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Chronic Pain: Integrative Treatments

Nontraditional techniques, coupled with trusted drug therapies, are lifting the spirits of chronic pain sufferers.

Integrative Approach to Chronic Pain continued...

Steven Stanos, DO, medical director of the RIC Chronic Pain Care Center and Sienkiewicz's doctor, agrees. "The multidisciplinary approach toward treating pain is definitely a trend. The public is more aware of it because of all the problems we have had with pain medications recently."

Stanos is referring to the recent headlines about Vioxx, a painkiller Merck voluntarily withdrew from the market in September 2004 after research linked it to an increased risk of heart attack. A similar drug, Bextra, was later taken off the market. Since then, all anti-inflammatory painkillers have been under scrutiny.

And this multidisciplinary trend has legs. "Baby boomers are aging at a rapid pace ... and [this group] will not put up with pain," says Mary Pat Aardrup, executive director of the National Pain Foundation in Englewood, Colo. "We are going to see some big changes in the pain field in terms of how to have a functional life within the confines of what you are experiencing."

Treating the Person, Not Just the Pain

Like diabetes, chronic pain is a condition that needs to be managed on many fronts, says Dennis Turk, MD, the John and Emma Bonica professor of anesthesiology and pain research at the University of Washington School of Medicine in Seattle and president of the American Pain Society. "When we treat diabetes, we use insulin, but we now know that all people with diabetes also need to watch their diet and exercise, in addition to the use of insulin therapy [and other diabetes medications]. The same [multidisciplinary approach] is true with pain," he says.

Turk explains how-and why. "From a biomedical standpoint, we [tackle] the tissue source of the pain with medication or surgery. From a psychological standpoint, a significant number [of patients] have related depression and anxiety. From the social side, people with chronic pain may engage in bad behaviors that can make things worse.

"We need to find ways to treat the person, not just the pain," he says.

Treatment should also include coping and pain-management skills. "When you have chronic pain, you think that anything you do will hurt you further --- so you become a recluse," Sienkiewicz says. "The program enabled me to see that I won't hurt myself if I become active again."

Managing pain is often a family affair, says Stanos. "Pain psychologists work with the family, who want to help but go about it the wrong way. As a result, the patient gets lazy and passive because they know their family members will do it for them."

Some programs such as RIC's also include a recreational therapist. "A therapist takes them out and into the community," explains Stanos, "to use techniques learned in boot camp to get back to the activities they once loved. The problem in chronic-pain patients is that they are not coping well ... but learning to live better with the pain can decrease the ongoing use of medications."

"That's the best thing the clinic did for me," Sienkiewicz says. "I tried to fix the pain and get rid of it, as opposed to accept it and learn how to live with it."

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