When pain becomes chronic, medication is not always the best solution. These eight proven approaches may provide relief.
Only recently have doctors begun to treat chronic pain as a disease in its own right. So many people live with some form of chronic pain: from migraines to back problems, from fibromyalgia to osteoarthritis, from lingering pain from old injuries to pelvic floor dysfunction. While medications like NSAIDs (non-steroidal anti-inflammatory drugs) and opioids are helpful in treating acute pain, they often fail to significantly relieve pain that has become chronic and, in the case of opioids, can create more problems than they solve. Fortunately, there are many non-pharmacological treatments and approaches available today that can reduce chronic pain and help people relearn how to enjoy life.
Here are eight science-backed methods:
1. Mindfulness-Based Stress Reduction
Mindfulness is more than a buzzword, and it’s certainly not new. Based on ancient meditation practices from Eastern cultures, mindfulness is gradually being adopted by conventional medicine to improve the symptoms of certain illnesses. Learning to tune into your body, connect to the environment around you, and help your mind slow down has a host of research-backed benefits, such as reducing stress, chronic pain, and even symptoms of depression and anxiety. It can also increase feelings of well-being and self-awareness.
When it comes to chronic pain, the goal of mindfulness training is to learn and potentially change your perceptions and reactions to pain. Studies have shown that an eight-week course in mindfulness can reduce pain frequency, sensitivity, and even the unpleasantness of the pain itself. This doesn’t mean the pain is just “in your head”; in fact, magnetic resonance imaging (MRI) scans have shown that practicing mindfulness changes the way the brain responds to pain. It has been shown to be useful for inflammatory bowel syndrome and inflammatory bowel disease, lower back pain, psoriasis, fibromyalgia, and symptoms related to rheumatoid arthritis (RA).
2. Qigong and tai chi
These ancient Chinese practices involve slow, deliberate movements, and can be considered forms of moving meditation. Tai chi is more of a whole-body approach that is part of a martial art form, while qigong is usually practiced in a standing or seated position, with less active times. The goal of these low-impact practices is to increase or access the body’s energy, called “chi” or “qi”, which helps improve inner balance and well-being.
Although the many benefits of these practices are supported by science and they are generally considered safe, it is not known exactly how tai chi and qigong reduce chronic pain. Experts believe that the deep relaxation facilitated by these practices can relieve muscle tension, boost endorphins and calm the nervous system. Exercise in general helps loosen stiff muscles and improve blood circulation, which can also help reduce pain. Clinical trials have shown that these practices relieve chronic lower back pain and pain associated with fibromyalgia, osteoarthritis, and rheumatoid arthritis.
3. Pain Reprocessing Therapy
This newer treatment has only been extensively tested in people with chronic back pain, but the results have been very positive: In a clinical trial published in September 2021 in the journal JAMA Psychiatry, on approximately 150 patients with mild to moderate back pain with no clear physical origin, two-thirds had no or almost no pain after four weeks of pain reprocessing therapy (PRT) instruction and 98% had at least some improvement.
The therapy is based on the idea that with specialized training, people can actually train their brains to turn off chronic pain. Patients first learn how the brain interacts with pain, the toxic pain-fear cycle, and the reversibility of pain. They learn to modify their perception of pain, viewing it with curiosity and without judgment, rather than with fear or apprehension. PRT instructors will also help people overcome other emotional barriers that can raise perceived threat levels that exacerbate pain, such as difficult relationships and harmful self-criticism. Treatment is also particularly useful for pain catastrophizing, that is, believing that the pain is unbearable, intolerable, or will never end. These thoughts are just thoughts, not facts, and reprocessing the pain can help you overcome them.
Sessions are one-on-one with a therapist, twice a week for four weeks. Providers must undergo special training. Further research is ongoing to investigate the long-term effects and to determine if this technique may benefit other types of pain.
4. Acupuncture
Acupuncture treatment originated from Traditional Chinese Medicine (TCM), a practice that has been around for thousands of years. An acupuncturist treats a patient by using fine needles to pierce the skin at specific points on the body to activate or alter the flow of chi, or energy, that helps the body stay healthy and function properly. From the perspective of Western medicine, the needles are primarily meant to stimulate the central nervous system in such a way as to increase or decrease different chemicals in the body to promote healing.
When it comes to chronic pain relief, a review of several studies looking at the effectiveness of acupuncture showed that the practice is effective, its results persist over time, and its benefits cannot be explained by reason. placebo effect. The treatment is also generally considered safe. It can treat chronic back pain, joint pain, and even headaches and migraines. Studies suggest it may also improve symptoms of Crohn’s disease and ulcerative colitis, psoriatic arthritis, rheumatoid arthritis, and even endometriosis.
Acupuncture sessions take place with the patient sitting or lying on a table, often in a quiet, dimly lit room. The location of the needles will depend on the area of pain, and they shouldn’t be very painful. Most people find the treatment relaxing. While some people report a worsening of their symptoms after starting acupuncture, TCM practitioners say this is often normal and that worsening is usually followed by rapid improvement.
5. Cognitive-behavioral therapy
Cognitive-behavioral therapy, commonly referred to as CBT, is the cornerstone of contemporary talk therapy, but you may be surprised to learn that it can also help chronic pain. CBT teaches people to identify negative or unproductive thoughts and replace them with beneficial thoughts. In other words, patients learn to deal with discomfort by changing focus and perspective, thereby reducing the perceived intensity of pain, which, if left unchecked, can create a loop of pain. negative feedback.
Studies have shown that CBT can improve symptoms of chronic back and joint pain, in addition to headaches. In a study of nearly 1,000 people on long-term opioid treatment for chronic pain, people who took CBT along with yoga and breathing exercises for three months found that their pain was reduced, even a year later. They also saw an improvement in their sleep and their ability to perform daily tasks.
CBT is usually practiced in individual sessions that can take place in person. It’s important to find a provider you feel comfortable with, and the first session should feel like a consultation. If the relationship isn’t good, know that it’s okay to find a new therapist. Once your therapy is complete, usually after 5-20 sessions, you will need to continue practicing the skills learned to see the benefits. There are also apps that offer CBT lessons that have been researched.
6. Chiropractic
People who swear by their chiropractor…. swear by their chiropractor. This manual therapy involves manipulating the spine, and sometimes other parts of the body, to improve range of motion and physical function, and to correct alignment. Practitioners believe that correcting the alignment of the spine reduces pressure on the central nervous system, which increases the body’s ability to heal itself and therefore reduces chronic pain.
The effectiveness of the technique has only been proven for musculoskeletal problems: low back pain, sciatica, headaches and migraines, and neck pain. The evidence is strongest for low back pain. It may also benefit people with multiple sclerosis (MS) and those with hip and back pain from osteoarthritis. It is not recommended for active ankylosing spondylitis (AS).
The sessions take place in an office and several visits may be necessary. The chiropractor makes adjustments with the patient sitting or lying on a table. Aches or fatigue may be felt for a few days after a session, such as after a rigorous training session.
7. Biofeedback
Biofeedback shares some foundations with mindfulness-based stress reduction. Using various soft sensors attached to the body, this practice can help people become aware of their physical reactions to stress or pain, such as rapid breathing or contraction of certain muscles. A therapist can then impart techniques to prevent or reverse these reactions when they threaten to exacerbate the pain, thereby providing physical and emotional relief.
This technique has proven effective in treating chronic pain related to many conditions, from fibromyalgia and osteoarthritis to lupus and ATM. It also helps relieve headaches and migraines, as well as back and knee pain. It not only reduces the intensity of pain, but also alleviates the symptoms of depression and anxiety. The types of sensors used and the techniques taught can vary greatly depending on the type of pain and its cause. The recommended number of sessions may also vary.
