This is a synopsis of an article published in the New York Times

“The best treatment for pain is right under our noses...Acute pain is nature’s 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. If the pain is not an indication that something is seriously wrong, you can learn to live with it. Too often, people with pain get caught in a vicious cycle of inactivity that results in lost muscle strength and further pain problems," explains Dr. James Campbell, a neurosurgeon and pain specialist at Johns Hopkins Medical Institutions. 

Using drugs to alleviate chronic pain may only exacerbate the problem, because, over time, higher dosage will be needed to mask the pain. More and more specialists are now prescribing non-drug treatments for their patients, in order to avoid drug dependence and treat the pain. And, it's proving effective!

The American College of Physicians published guidelines for treating chronic or recurrent back pain. Chronic back pain affects one-quarter of adults, costing our country over $100 billion a year in health care costs and productivity loss. In lieu of medications, the ACP recommends superficial heat, massage, acupuncture and chiropractic or osteopathic care, if necessary. They also suggest maintaining a regular exercise program, tai chi, yoga, C.B.T. (cognitive behavior therapy) and mindfulness and relaxation techniques. 

The National Center for Complementary and Integrative Health, a division of the National Institutes of Health, is making drug-free pain management research a priority. Last year a summary highlighting the efficacy of non-drug treatments for common pain (back pain, fibromyalgia, severe headache, knee arthritis and neck pain), was published in Mayo Clinic Proceedings by Richard L. Nahin and colleagues. The researchers report that acupuncture and yoga may help manage back pain, acupuncture and tai chi are beneficial for osteoarthritis of the knee, massage therapy subdues neck pain (for the short term), and relaxation techniques treats severe headaches and migraines. 

The most recent studies, conducted by Daniel C. Cherkin and colleagues at the Group Health Research Institute (now known as the Kaiser Permanente Washington Health Research Institute) and the University of Washington in Seattle, found that "mindfulness-based stress reduction and cognitive behavioral therapy proved more effective than “usual care” in relieving chronic low back pain and improving patients’ function."

Mindfulness-based stress reduction therapy (practiced once a week for eight weeks, combined with gentle yoga) not only proved more cost effective (than C.B.T. and other routine pain management plans) at reducing health care costs and productivity decline, but it also teaches patients how to relax and remain non-reactive towards the pain they may experience over their lifetime. Two years later (in a follow-up study), patients treated with mindfulness therapy and C.B.T. maintained their treatment outcomes and continued to improve.

Although, there are two major setbacks with accessibility to these non-drug treatments: most health insurance companies do not cover the costs of complementary modalities or the practitioners who offer them. The looming out-of-pocket costs, causes most patients to choose drug prescriptions because they are covered. The other issue is availability to complementary modalities in "non-urban areas." There may not be massage therapists, yoga studios or acupuncturists nearby. 

A saving grace for many patients seeking non-drug pain treatment is the availability, accessibility and coverage of physical therapy. PT address the acute needs of patients, while teaching people how to exercise properly and mitigate aches and pains they may have after their treatment plan has ended. 

If you are interested in our complementary modality services including physical therapy, yoga therapy, mindfulness classes, massage therapy and psychotherapy, please email us at info@4cmedicalgroup.com.

Read the full article here

Primary Care & Hospitalist