Wellness and chronic pain

Posted March 20, 2013, at 11:55 a.m.

The statistics about chronic pain in our society are sobering. The Institute of Medicine estimates that 100 million Americans suffer with chronic pain, defined as pain that persists for 3 months or longer. About 10 percent of the adult population is on a pain relief drug. While they ease pain for many patients, there is a price to pay for this relief.

Anti-inflammatory drugs such as aspirin and ibuprofen damage the lining of the stomach and can cause heart, liver and kidney damage. These drugs cause an estimated 100,000 hospitalizations and 16,500 deaths per year, and these numbers do not include deaths from over-the-counter drug use.

Painkillers like Oxycontin are fueling addiction throughout the country. From 1994 to 2001, there was a 117 percent increase in emergency room visits related to opioid painkiller abuse. Low back pain is the most common form of chronic pain, and when medications do not prove effective enough for pain, many go on to more aggressive treatments, ranging from cortisone shots to surgery, which do not have good long-term results.

From a wellness perspective, chronic pain is little different from other chronic health problems like obesity, diabetes, and heart disease. It is a direct result of our unnatural lifestyles, especially our diets and lack of activity. Our current diets of processed, “fast” foods, grain-based meals, and meat from animals fed grains rather than their natural foods, promote inflammation throughout our bodies. This leads to such diseases as heart disease, cancer, allergies and, because inflammation lowers pain thresholds, chronic pain.

Most chronic pain starts in the joints and muscles, as a mechanical problem. These types of problems respond best to a mechanical treatment, such as chiropractic adjustments or deep tissue therapy. Treating a mechanical problem with a chemicals (drugs) does not address the underlying cause. Because drugs cannot correct the cause of the pain, the problem tends to worsen with time. This can lead to more, stronger drugs; eventually even everyday activities can become painful. This downward spiral can lead to depression and even disability.

Because chronic pain is a complex lifestyle problem, wellness care is a perfect match for these patients. It is not enough to simply numb the pain; serious, ongoing treatment is necessary. In my office, I always start with very simple and gentle treatments to start getting the patient some relief — and some hope. Gentle manipulation, traction, home stretches and non-piercing electro acupuncture are the first line of attack. As the patient improves, we begin to introduce exercises and treatments that go deeper into the core problems, often caused by a lifetime of too much sitting. Walking is one of the simplest and best exercises, as long as it does not increase the patient’s pain. If necessary, treatment will progress to needle acupuncture, which is an amazingly effective form of pain relief for many patients. With further improvement, we then begin to address what is usually the biggest hurdle for patients — improving their diets.

Most patients with chronic pain have diets full of “comfort foods” that are tasty and have an emotional link to feeling good. But they also are typically “pro-inflammatory” foods such as macaroni and cheese, sweets, and ice cream. When we don’t feel well, we don’t rush to the salads and veggies that are actually what our bodies need. Eliminating these foods from their diets can go a long ways toward lowering their inflammation levels, and therefore reducing not only chronic pain, but all chronic diseases.

There is some research to support wellness care for chronic pain. The state of Florida used “Complementary And Alternative” providers (primarily chiropractors, but also acupuncturists, massage therapists, nutritionists, nurse care managers and even pharmacists) to treat some of its Medicaid beneficiaries who have been diagnosed with chronic fatigue syndrome, chronic back or neck pain and fibromyalgia. Other patients with the same problems continued with the usual medical services. These CAM providers were instructed to provide holistic care to their charges.

After three years, the results were compared to those patients who still were under regular medical care. The patients that were managed by CAM providers showed a 20 percent improvement in overall health scores, which is a remarkable number for this unhealthy group. There was a 9 percent reduction in costs for the patients of the CAM providers, compared to a 15 percent increase in the other group, which was consistent with increased expenses in the overall medical costs for chronic pain patients throughout the health care system.

Our current approach to chronic pain is not working. What is needed is not more drugs to numb the pain but a more aggressive treatment approach that looks at the causes of chronic pain and treats the patient accordingly. For an increasing number of pain sufferers, wellness care is that treatment.

Dr. Michael Noonan practices chiropractic, acupuncture and other wellness therapies in Old Town.

 

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