Chronic pain can include anything from migraine to back issues, fibromyalgia to osteoarthritis, lingering pain from old injuries to pelvic floor dysfunction. While medications like NSAIDs (nonsteroidal anti-inflammatory drugs) and opioids are useful for treating acute pain, they often fail to provide meaningful relief for pain that’s become chronic, and in the case of opioids, can create more problems than they solve.
Fortunately, there are multiple non-pharmacological treatments and approaches available today that can decrease chronic pain and help people learn to enjoy life again.
Mindfulness-Based Stress Reduction
Mindfulness is more than a buzzword, and it’s definitely not new. Based on ancient meditation practices originating from the cultures of the East, mindfulness is gradually being adopted by mainstream medicine to improve the symptoms of certain conditions.
Learning to tune into your body, connect with the environment around you, and help your mind slow down has myriad benefits backed by research, like reducing stress, chronic pain, and even symptoms of depression and anxiety. It can also increase feelings of wellbeing and self-awareness.
When it comes to chronic pain, the intention of mindfulness training is to learn about and potentially shift your perceptions of and reactions to pain.
Studies have shown an eight-week course in mindfulness can lower pain frequency, sensitivity, and even just the unpleasantness of pain itself. Magnetic resonance imaging (MRI) scans have shown that practising mindfulness changes how the brain responds to pain, and has proven to be useful for inflammatory bowel diseases, lower back pain, psoriasis, fibromyalgia, and rheumatoid arthritis (RA)–related symptoms.
Mindfulness-based stress reduction courses are most commonly offered in a group setting with an instructor, or some may explore practising mindfulness independently via books and audio recordings.
MBSR activities often include guided meditation and group discussions, writing exercises to facilitate self-reflection, and other practices such as loving kindness.
Qigong and Tai Chi
These ancient Chinese practices involve slow, deliberate movements, and can be thought of as forms of moving meditation.
Tai chi is more of a full-body approach that is part of a martial art form, whereas qigong is usually performed while standing or sitting with less active moments.
The goal of these low-impact practices is to increase or access energy in the body, known as “chi” or “qi,” which in turn leads to heightened inner balance and wellbeing.
While the many benefits are backed by science and the practices are generally considered safe, western medicine doesn’t understand how tai chi and qigong reduce chronic pain. Experts theorise that the deep relaxation the practices can facilitate may relieve muscle tension, boost feel-good endorphins, and calm the nervous system.
Exercise in general helps loosen up stiff muscles and improve blood flow, which can also help with pain reduction. In clinical trials, the practices have been found to help chronic low back pain and pain associated with fibromyalgia, osteoarthritis, and rheumatoid arthritis.
Pain Reprocessing Therapy
This newer treatment has only been extensively trialled in people with chronic back pain, but the results have been very positive: In a clinical trial published in September 2021 in JAMA Psychiatry, out of about 150 patients with mild or moderate back pain without a clear physical origin, two-thirds were pain-free or nearly pain-free after four weeks of pain reprocessing therapy (PRT) instruction — and 98 percent had at least some improvement.
The therapy is based on the idea that with specialised training, people can actually train their brains to switch off chronic pain.
Patients are first taught about how the brain interacts with pain, the toxic pain-fear cycle, and the reversibility of pain. They learn to change their perception of pain, viewing it with curiosity and non-judgement instead of fear or apprehension.
PRT instructors also helps people address other emotional roadblocks that can raise perceived threat levels which exacerbate pain, like difficult relationships and pernicious self-criticism.
The treatment is also helpful specifically for pain catastrophising, or believing your pain is unbearable, intolerable, or will never end. These sorts of thoughts are just that — thoughts, not facts, and pain reprocessing can help you overcome them.
Acupuncture
Acupuncture treatment comes from traditional Chinese medicine (TCM), a practice that has been around for thousands of years. An acupuncturist treats a client by using thin needles to puncture the skin at specific points on the body to activate or shift the flow of chi, or energy, that helps keep the body healthy and functioning appropriately. From a western medicine perspective, the needles are primarily thought to stimulate the central nervous system in ways that either increase or decrease different chemicals in the body in order to help with healing.
When it comes to chronic pain relief, a look at multiple studies examining the effectiveness of acupuncture showed that the practice is effective, its results persist over time, and its benefits cannot be explained away by the placebo effect. The treatment is also generally considered safe. It can treat chronic back pain, joint pain, and even headaches and migraine. Studies suggest it may also improve symptoms of Crohn’s disease and ulcerative colitis, psoriatic arthritis (PsA), rheumatoid arthritis, and even endometriosis.
Cognitive Behavioural Therapy
Cognitive behavioural therapy, commonly known as CBT, is a cornerstone of contemporary talk therapy, but you may be surprised to know that it can help chronic pain as well.
CBT teaches people to identify negative or unproductive thoughts and replace them with beneficial ones.
Put another way, patients learn to manage discomfort by shifting their focus and perspective, thereby lessening the perceived intensity of pain, which left unchecked can create a negative feedback loop.
Research studies have shown 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, individuals who received CBT along with yoga and breathing exercises for three months found their pain reduced even one year later. They also noticed improvements in sleep and the ability to complete everyday tasks.
Chiropractic Therapy
People who swear by their chiropractor, swear by their chiropractor. This hands-on 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 fixing spinal alignment reduces pressure on the central nervous system, increasing the body’s ability to heal itself and therefore reducing chronic pain.
The technique has only been proven effective for musculoskeletal issues: low back pain, sciatica, headaches and migraine, and neck pain. The evidence is strongest for low back pain. It also may be beneficial for people with multiple sclerosis (MS) and those with hip and back pain from osteoarthritis. It’s not recommended for active ankylosing spondylitis (AS).
Biofeedback
Biofeedback shares some foundations with mindfulness-based stress reduction. Using different gentle sensors attached to the body, the practice can help people become aware of their physical responses to stress or pain, like quickening their breathing or tensing certain muscles. A therapist can then share techniques that can prevent or reverse these reactions when they threaten to exacerbate pain, providing physical and emotional relief in the process.
The technique has proven effective in treating chronic pain for numerous conditions, from fibromyalgia and osteoarthritis to cancer, lupus, and TMJ. It also helps with headaches and migraine, as well as back, knee, and vulvar pain. Not only does it reduce pain intensity, but it can also help with symptoms of depression and anxiety.
Physical Therapy
Physical therapy, often called “PT” for short, is a mainstream, active treatment that can help patients with chronic pain regain strength and mobility, with the goal of reducing pain in the process.
A physical therapist could help you build up the muscles around your core, for example, to help with low back issues. They might also use additional techniques like massage or TENS therapy (transcutaneous electrical nerve stimulation) to potentially help disrupt pain signals, increase blood flow for healing, and encourage the production of endorphins.
Physical therapy is effective for treating chronic pain related to hip and knee osteoarthritis, fibromyalgia, sciatica, back issues, and even pelvic pain associated with gynaecological cancers.
It can also help people who are scared to move feel more comfortable and safe with exercise again, which has numerous physical and emotional benefits.
SOURCE: Everyday Health
