By Janet Jay
Learn which complementary therapies may benefit you the most.
Chronic pain is different for everyone, and there’s no one-size-fits-all approach to care. More than 50 million Americans experience pain every day, almost half of which live with pain that significantly impacts their daily life. Given the complexity and individuality of pain, the most effective treatment plan usually involves a combination of multiple types of therapies.
Multidisciplinary care, also known as integrated health, refers to the whole spectrum of care and the practice of using different modalities in conjunction to reduce pain.
The wide range of multidisciplinary treatments that exist can be daunting to those seeking treatment. Unfortunately, more than three-quarters of patients seen at pain clinics/centers said in a U.S. Pain Foundation survey that their center only offers pain doctors, not multidisciplinary specialists. Medical professionals “need to treat folks with an individualized patient-centered approach,” said Vanila M. Singh, MD, Former US Chief Medical Officer & current Chair of the Health and Human Services’ Pain Management Best Practices Inter-Agency Task Force.
Even if the bulk of the research falls on you as a patient, a site like MyPainPlan.org will help you learn the range of possible treatments and narrow down what might help your specific issues. These range from more traditional medical approaches like medications, surgical interventions, or external devices, to complementary options, behavioral health, self-management, and restorative therapies.
Here are just a few of the options out there for a person with chronic pain seeking multidisciplinary care.
One of the first options for pain relief many people try is medication. Different types of medications treat pain in different ways: some provide generalized pain relief, but others relieve pain by treating specific conditions (e.g., calcitonin gene-related peptides for headache disorders or immunosuppressants for autoimmune disorders). Some medications address multiple categories of pain, while others use a combination of medications to target more than one pain type.
Unfortunately, the barriers around opiate medications make it so that some patients have difficulty obtaining adequate pain relief: in a survey of 3,000 physicians nationwide, more than one-third said opioid restrictions “have hurt patients with pain.”
Prescribing habits also reflect wider health care disparities. “A lower percentage of Black patients receive opioid prescriptions & a 36% lower mean annual dose,” observed Dr. Singh. “Pain medicine providers must be vigilant in avoiding implicit bias when treating patients.”
Working closely with your doctor and health care team is a must. But medication is not an exact science, and every person’s pain, comorbidities, and body chemistry are different. Some patients will find that their meds take a while to reach full efficacy, or may have to try multiple medications or dosages to find one that helps. The way that medication is delivered (orally, topically, intravenously, even implanted) can also affect how your body responds.
Interventional medicine is a term for surgical procedures performed by a doctor, which can range from minimally invasive outpatient treatments to more invasive procedures performed by a medical team. A common type of interventional procedure is injections/blocks, which involve injecting a steroid, anesthetic, or acid into the nerves, muscles, or joints.
Neurolysis, another treatment often used for nerve pain, employs chemicals, heat, or cold to degenerate or injure the nerve and reduce or interrupt its transmission of pain signals.
Implantable neuromodulation technology can be a great choice for patients with some types of long-term pain, and the options for these devices, which use electrical pulses to “drown out” pain signals in nerves, have boomed in recent years.
External neuromodulation and electrical stimulation
This treatment category uses electrical signals to reduce pain by interfering with, or even blocking, pain signals in the body. While some treatments in this category, like TENS (transcutaneous electrical nerve stimulation) units, have been around for decades, the technology around neuromodulation is quickly evolving and new devices are approved by the FDA often.
A wide range of treatments and technologies use unique delivery methods, varying amounts and types of current, and other non-invasive (or minimally invasive) treatment strategies to target the specific nerve and muscle groups that are causing pain. Some of these devices can be used at home, while others require treatment in a medical facility.
This category of treatment is low-risk but can be expensive and may not be covered by insurance. Scientific evidence on the effectiveness of these treatments also widely varies.
The term “complementary medicine” describes a treatment that you use in conjunction with conventional medicine, adding to the treatment plan your doctor has in place. These include treatment options that are not typically part of conventional medical care and/or have origins outside of Western medicine.
Patients must be aware that each treatment is different, but the treatments in this category have varying levels of scientific evidence supporting them. Cost is a major concern with complementary health approaches: in fact, a U.S. Pain survey found that over 75% of respondents indicated cost prevented them from accessing one or more treatment options.
Mind-body and behavioral health approaches
Stress, anxiety, and depression increase pain, and then pain increases stress, anxiety, and depression. Chronic pain patients are significantly more likely to experience these issues and this cycle, which can exacerbate pain.
For example, a U.S. Pain survey found that 84% of children with chronic pain indicated they experienced anxiety. That doesn’t mean the pain is not “real,” just that the body and mind are closely interrelated. Because of this, mind-body and behavioral health approaches help to reframe how you see your pain, improve your ability to cope with it, and work towards breaking that cycle.
These treatments include counseling, psychiatric care, CBT (cognitive behavioral therapy), mindfulness—even biofeedback. It’s extremely important for people with chronic pain to have accessible mental health care, as they have more than double the risk of suicide than those without chronic pain.
This category of treatment focuses on utilizing or modifying physical movement to reduce pain. Restorative therapies like physical therapy, pool therapy, and strength training help develop mobility, flexibility, and strength, which can greatly reduce pain levels, while treatments like occupational therapy aim to help develop solutions and coping mechanisms for the physical requirements and challenges you face daily.
While some of these strategies can provide immediate pain relief, others may take time to see results. Some people may even experience increased pain in the short term, although eventually some of these treatments actually address the underlying cause of pain.
Some restorative therapies are simple and easy to try at home: for instance, a U.S. Pain survey found that 83% of respondents mentioned the successful use of heat and cold therapy to manage pain.
Unfortunately, finances are still a significant factor in patients’ access to many other treatments: for instance, the same survey found that the majority (52.8%) of respondents said cost prevented them from accessing massage therapy. When asked which providers they would like to see or see more of, but cannot because of barriers like cost, massage therapists were the top choice of respondents (48.4%).
Options in this category focus on changes you can make in your daily life, like improving sleep habits, diet, utilizing assistive devices, or learning ways to pace yourself and reduce stress. While these treatment options are not quick or easy, and some require major changes in your outlook or habits, those changes can lead to a major improvement in your overall health.
Whatever the specific condition or diagnosis, the combination of multidisciplinary therapies that makes up an integrated health approach is the best option to help patients lessen their pain or better learn to handle it. MyPainPlan.org can help chronic pain patients search in each of these categories for the specific treatments or therapies that may best provide relief.
To learn more about U.S. Pain’s Pain Awareness Month initiative and view other articles, click here.