The 2012 National Health Interview Survey estimated that 126.1 million adults reported some pain in the previous 3 months, 25.3 million adults reported suffering from daily (chronic) pain, and 23.4 million reported experiencing a lot of it overall (Nahin, R. L., 2015).
Opioid painkillers are a common first-line approach to managing relatively severe pain, and while they are sometimes a necessary part of treatment, they often carry a slew of side effects as well as the danger for abuse and addiction. In fact, in March of 2016, the Centers for Disease Control (CDC) released new guidelines for the prescription of opioids in the treatment of chronic pain, and the Food and Drug Administration (FDA) announced new warning labels to caution against the dangers of those commonly prescribed medications.
Severe pain that causes significant functional impairment often requires prescription painkillers; however, it’s important to understand that painkillers only reduce the sensation of pain – they don’t treat the cause. The best approach to treating your pain may involve integrative medicine that incorporates other techniques to address it. The American Chronic Pain Association (ACPA) advocates a holistic approach that treats the whole person and allows you to take an active role in your treatment—helping to determine which specific combination of treatment approaches works best for you.
There are numerous options available to you so that you can explore alternatives to medication in the treatment of your pain. Some of the interventions you might consider include:
- Exercise and nutrition.
- Various physical and psychological therapies.
- Natural supplements.
- Mind-body therapies.
It is best to consult your doctor before undertaking any of these activities. It may also take a little bit of experimenting to discover which options work best for your individual needs.
Exercise and Nutrition
Certain types of physical exercise can help reduce pain and increase functionality by:
- Increasing your range of motion.
- Helping to stretch and strengthen your muscles.
However, before beginning any type of exercise program you should always consult your doctor so that you don’t do more harm than good. The specific exercises that may help you should also be tailored to your specific type of pain. A physical therapist can help in this area. (See below for more information.)
Making dietary changes related to the type of pain you experience may help you manage some of your symptoms. There may be very specific instructions for your condition (such as eating a gluten-free diet to manage pain associated with celiac disease), or more general recommendations such as:
- Eating fresh foods.
- Avoiding caffeine.
- Following an anti-inflammatory diet.
Physical and Psychological Therapies
Certain licensed therapeutic professionals can help you alleviate your symptoms of pain through various therapies:
- Physical therapy utilizes trained professionals who will prescribe specific exercises, stretches, and body movements that can help enhance your strength and flexibility and target underlying causes of your pain. Physical therapists can also educate you about body mechanics, such as posture, so that you can make adjustments to relieve pain. An added benefit is that you can take the exercises and stretches home with you so that you can reduce it on your own.
- Massage therapy can be beneficial for your pain by promoting relaxation and reducing muscle tension. There are also specific techniques your therapist might be trained in that can provide more focused treatment such as neuromuscular therapy, trigger-point therapy, or myofascial release. Getting a massage can also contribute to emotional well-being.
- Chiropractic therapy utilizes manipulation of the spine to correct alignment and reduce pain. This mode of treatment may be effective for low back and neck pain, headaches, some joint conditions, and whiplash-associated disorders.
- Acupuncture is a traditional Chinese medicine technique that involves stimulating acupuncture points along the body, most often with very thin needles. Acupuncture may help alleviate some types of chronic pain such as low-back, neck, and osteoarthritis/knee pain.
- Psychotherapy can be helpful for uncovering and working on beliefs and behaviors that may be exacerbating your pain. For example, when you are distressed you may tense your body, so working through your emotional distress with a trusted therapist can help you keep from worsening your pain.
Natural Supplements and Other Medicine
If you want to try a medicinal substance that is not a prescription painkiller, there are some over-the-counter supplements you can try, as well as topical medicines:
- Omega-3 fatty acids are found in some types of seafood, fish oil, and vegetable oil. Increasing your intake by eating more fatty fish or shellfish, or by taking a dietary supplement, may help relieve your symptoms of pain, particularly if you have rheumatoid arthritis.
- Turmeric is a plant of the ginger family that may alleviate some types of pain due to its anti-inflammatory properties.
- Other pain relievers may also work to help alleviate your symptoms. Over-the-counter anti-inflammatory agents such as ibuprofen or naproxen, and prescription topicals like diclofenac may help acute soft tissue injuries or chronic joint-related conditions if used regularly. Topical lidocaine may help mitigate symptoms of neuropathy. Other pain-relieving gels include Biofreeze and Tiger Balm.
Speak with your doctor about incorporating any of these into your daily regimen, as there may be contraindications specific to you and your condition.
A 2014 study examined the link between the rise of medical cannabis laws and the number of prescription opioid painkiller deaths across U.S. states between 1999 and 2010. Their results revealed that as medical marijuana laws increased, the number of painkiller overdose deaths decreased. (Bachhuber, Saloner, & Cunningham).
Could the analgesic effects of marijuana help ease the opioid epidemic? More research must be done, but it could be a promising prospect for those struggling with chronic pain.
Over the years, mind-body medicine has become increasingly popular and well utilized as scientists continue to acknowledge the powerful mind-body connection. Certainly, healing the body can help heal the mind, and healing the mind can help heal the body. There are numerous mind-body approaches out there, but here we have highlighted some that are most often associated with pain reduction:
- Yoga involves practicing physical postures (asanas) and breathing exercises that can help you increase your awareness of your body, stretch your muscles, and increase your strength and mobility. This may help reduce and prevent pain as well as improve your functioning. Many people also experience significant improvements in their overall well-being and stress levels, which can also positively impact your physical symptoms. The particular asanas that may be most helpful for you will depend on your type of pain, and it may be important that you avoid certain poses or make appropriate modifications to practice safely and avoid aggravating your condition.
- Mindfulness-Based Stress Reduction (MBSR) can help you with the management of your pain as it teaches you to practice acceptance of your present moment whether pleasant or unpleasant. There is a commonly used expression that says what you resist persists, and this may apply to pain as well, especially since focusing on it may result in tensing up and exacerbating the condition. MBSR is often taught through an 8-week course that incorporates a variety of mindfulness practices such as sitting meditations, gentle yoga, and body scans.
- The Feldenkrais Method® is a process that helps you explore several types of movements associated with daily activities such as bending, walking, sitting, standing, and turning. This allows you to self-correct so that you can move with more ease and less strain, resulting in the reduction and prevention of pain. There are individuals who have solely been trained to be practitioners of this work, as well as physical therapists who have added this technique to their repertoire. Typically, the method involves Awareness through Movement workshops as well as individual sessions that can be tailored to your specific needs.
- Hypnosis is often performed by a psychotherapist who has been trained in this technique, but your sessions will also likely instruct you in how to conduct self-hypnosis so that you can utilize this technique at home as well. Learning hypnosis may help you relax, refocus your attention, and change your thoughts and behaviors related to the pain so that you can deal with it more effectively.
- Guided imagery and other relaxation techniques are often a part of the commonly used cognitive-behavioral therapy. They can help you with your pain as you learn to relax by slowing and deepening your breathing, releasing muscle tension, and visualizing peaceful scenes while recreating the positive emotions they elicit. Here is an example of a short 5-minute relaxation exercise you can practice: https://theacpa.org/Relaxation-Guide
As you can see, there are many avenues you can explore if you desire alternatives to medication in the treatment of your pain. The techniques that eventually work for you are likely going to depend on the type that you experience and how committed you are to practicing them. Ideally, you can work with a variety of professionals as part of an integrative medicine program that will help you address your pain from a variety of different angles so that you can have the best possible outcome. Whatever path you pursue, just remember that there are numerous resources out there and you don’t have to try and manage your pain alone.
- NCCIH. (January 2016). Acupuncture: In Depth
- American Chronic Pain Association. (2016). Resource guide to chronic pain treatment: an integrated guide to physical, behavioral, and pharmacologic therapy.
- CDC. (2016). CDC Guideline for Prescribing Opioids for Chronic Pain | MMWR.
- FDA. (March 22, 2016). FDA announces enhanced warnings for immediate-release opioid pain medications related to risks of misuse, abuse, addiction, overdose and death.
- NCCIH. (August 2015). Omega-3 Supplements: In Depth
- NCCIH. (April 2012). Turmeric.
- Argoff, C. E. (2013). Review: Topical Analgesics in the Management of Acute and Chronic Pain. Mayo Clinic Proceedings, 88195-205. doi:10.1016/j.mayocp.2012.11.015
- Boyd, C., Crawford, C., Paat, C. F., Price, A., Xenakis, L., & Zhang, W. (2016). The Impact of Massage Therapy on Function in Pain Populations-A Systematic Review and Meta-Analysis of Randomized Controlled Trials: Part II, Cancer Pain Populations. Pain Medicine (Malden, Mass.).
- Bronfort G, Haas M, Evans R, et al. Effectiveness of manual therapies: the UK evidence report. Chiropractic & Osteopathy. 2010;18(3):1–33.
- Cherkin, D.C., Sherman, K.J., Balderson, B.H., Cook, A.J., Anderson, M.L., Hawkes, R.J. et al. (2016). Effect of Mindfulness-Based Stress Reduction vs Cognitive-Behavioral Therapy of Usual Care on Back Pain and Functional Limitations in Adults With Chronic Low Back Pain: A Randomized Clinical Trial. JAMA, 315(12):1240-1249. doi:10.1001/jama.2016.2323
- Elkins, G., Jensen, M. P., & Patterson, D. R. (2007). Hypnotherapy for the Management of Chronic Pain. The International Journal of Clinical and Experimental Hypnosis, 55(3), 275–287. http://doi.org/10.1080/00207140701338621
- Maroon, J. C., & Bost, J. W. (2006). Pain: ?-3 Fatty acids (fish oil) as an anti-inflammatory: an alternative to nonsteroidal anti-inflammatory drugs for discogenic pain. Surgical Neurology, 65326-331. doi:10.1016/j.surneu.2005.10.023
- Nahin, R. L. (2015). Original Report: Estimates of Pain Prevalence and Severity in Adults: United States, 2012. Journal Of Pain, 16769-780. doi:10.1016/j.jpain.2015.05.002
- Schulenburg, J. (2015). Considerations for Complementary and Alternative Interventions for Pain. AORN Journal, 101(3), 319-326 8p. doi:10.1016/j.aorn.2015.01.013
- Searle, A., Spink, M., Ho, A., & Chuter, V. (2015). Exercise interventions for the treatment of chronic low back pain: a systematic review and meta-analysis of randomised controlled trials. Clinical Rehabilitation, 29(12), 1155-1167.
- SÎrbu, E. (2015). Effectiveness of a home-based physical therapy program in patients with chronic low back pain. Timisoara Physical Education & Rehabilitation Journal, 8(15), 12-16.
- Trinh, K. (2016). Acupuncture for neck disorders. Cochrane Database Of Systematic Reviews, (5), doi:10.1002/14651858.CD004870.pub4
- Wyszynski, M. (2010, Spring). The Feldenkrais Method for people with chronic pain. The Pain Practitioner, 20(1).
- Source: Bachhuber, M. A., Saloner, B., Cunningham, C. O., et al. (2014). Medical cannabis laws and opioid analgesic overdose mortality in the United States, 1999-2010. JAMA Internal Medicine, 174(10). 1668-1673.