“Integrative medicine is when conventional medicine broadens its horizons to include healing therapies beyond traditional western treatments,” says Daniel Monti, M.D., director of the Jefferson Center for Integrative Medicine Center at Thomas Jefferson University in Pennsylvania.
The integrative approach
Because it is impossible to know which therapies (or combinations) are likely to work for each individual, an integrative approach open to numerous therapies is ideal. “At our center, for example, we start with a thorough assessment and consider a treatment approach that reaches the patient on as many traditional levels as possible; e.g., medication (if needed), emotional (like stress management), and even spiritual,” he says.
“Then we include complementary therapies that make sense, based upon available evidence,” he adds. A therapy is considered complementary when it works with your current treatment; alternative therapies are when you abandon other treatments—something not recommended.
Monti’s center is part of a current national study to lower stress levels in cancer patients. “It combines a supportive group experience, meditation and expressive art tasks, among other things. Other studies have shown acupuncture and hypnotherapy help reduce chemoinduced nausea and some cancer-related pain,” he says.
“Many regular therapies for osteoarthritis only provide small effects. But put a lot of small effects together and you can get large benefits,” says Brian Berman, M.D., director of the Center for Integrative Medicine at the University of Maryland School of Medicine in Baltimore.
The no-pain needle
An estimated 8.2 million Americans have used acupuncture. The most common acupuncture therapy in the U.S involves penetrating the skin with thin, solid, metallic needles. It still isn’t clear exactly how acupuncture works, but it seems to reduce pain by stimulating certain anatomical locations.
“In one national study I led on acupuncture’s effect on OA, we found the group that received acupuncture gained a 40% increase in knee function and a 40% decrease in pain,” Berman says. “I have two warnings for older adults. Because of bleeding risks, acupuncture isn’t advisable if you are on a blood thinner, like Coumadin. Also, some forms of acupuncture involve electrical stimulation. That isn’t advisable for someone with a pacemaker,” he adds.
Roney has supported in acupuncture for over 20 years. “I have had a lot of success sending older patients with sciatica, for example, to acupuncturists. Sometimes acupuncture has even gotten them off all medications,” Roney says. Berman agrees it is possible. “It’s worth a try. If it works, you should see relief between seven and ten treatments,” he says.
You aren’t where you think
Hypnosis also has physical effects. “It constricts blood vessels, so when I hypnotize dental patients who can’t handle anesthesia, there is less bleeding, less swelling, and less risk of infection later,” says Paul G. Schauble, Ph.D., a professor and licensed psychologist at the University of Florida, who is an expert in hypnotherapy.
Hypnosis offers many ways to help you cope with long-term pain, from helping you sleep to actually diminishing your pain level, like the snow-numbed knee. “Older people are among the best hypnotic subjects. They tend to be more open-minded,” Schauble says.
Create an image you really despise. If you actually sense things, like a clenched stomach or a bad smell, you are probably a good hypnotherapy candidate. “If I can help you create an image that makes you feel bad, it’s just as likely I can find one that helps you feel good, despite your pain.”
Simply thinking differently about your pain, using techniques Dhingra teaches in a process called cognitive behavioral therapy, can both modify pain and its negative consequences.
More mind control
Relaxation therapies (which come in several forms) can diminish pain. “In progressive muscle relaxation therapy, you consciously tense and relax your muscles. You may focus on one area, or work your way throughout your body to relax all your muscles,” Herr says.
Once learned, you can do this therapy yourself, preferably in a quiet setting. “Unplug the phone, turn down the lights, wear comfortable clothes. It takes about 20 to 30 minutes, less if you are targeting a small muscle group,” Dhingra says.
“People will say, ‘I feel better and slept last night.’” Dinghra says. Relaxation therapies are also thought to improve blood flow in the brain’s blood vessels, thus reducing the frequency and intensity of migraine headaches.
Reducing your pain level
Although the acceptance of newer therapies is positive, you shouldn’t expect any of these methods to totally eliminate your pain. Be leery of anything that claims to. “It would be very unusual for one pill to fix everything related to your low back pain, for example,” Monti says. “The government’s website on complementary and alternative therapies, NCCAM, is a very useful resource,” Herr says.
Besides not always being possible to make someone painfree, it isn’t always advisable.
“Pain serves as a signal that something isn’t the way it should be. If I completely removed your low back pain, it probably wouldn’t take long before you would over-exert your back—and do even more damage,” Schauble says.
“Be persistent in finding help, and remember it doesn’t have to be a doctor. Nurse practitioners and physical therapists, for example, are educated in certain therapies. Ultimately your goal in fighting chronic pain is not so much to totally eliminate it, but effectively control it to enhance your quality of life,” Herr says.