stimulators that are more high-tech can often be found at physical therapist and chiropractic offices as well.
Physical Therapy - Many of our joints rely as much on the muscles surrounding them for stability as on the tendons and ligaments keeping them together. When the muscles that support joints become weak, we start to use other, smaller and weaker muscles, creating irritation, scar tissue, and spasm in the process. Physical therapists use a combination of graded exercise training, massage, electrical stimulation, and heat to help people decrease pain and risk of injury. Since NOT moving can worsen the pain, learning how to exercise safely from a physical therapist is essential. It helps people ease back into exercising while minimizing the risk of injury.
Manipulative Therapy – Osteopathic manipulative therapy, Chiropractic adjustment, myo-fascial release, massage and other manipulative therapies can be helpful. Chiropracters have the most training in manipulative therapy. Scientific studies have not shown manipulation to be better than conventional treatment. As for most integrative therapies, the trials are small, but evidence is accumulating. In my experience, these therapies work best when combined with physical therapy.
Acupuncture/Acupressure - There is more and more evidence accumulating to suggest that acupuncture and acupressure are effective therapies for many conditions, but especially for pain and injury. Acupuncture is predicated upon the East Asian theory of health and illness that attributes disease to a blockage in the flow of Qi (pronounced like “chee”). What has always been interesting to me is that Chinese meridians are exactly along the lines of what call fascial planes – the planes into which the various body compartments are separated by tissue called fascia. I remember being at a presentation about how acupuncture might work. Some say that it stimulates our connective tissue cells called fibroblasts to do what they do when we stretch our muscles. All of this is still being worked out in labs and peer reviewed journals. In the mean-while, getting needled to help your pain may not be such a bad idea!
Trigger-point Injections – Trigger points are tender areas on the body where pain can be localized, often co-existing with muscle spasm. While there are physicians who use small needles to introduce steroids into trigger points, there are also several acupuncturists and physical therapists who use dry needling to release trigger points medication free. Here’s a cool video!
What do you do when medication fails to treat your pain? Would love to hear what works for you!