Alternative Treatments for Chronic Pain

Sarah Timbie for Health Empowerment Coalition

What is chronic pain?

Chronic pain is pain that lasts longer than three months or, if caused by an injury, past the amount of time the body should take to heal the injury.¹ Chronic pain is different from acute pain, which does not last as long and is often more severe. Common cases of chronic pain involve lower back pain, headaches, and arthritis, but it can occur anywhere in the body.² The causes for chronic pain are numerous, ranging from an original injury or accident to lifestyle choices or bad posture. In other cases, it cannot be attributed to any one cause. In addition to affecting the lives of over 100 million adults, chronic pain is one of the most expensive medical issues in the United States, estimated as of 2012 to be responsible for up to 635 billion dollars in health care costs.³

Managing chronic pain

If the source of chronic pain is unknown or untreatable, the best option is to manage the symptoms.⁴ The choices for treatment are abundant and most involve little to no risk to health, so trying out multiple options is easy. The success of chronic pain treatments varies for each patient depending on their type of pain, but most treatments are at least somewhat effective for all types of pain. Choosing where to start in chronic pain management can seem daunting at first, but learning about the different courses of action one can take is the first step towards feeling better.

Medication for pain

Using over-the-counter or prescription pain medication is one option for dealing with chronic pain. The U.S. health system relies heavily on painkillers for dealing with all types of pain. While they are safe to use in moderation and offer a quick fix to discomfort, many pain medications are not meant to be taken over long periods of time and can have adverse side effects. The most commonly used pain medications on the market are nonsteroidal anti-inflammatory drugs (NSAIDs) like Advil, Aleve, and Motrin, which when used for too long or in high dosages can lead to kidney problems, high blood pressure, and stomach pain.⁵ Long-term use of opiate pain medication is particularly dangerous, as evidenced by the opioid crisis in the U.S., with between eight and twelve percent of people using opioids for chronic pain developing opioid use disorders.⁶

Physical therapy for chronic pain

The American Physical Therapy Association describes physical therapists as “movement experts who improve quality of life through prescribed exercise, hands-on care, and patient education.”⁷ Chronic pain usually involves some aspect of joint or muscle pain. Accordingly, physical therapy that targets these parts of the body can strengthen muscles and loosen joints to prevent further damage to these areas. Physical therapy can also help reduce pain and inflammation, improve general strength, and extend the body’s range of motion. The low-intensity exercise involved in physical therapy can be highly beneficial for pain management. Stretching exercises are particularly useful because they address current pain while also preventing future related injury by increasing flexibility and range of motion.

What does physical therapy involve?

The treatment that a physical therapist chooses is dependent on and tailored to the patient’s type of pain. First, a physical therapist evaluates the condition of a patient. This may involve observing a patient walk, bend over, or move parts of their body in different ways to assess balance, coordination, strength, and other physical capabilities. Once the physical therapist makes a diagnosis, they will create a specialized treatment plan for the patient. Often, this will include stretching routines, strengthening exercises, and massage. Throughout the treatment, the physical therapist will ask questions to check in on the patient’s progress and pain levels. The duration of physical therapy programs depends on the patient’s severity and location of the pain. type of pain. Most sessions last between 30 to 60 minutes, but physical therapists will often assign a patient exercises to practice at home as well. The length of time that a patient is part of a program relies on how their body is reacting to the physical therapy. Some people may need longer or shorter programs to recover and resume normal function.

Massage for chronic pain

Therapeutic massage can be an effective treatment for people suffering from chronic pain. Massage therapists are trained and certified medical professionals who use their hands to add pressure to and manipulate parts of the body, often muscle, connective tissue, tendons, and skin. Massage helps to treat chronic pain by reducing muscle tension. Even if the source of chronic pain in a patient is not muscle-related, muscles around the body can develop tension from being braced against pain or used in different ways to avoid pain. Massage therapy may not provide as much relief for individuals with certain types of pain conditions, such as fibromyalgia or chronic fatigue syndrome. In these cases, massage can still be helpful with lighter pressure. Massage is also not recommended for people with skin conditions, heart problems, or certain infectious diseases.⁸

Acupuncture for chronic pain

The ancient practice of acupuncture originates from Traditional Chinese Medicine and involves applying needles, heat, and pressure to certain areas of the body. While acupuncture is newer to the United States than other treatments, the studies that have been conducted show that it is particularly helpful for chronic pain involving the back, neck, knees, and head.⁹ When beginning treatment, acupuncture is typically recommended on a weekly basis until improvement is observed. Unfortunately, treatment can be expensive and not typically covered by private insurance.¹⁰ It is also important to visit a trained and certified provider, as certifications are not always needed for acupuncturists to practice.

Surgery for chronic pain

Surgery for chronic pain is typically recommended as a last resort for treatment. There are risks involved in any type of surgical procedure, and it is often challenging to pinpoint the precise cause of chronic pain, making it difficult to determine the location needed for surgical intervention. However, if the cause of the pain is known, surgery can be an option for some patients. Additionally, surgery is recommended for chronic pain that follows previous surgeries such as hip replacements, hernia repairs, and foot operations as well as traumas and sports injuries. In such cases, the pain could be caused by an error during the original surgery that can be fixed by additional surgery.¹¹

Heat therapy for chronic pain

Heat therapy is one of the simplest options for treating chronic pain and can be performed at home with an electric heating pad, microwaveable pillow, or hot bath. The heat helps relax muscles and increase blood flow, which can reduce pain and stiffness. It is important to avoid using excessively high heat to prevent burning skin. Using cold therapy on painful areas can also help ease pain from swollen muscle joints, slight injuries from overexercising, and arthritis.¹²

Conclusion

Chronic pain is a serious and common health issue that varies greatly in different people. It is common for chronic pain to be associated with anxiety and depression, disrupt sleep patterns, make it harder to be productive, and decrease self-esteem.¹³ As debilitating and frustrating as chronic pain can be, it does not have to control your life. Consider communicating with a healthcare provider about what treatment options might be best for your specific situation. It can also be useful to do research on your own or reach out to family and friends that might be struggling with a similar problem. The journey to finding the best option for treating your chronic pain can be difficult, but there are many different options available to try.

References:

1. Centers for Disease Control and Prevention, “Opioid Prescribing Guideline Resources,” U.S. Department of Health & Human Services. https://www.cdc.gov/opioids/providers/prescribing/faq.html. Reviewed August 5, 2021.

2. Cleveland Clinic, “Chronic Pain,” https://my.clevelandclinic.org/health/diseases/4798-chronic-pain. Reviewed September 1, 2021.

3. Darrell J. Gaskin, “The Economic Costs of Pain in the United States,” The Journal of Pain, https://www.jpain.org/article/S1526-5900(12)00559-7/fulltext. (2012).

4. Johns Hopkins Medicine, “What is Pain/Types of Pain Treated?” Blaustein Pain Treatment Center, https://www.hopkinsmedicine.org/pain/blaustein_pain_center/patient_care/what_is_pain.html.

5. Mayo Clinic Staff, “Chronic pain: Medication decisions,” https://www.mayoclinic.org/chronic-pain-medication-decisions/art-20360371.

6. National Institutes of Health, “Opioid Overdose Crisis,” https://www.drugabuse.gov/drug-topics/opioids/opioid-overdose-crisis

7. American Physical Therapy Association, “Becoming a PT,” https://www.apta.org/your-career/careers-in-physical-therapy/becoming-a-pt.

8. Harvard Medical School, “Therapeutic massage for pain relief,” Harvard Health Publishing. https://www.health.harvard.edu/alternative-and-complementary-medicine/therapeutic-massage-for-pain-relief. (2016).

9. National Center for Complementary and Integrative Health, “Acupuncture: In Depth,” NIH, https://www.nccih.nih.gov/health/acupuncture-in-depth.

10. Daniel Pendick, “Acupuncture is with a try for chronic pain,” Harvard Health Publishing. https://www.health.harvard.edu/blog/acupuncture-is-worth-a-try-for-chronic-pain-201304016042. (2013).

11. University of Michigan Surgery, “Peripheral Nerve Surgery,” University of Michigan Health. https://www.uofmhealth.org/conditions-treatments/surgery/peripheral-nerve-surgery

12. Diana Rodriguez, “Heat or Cold for Chronic Muscle Pain?” Everyday Health. Reviewed by Pat F. Bass III, MD, MPH. https://www.everydayhealth.com/pain-management/using-cold-and-heat.aspx. (2012).

13. Mental Health America, “Chronic Pain and Mental Health,” https://www.mhanational.org/chronic-pain-and-mental-health.

Author: Sarah Timbie

Edited by: Emily Lin and Darshana Banka

The Health Empowerment Coalition is a student-led organization that aims to empower individuals across the United States to improve their health literacy and take charge of their health. The views expressed in this article are the authors’ own and do not reflect the official opinions of the institutions at which they work and study. Additionally, the content in this article is not intended to provide medical advice.