Holistic Approaches to Managing Chronic Pain
Jessica Neutz
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There are an estimated 50 million Americans suffering from chronic pain. This is more than 20% of the American population. Chronic pain can affect your life enormously through increased medical bills, lost income, lost productivity, compensation payments, and legal fees. The economic impact is costing Americans more than 80 billion dollars a year in lost wages. Amidst an opiate epidemic, there are some new treatment options to help manage your chronic pain without addictive or harmful medications.
Understanding Chronic Pain
Chronic pain refers to persistent pain that lasts for an extended period of time–beyond the expected healing time. According to the National Health Interview Survey (NHIS), consumers reported the most common areas that cause them pain are the back, knees, hips, and feet. Chronic pain often persists for three months or even years and can be caused by various underlying conditions, such as arthritis. The pain may come and go or be constant. It’s a major medical problem that can lead to not being able to work, eat properly, participate in physical activity, or being able to enjoy life at all!
Acute pain, on the other hand, is temporary and usually arises suddenly due to illness or injury. This pain is your body's protective response that alerts you to potential harm. It generally subsides as the underlying cause heals.
Common Causes and Conditions That Lead to Chronic Pain
Arthritis
Cancer
Past Injury/Illness
Neuralgias and Neuropathies (affects the nerves in the body)
Damage to the Central Nervous System (the brain and spinal cord)
While these can be some common causes, there are many people who live with chronic pain with no history of injury or illness. Psychogenic pain is pain where no physical cause can be found.
Multi-Dimensional Pain
Chronic pain is a multi-dimensional phenomenon involving intricate physical sensations, emotional turmoil, psychological struggles, and spiritual challenges.
Physical symptoms can include:
Aching
Burning
Shooting
Squeezing
Stiffness
Stinging
Throbbing
While emotional symptoms may present as:
Anxiety
Depression
Stress
Mood Swings
Insomnia
Fatigue
Anger
Spiritually, you may start to question your beliefs, values, and purpose, as you grapple with the unfairness of your chronic pain or the search for meaning in your suffering.
A comprehensive approach is crucial to managing a complex condition like chronic pain. Addressing just the physical symptoms isn’t enough. Chronic pain often leads to mental health issues, social isolation, and decreased quality of life. A holistic strategy, involving medical, psychological, and lifestyle interventions can offer more successful outcomes by addressing this multi-dimensional nature of chronic pain.
Limitations of Conventional Treatments
While the first line of defense for chronic pain is medication, there are major drawbacks to this approach. They can cause a range of side effects from nausea to heart complications–and some can be extremely addictive. Opioid prescriptions have increased substantially in the last 20 years. Long-term use of pain medications can present very serious risks. Here are some common pain medications and their risks:
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): [Advil, Motrin] NSAIDs may cause nausea, stomach pain, stomach bleeding, or ulcers. Excessive use can result in kidney problems, fluid retention, and elevated blood pressure. The risk escalates as you age or if you have underlying conditions such as diabetes, a history of ulcers or acid reflux, or kidney issues.
Acetaminophen: [Tylenol] If taken in excess or with alcohol, acetaminophen leads to an increased risk of kidney damage and liver failure over time.
COX-2 Inhibitors: [Celebrex] COX-2 inhibitors may cause dizziness and headaches. When taken in high doses, it can lead to stomach bleeding, fluid retention, kidney problems, high blood pressure, heart attack, and stroke.
Opioids: [Percocet, hydrocodone, oxycodone, etc.] Side effects may include drowsiness, nausea, itchiness, constipation, tolerance, dependence, misuse, addiction, and overdose. The side effects, including tolerance and dependence, can develop within the first week of use. Opioids are responsible for the majority of overdose deaths in the US. The 2016 CDC Guidelines for Prescribing Opioids for Chronic Pain recommends non-opioid treatment for chronic pain.
Holistic Approaches to Chronic Pain Management
Mind-Body Techniques
Mindfulness Meditation: In the book Full Catastrophe Living, mindfulness is described as a “non-elaborative, non-judgmental awareness” of present-moment experience. While mindfulness can be practiced in many ways, most commonly through meditation. Clinical studies have shown that after completing an 8-week Mindfulness-Based Stress Reduction (MBSR) program, patients reported a significant reduction in pain, even up to 4 years after completing the program. These practices focus the mind on the present moment, alleviating any perceptions of pain and improving your pain-coping skills and overall well-being.
Relaxation Techniques: Some common practices include meditation, breathing, visualization, autogenic training, and progressive muscle relaxation. These techniques help calm your body's stress response. Deep breathing promotes relaxation by slowing the heart rate and reducing muscle tension. Progressive muscle relaxation involves tensing and then releasing different muscle groups, reducing the perception of pain and promoting a sense of control.
Physical Modalities
Yoga and Gentle Stretching: These techniques can help with chronic pain by promoting relaxation, improving flexibility, and enhancing your body awareness. They encourage gentle movements and deep breathing which can reduce muscle tension and increase blood flow. They can help release endorphins in your body which is nature’s painkiller.
Acupuncture and Massage Therapy: Acupuncture involves inserting small needles into specific points on the body, aiming to stimulate energy control. Massage therapy involves manipulating soft tissues to alleviate tension and improve circulation. These techniques may work by promoting relaxation, releasing endorphins, and improving blood flow.
Nutrition and Lifestyle Factors
Balanced Diet Rich with Anti-Inflammatory Foods: Maintaining a healthy diet is crucial for managing your chronic pain because it reduces inflammation, which is often a key factor in pain. Include anti-inflammatory foods such as fruits, vegetables, whole grains, fatty fish, nuts, and seeds. These foods can alleviate discomfort and promote overall well-being. They provide essential nutrients and antioxidants that support the body's natural healing processes.
Regular Exercise: Exercise helps to improve muscle strength, flexibility, and overall physical function. It also stimulates the release of endorphins. Maintaining a healthy weight can reduce stress on joints and alleviate pain associated with conditions such as osteoarthritis. Remember–it’s important to tailor your exercise routine to your individual capabilities. Consult your doctor to avoid worsening your pain.
The Role of Emotional Well-Being
There is a strong link between chronic pain and your emotional well-being. Chronic pain can lead to emotional distress such as anxiety, depression, and stress. Emotional factors like stress and negative emotions can actually increase your pain perception. The thing cycle, creating a feedback loop, can make pain harder to manage. Approaches, like cognitive-behavior therapy and mindfulness, that address both the physical and emotional aspects, can be extremely effective in managing chronic pain and improving your emotional well-being.
Cognitive Behavioral Therapy (CBT)
Cognitive Behavioral Therapy (CBT) offers multiple benefits if you’re suffering from chronic pain. It helps you reframe your thoughts about pain, develop coping strategies, and improve your overall well-being. CBT can reduce pain-related distress, enhance functional abilities, and provide a sense of control over your perception of pain. It also addresses emotional aspects like anxiety and depression that often accompany chronic pain.
Positive Emotions and Resilience
Positivity can help manage pain perception, reduce stress, and enhance well-being. Resilience aids in adapting to challenges, maintaining a sense of control and preventing emotional distress from extreme pain. Together, they create a foundation for better coping skills and improved quality of life despite your ongoing pain.
Integrating Spirituality in Pain Management
Spiritual practices can offer solace and meaning if you’re experiencing chronic pain by providing a framework for a more peaceful understanding of suffering and finding purpose beyond the physical realm. Engaging in rituals, connecting with a supportive spiritual community, and exploring philosophical teachings can all contribute to a greater sense of purpose and resilience in the face of chronic pain.
Prayer
Prayer offers a means of focusing your attention away from your pain, allowing for mental relief and an altered perception of discomfort. The act of prayer often induces a state of relaxation, helping relieve anxiety and stress. It also serves as a channel for emotional expression. This enables you to voice your feelings and seek solace in your faith.
Prayer can also foster a sense of hope, giving you a different way to view your pain and encouraging you to find meaning despite your challenges. Spiritual beliefs often emphasize resilience and the idea of a bigger plan, instilling a positive outlook. Prayer can also act as a coping mechanism that provides a structured way to navigate your pain and the emotional toll it takes.
Connecting with Nature
The natural environment offers a much-needed distraction from the constant focus on pain by creating a space of relaxation and mental relief. The inherent tranquility of nature works to reduce stress levels and counteract anxiety. Engaging in physical activities outdoors, such as walking or light stretching, not only contributes to your physical well-being but also triggers an endorphin release providing a natural pain-relieving effect.
Nature’s power to encourage mindfulness through its sensory engagement helps redirect attention away from your pain. The positive mood enhancement and potential for social interaction while connecting with nature contribute to a better quality of life. The reduced sensory overload and the potential for better sleep quality due to exposure to natural light and fresh air can play a vital role in managing your pain.
Sarah’s Spiritual Path to Healing
Sarah, a woman in her 40s, had been dealing with chronic pain due to an autoimmune disease. The pain was constant and often left her feeling isolated and helpless. Despite trying various treatments, her pain persisted. One day, a friend introduced her to mindfulness meditation, deep breathing, and spiritual practices. Skeptical at first, Sarah decided to give it a try.
Over time, utilizing spiritual practices regularly, Sarah found her relationship with pain had changed. Instead of resisting or fearing pain, she learned to observe it without judgment. She realized that her thoughts and emotions played a significant role in amplifying her suffering. Through her spiritual practice, she developed a greater sense of acceptance and detachment from her pain.
While her pain didn’t completely disappear, Sarah’s newfound ability to manage her reactions to it brought her a sense of solace and empowerment. She began to focus on the present moment, cultivating gratitude for the aspects of her life that weren’t affected by her pain. Her practices also helped her connect with other people who were dealing with chronic conditions and created a supportive community that understood her struggles.
Conclusion
Chronic pain is a complex issue that goes beyond mere physical discomfort, encompassing emotional and psychological dimensions. Conventional treatments may have limitations, urging the need for a holistic approach that addresses all aspects of your condition and well-being. Mind-body techniques, physical modalities, nutrition, emotional well-being, and spirituality can all play important roles in managing your chronic pain effectively. By embracing a holistic approach, you can find relief, empowerment, and improved quality of life in your battle against chronic pain.
Personalized approaches are necessary for chronic pain management as they consider individual needs, tailoring strategies for better results. Always consult your healthcare professional before adjusting pain management plans to ensure safety and effectiveness for your unique situation.
Sources Cited
Zeidan, F et al. “Mindfulness meditation-related pain relief: evidence for unique brain mechanisms in the regulation of pain.” Neuroscience letters vol. 520,2 (2012): 165-73. doi:10.1016/j.neulet.2012.03.082
Kabat-Zinn, Jon. Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness. 2008, ci.nii.ac.jp/ncid/BB19776576.
Vambheim, Sara Magelssen et al. “Relaxation techniques as an intervention for chronic pain: A systematic review of randomized controlled trials.” Heliyon vol. 7,8 e07837. 20 Aug. 2021, doi:10.1016/j.heliyon.2021.e07837
