Alternative or Complementary Ways to Control Pain

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KEY POINTS

• Medicine and other methods can be used to manage pain.
• Ask your healthcare provider about any therapy that you are thinking about using, including supplements, changes in your diet, or devices.
• Certain products and therapies can be useful for some people but not helpful for others.

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There are many ways to help manage pain. Medicine is one way, but other methods can be used instead of or with medicine.

Talk with your healthcare provider about any therapy that you are thinking about using, including supplements, changes in your diet, or devices. Certain products and therapies can be useful for some people but not helpful for others. Some remedies can even be dangerous. Examples of these are coffee enemas for cancer, motor oil for arthritis, and iron supplements for energy unless the iron is prescribed by your healthcare provider for iron deficiency.

Therapies that may be helpful include:

Acupuncture. Acupuncture uses needles inserted into specific points on the skin by a licensed practitioner. It has been shown to be effective in treating some forms of pain, such as headache, arthritis of the knee, and chronic back pain. It seems to stimulate the release of the body's natural painkillers.

Art and music therapies. Drawing, painting, or working with clay can help you express feelings that you may not be able to put into words. Music therapy uses music to improve physical and mental health. Music therapy may involve singing, listening, moving, playing instruments, and other creative activities. Art or music therapy may also distract you from the pain.

Biofeedback. Biofeedback therapy trains you to be aware of your body and how it works. You are connected to a machine that senses your body's response and gives you feedback in the form of light or sound. During the treatment sessions, you will be asked to relax and to pay attention to how you feel and how your feelings change the feedback. You can learn to control some of your feelings with biofeedback.

Cognitive behavioral therapy (CBT). This type of therapy takes the approach that how you think affects how you feel and behave. This therapy helps you to recognize negative ways of thinking and to change your thoughts and mood. This can lead to changed behaviors. It can help you feel less anxious and stressed, which may help decrease your pain.

Chiropractic or osteopathic manipulation. Chiropractic providers use their hands to move and adjust the joints, especially the joints of the spine. Chiropractic treatment may ease pain in the back, neck, or joints. Sometimes it helps relieve the pain of headaches, muscle spasms, and inflamed nerves. Treatments should involve slow, gentle movements of the head, neck, and spine. Adjustments that are done too rapidly can cause injury.

Osteopathic physicians are trained in medicine, plus they know how to use their hands to move and adjust the spine, joints, and muscles. Stretching and putting pressure on painful parts of your body may improve flexibility and reduce pain.

Distraction. Focusing on something else can be a good way to relieve pain temporarily. Try focusing on music, hobbies, social activities, TV, comedy, movies, or conversation with family or friends. This can work well while you are waiting for pain medicines to take effect. Listening to music during painful procedures can be helpful. You may be able to learn to use distraction on your own, or you may need guidance to learn to use distraction.

Exercise. Range-of-motion exercises can improve function and lessen pain. Another kind of exercise is water therapy using swimming pools, hot tubs, or whirlpools. Exercises such as qi gong or tai chi can also help control pain. Yoga can be helpful and involves breathing and posture exercises. Exercising regularly can help you feel and sleep better. Your healthcare provider or a physical therapist can recommend an exercise program for you.

Herbs and supplements. Some herbs and supplements may help reduce pain. Yerba mate tea has been found to decrease pain during chemotherapy. Valerian may reduce pain and help you sleep better. Feverfew and magnesium may be used to prevent migraine headaches. Probiotics included in some brands of yogurt can reduce belly pain and bloating.

In some states, a healthcare provider can prescribe marijuana to treat pain.

No herb or dietary supplement has been proven to relieve pain consistently or completely. Supplements are not tested or standardized and may vary in strengths and effects. They may have side effects and are not always safe. Herbs can interact with other medicines you may be taking. Talk with your provider or pharmacist before you use herbs and supplements to manage your pain.

Hypnotherapy. Hypnotherapy uses a state of deep, relaxed focus to treat medical or mental health conditions. This kind of therapy can help change feelings or behaviors in your subconscious mind. Your subconscious mind stores feelings, thoughts, and urges that you are often not aware of. While you are hypnotized, the therapist can suggest different ways to experience the pain, so that it may bother you less. Hypnosis may be done by a licensed therapist, or you can purchase programs for self-hypnosis.

Ice and heat. You will learn over time whether ice or heat helps you most. As a general guide:

• Ice. During an acute flare-up of pain, ice may be more helpful than heat at first. Wrap an ice pack, gel pack, or package of frozen vegetables in a cloth, and try putting it on the painful area every 3 to 4 hours for up to 20 minutes at a time, 1 to 4 times a day.
• Heat. After the first day or so (or earlier if you don’t have any redness or swelling), heat may be more comforting to the painful area. You can apply heat with warm baths, showers, or a hot tub. Or you can use heating pad set at low or a covered hot water bottle for 20 to 30 minutes at a time. To prevent burns to your skin, follow directions on the package and never lie on any type of hot pad. Don’t use heat if you have swelling.

Magnetic therapy. Pulsating electromagnetic therapy has been used to help heal bone fractures. It may be helpful for osteoarthritis, migraine headaches, multiple sclerosis, and sleep disorders. Magnet products include shoe insoles, mattress pads, pillows, belts, jewelry, headwear, and bandages. Do not use magnetic therapy if you have a medical device such as a pacemaker. The magnet may interfere with the device.

Massage. Massage therapists work on muscles and other soft tissues to help you feel better. For example, they may use long, smooth strokes and put pressure on painful muscles, tendons, and joints. Massage can be given by a trained massage therapist or a caregiver. You can also buy massage tools or devices to add vibration or heat to a massage. A gentle stroking massage is safest. Avoid a vigorous massage by someone untrained in massage. Don't massage areas that are red or swollen.

Food. Foods can affect pain. Some foods may make headaches, joint pain, or digestive pain worse. It may help to keep a diary of the foods you eat and your pain symptoms. The diary can help you see how foods you are eating may affect your pain.

You may find that you feel better when you eat foods that are rich in omega-3 fats such as salmon, flaxseeds, and walnuts. Other foods that may help improve your mood and decrease your pain are dairy products, almonds, Brazil nuts, dark chocolate, and dark leafy greens such as spinach or broccoli. Coffee in small amounts may improve your mood, but too much caffeine or the acid in coffee (even decaf) might make you feel worse.

Comfort foods have been used for years to ease pain and improve mood. They are different for each person but usually include foods like mashed potatoes, macaroni and cheese, and ice cream. These foods can be soothing, but if you eat too much, can lead to unwanted weight gain, high blood sugar, and guilt.

Orthopedic devices. Wraps, pressure stockings, splints, and neck collars may help relieve pain and help you do tasks more easily.

Relaxation. Relaxation reduces tension in the muscles, which can also reduce painful pressure on nerves running in or through muscles. This helps keep pain from getting worse. Relaxation can give you more energy. It may reduce anxiety and allow other pain relief methods to work better. You may be able to fall asleep more easily. Relaxation skills include:

• Deep breathing: Focusing on taking slow deep breaths
• Mental imaging: Picturing yourself in a calm place and letting your muscles relax
• Mindfulness: Focusing only on the present moment, without judging or thinking about the past or future
• Progressive muscle relaxation: Tensing and relaxing your body, one muscle group at a time

Yoga and meditation practice are also good ways to relax.

Transcutaneous electrical nerve stimulation (TENS). TENS relieves pain by sending small electrical impulses to your nerves through patches put on your skin. The electrical impulses block pain.

Select an alternative or complementary medicine provider carefully. Seek treatment from a licensed professional if you can. Ask about their training and experience. Ask questions and get referrals from people you know and trust.