Alternative Treatments for Relief of Chronic Pain
Older adults may benefit from acupuncture, meditation and simple exercise
Donna Story, whose right arm ached with tendonitis, tried relieving her chronic pain with Icy Hot ointment by day and Advil PM by night. It wasn’t working. So the sales and customer support specialist, who spends her workday on the phone and computer, decided to try an alternative treatment: acupuncture.
Much to her relief, it worked.
“The first session felt great, and the second session … it was unbelievable. I realized that my arm — from my shoulder to my wrist — wasn’t hurting anymore,” says Story, 57, who works from her home office in Piscataway, N.J. She’s improved her admittedly poor ergonomic habits and continues to see her acupuncturist on a quarterly basis to ensure the pain doesn’t return.
Alternative Treatments Beyond Pills and Surgery
Acupuncture, the ancient Chinese practice of inserting ultra-thin needles in strategic parts of a patient’s body, is just one of a variety of alternatives to the more traditional means of pain relief — medications and surgery. Alternative treatments include massage, cognitive behavioral therapy, hot or cold baths, stretching, yoga and chiropracty, and older adults may benefit greatly.
Rhonda Hogan owns and operates AbsoluteQi, an acupuncture and wellness clinic in Somerset, N.J., where Story found relief from her pain. “If a patient is getting acupuncture for the first time, it’s usually a last resort. They’ve tried everything else,” says Hogan. The acupuncturist studied pre-med at Lehigh University and worked as a microbiologist in the pharmaceutical industry before pursuing an alternative path in health care.
“[Acupuncture] should be considered an earlier resort because people would be subject to less invasive procedures, and they’d be taking less medication,” Hogan said. “Unfortunately, that’s not how our medical system works.”
Barriers to Acceptance of Acupuncture
Acupuncture, she believes, faces three hurdles. “Some people are terrified of needles, although they would find it’s not at all painful. Second, some aren’t convinced acupuncture works, and third, people often don’t have acupuncture coverage in their health insurance plan, although it’s becoming more common.”
The barriers are unfortunate, she says, because acupuncture has proven effective at relieving pain without more invasive and more expensive treatments. Her clinic specializes in Trigger Point Acupuncture, also known as dry needling.
“Needles are used to help the body function better,” Hogan says. “Beneath the skin of the acupuncture points is usually a lot of blood supply and nerves. The needling helps the nervous system function better and increases blood circulation.”
Acupuncture can relieve tension in tight muscles that can often refer pain to nearby parts of the body. The practice also promotes positive hormonal and chemical changes in the body, Hogan says.
The Wrong Prescription?
Traditional medicine is not always the best treatment for chronic pain, says Dr. Robert Sallis, a family practice physician with Kaiser Permanente in Fontana, Calif. In many cases, exercise works best, which might strike some as counterintuitive. Shouldn’t people experiencing chronic pain, especially someone 50 and over, be sedentary?
Sallis allows that prescribing exercise can be a hard sell with some patients. But “as a primary care physician, there isn’t a condition I have seen that would not be helped by becoming more active,” said Sallis, chairman of the Exercise Is Medicine initiative managed by the American College of Sports Medicine.
“Obviously, we need to work around the source of pain,” he said. “If we are talking about musculoskeletal pain, physical therapy is the first thing you want to do to strengthen the muscles above and below the affected joint.”
Doctor’s Orders: Take a Hike
Using a prescription pad, Sallis details the physical activity he’d like his patients to undertake. “Walking is my default exercise prescription,” he said. In the prescription, he will often specify the number of days a week the patients should walk, for how long and at what level of intensity. It’s not enough just to tell them to walk, he notes.
People in chronic pain often have difficulty sleeping, suffer from depression, have disrupted bowels and other physical and psychological issues. Multiple studies, Sallis said, have demonstrated that physical activity can reduce pain and break a vicious cycle.
“The answer to chronic pain is not chronic pills,” Sallis said. “Pain medications are not a solution — certainly not opioids, which are downright dangerous. Even the nonsteroidal medications are bad because they can have serious side effects like ulcers or can even lead to a heart attack. Nobody should be on medicine every day for pain. That’s not a logical solution.”
Meditating the Pain Away
Another type of drug-free pain relief is Buddhist-inspired mindfulness meditation — in which individuals sit comfortably, focus their breathing and bring their full attention to the present moment.
“We know mindfulness meditation works. We just don’t know how it works,” said Fadel Zeidan, associate director of neuroscience at the Wake Forest Center for Integrative Medicine in Winston-Salem, N.C. In their quest to learn how it works, researchers there recently discovered that mindfulness meditation does not use the body’s primary pain-relieving pathway, known as the endogenous opioid system.
Other forms of pain relief, such as pain killers, acupuncture or hypnosis, do use the endogenous opioid system. That’s significant, Zeidan said, because if mindfulness meditation is using a different pathway, it may be possible to compound the effect of pain relief by combining different therapies, including medicines.
“You always want to treat pain using a multi-modal approach,” he said.