Alternative methods of pain relief

American Chronic Pain Association

American Pain Society

Will my pain ever go away?

This question is surely at the top of every person’s mind if they are in pain. The difficulty in answering this stems from the variety and types of chronic pain syndromes, as well as individual variability. What has been shown to make a difference in people managing chronic pain is trying a variety of approaches, such as cognitive and behavioral techniques, staying active, practicing meditation, and working with your doctor to find effective medical and procedural interventions. The more of these interventions you try, the more likely you will find something that makes a positive impact.

The challenges of coping with a chronic pain condition cannot be understated. The negative emotions that come from it can be self-perpetuating, as one’s feelings of pain can lead to depression, and that very depression can lead to worsening pain. In coping with this cycle, the goal is to take whatever steps are possible to continue to lead a fulfilling life, including getting emotional and social support.

Our understanding of pain continues to evolve, and with it may come improved personalized treatments and better understanding of chronic pain’s influence on the body and mind.

Chronic Pain: In Depth

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Common Alternative Treatments for Chronic Pain

Acupuncture, Herbal Remedies, Massage, and Mind-Body Techniques

Sometimes conventional medicine—such as prescription medication—is not effective at treating chronic pain associated with certain medical conditions, such as fibromyalgia and rheumatoid arthritis. But some people living with chronic pain find relief with complementary and alternative medicine (CAM).

Complementary and integrative health practices, like yoga, massage therapy, and natural supplements, are common in the US. According to the 2012 National Health Interview Survey, 9.5% (21 million) adults said they practiced yoga, a stark increase from 2002, when only 5.1% said they practiced yoga.

CAM treatments can be used with traditional medicine or as an alternative to it. However, as with other types of treatments, complementary and alternative medicine doesn’t work for everyone the same way. You may need to try several CAM treatments—and perhaps several combinations of treatments—to determine what will work best for you,” said Josephine P. Briggs, MD, director of the National Center for Complementary and Integrative Health (NCCIH).

From fibromyalgia to headaches to neck pain, CAM treatments have the potential to help alleviate your pain and other symptoms and to give you a better quality of life. Below is a sample of some of the most common CAM treatments.

Acupuncture, an ancient Chinese practice, uses fine needles—about the width of a strand of hair—that are inserted into various “acupuncture points” on the body to treat your pain.

Because the needles are so tiny, acupuncture doesn’t hurt, but the needles are generally left in for up to 40 minutes. These needles aid in the healing process and can provide significant pain relief for people who have regular acupuncture sessions.

Acupuncture works to restore a healthy flow of an energy force called Chi (also known as Qi). This technique frees up your body’s Chi channels, so energy can flow freely in the body, ultimately reducing your pain.

Herbal Remedies/Supplements

There are many conditions associated with chronic pain, so it’s hard to list all the possible herbal remedies that can help decrease your pain. Some popular supplements include fish oil (Omega 3/DHA, EPA Fatty Acids, glucosamine/chondroitin, probiotics/prebiotics, and melatonin).

To learn more about your specific condition causing your pain and the herbal remedies that can help alleviate it, you can research herbal remedies online. Check out the list of herbal remedies on the National Center for Complementary and Integrative Health website. Or, talk to an experienced doctor who is knowledgeable about herbal remedies.

You’ll find that certain herbal remedies work well with certain conditions. Devil’s claw and white willow bark, for example, can decrease the joint pain and inflammation associated with rheumatoid arthritis. And primrose and ginger may help ease chronic muscle pain associated with fibromyalgia.

But be careful when taking herbal remedies—some herbal remedies may interfere with prescription medications. That’s why it’s best to talk to your doctor before trying any herbal remedies. Be sure to carefully follow your doctor’s directions.

Is it true that you can really rub away your pain with a massage? Many people with chronic pain turn to massage to ease their pain, reduce stress, and decrease anxiety and depression.

Massage therapists use their fingers and hands to press and manipulate your muscles and soft tissues. There are many massage techniques, but find the one that works for you: You may prefer a deep tissue massage to a hot stone massage, for example.

In general, massage is an excellent and effective way to relax your body, while relieving muscle inflammation and pain.

Mind-Body Techniques

The mind is a very powerful thing, and mind-body techniques can help you learn how to cope with your pain and other symptoms. Eight percent (18 million) of adults reported using meditation in 2012. Meditation also appears to have increased in popularity amongst children, where 1.6% (927,000) reported using it in 2012, up from 202,000 more than in 2007.

There are many forms of meditation, like Mantra meditation, Mindfulness meditation, Transcendental meditation, and so on. The practice has become more common outside of its religious context, though, as past studies have found it helps manage chronic pain, improve mood, reduce stress, and even treat anxiety disorders.

Meditation is one type of mind-body technique that helps you manage stress by clearing your mind and focusing on what signals your body is sending you. Taking a couple of minutes each day to sit back and reflect can bring you an overall sense of well-being and inner peace.

As noted, yoga surged in its popularity over the last decade. Yoga also seems to have become more prevalent amongst US children.

Yoga is a meditative movement practice originating from ancient India, and it’s believed to have numerous health benefits. Besides reducing stress and improving fitness, the practice has been shown to reduce discomfort in people suffering from low back pain and even improve the quality of life in cancer survivors.

Another beneficial mind-body technique—yoga teaches you that your breath is the bridge that links your mind and body. Using inhalation and exhalation properly with certain poses called asanas, you can achieve a deep sense of relaxation, not to mention flexibility and strength.

Biofeedback, according to the Association for Applied Psychophysiology and Biofeedback, is a process that enables individuals to learn how to change physiological activity for the purposes of improving health and performance. This treatment is used for a variety of chronic pain and other medical conditions, and often consists of sensors placed on the patient’s body while physiological data is viewed digitally, and often in real-time. It is considered a self-regulatory therapy, according to the Institute for Chronic Pain, because it increases awareness of physiological responses that may need to be changed to reduce symptoms and improve one’s life.

Measurements and feedback of brainwaves, heart function, breathing, muscle activity, and skin temperature, supports key physiological changes. Biofeedback can often be as simple as having your weight measured or your blood pressure taken. When combined with changes in thinking, emotions, and behavior, biofeedback can allow users to improve the health and function of their mental health and overall well being. You can learn more about biofeedback by going to A Healing Place.

If you’re considering complementary and alternative medicine, have a conversation with your doctor first. Remember, you may have to try several CAM treatments—or perhaps a blend of CAM treatments—to figure out which one(s) will work best to alleviate your pain and other symptoms.

Updated on: 07/24/18 View Sources

Sources

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Continue Reading: Hypnosis and Biofeedback

Complementary therapies for pain

Complementary therapies can be used to help with pain. These methods draw your attention away from the pain and release muscle tension caused by pain. They can help you relax. Some may work by releasing natural opioids within the body that can enhance the effects of pain medicine and medical therapies.

Talk to the healthcare team if you are thinking about using complementary therapies to manage pain. Ask if they will interfere with any cancer treatments or medicines.

Acupuncture

Acupuncture is an energy therapy that is part of traditional Chinese medicine. It uses very thin needles inserted through the skin at certain points to help restore the flow of energy in the body.

Find out more about acupuncture.

Biofeedback

Biofeedback uses monitoring devices to help you learn how to consciously control certain body functions, such as heart rate, blood pressure, temperature, sweating or muscle tension.

Find out more about biofeedback.

Energy therapies

Energy therapies are based on the belief that there are energy fields that flow through and around your body.

Find out more about energy therapies.

Guided imagery and visualization

Guided imagery is the use of images that help you think of and reach a specific goal. Visualizing happy, relaxed or pleasant pictures may help you overcome some pain.

Find out more about guided imagery.

Heat or cold

Heat, such as warm baths, warm water bottles and heating pads, may be used to treat aches or persistent muscle pain. Heat can help reduce stiffness in joints, relax muscles, ease muscle spasms and increase blood supply to the area. Heat should not be used on areas of skin that have received radiation therapy.

Cold, such as running cold water over or applying ice to an area, can be used to treat muscle spasms or headaches.

Hypnosis

Hypnosis is a state of relaxed and focused attention in which you concentrate on a certain feeling, idea or suggestion. Hypnosis can be used to block the awareness of pain or to substitute another feeling for pain.

Find out more about hypnosis.

Cannabis and cannabinoids for medical purposes

The Canadian government allows seriously ill people access to cannabis for medical reasons. This is commonly called medical marijuana.

Find out more about cannabis and cannabinoids for medical purposes.

Massage

Massage is a form of touch therapy. Depending on where your pain is, you may massage yourself or get help from a family member, friend or massage therapist. Massage can make you feel more comfortable and give you a sense of well-being. It can also be a soothing connection between you and a loved one. It may involve brief contact, such as holding hands or rubbing a shoulder, or it may involve longer contact.

Find out more about massage therapy.

Meditation

Meditation is the practice of concentrating or focusing your attention to increase mental awareness and calm your mind and body.

Find out more about meditation.

Music therapy

Music can help ease pain, lift your mood and work against depression. It can make you feel like moving and doing physical activities or it can help you relax and go to sleep. Music can also provide distraction from pain.

Find out more about music therapy.

Reiki

Reiki is an energy therapy that is part of a spiritual practice. It is also commonly called hands-on healing. It involves using the hands to transfer energy to promote healing and relieve pain. During a reiki session, the practitioner places hands on different parts of your body.

Tai chi

Tai chi is an ancient Chinese martial art that combines slow, focused body movements, mediation and deep breathing.

Find out more about Tai chi.

Transcutaneous electrical nerve stimulation (TENS)

Transcutaneous electrical nerve stimulation (TENS) is a non-invasive treatment that may reduce pain. TENS is believed to interrupt the pain signals sent to the brain. It may also work by promoting the release of endorphins, which are the body’s natural painkillers. TENS may help treat headaches, muscle aches or pains or nerve pain.

During TENS, wires and electrodes attached to a small battery-powered device are placed on the skin, usually on either side of the area where you feel pain. The electrodes carry electrical impulses to the nerves.

Yoga

Yoga involves stretches and poses with special focus given to breathing. It can be used to calm the nervous system and balance the body, mind and spirit.

Find out more about yoga.

5 alternative options for pain relief

Tell someone about an ache or pain and one of the first things they’ll ask is: “Are you taking anything for it?” In many ways we’re lucky that medical science has produced more, stronger and faster acting medications to help cure whatever ails us, and as a society we’re more than happy to take advantage of the “quick fix” of prescription or over-the-counter medicine. But there’s a downside to all that pill popping. Hazards range from minor side effects to serious and even deadly consequences, most notably when certain kinds of drugs are used to manage chronic pain.

The tide is beginning to turn as more healthcare professionals advocate for medication reviews, deprescribing and the use of “alternative” or non-drug therapies for managing pain. Even when medical treatments or prescription drugs are vital for recovery, people can still benefit from alternative therapies with proven benefits, which can be used to complement and enhance treatments.

Here are five that have been tested by researchers. Click on the links for details about the studies.

1. Get your groove on

There’s a reason why music is such a major part of life for most people: it can entertain, inspire, cheer, soothe, motivate and relax. But can it relieve pain? According to research evidence, listening to certain kinds of music before, during and/or after surgery helps reduce pain, anxiety and depression.

2. Get a move on

Like it or not, if we want to stay healthy and mobile into our senior years we need to make exercise a part of our daily routine. It’s hard to stay motivated and active though, especially when something (back, knees, hips, old football injury) is acting up again. But don’t give up: research shows exercise can be one of the best ways to relieve back pain or knee pain as well as build strength and stamina.

3. Try acupuncture

Acupuncture, long used in Chinese medicine, is now popular and widely practiced in North America to improve health and well being. Thin needles inserted into the body at specific points help to reduce pain and improve bodily functions. For example, recent research shows that acupuncture can reduce the frequency of headaches and migraines.

4. Change your mindset

Cognitive-behavioural therapy is a short-term, goal-oriented type of psychotherapy that helps people develop personalized coping skills and change harmful thoughts or beliefs. It’s often used to treat depression and other mental health problems, but it may also help relieve pain – particularly pain that isn’t due to a specific disease or condition. For example, studies show that cognitive-behavioural therapy helps reduce the frequency and intensity of chest pain.

5. Breathe and relax

Relaxation techniques and activities like yoga – including stretching, breathing and meditation – promote health and wellness by calming the mind, reducing stress and lowering blood pressure. What’s the evidence on pain relief? Research shows yoga helps ease pain and disability associated with low back pain.

Thinking outside the (pill) box

No one wants to be in pain and if there’s a pill that can make it disappear, most people will find it hard to resist. But drugs don’t always help everyone and if they do, short-term pain relief could come at the expense of potentially serious side effects and longer-term health problems. Non-drug strategies are worth trying as a safer first line of defense.

Complementary and Alternative Therapies for Pain

  1. Introduction
  2. Defining Complementary and Alternative
  3. Defining Pain
  4. Simple Pain Conditions vs. Lupus Pain
  5. Complementary and Alternative Therapies for Pain
  6. Closing Thoughts

Introduction

When pain is discussed, medications are often brought forth as the primary means of management. The focus of Dr. McSweeney’s presentation to the SLE Workshop honors the contribution of traditional medical approaches to pain management, while offering information on complementary and alternative therapies for pain. Many people with lupus have discussed medical treatments for pain with their doctors. For a variety of reasons, they may want to explore what non-pharmaceutical options exist. This is an opportunity to learn about what can be done that has the potential to offer additional relief.

Defining Complementary and Alternative

Although the therapies presented here are grouped together as both complementary and alternative, it is more accurate to say that they are complementary. It is not advisable to replace a prescribed regimen of medication, especially without consulting a doctor. Instead, complementary therapies can be added to a pain management plan in order to provide an extra measure of relief. At times, people are able to reduce the dose of their medications due to the added effects. Another benefit is the ability to proactively do something on one’s own to assist with the plan laid out by the doctors. It can be helpful to know that there are methods other than medication that can be effective.

Defining Pain

When discussing pain in lupus, it is important to look at the whole picture created by lupus. Many members of The SLE Workshop have identified pain as one of the major components of their lupus. Because pain plays such a major role for so many people, it is important that people with lupus have a variety of tools for managing pain.

Simple Pain Conditions vs. Lupus Pain

With a simple pain condition, such as banging your finger, there is a source you can identify. There is also a clear course of action that resolves the pain. Pain experienced with lupus is different. It is part of the systemic condition and is not as easily resolved. To deal with the pain, the cause of the pain may not always be addressed, but rather the ways the body expresses the pain, such as inflammation. Interventions such as anti-inflammatory medications reduce the pain, even if they don’t change the lupus itself.

Stress can also contribute to pain. This is the point where most complementary treatments can be of assistance. Even though the cause of the pain itself is not being directly addressed, reducing stress can often help to reduce pain, or at least help to deal more effectively with the pain.

Another point where pain can be addressed is with the immune system imbalance. Prednisone, for example, works to decrease the activity of an overactive immune system. Some complementary therapies aim to assist with immune system imbalance. This does not mean that complementary therapies are a cure for lupus, and that’s not the case. Some therapies can, however, have an impact on the immune system.

There are five categories. Some therapies cross over the categories.

1. Mind-Body: techniques for using your thoughts to have an impact on your body. Also, body therapies that target how the use of the body can have an impact on your emotions. Generally you can learn these and then do them yourself.

Examples of mind-body therapies:

  • Abdominal breathing is a simple technique to calm yourself down, open up the lungs, and get more oxygen into the body. This is done by taking deep breaths, initiating from the abdominals, holding the breath for a moment and then releasing.
  • Relaxation training is learning how to relax the muscles of the body by talking yourself through letting go of tension in the muscle groups of the body.
  • Guided imagery can be used for lots of different health conditions. This involves the process of mentally imaging a calming, relaxing experience which can include releasing pain from the body.
  • Self-hypnosis is giving yourself some kind of signal to release the pain, allowing your body to relax more
  • Meditation has been practiced for thousands of years. It was developed to deal with all kinds of pain: emotional pain, the pain of dealing with life, the need to find some kind of peace and calm. Physical pain is often connected to emotional pain. Many people find that meditation can help calm their mind in response to pain.
  • Biofeedback is done using equipment to give you feedback, or tell you, what’s going on in your body. Relaxation techniques are then used to help the body relax.

Reasons for using Mind Body Therapies:

The Gate Control Theory states that we have pain because there are messages going from the site of pain through the spinal cord to the brain where it registers that you have pain. The brain then signals back to the body. With chronic pain, however, nerves may fire continuously, even though there may not be any increase at a pain site. If we can shut off some of the pain messages in the spinal cord going up, or if the brain can actually send out different chemicals such as endorphins, than you can feel less pain and interrupt the chronic pain cycle. It’s not that your lupus condition is getting better and suddenly everything is fine, but that the brain and spinal cord are moderating some of the pain sensation. When practicing a mind body therapy such as guided imagery, your brain is calm and relaxed and therefore not processing, as much pain and you feel better.

2. Alternative treatments. This category is referred to as treatments because you would seek the help of a practitioner.

*Acupuncture can be helpful for pain and can have a beneficial effect on the immune system, but will not stop the lupus. Traditionally, 8-10 treatments are conducted by a practitioner. The treatments begin in a schedule of 2-3 times a week, reducing down to once a week. Acupuncture does not work for everyone. If you are not finding any relief by the 8th session, it’s probably not something that’s going to work for you.

Massage can be helpful and relaxing. It might be helpful to find a practitioner who is aware of lupus. The pressure used by a masseuse may be too great and cause more pain if the practitioner is unaware of the needs of a person with lupus.

3. Movement Therapies. These therapies use physical movement to help with both pain, and with calming the mind. These therapies tend to be very mind body focused. By calming the mind, the body is less sensitive to pain.

Some examples of movement therapies are Tai Chi, Yoga, and Qigong. Qigong may have a balancing effect on the immune system. With the eastern therapies the goal is to achieve balance in the mind-body system. It’s not something that will cure but that can help. It’s a matter of trying the different therapies and coming up with what works for you. Some classes are geared to people who suffer from pain, and one of those would be the best to take. It is also important to keep in mind that movement therapies are active and may not be helpful during a lupus flare.

4. Alternative remedies. These are different substances that you would take:

The Arthritis Foundation has put together a useful supplement guide. See also their information regarding this on their website, www.arthritis.org. Two of the most popular supplements for lupus are fish oil (omega 3 fatty acid) which targets inflammation, and DHEA, which has been thought to be helpful for lupus, but there are still some concerns about the side effects. It is a hormone. The ones at the health store are too low in dosage to make a difference, so if you’re serious about trying DHEA, you would want to talk to a doctor who could prescribe it at a higher dose. Again, you want to be careful about putting hormones into your body.

Homeopathy is a very gentle noninvasive remedy. Individuals report variations in helpfulness. It’s a complicated treatment where a practitioner will spend over an hour assessing your lifestyle and recommend treatments that are personalized. Practitioner visits tend to be expensive, although treatment generally involves very few visits. The remedies themselves are inexpensive.

5. Energy Medicine. These therapies address the energy fields of the body.

Reiki is similar to therapeutic touch where you barely touch a person in order to balance out the energy field on the body, smoothing out the energy. It can be very calming and can target specific points on the body such as the throat or the abdomen.

Aroma Therapy: Some people say it works on the energy system, others think it responds to specific sensory receptors. Aromatherapy may help decrease pain by promoting relaxation. Too many or too strong scents can be overwhelming and not helpful. Some scents are over stimulating. Lavender, chamomile, and peppermint are calming, which is the goal.

If you try a therapy and it’s not for you, then it’s not for you. It’s important to be patient and work on finding the combination that provides you with the greatest relief.

Closing Thoughts

During flare-ups, lupus symptoms should be addressed differently. This includes the use of complementary and alternative therapies. Pain can occur both during and between flare-ups. Strenuous activities should be avoided during a flare. Even something like meditation can be difficult to practice during a flare, since it can be difficult to concentrate. Anything that causes physical or mental stress should be avoided during a flare-up. Therapies marked with an asterisk (*) are considered mild enough to use during a flare, and can help decrease pain at these times. As with any change in lupus treatment plans, pain management or otherwise, it is important to discuss changes with your doctor before they are made., a free support and education group held monthly as HSS.
Learn more about the SLE Workshop, a free support and education group held monthly as HSS.

Updated: 11/4/2009

Summary of a presentation given at The SLE Workshop, a free support and education group held monthly for people with lupus and their families/friends Summary prepared by Olivia Ivey, MSW

Authors

Maureen McSweeney, PhD
HSS Integrative Care Center Faculty & Staff
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Why People Are Choosing Acupuncture Over Opioids for Pain Relief

In the midst of the opioid crisis, acupuncture has been growing in popularity in the United States.

Primarily used for pain management, this ancient Chinese form of alternative medicine — which involves thin needles being inserted into the skin — has gained support from the U.S. Department of Veterans Affairs and Medicaid as a viable treatment in recent years.

While the scientific evidence of acupuncture’s benefits is still widely debated, research from key Western studies suggests it can be used to manage certain pain conditions — especially back and neck pain, osteoarthritis pain, and headaches.

It’s also been used to treat a range of other conditions. As its popularity has grown, more people in the United States have begun turning to acupuncture when conventional medicine falls short.

Researchers are still trying to determine whether acupuncture can be a beneficial treatment for various health ailments. However, for those who may be seeking alternative options for hard-to-treat conditions, here are four areas in which acupuncture may help.

Acupuncture for easing pain

Heidi Boyson had suffered from chronic low-back pain for a decade when she tried acupuncture for the first time in England.

She’d already tried chiropractors, physical therapy, and medication. “Nothing worked,” she told Healthline. “The acupuncturist put needles in my head, and I fell asleep, which was great. When I woke up, I was much more relaxed.”

After just one visit, Boyson says her pain became manageable.

Western research has shown that acupuncture can be effective in managing pain. Exactly why it works is still unclear, though there are several theories.

The first written account of acupuncture, in “The Yellow Emperor’s Classic of Internal Medicine,” dates to 100 B.C. in China.

The theory behind the practice suggests the stimulation of specific spots prompts the body to release a flow of energy, or “qi,” which travels through “meridians.”

The Western explanation: The needle stimulates a nerve, which sends a signal to the brain to release beta-endorphins. These chemicals work as the body’s own opioids, lowering pain thresholds.

Another theory proposes acupuncture changes cells in connective tissue around the pressure points in lasting ways that lead to less pain.

There is also evidence, according to a 2016 study, that stimulating the vagus nerve, which runs from the brain stem to the colon, may lower inflammation throughout the body. Inflammation is closely tied to chronic pain.

States looking to cut opioid prescriptions have been experimenting with extending Medicaid coverage for acupuncture as another option for pain treatment. Rhode Island, Oregon, and Ohio all have programs that extend coverage in part.

When Vermont commissioned a small pilot study on acupuncture for chronic pain in its Medicaid population, it concluded that 32 percent of people taking opioids for pain cut back. They were eligible for up to 12 treatments over two months.

The U.S. Department of Veterans Affairs has trained more than 2,800 providers of “battlefield acupuncture,” a protocol that involves the ear to relieve pain.

According to Dr. Charles Levy at the Gainesville VA center in Florida, the protocol has helped with headaches, acute and chronic back and musculoskeletal pain, and neuropathic pain.

The result depends dramatically on the pain, the practitioner, and the patient.

Last year, when Boyson was coping with occasional migraines, she went to an acupuncturist in New York City.

“Traditional medicine wasn’t helping, and was lovely and affordable,” Boyson said, adding she’d feel good after each visit, but this time the effects didn’t stick.

The Cochrane Collaboration looked at seven studies that compared the effect of acupuncture against a sham (placebo) acupuncture procedure to treat tension headaches.

The group that received the sham (placebo) procedure had headaches 7 to 16 days a month, while those who had the real acupuncture suffered two fewer days with headache. Everyone had a minimum of six weekly treatments.

Narda Robinson, an osteopath who uses acupuncture, says that when she treats headaches, she does a careful examination of not only the patient’s head, but also the neck and back and the patient’s posture.

“I am accustomed to whole-person medicine — not focusing on one part at the exclusion of others,” she told Healthline.

Treating neurologic injury

Robinson, who runs CuraCore Integrative Medicine & Education Center in Fort Collins, Colorado, is also a veterinarian.

She’s seen acupuncture work wonders with both people and dogs suffering from nerve damage.

Stimulating acupuncture points in dogs with paralyzed hind legs has allowed them to walk, she says.

“My veterinary colleagues and I witness remarkable turnarounds in dogs with thoracolumbar spinal cord injury from disc disease” she said.

Another remarkable turnaround happened to an environmental scientist in his 50s who came to see her for acupuncture.

Because of a car accident 20 years earlier, he couldn’t smile fully on one side of his face or clearly pronounce words. His face, hands, and feet were numb.

Soon after she treated him, he began to regain sensation and motor skills he had been told would never return.

“At every visit, he’d report on how he could now feel the fine edges of the computer keyboard, use his fingers well enough to button his own shirt, and smile as well as speak more normally,” Robinson said.

Can acupuncture reliably help serious neurological problems?

“It’s certainly something that should be explored more intensively in human spinal cord injury clinics, both to facilitate recovery and reduce the need for surgery,” Robinson said.

However, the research so far has been mostly inconclusive. A 2015 review of using acupuncture to recover after a spinal cord injury found only 12 studies, which did show improvements in motor function and functioning.

Yet a 2018 review of whether acupuncture helps stroke survivors found more than 30 studies on the subject, and it was inconclusive.

Nevertheless, Robinson strongly disagrees. She maintains that the evidence is promising enough. She believes people with nerve damage should be offered acupuncture, especially if they have few other options.

The same reasoning might apply to hard-to-treat pain.

In 2018, four U.S. anesthesiologists conducted a review of nondrug treatments for fibromyalgia (a condition marked by fatigue and pain in many spots of the body).

They concluded that meditation and cognitive behavioral therapy were more promising than acupuncture. Because it rarely causes any harm, they wrote it also “should not be discouraged.”

Promoting weight loss

New strategies to lose weight are usually a fad. There is no gold-star research — large, controlled, randomized studies — to support a case for acupuncture to shed pounds.

However, there’s some early positive evidence.

Two points in the ear have traditionally been associated with appetite. A 2017 review found 18 randomized controlled studies of ear acupuncture for weight loss. These were small studies. The largest study only involved 200 participants.

The review concluded that ear acupuncture was linked to an average loss of about 3 pounds. Treatments that lasted longer than six weeks produced the best results.

A number of studies are being conducted on the effect of a person’s microbiome — the bacteria inside the body — on weight gain. A small Shanghai study found that acupuncture reduced the number of Bacteroidetes, which are more abundant in those who are obese.

Despite the widespread use of probiotics, we don’t currently have targeted ways of changing our gut flora.

In this study, among the 30 women who received acupuncture, the average BMI dropped from close to 28 to a little over 25. Their Bacteroidetes levels also fell. A small control group didn’t lose much weight or see the same favorable changes in their gut flora.

There is some data suggesting that electro acupuncture is more effective than needles alone for weight loss, according to another 2013 overview.

Acupuncture may reduce inflammation, which is related to obesity as well as pain. If it relieves pain or anxiety, that could help people avoid overeating too.

“I don’t see acupuncture as having that big an effect on obesity itself, but more on addressing problems with pain and mood,” Robinson said.

Taming nausea

According to a 2017 review, the National Cancer Institute and other major medical organizations in the United States and Europe regard acupuncture as an appropriate treatment for post-chemotherapy nausea and vomiting.

A systematic review of 30 randomized and controlled trials involving more than 2,500 volunteers concluded that stimulating various acupuncture points cut nausea and vomiting within hours or a day after surgery, which is a common reaction to anesthesia.

Ongoing research into acupuncture as treatment

The National Institutes of Health (NIH) supports research on acupuncture as a treatment for a range of conditions, including hot flashes, pain related to chemotherapy, and tinnitus.

The opioid crisis has also restored interest in acupuncture not just for pain relief, but also for relaxation to help wean people from addictions.

More research is needed to fully understand all the benefits acupuncture might offer. Until then, people seeking alternatives for hard-to-treat conditions may find relief through this Eastern approach to medicine.

“Conventional medicine is at a crossroads,” Robinson said. “The drugs-and-surgery dominant approach is costly and incomplete” and patients end up “misdiagnosed and overmedicated for problems medical acupuncture” could help.

Editor’s note: This piece was originally reported on June 5, 2018. Its current publication date reflects an update, which includes a medical review by Debra Rose Wilson, PhD, MSN, RN, IBCLC, AHN-BC, CHT.

If you have chronic pain and are looking for alternatives to medication and surgery, you have a lot of options. Alternative pain treatments that doctors once scoffed at are now standard at many pain centers.

“That phrase ‘alternative pain treatments’ doesn’t mean much to me,” says Seddon R. Savage, MD, incoming president of the American Pain Society. “I think the line between them and mainstream treatment is pretty blurry now.”

However, not all alternative pain treatments work. Some can even be risky. Some alternative treatments may help with pain from bad backs, osteoarthritis, and headaches, but have no effect on chronic pain from fibromyalgia or diabetic nerve damage.

“You have to do your homework when you’re considering alternative treatments for pain,” warnsAnne Louise Oaklander, MD, PhD, an associate professor of neurology at Harvard Medical School and director of the Nerve Injury Unit at Massachusetts General Hospital in Boston.”Make sure that you’re trying a treatment that is likely to work in your case.” And always discuss any alternative pain treatments you want to try with your regular doctor.

Here’s a rundown of the most commonly used alternative treatments for chronic pain.

  • Acupuncture. Once seen as bizarre, acupuncture is rapidly becoming a mainstream treatment for pain. Studies have found that it works for pain caused by many conditions, including fibromyalgia, osteoarthritis, back injuries, and sports injuries.
    How does it work? No one’s quite sure. It could release pain-numbing chemicals in the body. Or it might block the pain signals coming from the nerves.
    “I think there’s good scientific evidence for acupuncture and I prescribe it,” says F. Michael Ferrante, MD, director of the UCLA Pain Management Center in Los Angeles. “The nice thing is that even if it doesn’t work, it doesn’t do any harm.”
  • Marijuana. Setting aside the controversy, marijuana has been shown to have medicinal properties and can help with some types of chronic pain.
    There’s strong evidence that marijuana has a modest effect on certain types of nerve pain — particularly pain caused by MS and HIV, says Steven P. Cohen, MD, associate professor in the division of pain medicine at Johns Hopkins School of Medicine in Baltimore. Since it also relieves nausea, marijuana can help people who are suffering side effects from chemotherapy.
    However, marijuana does have risks. For some people, Cohen says, those risks can be serious, including addiction and psychosis. Because of the dangers and the obvious potential for abuse, experts generally only turn to marijuana when all other treatments have failed.
    On a practical level, you also need to be aware of the laws regarding the use of medical marijuana in your state. Could you be arrested for smoking marijuana for medical reasons? Talk to your doctor. There are also two prescription drugs, called pharmaceutical cannabinoids, that are derived from the active ingredient of marijuana. They are sometimes used for pain, although they are only FDA-approved for nausea caused by chemotherapy and HIV-related weight loss.
  • Exercise. Going for a walk isn’t a treatment, exactly. But regular physical activity has big benefits for people with many different painful conditions. Study after study has found that physical activity can help relieve chronic pain, as well as boost energy and mood.
    If you have chronic pain, you should check in with a doctor before you start an exercise routine, especially if you have any health conditions. Your doctor might have some guidance on what to avoid, at least as you get started.
  • Chiropractic manipulation. Although mainstream medicine has traditionally regarded spinal manipulation with suspicion, it’s becoming a more accepted treatment. “I think chiropractic treatment works reasonably well for lower back pain,” Oaklander tells WebMD. “Studies have shown that it’s comparable to other approaches.”
  • Supplements and vitamins. There is evidence that certain dietary supplements and vitamins can help with certain types of pain. Fish oil is often used to reduce pain associated with swelling. Topical capsaicin, derived from chili peppers, may help with arthritis, diabetic nerve pain, and other conditions. There’s evidence that glucosamine can help relieve moderate to severe pain from osteoarthritis in the knee.
    But when it comes to supplements, you have to be careful. They can have risks. Oaklander says that high doses of vitamin B6 can damage the nerves. Some studies suggest that supplements such as ginkgo biloba and ginseng can thin the blood and increase the risk of bleeding. This could lead to serious consequences for anyone getting surgery for chronic pain.
    “Supplements can cause real harm,” says Ferrante. He points out that people with chronic pain can be at higher risk of side effects from supplements. Why? They’re more likely than the average person to be taking other medications or getting medical procedures or surgeries.
    So treat supplements and vitamins warily, like you would treat any drug. Always check with a doctor before you start taking supplements, especially if you have any medical conditions or take other medication.
  • Therapy. Some people with chronic pain balk at the idea of seeing a therapist — they think it implies that their pain isn’t real. But studies show that depression and chronic pain often go together. Chronic pain can cause or worsen depression; depression can lower a person’s tolerance for pain.
    So consider giving therapy a try. Cohen says he’s seen particularly good results with cognitive behavioral therapy, a practical approach that helps people identify and change the thought and behavior patterns that contribute to their unhappiness.
  • Stress-reduction techniques. “Reducing stress is really crucial in pain management,” says Savage. There are number of approaches, including:
    • Yoga. There’s good evidence that yoga can help with chronic pain, says Cohen — specifically fibromyalgia, neck pain, back pain, and arthritis. “I’ve been including yoga as part of the treatment that I prescribe since the mid-1980s,” Savage says.
    • Relaxation therapy. This is actually a category of techniques that help people calm the body and release tension — a process that might also reduce pain. Some approaches teach people how to focus on their breathing. Research shows that relaxation therapy can help with fibromyalgia, headache, osteoarthritis, and other conditions.
    • Hypnosis. Studies have found this approach helpful with different sorts of pain, like back pain, repetitive strain injuries, and cancer pain.
    • Guided imagery. Research shows that guided imagery can help with conditions like headache pain, cancer pain, osteoarthritis, and fibromyalgia. How does it work? An expert would teach you ways to direct your thoughts by focusing on specific images.
    • Music therapy. This approach gets people to either perform or listen to music. Studies have found that it can help with many different pain conditions, like osteoarthritis and cancer pain.
    • Biofeedback. This approach teaches you how to control normally unconscious bodily functions, like blood pressure or your heart rate. Studies have found that it can help with headaches, fibromyalgia, and other conditions.
    • Massage. It’s undeniably relaxing. And there’s some evidence that massage can help ease pain from rheumatoid arthritis, neck and back injuries, and fibromyalgia.

Chronic Pain Treatment Options

The ACPA states that alternative therapies often lessen the need for medications and other more invasive procedures. Alternative therapies include:

  • cognitive therapies
  • behavioral therapies
  • physical therapies

These forms of treatment also allow people to take a more active role in pain management.

“Pain is like the oil light on your body’s dashboard telling you that something desperately needs attention,” says Jacob Teitelbaum, M.D., the medical director of the Fibromyalgia and Fatigue Centers. “Just as the oil light will go out when you put oil in your car, pain will often go away when you give your body what it needs.”

Exercise

Regular exercise and physical therapy are usually part of any pain management plan.

Dr. Teitelbaum believes exercise is critical in the relief of pain. A large percentage of pain comes from tight muscles. These may be triggered by overuse, inflammation, or other conditions.

Regular exercise is important for treating chronic pain because it helps:

  • strengthen muscles
  • increase joint mobility
  • improve sleep
  • release endorphins
  • reduce overall pain

Relaxation

Relaxation techniques are often recommended as part of a treatment plan. They help to reduce stress and decrease muscle tension. Relaxation techniques include:

  • meditation
  • massage
  • yoga

Yoga also has other benefits for chronic pain. It can help strengthen muscles and improve flexibility.

Acupuncture and acupressure

Acupuncture and acupressure are types of traditional Chinese medicine. They relieve pain by manipulating key points of the body. This prompts the body to release endorphins which can block messages of pain from being delivered to the brain.

Biofeedback is another technique for pain management. It works by measuring information about physical characteristics such as:

  • muscle tension
  • heart rate
  • brain activity
  • skin temperature

The feedback is used to enhance an individual’s awareness of physical changes associated with stress or pain. Awareness can help a person train themselves to manage physical and emotional pain.

TENS

Transcutaneous electrical nerve stimulation (TENS) applies a small electric current to specific nerves. The current interrupts pain signals, and triggers the release of endorphins.

Cannabis

Several states have laws permitting the use of cannabis, also known as medical marijuana, for pain relief. It is also used to manage the symptoms of other serious illnesses like cancer and multiple sclerosis.

According to the Mayo Clinic, cannabis has been used as a method of pain relief for centuries. There is a great deal of controversy and misinformation about cannabis use. However, recent research has made more people aware of the plant’s medicinal properties. It is now legal for medical use in several U.S. states.

Talk to your doctor before you use cannabis. It is not safe for use in all patients, nor legal for medicinal uses in all states.

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