Pain is by far the most common medical condition people experience and the #1 reason for doctor visits. Pain can impact people in so many ways, be long lasting, and make people desperate. But there is hope for relief from pain.
In the United States, we have created opioid and pain epidemics because of our failure to treat pain without using addictive drugs. Recently this has begun to change. Standard guidelines for various pain conditions around the world have begun shifting toward an integrative medical approach. Within these guidelines, conventional strategies (drugs, surgeries) are combined with natural or complementary and integrative approaches as well as therapies to improve mental-emotional and social health. Within some guidelines (e.g., American College of Physicians 2017 Non-specific Low Back Pain Guidelines), it is recommended that specific complementary therapies be tried before conventional methods.
Several complementary treatments have been shown to improve the health of people in pain as well as drugs with fewer side effects. Large studies offering people with pain access to multiple complementary and integrative practitioners have also reported up to 2-3 fold benefits over conventional care alone. (For a complete research report on natural therapies for different pain conditions [including specific forms of musculoskeletal, gastrointestinal, headache, neurological, and pelvic pain] please visit http://www.thelifecenterofct.com/tlcprpresearch)
Chronic Musculoskeletal Pain Relief
Let’s focus on the basics of chronic musculoskeletal pain relief. Chronic musculoskeletal pain means that a muscle, bone and/or joint has been hurting you for over 3 months. If you have chronic musculoskeletal pain, it’s best to keep active even when it’s difficult.
Exercise is essential to pain relief.
Start by gently stretching and massaging tight muscles. Strengthen weak muscles and gently move the joint in all directions. Utilize hot packs/baths regularly and ice packs if pain flares. Remember to keep moving with your activities of daily living and gradually increase exercise (i.e., graded exercise).
Try to incorporate multiple exercise modalities such as walking, interval training, strength training, sports, stretching, yoga, tai chi, hiking, and swimming to maintain activity and motivation while decreasing strain on the affected area. Specific forms of exercise are proven effective for certain types of pain.
- Yoga, core strengthening, Pilates and/or tai chi for low back pain
- Tai chi and agility exercises for knee pain
- Postural exercises and semi-supine technique for neck pain
- Nordic walking for hip arthritis
- Mobility exercises for shoulder and hip pain
- Nerve flossing exercises for arm or leg pain
Primary care providers, orthopedists/sport medicine doctors, physical therapists, chiropractors and naturopathic physicians can help find the right exercises for you.
See a healthcare practitioner that specializes in manual therapy.
These practitioners include most chiropractors, many naturopathic doctors and physical therapists, doctors of osteopathy specializing in manual therapy, and some medical doctors specializing in physiatry. Request gentler forms of manual therapy (such as cranial sacral therapy) if you are weary of spinal manipulations or have medical conditions that restrict its usage (such as osteoporosis). Regular massage therapy from a licensed massage therapist (LMT) can also help.
Try acupuncture through a licensed practitioner.
This ancient Chinese modality is proven helpful for various types of chronic pain including but not limited to neck, back, carpal tunnel and headaches. Shiatsu massage or at home acupressure may also be helpful.
It matters how you think, perceive and feel.
Enhancing mental and social health is an essential component in treating all chronic pain, whether or not a mental health disorder is evident. Proven treatments for mental health and pain include cognitive behavioral therapy, exercise, mindfulness (including MBSR), meditation, yoga, tai chi/qi gong, hypnosis, progressive relaxation, spirituality/religion, transcranial electric or magnetic nerve stimulation, being in nature, journaling, music, self-help books, Emotional Freedom Technique and other relaxation techniques. If you have a mental health disorder or are unsure, seek mental health care by a licensed psychologist and/or psychiatrist. If mental health is problematic, combining psychotherapy with medications, exercise and other options above is most successful.
Optimal nutrition is crucial for pain relief.
The top nutritional strategies for pain include lectin avoidance, anti-inflammatory, and Mediterranean diets. Make an effort to lose weight if you’re overweight, particularly if you have osteoarthritis. Some herbal therapies and nutritional supplements can be considered but should be used with naturopathic or medical supervision due to potential drug interaction risks. Assessment and optimization of vitamin/mineral (B12, folate, iron, magnesium, potassium, vitamin D, etc.) and omega-3 levels can help. Consider one month+ trials of ginger, turmeric and/or tart cherry capsules, glucosamine sulfate and/or chondroitin sulfate, egg shell membrane, alpha lipoic acid (for nerve pain), homeopathic remedies (e.g., Ruta, Rhus tox, Hypericum, Ledum, Bryonia), and other naturopathic methods.
You need sleep to help relieve pain.
Learn the basics of cognitive behavioral therapy for insomnia and seek professional treatment if you think it might help you. CBT has been found very effective for insomnia. Exercising during the day (nothing strenuous at night), relaxation and meditation techniques, avoiding negative thoughts regarding sleep, avoiding caffeine after morning hours, increasing sunlight/nature exposure during day and decreasing light/electronic exposure after sunset help re-establish regular sleep rhythms including melatonin production. If you have difficulty falling asleep or are a shift worker 3-5mg of melatonin (taken 1 hour before desired sleep nightly, as it has additive effects) is a low-risk and proven treatment option. If you awaken in the night, drinking Vervain/Verbena tea or 10-25 drops of the tincture around bedtime (and smaller doses if you awake) is also helpful for most. Valerian (for non-sanguine types), chamomile, hops, glycine, and l-tryptophan can also be tried.
Pain is complex. The information in this article is just a beginning. Naturopathic physicians are uniquely qualified to address your multifaceted case. It is critical to address overall levels of inflammation, autoimmune status, and any additional medical conditions for effective pain relief. If you’d like help with your particular type of pain please call The Life Center of Connecticut or see another integrative medicine pain specialist.
Robert Lee, ND, MS, MA is a naturopathic physician and director of pain management and mind-body medicine at The Life Center in North Haven, CT. Prior to this position, Dr. Lee worked for 10+ years as a research investigator of integrative medicines through Yale and other groups. He graduated with top of class clinical marks from the oldest accredited naturopathic medical school, NUNM in Portland, OR and also holds two Master’s degrees focused on research sciences and art of integrative medicine. (203) 239-3400.