Holistic Healing (an inset of The Right and Wrong Way to Treat Pain)

By Sora Song
Time Magazine
February 28, 2005

At the leading pain-management centers, the goal is to fashion a course of treatment that fits the patient and the condition. Modern pain management draws on a full range of options, from Advil and acupuncture to vitamins and self-hypnosis.

HEADACHE

Lifestyle Changes
Headaches can be triggered by all sorts of things - stress, caffeine, alcohol, bright lights, dusty air. Avoid whatever causes yours.

Medical Therapy
Try acetaminophen (Tylenol) or nonsteroidal anti-inflammatory drugs (NSAIDS)such as ibuprofen (Advil) or naproxen (Aleve). Some Anacin and Excedrin pills contain caffeine, which may make a headache worse. So-called triptans, such as sumaptriptan,(Imitrex), can quell migraines, but don't use them if you have heart problems.

Mindfulness Therapy
Relaxation techniques can ease headache pain - and indeed most chronic pain - with or without drugs. Meditation, biofeedback, self-hypnosis, progressive relaxation and guided imagery can be taught at a clinic and practiced at home.

Alternative Therapy
Some patients swear by acupuncture or the herb feverfew. Botox injections work for some migraine sufferers, though the injection is not FDA-approved for headaches.

OSTEOARTHRITIS

Lifestyle Changes
Losing weight - even 5 slbs. - takes pressure off joints. Frequent low-impact exercise - swimming, walking, yoga - eases pain.

Medical Therapy
Acetaminophen and NSAIDs soothe aching joints. But high doses or long-term use of acetaminophen can harm the liver and NSAIDs can cause stomach bleeding. The COX-2 inhibitors Celebrex and Bextra are just as effective for pain relief and pose less bleeding risk, but they may increase risk of heart attack and stroke.

Mindfulness Therapy
Any of the relaxation techniques can help.

Alternative Therapy
Glucosamine sulfate supplements may relieve pain and even rebuild cartilage. Other remedies: acupuncture, hot or cold packs, Bengay and the capsaicin cream Zostrix.

MUSCLE OR JOINT INJURY

Lifestyle Changes
Doctors have an acronym - RICE - for rest, ice, compression and elevation. Do this for one or two days. Apply continuous low-level heat afterward. Resume gentle activity as soon as you can.

Medical Therapy
Try an over-the-counter analgesic, such as Tylenol, Advil or Aleve. Patients with severe pain may need an opiod, such as codeine.

Physical Therapy
Sprains and strains usually heal on their own. Conditioning exercises can strenthen injured muscles or joints.

Mindfulness Therapy
If you're having chronic pain, get adequate rest. If you have trouble sleeping, practice good sleep hygiene: avoid caffeine, tobacco and alcohol, don't exercise or watch TV right before bed and try relaxation techniques.

BACK PAIN

Lifestyle Changes
Use a cold pack for the first day or so, then switch to continuous heat. Get back on your feet as soon as possible. Bed rest won't help, so resume normal activity, then moderate exercise.

Medical Therapy
Nonprescription pain relievers may be enough. For severe episodes of pain, you may need a long-acting opioid such as OxyContin or morphine. Disk pain or spinal problems could require epidural cortisone injections or, as a last resort, surgery.

Physical Therapy
Strengthen stomach and back muscles. Chiropractic, massage or Pilates may help.

Mindfulness Therapy
Relaxation techniques can lessen discomfort. They can also help reduce stress, which may be contributing to your pain.

NEUROPATHY

Lifestyle Changes
Neuropathy is pain from nerve damage, often caused by diseases such as AIDS, diabetes, cancer or shingles. Start by treating the underlying cause.

Medical Therapy
Doctors recommend anticonvulsant drugs like Neurontin, tricyclic antidepressants such as Elavil, the antidepressant duloxetine (Cymbalta), lidocaine patches to numb pain or opiods.

Mindfulness Therapy
Relaxation is key. Psychotherapy can also help manage pain and depression.

Alternative Therapy
Supplements containing primrose oil, B vitamins or E vitamins may help.

FIBROMYALGIA

Lifestyle Changes
To help ease the overall pain and tenderness caused by fibromyalgia, a musculoskeletal disorder, you must get enough restful sleep, stay active and keep your weight down.

Medical Therapy
Tricyclic and SSRI (Prozac-type)antidepressants can help.

Physical Therapy
Begin weight-bearing and aerobic activities as well as flexibility exercises such as yoga.

Alternative Therapy
Some doctors recommend the Feldenkrais Method, which teaches you how to move and posture your body more efficiently.

Sources: Consumer Reports; Dr. Seymour Diamond, National Headache Foundation: Dr. Scott Fishman, American Academy of Pain Medicine: Dr. John Klippel, Arthritis Foundation: Dr. Bill McCarberg, Kaiser Permanente; National Pain Foundation