Chronic Pain: Integrative Treatments

For decades, Mary Sienkiewicz, now 42, could barely get out of bed in the morning because of the severe lower back pain that radiated down her legs. This past summer, however, she was able to Rollerblade through her hometown of Schererville, Ind.

Sienkiewicz's pain, which she describes as a "deep aching and weakness with pulsating and throbbing," began after a car accident in 1986. "I lost my 20s and 30s because of this pain. If I ever did anything active, I suffered for three to four days afterward," says the financial planner, who recently returned to work after years of disability.

She didn't take the pain lying down. Since the accident, she had undergone two surgeries to repair the herniated disc in her back and tried just about every type of medication and therapy out there. Nothing made a difference for long.

All that changed when Sienkiewicz entered a four-week "boot camp" for people in chronic pain at the Rehabilitation Institute of Chicago (RIC), one of the nation's first multidisciplinary pain clinics.

"It was extremely intense," she recalls. With sessions Monday through Friday from 8 a.m. to 4:30 p.m., the program is composed of aerobic exercise to help boost the body's natural painkillers, called endorphins; individualized physical therapy; biofeedback lessons; psychological counseling to help the patient accept and function better with pain; and medication to treat some of the underlying tissue problems and other issues, including pain-related depression and sleeping difficulties.

"My pain went down from a level of seven or eight --- if not a 10 or higher --- to a one or a two," she says. "It's not a quick fix, and if you stop practicing what you learned, the pain will return," she cautions, but that knowledge gave Sienkiewicz the incentive to continue with her individualized program.

Integrative Approach to Chronic Pain

Clinics and programs with a multidisciplinary, or comprehensive, approach to pain management are becoming more popular as people reject the traditional pill-and-surgery model of treating pain because, like Sienkiewicz, they find it's not always effective.

In a 2004 survey, conducted on behalf of the American Chronic Pain Association, 72% of people with chronic pain said they had had pain for more than three years --- including 34% who had had it for more than 10 years. Nearly half said their pain was not under control. Such uncontrolled pain has ripple effects on jobs, relationships, and the ability to lead a normal life.

"There is no way to be pain-free unless you get comprehensive care. You just can't, say, inject pain away. It doesn't work," says B. Todd Sitzman, MD, MPH, director of advanced pain therapy at Forrest General Cancer Center in Hattiesburg, Miss. "Pain can be well-managed when the whole focus of treatment is on function. We want to get the patient as active and independent as possible."