| Treat mind, body for chronic pain |
|
|
|
|
Treat mind, body for chronic pain Meditation, yoga and other therapies augment medicine By JOY BUCHANAN Staff Writer Source: Tennessean.com Elizabeth Power of Nashville was born with defects of the knees that caused them to dislocate easily. She's had six surgeries on both knees since she was 12 years old. She used crutches in college often. Today she has no kneecaps. Like millions of other people, Power lived with chronic pain. "Pain was impairing my life significantly," she said. "I took a lot of anti-inflammatories. I'm lucky I've got a liver left." Chronic pain is prevalent in the United States. According to some estimates, nearly 30 million Americans, about 1 in 10, suffer from some form of chronic pain. It is the leading cause of adult disability and costs the nation $100 billion in lost productivity every year, according to the American Chronic Pain Association (ACPA). Chronic pain persists for weeks, months or years. It can be a sharp pain that shoots up the back or down the leg. It can be numbness or tingling in the hands and feet. It can be intense, sometimes incapacitating, migraines. It can be caused by repetitive motions, a joint or back sprain, arthritis, an infection, surgery or chemotherapy. Chronic pain can be difficult to treat. Joint or bone pain is often resolved with surgery or painkillers. But nerve pain, called neuropathy, is harder, explained Dr. Roy Elam, associate professor of medicine at Vanderbilt University Medical Center. "Some people get dramatic benefits from surgery or medication," he said. But other people are not fully helped by either intervention. When the pain doesn't subside, it spreads. Not just to other parts of the body, but it begins to seriously affect people's daily lives. Chronic pain can interfere with work, relationships, hobbies, even sex. People with chronic pain report that it makes them irritable, anxious and depressed. "It snowballs," Elam said. "That's when pain becomes suffering." Many doctors are only trained to use traditional methods for pain relief. "Physicians are also frustrated by the choices they have for treating pain," Elam said. "What we desperately need in our community are pain centers that focus on the whole person." Pain triggers emotions The underlying thought is that physical pain has an emotional component. Chronic pain can cause or worsen emotional distress such as anger, frustration, fear or depression. The emotional burden often worsens the pain. Relief of one, therefore, will also relieve the other. Some pain patients know this — 86 percent of people taking prescription drugs for pain also do physical therapy, get massages or practice meditation, according to an ACPA survey. In November, Elam and several local physicians and complementary therapy practitioners are opening the Vanderbilt Center for Integrative Health, which will offer many of those services in one place. Elam will serve as medical director for the center, which will have doctors, acupuncturists, behavioral psychologists and nutritionists. Power, who is 52, sought alternative therapies for her pain after doctors recommended double-knee and hip replacement surgery. She went to see Dr. Catherine Stallworth, medical director of the inpatient rehabilitation unit at Centennial Medical Center. Stallworth is also a physiatrist — a doctor specializing in physical medicine and rehabilitation. "I went in with an attitude," Power said. "Every time doctors saw my legs they wanted to do surgery or tell me they couldn't do anything." Stallworth had a different approach. She prescribed Power four exercises based on yoga, which Stallworth also teaches, to strengthen her legs. Power also has been seeing an acupuncturist for the past year. "My perception of my well being is greatly improved," she said. "I've had a 95 percent reduction in pain. I'm just a lot better." Stallworth said many of her patients come to her because they are not getting better with drugs and surgery. "Most of my patients, by the time they see me, they're frustrated," she said. "Their sleep is disrupted. They're anxious. They're depressed." Physical and emotional Treatment of the physical source of pain might call for less conventional treatments such as spinal injections or using seizure medication to calm nerves that constantly send pain messages to the brain. But not only do you treat the physical sources, Stallworth says, but you also treat the problems the pain has created or worsened. That might require counseling for depression, sleep therapy or medicine, or biofeedback. "Pain can be very complex," Stallworth said. "People should be open to all treatment options." Peggy West of Williamson County has been taking Stallworth's yoga class weekly since March. West, 71, enjoys walking and hiking. The osteoarthritis in her spine and the multiple surgeries on her feet years ago cause a considerable amount of pain, making it tougher to do those things. The yoga class and her physical therapy have strengthened her muscles and improved her flexibility. She said regular exercise spares her pain. "I'm overjoyed with the yoga," West said. "My feet are better than they've been in years." The new Vanderbilt center also will feature Mindfulness-Based Stress Reduction, a decades old technique that teaches concentration, deep relaxation and mental exercises. Though not originally developed to treat pain, many patients say it improves their pain and well-being. Gordon Peerman, a Nashville psychotherapist and Episcopal priest, teaches the technique. He explained that people usually try to distract themselves from pain. It then becomes their focus and takes over their lives, causing them to stop activities or withdraw from relationships. The technique requires people to think differently about the pain to reclaim their lives. "Pain, whether it is physical or emotional, is an organic, moving thing," he said. "We ask people, 'How big is it? Is it hot or cold? If it had a color, what would it be?' The point is to get to know the pain. This way, people deal with the pain at that moment. It then becomes more manageable." The technique uses breath awareness and muscle relaxation so the body does not tense or strain in response to the pain. "It does not help to get tough with pain," he said. "This is one way to attend to the pain that helps it rather than makes it worse." It's not that drugs and surgery don't work, but they often work better with other therapies. Penney Cowan, executive director of the ACPA, said many people look for the magic bullet, but in fact it does not exist. "People too often expect a pill to take the pain away completely," she said."They often go through a long process of trial-and-error with conventional treatments. Beyond medicine, people need exercise, emotional health and stress management." Local specialists agree that integration of treatment is key. "The multidisciplinary approach is the best," Elam said. "It's not about choosing one therapy over the other." • |
| < Previous | Next > |
|---|