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Taking a look at alternative treatments for chronic pain


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With the wide-reaching negative effects of the opioid crisis continuing to be addressed across the U.S., more and more people are exploring alternative therapies to manage their chronic pain and avoid the risks associated with prolonged use of the highly addictive drugs.
 
Alternative therapies, such as acupuncture and chiropractic services -- once viewed with intense skepticism in the medical community -- have received backing as viable options.
 
"Times have changed and (people) shouldn't be afraid to try alternative forms of medicine, such as acupuncture and chiropractic," said Theodore Davis, a chiropractor at the Center for Alternative Medicine.
 
"A lot of people have been trained to be fearful of alternative medicines. But now, lo and behold, it's showing that alternative medicines are way less scary than what is mainstream in western medicine, which are opioids."
 
Numerous studies have shown that chronic pain is a widespread problem in the U.S., and a 2015 report by the National Center for Complementary and Integrative Health found that over 25 million American adults -- more than 1 in 10 -- reported having experienced pain every day in the three months prior to the study.
 
The tendency for physicians to prescribe -- and sometimes over-prescribe -- opioids has left large numbers of Americans physically dependent on the drugs. A 2016 report by the Centers for Disease Control found that as many as 1-in-4 people who receive prescription opioids long term for non-cancer pain subsequently struggle with addiction.
 
Luckily for those who have, or may someday have, chronic pain, alternative treatments are gaining traction in the medical community as a non-addictive option.
 
Acupuncture
Originating in ancient China, acupuncture involves placing small needles in designated points along meridians of the human body. They stimulate nerves that send signals to the brain to release feel-good hormones, such as beta-Endorphins, and reduce pro-inflammatory markers that lead to inflammation and pain. It's also believed to stimulate nerve growth, which helps the nerve to regenerate.
 
"Acupuncture is the biggest (alternative treatment)," Davis said. "It has been proven over and over again to reduce the requirements of opiates. High-quality studies show this . . . So it can reduce the requirement of an opiate by 130 percent, sometimes 160 percent depending on (which study) you're reading."
 
Although the practice of acupuncture has been around for thousands of years, many physicians in western medicine are just now beginning to accept the practice as a viable way to treat chronic pain.
 
In his practice specifically, Davis said he's seen chronic pain sufferers who initially got onto opioids after surgery but never fell quite into the category of addicted completely rid themselves of their opioid dependency by using acupuncture.
 
"I've seen people come in here looking like zombies. And granted, for those people it takes more treatment," Davis said. "But they walk in here like zombies and when they walk out they send their whole families because they feel like these therapies have changed their life."
 
Dry Needling
Dry needling is similar to acupuncture in the sense that it uses acupuncture needles, placed strategically in specific target points, to facilitate healing in the body.
 
"Dry needling is, in my opinion, the gold standard for breaking chronic pain patterns," Davis said. "The goal is to go into a trigger point, break the trigger point up or even scar tissue in some cases, and then the patient feels a whole lot better. It improves their range of motion and breaks up pain patterns . . . It works great.
 
"Dry needling is just as good as acupuncture, in my opinion. It can be used for almost the exact same purposes."
 
Chiropractic
According to the National Institutes of Health, about 80 percent of adults experience low back pain at some point in their lifetimes, and about 20 percent of people affected by low back pain eventually develop chronic low back pain with persistent symptoms, making back pain one of the most common causes of chronic pain in the country.
 
Chiropractic is a form of therapy in which the structure of the body, particularly the spine, is deemed to affect the function of every part of the body, enabling chiropractors to try and correct the body's alignment to relieve pain and improve function to help the body heal.
 
A 2015 review by Harvard Medical School concluded that chiropractic spinal manipulation may be helpful for back pain, migraine, neck pain and whiplash.
 
"Typically, a chiropractor is going to look at the spine, because that's more or less your foundation, but then we'll find that spinal issue may be rooted in extremity issues. So like plantar fasciitis, or maybe an over-pronated foot, might be causing the lower back or the sciatica to flare up. Or chronic carpel tunnel syndrome might be causing the chronic neck problem or vice versa," Davis said.
 
"(Back pain) is what gets people through the door because that's what we're known for, but that's not what I predominantly treat. I treat ankles, wrists, elbows . . . we don't just do backs, we do everything."
 
Electrotherapy
Davis said one of the cheapest and most accessible forms of alternative therapies for chronic pain patients is electrotherapy, which uses different frequencies and wave lengths to run electrical pulses across the surface of the skin and along the nerve strands.
 
Davis said that in addition to receiving electrotherapies at licensed medical offices, chronic patients can use the highly accessible devices in their own homes without needing any training or medical license.
 
"It's a great alternative," he said. "There's very few side effects and, of course, you can look at those things online or ask a professional and they'll let you know if you have a co-morbid factor that you shouldn't be using a (electrotherapy) unit with."
 
Davis said another type of therapy that can have a positive impact on chronic pain is a hybrid of electrotherapy and acupuncture called electroacupuncture, in which acupuncture needles are inserted into the skin and then used to transmit the electric frequency between two specific points.
 
"Electroacupuncture is where they use a 'micro stem' . . . attached to the acupuncture needle . . . with a positive and a negative (charge) on top of the needles. It runs electricity down and through, across the tissue and then up, so that electricity stimulates the tissue," he said.
 
Non-opiate medications
In addition to alternative pain management therapies, the addictive properties of opiates have caused patients to seek non-opiate medicinal alternatives.
 
Over the counter acetaminophen, nonsteroidal anti-inflammatory drugs, topical medications and injections are just some of the medications increasingly being used by patients to manage chronic pain without opiates, but the medical treatment that's perhaps shown the most promise in treating chronic pain is cannabis.
 
In a comprehensive Harvard-led review of 28 studies examining the efficacy of exo-cannabinoids -- synthetic formulations of cannabinoids from the plant -- the author concluded, "Use of marijuana for chronic pain, neuropathic pain, and spasticity due to multiple sclerosis is supported by high quality evidence."
 
Another report published in January by the National Academies of Sciences, Engineering, and Medicine similarly found that cannabis or cannabinoids, found in the marijuana plant, can be an effective treatment for chronic pain.
 
The study notes that natural cannabinoid receptors found in the human body likely play a large role in pain control. However, the study notes that the exact mechanisms showing how marijuana relieves pain are not yet fully understood.
 
Relaxation therapies and healthy lifestyle
Not all forms of alternative therapies are medically based, as many studies suggest chronic pain can be at least partially alleviated through relaxation therapies and a healthy lifestyle.
 
Davis said that certain natural foods with anti-inflammatory properties, such as fish oils, curcumin, and vitamin D3, have been shown to relieve pain symptoms by reducing inflammation.
 
Physical activity through exercise has been shown to relieve chronic pain, as well as boost energy and mood. Relaxation therapies, such as yoga, meditation, music therapy and massage, have been shown to reduce pain, as well.
 
And while the opioid epidemic is seemingly far from over, the emergence of alternative therapies in the wake of the crisis bodes well for the emergence of other therapies that may help mitigate the nationwide impact of opioid drugs.
 
"The times have changed and alternative medicine is no longer the scary red-headed stepchild, and it's becoming much more acceptable and accessible," Davis said. "It's shown to be beneficial and healthy, whereas opiates -- they're showing themselves to be the monster in the room. It used to be we were the monsters, and now its opiates."
 
By John Jaques
 

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