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Publix GreenWise Market Magazine - August 2008

What is the Alternative?
Dial down chronic pain the natural way with therapies that pick up where conventional medicine leaves off.

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What

Pain snuck up on 43-year-old Kelly Powell of Greenville, South Carolina, who began experiencing daily problems with her neck several years ago. Before long, she recalls, “I was achy all the time, and even sleeping was uncomfortable.”

At first Powell lived with the pain, but in time she found it took a toll on her quality of life. Even playing tennis, something that she loved, was no longer enjoyable. “I kept thinking, It will go away, it will go away,” she says. But when the problem got worse, Powell knew it was time to act.

A neighbor recommended a chiropractor, and after two visits, Powell felt she had turned a corner. She now goes once a week for what she describes as a 15-minute  “gentle manipulation.” If she waits longer than that, she says, her symptoms return.

To understand the problem with chronic pain, it helps to differentiate it from acute pain. Sudden, acute pain is unpleasant but helpful. It alerts the body that something is wrong and that protective action must be taken. Its source—typically disease, inflammation or injury—can usually be diagnosed and treated.

Chronic pain is a different story. The nervous system continues to send signals that something is not right for months or even years. The source of the discomfort can’t always be pinpointed, but it’s no less real. Often occurring in the form of headaches, arthritis, or lower back or neurogenic problems, this type of daily, grinding pain can wear down not only your body but also your attitude.

Medication, physical therapy or surgery may help with chronic pain. But since conventional medicine often doesn’t alleviate all the discomfort, many people turn to complementary/alternative medicine (CAM). Turn the page to learn more about five CAM treatments that are sometimes combined with conventional medicine for additional relief.

Acupuncture

Acupuncture
A recent study in Germany showed that acupuncture treatment was almost twice as effective at reducing low back pain as conventional treatment, but, surprisingly, so was sham acupuncture. The study included 1,162 adults of all ages with chronic low back pain that had lasted for an average of eight years (Archives of Internal Medicine, September 2007). Study participants were randomly assigned to receive either acupuncture, sham acupuncture (superficial needling at nonspecific points) or conventional treatment (medication, physical therapy and exercise) for at least six months.

Acupuncture originated in China over 2,000 years ago, but researchers are still sorting out its effects. In traditional Chinese medicine, acupuncture is thought to work by unblocking the flow of energy along invisible pathways in the body known as meridians. Specific anatomical points are believed to link these pathways like a connect-the-dots drawing, and placing needles at the right points is critical. However, the German study—one of the largest and most rigorously controlled ever done on acupuncture for back pain—raises questions about just how important specific acupuncture points may be. Some Western scientists theorize that acupuncture actually may work by promoting the release of pain-killing chemicals and immune system cells.

The best-studied technique uses hair-thin, solid metallic needles that are inserted into specific points on the skin. Little or no pain accompanies the procedure unless the needles are defective or improperly placed, or the person moves during treatment. To avoid infection, practitioners should use a new set of needles taken from a sealed package and swab areas to be treated with alcohol or another disinfectant before placing the needles.

Hypnosis
Better known for its use in quitting smoking and weight loss, hypnosis has a growing reputation as a tool for pain management as well. In essence hypnosis decreases activity in key areas of the brain so that you “feel less pain and care less about it,” explains David Spiegel, M.D., associate chair of psychiatry and behavioral sciences at Stanford University School of Medicine.

Hypnosis is a state in which your mind and body are deeply relaxed, your attention is focused and you are unusually open to suggestion. Don’t worry about being put into an involuntary trance. A qualified health professional won’t hypnotize you against your will.

“When you are in a true hypnotic state, you simply feel very relaxed and can … block out pain,” says Suzanne Taylor of Huntsville, Alabama, a runner who uses hypnosis to manage discomfort while competing in races. Under hypnosis, a person is receptive to suggestions from a therapist that the sensation is fading or the painful area is becoming numb. With training, you also can learn to hypnotize yourself.

Children may be even easier to hypnotize than adults. One study of 144 youngsters with chronic headaches found that they reported less pain after being trained in the use of self-hypnosis (Journal of Pediatrics, June 2007).

Chiropractic
I don’t treat conditions; I treat the spine for misalignment,” explains Kelly Miller, D.C., a Greenville, South Carolina, chiropractor who counts Kelly Powell among her patients. When the spine is properly aligned, Miller says, it opens the path for pain relief.

Typical patients are in their 40s or older, a time when aches and pains start to become more prevalent. And although a bit of apprehension is normal at the first visit, Miller says a good chiropractor will quickly calm any fears and educate patients in the process.

Being treated by a chiropractor shouldn’t hurt, she explains. There are many different treatment techniques, and a chiropractor doesn’t have to “crack” someone’s back to correct the positioning of the spine. For instance, a practitioner might use various adjusting machines or simply apply pressure.

A recent review of the medical literature found “good evidence” that spinal manipulation is moderately effective in treating chronic low back pain (Annals of Internal Medicine, October 2007). Possible side effects of chiropractic treatment include temporary headaches, fatigue or discomfort. However, the likelihood of serious complications is low when spinal adjustment is performed by a licensed chiropractor.

Massage

Massage Therapy
Although massage is usually thought of as a spa indulgence, the American Massage Therapy Association (AMTA) says more people get a rubdown for medical reasons than for relaxation. According to the AMTA, about one-third of Americans say they’ve turned to massage—the manipulation of the muscles and soft tissues of the body—for pain relief. And a survey sponsored by the association shows that 87 percent of the people polled believe massage can be effective for that purpose. Scientists theorize massage might help by blocking pain signals to the brain and stimulating the release of endorphins, chemicals that are natural pain relievers.

During treatment, you may be partially or fully undressed, although you’ll be draped by a sheet or towel. The therapist may use powder, ice, heat, fragrances or massage machines to assist the process. Possible side effects include temporary discomfort, bruising, swelling or an allergic reaction to the massage oil. Massage is not advised for people with certain conditions, including deep vein thrombosis (a blood clot in a deep vein), bleeding disorders, damaged blood vessels, osteoporosis, fever, or infection or inflammation in the area being massaged. People with some other conditions—including pregnancy, cancer, fragile skin or heart problems—should check with their doctor first. Be sure to tell your massage therapist about any health problems you have.

WhatGuided Imagery
One study of adults with chronic tension headaches found that listening to a guided imagery tape every day improved pain management (Headache, May 1999). And what could be better than being able to escape to a warm beach or peaceful mountaintop whenever the pain gets to be too much?

That's the idea behind guided imagery, in which people use their imagination to conjure up sensory experiences-sights,sounds,smells,tastes and touch sensations-that help them reduce stress and manage discomfort.

In a guided imagery session, you may be asked to breathe deeply and mentally visit a place you find peaceful and safe. While you're imagining the feel of warm tropical breezes and the smell of a fresh pineapple-guava smoothie, the brain sends messages to the nervous system, telling it that stress has taken a breather and allowing the body to quiet the signals of pain.

There really is no downside to daydreaming your way to a less stressed and more comfortable state of mind. It can't hurt, and it just might help ease your chronic pain.

LEARN MORE: Visit the American Chronic Pain Association at theacpa.org.

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