•  Acupuncture •  Biofeedback •  Guided Imagery •  Hypnosis: Is It For Me? •  Massage Types •  Meditation: Health Benefits •  Yoga: Is It for Me?

In our first class, we described ways to use your mind to overcome pain, and in the previous class, we covered self-care options. In our final class, we'll explain different alternative therapies -- also called complementary therapies -- that you can try with the help of special practitioners.

Alternative or complementary therapies can be useful tools in combating pain, but there are a few things to keep in mind before you get started.

•Talk to your doctor to make sure the therapy you're considering won't conflict with any treatment you're already receiving. Ask your doctor whether the alternative therapy is safe and effective -- specifically that it won't harm you and may help ease your type of pain.

•When you find a therapy you want to try, check the credentials and experience of a few practitioners. There are professional organizations for practitioners of alternative therapies that can give you information about licensing requirements or standards of care. Often, you can even find referrals to practitioners in your area.

•Talk to the practitioner before you book an appointment. Ask what you can expect, how a procedure is performed, and what the possible side effects may be. Find out how much time the practitioner will spend with you.

•Also ask about the costs. You may want to contact a few practitioners to find out how much each charges for similar services. Many insurance plans now cover acupuncture, so check what your plan will -- and will not -- cover.

Can acupuncture really ease chronic pain? There is growing evidence that the ancient Chinese practice of acupuncture can help relieve certain types of pain. In an analysis published in 2005, researchers reviewed 33 randomized, controlled trials and found that acupuncture was as effective as traditional medical treatment for relieving low back pain. The National Center for Complementary and Alternative Medicine says that when used as one part of a comprehensive pain management program, acupuncture may help people who suffer from headaches, menstrual pain, osteoarthritis, carpal tunnel syndrome, fibromyalgia, tennis elbow, and myofascial pain (a condition similar to fibromyalgia).

Traditional acupuncture operates on the theory that the body's energy flows along pathways known as meridians. There are more than 2000 acupuncture points on the body that connect with these meridians. By stimulating these points with very thin needles, practitioners say it is possible to balance the body's energy to facilitate healing and pain relief.

According to the American Pain Foundation, some patients feel the most benefit when needles are placed near the source of the pain, rather than at traditional acupuncture points. Western medicine also offers a different theory of how acupuncture works. Some researchers think the needles may work by stimulating the body to produce pain-killing endorphins -- and, in fact, some studies have found higher levels of endorphins in patients’ spinal fluid following an acupuncture session.

Therapeutic massage is another method of healing that has been around for thousands of years. Massage helps relax tense muscles that can cause or worsen pain. Massage may help override the pain messages your brain receives, which explains why it feels comforting to rub a stubbed toe, for example. Once your brain recognizes pain, massage may help by encouraging the release of endorphins. Massage also increases circulation to the affected area, which helps get rid of pain-causing irritants your body produces, like lactic acid.

Some types of massage target trigger points -- small, knotted areas inside muscles. Some of these trigger points can "refer" pain to another part of the body. (If you've ever scratched an itch in one place and felt a "ping" in another place on your body, you get the idea.) Deep tissue massage aimed at these trigger points can often relieve pain in other areas.

Acupressure uses manual pressure instead of needles to stimulate acupuncture points. It's very similar to trigger point massage, but acupressure can be used to treat more than just localized pain. (Shiatsu massage is a well-known type of acupressure.) If you don't like the idea of acupuncture needles, you might consider acupressure or trigger point massage.

Massage isn't for everyone, however. If you have cancer, heart disease, swollen blood vessels, or are prone to blood clots, you shouldn't get massage therapy without checking with your doctor to see if it is safe. Also, massage should not be performed on broken, infected, or irritated skin. If you have osteoporosis, are pregnant, or have severe back pain, talk to your doctor before you consider therapeutic massage, and then find a therapist who specializes in working on people with your condition.

When done properly, hypnosis is far more than an entertaining stunt. It's a way to harness the power of your mind to help you gain control over your emotions, behavior, or physical health. During hypnosis, a therapist will guide you through visual imagery and other cues until you are in a very relaxed state, free of distractions, and open to suggestion. While you are in this relaxed state, your hypnotherapist can suggest ways to help you change how you perceive your pain. For instance, if you suffer from headaches, you might first visualize the pain as constricted blood vessels in your brain and then imagine the vessels relaxing and opening wider to relieve the pain. According to the American Pain Foundation, studies suggest that 15 to 20 percent of people with moderate to severe pain who are able to be hypnotized, may experience total relief through hypnosis. Therapists or specialists at a pain treatment centers can also train you to hypnotize yourself at home, so you can ease your pain by practicing your visualizations and responses.

Meditation is simply a way of calming your mind by tuning out the chatter and noise of the world around you. There are many ways to do this. Some ancient practices incorporate meditation with physical activity, such as yoga and Tai Chi. You can also meditate while simply walking, doing artwork, or just sitting still with your thoughts. Praying, saying the rosary, chanting, looking intently at something, or visualizing a favorite place can also help clear and focus your mind.

Yoga is becoming very popular in America, and provides a dual approach to pain relief. On the physical side, yoga improves muscle tone and flexibility, increasing support to the body. It also involves deep breathing exercises that help relax the body and relieve stress. But yoga also teaches you how to quiet your mind, even in the face of pain. Chronic pain can become overwhelming to the point where it is practically all you think about. Yoga helps you regain control over your conscious thoughts, and find a peaceful way to live without letting pain be your sole focus.

Imagine that your body is a noisy factory full of machines and conveyor belts that keep your bodily functions operating. Biofeedback helps you tune into key physical systems, and teaches you how to control them. A biofeedback trainer will hook you up to a machine that translates internal signals, like muscle tension or a rapid heart rate, into external signals, like sound or light. Then you focus on making the sound or light signals go away. Your trainer will help you develop ways to do this. Eventually you'll be able to monitor tense muscles and other key indicators on your own, and bring them under control without being hooked up to a machine. Results are mixed on using biofeedback for pain relief, but it is most likely to be effective against pain that is due to muscle tension.

Biofeedback is generally safe, but talk to a doctor who is knowledgeable about this therapy if you suffer from depression, diabetes, or other endocrine disorders. Biofeedback may have an impact on the effectiveness of some medications, such as insulin.

What to do next

•• Use the Daily Pain Diary to keep track of your pain and what you did to relieve it.

•• Consider adding an alternative therapy to your pain-fighting plan. Discuss it with your doctor before making any changes.

•• Continue to practice the relaxation and positive thinking exercises from the previous classes.

Further Resources

National Center for Complementary and Alternative Medicine
9000 Rockville Pike
Bethesda, Maryland 20892 USA
http://nccam.nih.gov/

American Academy of Medical Acupuncture
4929 Wilshire Boulevard, Suite 428
Los Angeles, California 90010
323-937-5514
http://www.medicalacupuncture.org/acu_info/generalinfo.html

American Massage Therapy Association
500 Davis St.
Evanston, IL 60201
877-905-2700
http://www.amtamassage.org/

The Yoga Site
http://www.yogasite.com/chronicpain.htm

International Association of Yoga Therapists
115 S McCormick St Suite 3
Prescott, AZ 86303
928-541-0004
http://www.iayt.org/

Association for Applied Psychophysiology and Biofeedback
10200 West 44th Avenue, Suite 304
Wheat Ridge, CO 80033
800-477-8892
http://www.aapb.org/i4a/pages/index.cfm?pageid=1

American Psychotherapy and Medical Hypnosis Association
1100 Kittitas Street
Wenatchee, WA 98801
509-662-5131
http://apmha.com/

References

First published June 14, 2006
Last updated May 14, 2008
Copyright © 2006 Consumer Health Interactive

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