A holistic approach to chronic pain

Chronic pain – whether it’s headaches, backaches, joint pain or other pain in the body – can be frustrating and sometimes debilitating.

When treating a person with chronic pain, I have two primary goals in mind: rule out treatable causes for the pain, and in the process find the root cause and help the patient find adequate relief.

Over-the-counter or prescription pain relievers are not always the best or only answer for chronic pain. Treatment of chronic pain requires patience and sometimes a broader strategy.

It is best to deal with pain using a more holistic or complementary approach to get maximum relief while taking the minimum amount of medication.

Ibuprofen, naprosyn and aspirin are helpful, but high doses over time can cause kidney or stomach problems – especially in the elderly or people with diabetes, high blood pressure or heart disease.

Acetaminophen, when taken in high doses over many years, can be hard on your liver, especially if you drink alcohol or have liver disease.

Usually these medications are quite safe, but you should pay close attention to how much you take on a daily basis and to how much is in various over-the-counter preparations such as cold remedies and sleeping aids.

Another reason for seeking an alternative approach is that when a person takes narcotics (such as hydrocodone, oxycontin, codeine and morphine) over time for chronic pain they become physically dependent and the medications can lose their effectiveness. Progressively higher doses are sometimes required and this can be dangerous.

Acupuncture, chiropractic manipulation, massage, yoga, adequate sleep, support groups, supplements and meditation can all help chronic pain sufferers reduce their pain and their reliance on medication.

Talk with your health care provider about what options might help you. Here are some basics:

Acupuncture: Acupuncture is used in treating headache and osteoarthritis. Make sure your acupuncturist (like your physician) has a current license from the Department of Health.

Chiropractic manipulation: Chiropractic adjustments can help with back pain, neck pain, headaches and many other musculoskeletal problems. It may take a few adjustments to achieve lasting pain relief.

Massage: Massage therapy can help with back and other types of pain, headaches and osteoarthritis.

Yoga: Yoga has been found to be effective for relieving low back pain, so that you can use fewer medications and be better able to do daily activities.

Adequate sleep: When I do not get enough sleep (especially for several days in a row), I notice that I feel achy all over. It is important to allow enough time each night for a good night’s sleep, and if you have trouble falling or staying asleep, to find the causes and work to eliminate them.

Support groups: Joining a chronic pain support group can help you cope better with daily living. Having other people to talk to who know what it is like to live with chronic pain can be a great help. They can also be resources for leads on new types of treatments.

Supplements: I have had some patients report an improvement in chronic pain when they take vitamin D supplements. An adequate dose is at least 1,000 IU in the summer and at least 2,000 IU in the winter.

Glucosamine is found in our joints and many osteoarthritis sufferers experience less pain (especially in the knees) when taking 1,500 milligrams of glucosamine daily. If you are allergic to shellfish, you should not take it.

Meditation: The mind is powerful and its ability to affect your health is undeniable. Meditation harnesses the mind’s effect on your body. Things common to different types of meditation are the need for quiet and a comfortable position, focusing your attention and an open attitude.

The most important thing to remember when you have chronic pain is to be patient. Some treatments and therapies require time and your active participation to achieve results that will let you lower the amount of medication you take each day.

Another thing you should keep in mind is that not all treatments and therapies will help every single chronic pain sufferer. Each person needs to find the combination of treatments and therapies that bring them the most relief.

Dr. Alisa Hideg is a family medicine physician at Group Health’s Riverfront Medical Center in Spokane. Her column appears every other Tuesday in the Today section. Send your questions and comments to drhideg@ghc.org.


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