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Chronic Pain: Integrative Treatments

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

Biofeedback, Deep Breathing, and More

Many of these programs use biofeedback and deep-breathing techniques. Biofeedback measures bodily functions, such as breathing, heart rate, and muscle tension. Patients learn to train their minds to control these functions. When first learning biofeedback, patients have sensors attached to their bodies and to a monitoring device that provides instant feedback about their pain. A biofeedback therapist then teaches them physical and mental exercises to help control that function.

The results are displayed on the monitor so that patients can see what works to relieve their pain. "People in chronic pain have elevated levels of stress, and we teach them to control their anxiety and reduce tension with a deep-breathing technique," Stanos says.

Patients in pain can learn much the same method at Stanford University's Pain Management Center, where they undergo cutting-edge functional magnetic resonance imaging (fMRI) scans to visualize pain in the brain by mapping blood flow. Then doctors feed signals back to the person, showing him or her how pain can intensify with stress and, conversely, improve with distraction techniques such as music or deep breathing.

Acupuncture is on the treatment roster of some major pain clinics, such as The Cleveland Clinic's Pain Management Center, which has acupuncturists like Timothy Rhudy, MS, Lac, on staff. "Clinics would never have non-MDs and acupuncturists in the past," he says.

According to Rhudy and other practitioners of acupuncture, this treatment uses needles to correct energy-flow imbalances in the body's qi, or energy patterns flowing through the body. Diseases, including chronic pain, occur when there are disruptions in this flow, they say.

But acupuncture is "no quick fix. It's part of an integrated approach," Rhudy says. "Acupuncture can sometimes jump-start a patient to get them to make changes in their own life, whether trying tai chi or yoga, or finding other ways of staying active and keeping the body flexible and working the muscles to keep pain at bay." In most cases, acupuncture requires multiple treatments over several weeks.

In a study of 570 people with knee osteoarthritis, those who received acupuncture in addition to anti-inflammatory pain relievers significantly improved knee function and had decreased pain compared with people who only took medication. This study appears in the Dec. 21, 2004, issue of the Annals of Internal Medicine.

Gain on Pain

"We are starting to realize pain is not the enemy, but an important warning system on the body's part," says Jacob Teitelbaum, MD, medical director of the Annapolis Center for Effective CFS/Fibromyalgia Therapies in Maryland and the author of Pain Free 1-2-3! A Proven Program to Get You Pain Free NOW.

"Pain tells us if something needs attention, but we normally ignore it and try to mask it with medication. Pain is trying to get our attention just like the oil light on the dashboard."

According to Teitelbaum, pain management involves better nutrition and a focus on sleep, as well as addressing potential hormonal deficiencies that may make pain worse. In a National Sleep Foundation poll taken in 2000, 20% of American adults reported that pain or physical discomfort disrupted their sleep a few nights a week or more.

The bottom line is that "chronic pain should not be a passive disease," Sitzman says. "You have to fight it and find what works for you."

Just like Mary Sienkiewicz did. "The clinic gave me a toolbox. It taught me how to accept this disease, and how I can learn to live and work with it," she says.

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Reviewed on June 01, 2006

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