Pain >

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• C.H. = Clare Horn

• TODO - Cut this apart and use the little articles as starters for other topics.

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Intro ∞

Drugs or surgery don't have to be your first line of defense against pain. We take an in-depth look at the most promising natural therapies and help you choose the one for you.

All she'd done was lean over the bathroom sink to scrub her face. Then my roommate Cheryl McGrath heard a crunching sound and felt pain radiate down her neck and into her shoulders. With a grimace on her face and walking with a stiff, upright posture, she came into my room, where I was in the early stages of research for this article. She told me she couldn't move her neck and was going to the doctor. I could tell she wasn't kidding. She was in pain.

That night she lay on the couch, the doctor-recommended ice pack on her neck and sedated by Motrin. "A pinched nerve," the doctor had diagnosed. "See how it is in a few days." We tried to figure out how she, a 27-year-old avid biker, yoga enthusiast, and hiker, could have done so much damage to her neck by just washing her face.

A day or two later I came across a book called The Mindbody Prescription (Warner Books, 1998) by John Sarno, M.D., a professor at the New York University School of Medicine and physician at the Rusk Institute of Rehabilitation Medicine in New York City. In his book Sarno maintains that chronic pain--including back pain, headache, heartburn, and irritable bowel syndrome--often isn't caused by injury or structural defects; it's caused when repressed anger stored in the unconscious tries to emerge into consciousness. (See "Why Rage Is a Pain" on page 126.) According to Sarno, he's helped 95 percent of his patients uncover this repressed anger and eliminate their pain. I began to quiz my roommate.

It turns out she'd been under a lot of stress. She confided that she was upset about a waning friendship with a longtime friend, she'd had an awkward chance meeting with a former employer, and her boyfriend had just left town for a month. Though on the surface McGrath felt she was coping with these events, tension and resentment had been building subconsciously for days, maybe weeks. Acknowledging her feelings didn't cure her neck overnight, but talking about Sarno's theory did make her wonder whether her buried feelings might have contributed to her sore neck. Slowly she got control of her pain. Over the next two weeks she examined her different emotions and resumed gentle exercise.

What Is Pain? ∞

Firsthand I saw that pain may not always be the result of physical problems. Theories abound to explain why pain happens. For centuries doctors thought it was purely a reaction to tissue damage, with nerves sending impulses to the brain. Treatments therefore focused on repairing the damage, together with blocking nerve impulses with drugs.

The latest theory is that the brain feels pain on its own, regardless of injury or any other outside stimulus. In an article on pain in the Sept. 21, 1998, issue of The New Yorker, Canadian psychologist Ronald Melzack, Ph.D., described the role of the brain in pain perception: "If a mad scientist reduced you to nothing but a brain in a jar, you could still feel pain--indeed, you'd have the full range of sensory experience." This theory would help explain how amputees can still feel pain from missing limbs.

Just as there are many ways to interpret pain, there are many ways to heal it: pain medication, surgery, acupuncture, herbal treatments, and more. Of course, many people usually turn to surgery and prescription and over-the-counter drugs. These may be useful in certain circumstances (such as the occasional ibuprofen to treat a tension headache), but they do carry risks and side effects. Consider the painkilling drug Duract, which the Food and Drug Administration pulled from pharmacy shelves last summer after four users died and eight required liver transplants.

There are safer, equally effective alternatives that often go to the heart of what is causing the pain, instead of merely blocking it. The following pages present 13 such therapies. They've been used successfully in a variety of clinical settings, though many are supported by anecdotal and historical evidence rather than rigorous scientific evidence. But the evidence is sufficient to warrant trying them as a first course of treatment. To find the most promising for your type of pain, see "The Right Therapy for You" on page 127.

There are dozens of worthwhile therapies besides the 13 we detail. For more therapy ideas, including homeopathy and biofeedback, see "More Choices in Pain Relief" on page 135.

Keep in mind that you shouldn't always mask pain. It can be useful in letting you know something is wrong physiologically. Be sure to see a doctor for a full examination to rule out any serious illnesses before beginning any of these treatments.

Acupuncture ∞

(Acupuncture)

What to Expect: An acupuncturist inserts extremely thin needles into particular points of the body, leaving them in for a few minutes or up to an hour or more. Sometimes electrical energy is passed through these needles. Complete pain relief normally takes more than one session, says David Maloney, L.Ac., acupuncturist and executive director of the National Association of Acupuncture and Oriental Medicine in Catasaugua, Pa. However, patients usually experience some immediate relief.

Needles aren't the only tools an acupuncturist can use. Moxabustion, the burning of herbs over a painful area, is a powerful way to treat pain, according to Michael Tierra, L.Ac., O.M.D., acupuncturist and author of The Way of Herbs (Pocket Books, 1998). Other methods include cupping, applying suction to the skin, and guasha, which involves scraping a porcelain spoon against the skin.

How It Works: According to traditional Chinese medicine, pain can result when qi (the body's life energy) becomes blocked in the blood or along energy pathways called meridians. Acupuncture breaks up these blockages, either near the site of pain or farther away along the meridians. Both cupping and guasha disperse stagnated blood. Dispersing qi blockages can stimulate endorphins (a group of brain chemicals that act like pain relievers), while better blood circulation increases oxygen distribution (oxygen helps damaged tissue heal).

What's the Proof? In research studies, acupuncture has been shown to effectively treat such ailments as neck and back pain, menstrual pain, and migraines. A study published in Rheumatology International in 1998 reported that acupuncture decreased pain levels in the 29 fibromyalgia patients tested. The researchers speculated that the treatment increased concentrations of pain-modulating brain chemicals in the blood.

Getting Started: Look for an acupuncturist certified by the National Certification Committee of Acupuncture and Oriental Medicine (NCCAOM). California has its own test that meets NCCAOM standards. To locate an acupuncturist, contact the American Association of Oriental Medicine (610-266-1433) or visit its website at www.aaom.org. "If you want the most rapid recovery," says Maloney, "you should go to an Oriental medical practitioner right away--not three years after you injure yourself."

Caveats: Hemophiliacs shouldn't receive acupuncture treatments.

Chiropractic ∞

(Chiropractic)

What to Expect: A typical first visit begins with the chiropractor taking a personal and family health history, and then performing an orthopedic and neurological exam (including blood pressure checks, blood tests, and possibly an MRI or X-ray). Then the chiropractor guides the patient through a range of what should be normal movements--turning the head, bending over, arching, slumping--while feeling along the spine for any out-of-line vertebrae. Adjustments may be frequent at first (possibly several sessions a week), but will decrease as misalignments are corrected, says Wayne Zemelka, D.C., a chiropractor and the retired president of the faculty at Palmer College of Chiropractic in Davenport, Iowa.

How It Works: Chiropractic attributes pain to misaligned joints along the spine, called subluxations. These defective joints cause the rest of the spine--and in turn the body's muscles--to compensate by shifting, tightening, or going into spasms. Jerome F. McAndrews, spokesman for the American Chiropractic Association in Arlington, Va., gives this analogy: "It's like a mobile hanging from a ceiling. Each part has a role in the equilibrium of that mobile, creating a state of dynamic equilibrium. If you cut off a piece of that mobile, the equilibrium shifts, creating a new dynamic equilibrium." The same holds true for the spine. Just one subluxation can cause the whole spine--and to some extent the whole body--to shift into a new equilibrium. A licensed chiropractor makes adjustments to these subluxations so the body can return to its original aligned state.

What's the Proof? In 1994 the United States Agency for Health Care Policy Research (AHCPR), part of the U.S. Department of Health and Human Services in Washington, D.C., reviewed the scientific evidence and literature on spinal manipulation for a publication called The Guidelines for Chiropractic Quality Assurance and Practice Parameters. Based on its findings, the AHCPR recommended chiropractic as the therapy of choice for back pain sufferers.

Evidence for other types of pain relief is limited, but areas of ongoing chiropractic research include carpal tunnel syndrome, fibromyalgia, and headaches.

Getting Started: For a list of chiropractors in your area, call the National Directory of Chiropractors at 800-888-7914.

Caveats: Chiropractors recommend against spinal manipulation if you have rheumatoid arthritis, severe osteoporosis, bleeding disorders, or a fracture, infection, or inflammation of the spine.

Craniosacral Therapy ∞

(Craniosacral therapy)

What to Expect: A craniosacral therapist uses a light touch to examine the whole body, looking for irregularities in the motion of cerebrospinal fluid (which envelops the brain and spinal cord), as well as irregularities in other parts of the body. Most often he or she checks the skull, neck, and tailbone. While still using the hands, the therapist applies gentle pressure to return the fluid to its ideal motion.

Craniosacral therapy is also practiced by chiropractors, dentists, osteopaths, physical therapists, and psychiatrists. Sessions typically last 45 minutes to an hour. You should notice an improvement within five sessions.

How It Works: This therapy doesn't directly alleviate pain. Instead, craniosacral therapists believe that when the craniosacral system (the cerebrospinal fluid and surrounding membranes and bones) functions optimally, the body can mend its wear and tear. When the system is amiss, pain is more likely to develop and stick around.

The cerebrospinal fluid, acting like a semi-closed hydraulic system, moves up and down the spine at about six to 12 cycles per minute. The premise of craniosacral therapy is that when the fluid moves, the membranes containing the fluid move. As the membranes pulse they create a spider-web effect, exerting pressure on connective tissue all over the body. The therapist manipulates the membranes and the flow of cerebrospinal fluid, helping it return to its proper rhythm.

What's the Proof? Published research on craniosacral therapy focuses primarily on how the craniosacral system operates, not on how it relieves pain. But in March 1990 the Appellate Court of Colorado ruled that craniosacral therapy is an effective form of treatment for temporomandibular joint syndrome (TMJ), and Colorado dentists are allowed to use the treatment in their practices.

Getting Started: Here's a simple technique to try on your own to relax your central nervous system, recommended by the Upledger Institute, a craniosacral therapy training center and clinic in Palm Beach Gardens, Fla.: Put two tennis balls in a sock and tie a knot so they're tightly in contact. Lie down on your back and put the sock under your head with the balls directly behind your eye sockets for about 10 to 20 minutes. This little bit of pressure causes brief interruptions in the rhythm of the cranial fluid, known as still points, during which the whole central nervous system relaxes. Don't try this if you're recovering from a stroke and need to avoid increases in pressure on the skull.

For a directory of craniosacral practitioners, contact the Upledger Institute at 800-233-5880.

Caveats: If you have experienced an intracranial hemorrhage, aneurysm, or stroke--or suspect you've had one--don't try craniosacral therapy.

Feldenkrais Method ∞

(Feldenkrais Method)

What to Expect: When you learn the Feldenkrais Method, you become aware of how the body moves. During one-on-one training, a teacher might gently move a student's limbs into different positions while the student lies on a table and focuses on how each position feels. In classroom sessions and in some individual sessions, the teacher gives only verbal instructions on how to move more easily.

How It Works: The Feldenkrais theory holds that poor posture and bad movement habits--slouching in chairs, incorrectly lifting heavy objects--put strain on the muscles and cause musculoskeletal pain. "We abuse our bodies on a daily basis. Feldenkrais teaches people to be aware of how to move much more easily," explains Jim Stevens, a professor at the Institute for Physical Therapy at Widener University in Chester, Pa. By learning to move more efficiently, you take unnecessary strain off painful muscles and allow them to heal.

What's the Proof? Evidence is anecdotal or limited to small pilot studies. A case study in the Journal of Orthopedic Sports Physical Therapy in 1997 suggests Feldenkrais as an option for patients with chronic low back pain. And a study presented at the Feldenkrais Guild Conference in August 1997 reported significant improvements in a group of five patients with fibromyalgia.

Getting Started: For a list of certified teachers in your area, contact the Feldenkrais Guild of North America at 800-775-2118.

Caveats: It may take several months before you feel the benefits of Feldenkrais work, warns Victoria Ahrensdorf, founder and director of the Feldenkrais Center for Learning in Northampton, Mass.

Guided imagery ∞

(Guided imagery)

What to Expect: Guided imagery asks people to use their imaginations to fight pain. Perhaps a patient will picture a paintbrush slathering sore muscles with soothing ice-blue gel. A session with a therapist usually lasts between 50 minutes and an hour and a half. The guided imagery exercises take up about 20 minutes, and the rest of the time is spent talking about the meaning of the images and the feelings they evoked. Guided imagery is not the same as hypnosis (though some imagery is used in hypnosis). In hypnosis the operator makes all the suggestions; in guided imagery the patient makes the suggestions.

The first step of a session is to think of an image that represents the pain (this can be a predetermined image or a spontaneous one). Next, begin a dialogue with this image. Ask the image why it's there and what its purpose is. Pain has meaning, reminds David Bresler, Ph.D., chairman of the Academy for Guided Imagery and an anesthesiology professor at the University of California School of Medicine in Los Angeles. Its purpose is to call attention to something that's wrong, whether the problem is physical or psychological. Finally, create an "inner doctor" with whom you discuss the best way to handle your pain.

How It Works: Often patients come up with very graphic images to describe their pain--a twisting knife in a muscle, an animal gnawing on nerves, an elephant sitting on a chest--Bresler says. Patients can use these images to interpret their pain, to understand its origins, and to discover how to manage it. The process of guided imagery also promotes relaxation, a key ingredient in pain management.

What's the Proof? Many studies have shown that relaxation techniques as a whole--guided imagery as well as progressive relaxation and other similar therapies--can successfully treat painful conditions such as arthritis, headaches, and irritable bowel syndrome (IBS). One study published in the September 1993 issue of Biofeedback and Self Regulation tested the effects of 10 sessions of progressive relaxation exercises on patients suffering from IBS. Symptoms were reduced for half of the group at the end of the treatment.

An increasing number of conventional medical doctors use guided imagery, and more than 60 medical schools are beginning to teach the technique for pain diagnosis, prognosis, and treatment.

Getting Started: A method called glove anesthesia offers one way to manage pain using guided imagery. First, imagine dipping your hand into a bucket of highly potent anesthetic and swirling it around until the entire hand is numb. Then visualize transferring this numbness to any painful areas. Bresler says this technique typically works for almost every type of pain. The more you do it, the more effective and long-lasting is the pain relief.

For a list of local guided imagery therapists, call the Academy for Guided Imagery of Mill Valley, Calif., at 800-726-2070.

Caveats: Because guided imagery is the language of the unconscious, very strong emotional responses can be elicited, a rare but potential danger for people with high blood pressure. It may be best to use guided imagery under the supervision of a certified guided imagery therapist--at least at first.

Herbal medicine ∞

(Herbal medicine)

What to Expect: Most pain-relieving herbs provide only temporary relief when pain acts up. However, some herbs can prevent some kinds of pain; for instance, feverfew can protect against migraines. Most herbs are relatively safe and easy to use, and their pain-relieving effects take effect in 30 minutes to an hour.

Laurel Vukovic, Natural Health's Home Remedies columnist and the author of 14-Day Herbal Cleansing (Prentice Hall, 1998), does not use herbs merely to numb pain. Instead she relies on herbal remedies to take the edge off pain and accompany other relaxation therapies like warm baths and massage.

How It Works: Every herb has a combination of therapeutic properties, many of them useful for pain relief. In particular, look for herbs with analgesic, antispasmodic, or anti-inflammatory properties. Analgesics work by reducing pain signals to the brain. Antispasmodics help prevent or relax muscle spasms. Anti-inflammatory herbs reduce redness, swelling, pain, heat, and loss of function. Peppermint oil, for example, possesses both analgesic and antispasmodic properties: When used to treat irritable bowel syndrome, it eases pain and blocks the calcium that causes contractions in smooth muscles such as the intestine.

What's the Proof? According to Michael Murray, N.D., a naturopathic physician in Bellevue, Wash., and author of The Healing Power of Herbs (Prima Publishing, 1995), the past 10 to 20 years have produced a tremendous amount of research on herbs, and many studies conducted in both the United States and Europe show they can alleviate pain.

Two examples: A double-blind study published in the Journal of Gastroenterology in December 1997 reported that enteric peppermint off capsules (capsules coated to prevent them from digesting in the stomach and causing heartburn) reduced symptoms of irritable bowel syndrome. For the test, 52 patients took peppermint oil three to four times daily for one month; 79 percent experienced less abdominal pain, and of those, 56 percent were pain-free. Only 43 percent of the placebo group reported pain relief.

Danish researchers tested 500 to 1,000 mg of ginger per day on 56 patients with rheumatoid arthritis, osteoarthritis, or muscular discomfort and found the herb reduced pain and swelling for 75 percent of them. Their results were published in Medical Hypotheses in December 1992.

Getting Started: Vukovic recommends the following herbal treatments for common types of pain:

• Cramp bark alleviates menstrual and back pain. To make a tea, use 2 teaspoons of herb per cup of water and simmer, covered, over low heat for 15 minutes. Drink three cups a day. If you can't tolerate the taste, mix with ginger tea (see recipe below).

• Ginger eases musculoskeletal pain, such as rheumatism and osteoarthritis. Boil a strong tea with 2 teaspoons of fresh ginger per cup of water. Simmer, covered, over low heat for 5 minutes. For additional pain relief, add 1 tablespoon of chamomile, a milder herb, per cup after you've removed the pot from the heat; steep for 10 minutes. Drink as much ginger tea as you want, whenever you feel pain.

• Peppermint oil relieves irritable bowel syndrome. Three times daily take one or two enteric capsules (coated to prevent them from being digested in the stomach and causing heartburn).

• Valerian is a sedative as well as a superior general pain reliever, helpful when pain keeps you from getting enough sleep. Take as a liquid extract (1/2 to 1 teaspoon). Repeat dose in one hour if not effective; then take only as needed.

For an information packet on herbs used to relieve pain, including usage, dosages, and side effects, contact the Herb Research Foundation at 303-449-2265. The cost is $7. To locate an herbal practitioner who can help you decide which pain-fighting herbs are best for you, contact the American Herbalists' Guild at 435-722-8434.

Caveats: Before treating yourself with herbs, make sure you know your ailment. Consult a physician, preferably a holistic one, for a diagnosis. For a list of doctors in your area, contact the American Holistic Medical Association at 703-556-9728 or www.holisticmedicine.org.

The herbs mentioned above are extremely safe. However, in a minority of people valerian acts as a stimulant, similar to caffeine. And peppermint oil if not taken in an enteric form can cause heartburn.

Hydrotherapy ∞

(Hydrotherapy)

What to Expect: Alternating applications of hot and cold water to the skin of an afflicted area can relieve pain. Heat is always applied first, followed by cold. The length of time for each depends on the ailment. You might soak an individual area of your body in a bucket of water (sitz baths, used to treat hemorrhoids and menstrual pain, involve sitting in alternating buckets of hot and cold water), or apply wet towels or cold and hot compresses. Sometimes Epsom salts are added to increase the effectiveness of the treatment.

Hydrotherapy can relieve, but not cure, most types of pain and is therefore best used as an adjunct to other therapies. Like many naturopathic doctors, William Nelson, N.D., of Colorado Springs, Colo., teaches his patients how to do the treatments at home. You can also learn the treatment from books and treat yourself.

How It Works: The principle behind hydrotherapy is simple. Nelson explains that the treatment works like an artificial pump, breaking up poorly circulating blood that can contribute to pain. Hot water is used to stir up stagnated blood and draw fresh oxygen and nutrient-rich blood to the painful area. Then cold water is applied to draw the stagnated blood away from the painful spot. Sometimes, as in the case of a headache, pain is caused by too much blood in an area of the body. In such a case, hot water would be applied to a part of the body far from the painful area to draw some of the overabundance of blood away.

What's the Proof? Evidence comes mainly from clinical studies done in Europe. In a four-week-long study published in the June 1996 issue of Arthritis Care and Research, 139 patients with rheumatoid arthritis were randomly assigned to 30-minute sessions of hydrotherapy, seated water immersion (not strictly considered hydrotherapy because the treatment doesn't target a specific area of the body), land exercise, or progressive relaxation. Hydrotherapy provided the greatest pain relief with significant improvements in joint tenderness and range of movement in the knee.

Getting Started: Here's a simple treatment for tension headaches: Soak your feet in a tub of hot water (102 degrees) for five to 10 minutes. Then apply an ice pack or cool towel to your neck at the base of your skull for about 30 seconds. Alternate this routine about six times, increasing the temperature of the hot water for your feet each time. You should feel relief within an hour.

For instructions on hydrotherapy treatments for other ailments, Nelson recommends Lectures in Naturopathic Hydrotherapy (Eclectic Medical Publications, 1988) by naturopathic physicians Wade Boyle, N.D., and Andre Saint, N.D. To locate a hydrotherapist in your area, contact the American Association of Naturopathic Physicians at 206-298-0126.

Caveats: Hydrotherapy may not be appropriate for people who have diabetes.

Hypnosis ∞

(Hypnosis)

What to Expect: Olafur Palsson, Psy.D., clinical psychologist and director of the Behavioral Medicine Clinic at the Eastern Virginia Medical School in Norfolk, Va., likens hypnotism to turning the lights out in a room and turning on a flashlight. The process forces you to focus on one particular thing, whether it's a spot on the ceiling or the stereotypical swinging pocket watch. During a session the hypnotist helps you to focus and then offers suggestions to help you relax. This leads to a feeling of involuntariness, during which the hypnotist can take you to a deeper hypnotic state and make suggestions about how to change your interpretation of pain.

With self-hypnosis, you guide your own relaxation and offer your own suggestions.

How It Works: Hypnosis can help you manage pain by changing your perception of the pain sensation. "The basis of hypnosis is that without the experience of pain, there is no pain," explains Palsson. "We are changing the consciousness of pain."

According to Palsson, hypnotism works in one of four ways. All four are dependent on achieving a state of relaxation, focused attention, and involuntariness:

• It can help you block out pain. This method is sometimes used for temporary anesthesia during surgery.

• It can help change one sensation into another. For example, a patient might turn pain into a sensation of warmth, which is sometimes easier to accomplish than trying to block the pain out entirely.

• It can let you turn down the intensity of pain, which may have a lasting, even permanent, effect.

• It can be used to move pain to a place in the body where it's more tolerable.

What's the Proof? For several ailments, there is strong evidence of its effectiveness. For instance, 25 patients with irritable bowel syndrome were administered hypnotherapy and reported less severe abdominal pain than the 25 patients in the control group. Results of this study were published in the February 1996 issue of Alimentary Pharmacology and Therapeutics.

Twenty-three experts in fields that included behavior medicine, psychiatry, and pain medicine presented to a National Institutes of Health panel both scientific and anecdotal evidence to support the use of behavioral and relaxation approaches to treat chronic pain. In particular, the panel found strong evidence for the use of hypnosis to alleviate cancer pain. The article was published in the July 1996 issue of the Journal of the American Medical Association.

Getting Started: George Bridges, Ph.D., a faculty member at the American Institute of Hypnotherapy (AIH), recommends self-hypnosis as well as supervised hypnosis. He says even 20 minutes of this deep form of relaxation can help relieve pain. The AIH recommends Self Hypnosis: The Complete Manual for Health and Self Change (Brunnet Mazel, 1991) by Brian M. Alman and Peter T. Lambrou. Palsson says self-hypnosis will work better if you first have a session with a trained hypnotherapist. For a referral, contact the American Institute of Hypnotherapy at 800-634-9766.

Caveats: Most people are capable of being even at least moderately hypnotized, according to Palsson--but about 20 percent of the population cannot experience hypnotism at all. You can't increase your hypnotizability if you're one of those 20 percent.

Magnet therapy ∞

(Magnet therapy)

What to Expect: Magnet therapy doesn't cure pain, but it can help manage it. People in pain can place magnets on their bodies for minutes or hours at a time. As there are very few magnet therapy experts in the United States, most people treat themselves, purchasing magnets on their own. Magnets come in a variety of shapes and sizes, including shoe inserts, buttons for clothes, seat cushions, and mattress pads. Even refrigerator magnets can reduce pain somewhat, says William Pawluk, M.D., vice president of the North American Academy for Magnetic Therapy. He usually recommends magnets whose strength ranges from 200 to 1,000 gauss (the unit magnetic force is measured in). Only in rare cases do people feel magnetic fields; in general, magnets don't cause any sensation.

Pawluk says about 20 percent of patients experience a temporary worsening of symptoms (lasting two to three days) and then feel total relief from pain, and five to 10 percent experience no pain relief at all.

How It Works: There are several theories. One hypothesis is that magnets increase circulation by relaxing capillary walls. This, in turn, increases oxygen and nutrient delivery to painful tissue, which aids in repairing damage. More efficient capillary function also speeds fluid exchange, flushing substances that trigger inflammation from the pain site. Another theory is that magnets alleviate pain by blocking transmission of nerve impulses and thus the pain signal to the brain. A third theory is that magnets cause muscle tissue to relax by improving calcium influx into muscle cells. And a fourth is that magnets stimulate blood flow because blood is composed of positively and negatively charged particles. The truth is that no one knows how magnets work.

What's the Proof? Two researchers, Carlton Hazlewood, M.D., and Carlos Vallbona, M.D., both affiliated with Baylor College of Medicine in Houston, have conducted one of the few published scientific studies on the use of magnet therapy to treat pain. They tested 50 people suffering from post-polio pain using permanent magnets, which have static magnetic fields. The results of their study, published in the November 1997 issue of the Archives of Physical Medicine and Rehabilitation, showed that using magnets for just 45 minutes cut pain in half for the 29 patients who wore magnets. The 21 patients in the placebo group experienced only a minor reduction in pain.

Agatha Colbert, M.D., a professor at Tufts New England Medical Center in Boston, completed a study in April 1998 that found that 25 fibromyalgia patients who slept on magnet mattresses experienced significant decreases in pain symptoms. She presented her findings at the North American Academy for Magnet Therapy conference.

Getting Started: For answers on how to use magnets or for a list of reputable magnet companies, contact the North American Academy for Magnetic Therapy at 800-457-1853.

Caveats: Magnets are generally considered safe, but pregnant women and people with pacemakers or suffering from bleeding disorders should avoid them. Pawluk says magnets can be used every day as long as they are occasionally removed. (For example, after wearing them for eight hours or so, take them off for about two hours.)

Massage ∞

(Massage)

What to Expect: One of the most well-known techniques for pain management is massage therapy. According to Maria Hernandez-Reif, Ph.D., the director of research at the University of Miami Touch Research Institute, most pain conditions respond well to the treatment.

Swedish massage, the most commonly used, consists of seven different strokes or movements, including clapping, kneading, and skin rolling. Other popular massage techniques include acupressure, deep tissue massage, geriatric or infant massage, Rolfing (see page 138), and shiatsu.

How It Works: Massage reduces pain, strengthens the immune system, and reduces anxiety and stress. Hernandez-Reif explains that by massaging the skin, messages are sent up the spine and stimulate the vagus, one of the 10 cranial nerves, to relax the body. Cortisol, a stress hormone that increases in people experiencing pain, decreases. And serotonin, a neurotransmitter associated with good feelings that becomes depleted in instances of chronic pain, is replenished with massage.

What's the Proof? There is a growing body of evidence that supports massage therapy as an effective way to treat pain. In one example, the Touch Research Institute monitored children with mild to moderate juvenile rheumatoid arthritis who were massaged by their parents for 15 to 20 minutes a day for 30 days. Levels of cortisol, anxiety, and pain all dropped. The study was published in the Journal of Pediatric Psychology in October 1997. Another study, published in the Journal of Clinical Rheumatology in 1996, reported decreased cortisol and pain levels in fibromyalgia patients receiving 30-minute treatments two times a week for five weeks.

The Touch Research Institute is currently studying the effects of massage on carpal tunnel syndrome.

Getting Started: To locate qualified massage therapists, including those specializing in shiatsu, sports massage, and other treatments, contact the Associated Bodywork & Massage Professionals at 800-458-2267. Or contact the American Massage Therapy Association at 847-864-0123 or visit its website at www.amtamassage.org.

Caveats: People with cancer should check with their physicians before receiving bodywork, especially deep tissue or high-pressure styles, including Rolfing, acupressure, shiatsu, and sports massage.

Nutrition ∞

(Diet and nutrition)

What to Expect: Eliminating pain may require cutting out animal fats entirely with a vegan diet, or it may mean adopting a temporary elimination diet to figure out which foods trigger pain and then avoiding those foods. Certain foods and supplements (like turmeric) contain pain-fighting ingredients and can be used to alleviate pain temporarily. And other foods (like ginger) act as anti-inflammatories. The strategy you choose depends on your type of pain.

Some people become overwhelmed with the idea of overhauling their diets. Neal Barnard, M.D., author of Foods That Fight Pain (Harmony Books, 1998) and founder of the Physicians' Committee for Responsible Medicine in Washington, D.C., suggests making short-term diet changes. If you feel better after a few weeks, continue with the changes.

How It Works: Barnard says nutrition therapy can combat pain by improving circulation and balancing hormones. It also allows people to identify and then eliminate the foods that trigger pain. Some foods in some people elicit an allergiclike response that produces inflammation, which can affect many places in the body (such as intestines, joints, and muscles).

What's the Proof? Studies supporting the role of nutrition in fighting pain come from a variety of sources worldwide. For example, Norwegian researchers found that eliminating certain foods from the diets of 26 arthritis sufferers drastically reduced joint stiffness, swelling, and pain. This breakthrough report was published in the Oct. 12, 1991, issue of The Lancet. One study published in the August 1985 issue of Annals of Allergy and a review published in the summer 1994 issue of Clinical Reviews in Allergy reported that between 20 and 50 percent of adults reduced or eliminated their migraines by avoiding common trigger foods.

With Anthony Scialli, M.D., a gynecologist at Georgetown University Medical Center in Washington, D.C., Barnard has been studying approximately 40 women with moderate to severe menstrual pain who agreed to avoid all animal products and added vegetable oils for two menstrual cycles. Their estrogen levels dropped, and in most of them, the pain decreased dramatically.

Getting Started: What kind of changes are in store? As an example, here is Barnard's treatment plan for back pain:

• Follow a low-fat vegetarian diet to open up clogged lumbar arteries.

• Increase carbohydrate intake (by eating foods such as potatoes, rice, pasta, and bread) to boost the amino acid tryptophan, which raises levels of serotonin, the feel-good brain chemical.

• Take vitamin [B.sub.6] (50 to 150 mg daily) to increase pain resistance; [B.sub.6] is probably involved in the manufacture of all amino acid neurotransmitters, including serotonin, one of the body's painkillers.

• Take 1 to 2 g of powdered ginger a day as an anti-inflammatory.

For more information on nutrition and pain as well as recipes, read Barnard's Foods That Fight Pain. Also check out the Menstrual Cramps Self Help Book: Effective Solutions for Pain and Discomfort Due to Menstrual Cramps and PMS (Celestial Arts, 1995) by Susan Lark, M.D.

To obtain a list of holistic physicians who specialize in nutrition, contact the American Holistic Medical Association at 703-556-9728 or www.holisticmedicine.org. For information on new research on health and nutrition, the Physicians' Committee for Responsible Medicine (202-686-2210) publishes a quarterly magazine.

Caveats: If you're following a low-fat vegetarian diet, Barnard says to be sure to get plenty of vitamin D (200 IU daily; 400 IU if you don't get sun), which helps retain calcium for healthy bones, and vitamin [B.sub.12], which is important for healthy nerves and blood cells. The [B.sub.12] Recommended Dietary Allowance is 2 mcg daily, which you can get by eating fortified soymilk products and [B.sub.12]-enriched breakfast cereals, or taking a multivitamin.

Rolfing ∞

(Rolfing)

What to Expect: Rolfing is a hands-on manipulation of the fascia, the connective tissue that covers the muscles, bones, tendons, and organs. An initial Rolfing session usually begins with an interview, during which the Rolfer asks questions about your health and pain. Next the Rolfer evaluates your posture by looking at and photographing the way you stand and move. "Pain has a certain look about it," explains Paul Gordon, a certified Rolfer in Cambridge, Mass. Then comes the actual treatment, when the Rolfer applies firm pressure to the muscle and fascia, releasing tension and lengthening the muscle.

How It Works: "People respond to pain predictably. They tense, tighten up, pull away, get smaller," Gordon explains. Muscles hold tension from previous injury, physical or emotional trauma, or stress. The fascia contracts around these tensed muscles, holding them in a rigid state of misalignment. When the body tries to move in this state of misalignment, pain occurs. Rolfers attempt to break these patterns of contracted movement.

Aline Newton, a certified advanced Rolfer in Cambridge, Mass., goes so far as to suggest that this lack of space caused by contracted muscles can accelerate the joint degeneration of osteoarthritis. Typically, muscle pain associated with osteoarthritis is attributed to the muscle tensing to compensate for the damaged joint. Newton switches the cause and effect, suggesting that the tightening of muscle against bone may contribute to the bone deterioration.

What's the Proof? Rolfing has earned many testimonials from people who have benefited from it. The Phoenix Suns, a professional basketball team, has its own Rolfer. American concert pianist Leon Fleisher, for years relegated to playing the piano one-handed because of a debilitating repetitive stress injury, underwent Rolfing treatments and was able to return to playing the piano with both hands.

Getting Started: For a certified Rolfer near you, contact the Rolf Institute at 303-449-5903. An "advanced Rolfer" has gone back for more training after three years of being certified by the institute.

Caveats: Pregnant women and those with systemic diseases, such as rheumatoid arthritis, cancer, or acute pain problems, should consult a doctor before seeking Rolfing treatments.

Yoga ∞

(Yoga)

What to Expect: Be prepared to assume some unfamiliar poses and focus on your breathing. Yoga routines designed to address pain vary from individual to individual; what may be an effective posture for one person with low back pain may not work for another. Yoga therapists, unlike yoga instructors, are trained to work with specific ailments and can tailor a program of poses.

How It Works: By stretching, relaxing, and elongating muscles, yoga postures help to release endorphins, the body's natural painkillers. The postures also increase blood circulation, which delivers healing nutrients and oxygen to tissue, and they allow fluid and lymph to flush toxins from the muscles. Many forms of exercise perform these functions--including running, aerobics, and biking--but often they put too much pressure on painful areas and require too much exertion. Yoga is a more gentle way to achieve the same effects.

Jnani Chapman, R.N., a registered nurse and executive director of the International Association of Yoga Therapists, maintains that in yoga, breathing is as important as postures. By learning to control the breath and exhale more deeply, you decrease the amount of carbon dioxide in the blood, which triggers the brain to relax the nervous system. You also allow the body to eliminate the physiological effects of anxiety, such as the buildup of lactic acid, which tightens muscles.

What's the Proof? Most of the research on yoga has been done in India, says Chapman. In the West there is anecdotal evidence that points toward yoga as an effective pain reliever. One study conducted at the University of Pennsylvania School of Medicine in Philadelphia found that patients with osteoarthritis of the hands who participated in yoga sessions once a week for eight weeks significantly decreased their levels of pain when compared to the control group, which received no therapy The results of this test were published in the December 1994 issue of the Journal of Rheumatology.

Getting Started: Yoga instructors who are trained as yoga therapists can tailor programs to individual physical conditions. To locate a therapist, contact the International Association of Yoga Therapists at 413-296-4061.

Caveats: Before choosing a yoga program, interview the instructor or therapist. Find out what types of ailments he or she has worked with. Chapman recommends that people look for someone with at least three years of teaching experience.

Once you begin a yoga program, remember that results may come slowly and don't exert yourself beyond your physical limits.

Profiles In Pain ∞

Mary Kay Essik ∞

Accounting clerk in Canton, Ohio. Age: 30.

THE PAIN: Severe menstrual pain that lasted an entire week every month. At the end of 1995, Essik started missing work because of it.

THE PAINKILLERS: Motrin. Anaprox. Neither worked for her.

TAKING MATTERS INTO HER OWN HANDS: Essik began researching her condition and read the Menstrual Cramps Self Help Book (Celestial Arts, 1995) by Susan Lark, M.D., which suggests diet changes, meditation, and exercise. Then she saw Neal Barnard, M.D., on television talking about using nutrition to combat menstrual cramps.

HER CHOICE: She decided to go vegan, impressed by Barnard's list of scientific studies that support this diet change.

STEP 1: No more dairy products. The next month the pain lessened and she could go to work. She still had to take painkillers, though. Succumbing occasionally to ice cream or pizza caused the pain to worsen.

STEP 2: After six months she stopped eating meat. Eight to 10 months later she was pain-free. Because of her success, she says, "People at work are even trying [a vegan diet]."

A SETBACK: In November 1997 Essik was diagnosed with endometriosis (in which the lining of the womb grows on organs outside the uterus). She underwent the recommended surgery, and to prevent recurrence of the disease, decided to stop cheating on her vegan diet (no more ice cream and pizzas).

THE PROGNOSIS: According to a recent checkup, no signs of endometriosis. And, also important, no more menstrual pain.

--C.H.

Steve Woodward ∞

Airline pilot in Goshen, Ind. Age 41.

ONE MAN'S LAUNDRY LIST OF PAIN: A broken vertebra (from swimming the butterfly stroke), sciatica (pain in the hip and thigh region), Barre-Leiou Syndrome (a painful condition of the nerves, felt in the head and neck), and iritis (inflammation of the eye's iris).

WHY SO MUCH PAIN? Woodward thinks a trauma during birth may be partially to blame.

THE LONG ROAD TO RECOVERY: Woodward has had eight surgeries on his jaw and chiropractic treatments for years (three times a day at one point). He's also tried acupuncture, craniosacral therapy, nutritional therapy, energy work, reflexology, and finally prolotherapy.

PROLOTHERAPY DEFINED: A therapist injects into trigger points--where the pain is held--a solution such as dextrose, a corn extract. This is thought to strengthen weakened ligaments, repair joints, and relieve pain.

RELIEF, AT LAST: For six months Woodward underwent prolotherapy treatments every six weeks; then he needed none for three years. This year he's gone back for three more treatments. So far he's received more than 2,500 injections--just about everywhere except his fingers and toes.

THE REPORT CARD: An 80 to 90 percent reduction in his pain, no more iritis, and a year of perfect attendance at work (his first).

AN INSIDER'S TIP: "A lot of it is emotional and attitude," says Woodward of his progress.

--C.H.

Margret McBride ∞

Literary agent in La Jolla, Calif. Age: 53.

The scene: One Friday morning eight years ago, McBride stood up out of bed and crumpled to the floor. Pain radiated from her head to her toes. She couldn't move.

The diagnosis: An MRI showed a herniated disk, and the standard operation was scheduled to take place as soon as the swelling went down.

Intevention: A friend called McBride in her hospital room to deliver get-well wishes and suggested that instead of surgery she try a musculoskeletal exercise program developed by a man named Pete Egoscue.

Indecision: "At first I thought, `Come on, an exercise program? Every doctor in town is saying I need surgery,'" remembers McBride. Then her friend told her to ask the doctor if she'd be without pain and able to walk normally after the operation.

The decision:: The doctor answered yes only to the first question. McBride took an ambulance back home and called Egoscue, who came over that day.

The recovery: Within 45 minutes of doing exercises designed to realign the musculoskeletal system, her pain began to ease. After three months of daily exercises, her pain was gone.

Maintenance: At first, an hour and a half of exercises a day. Then an hour. Then 45 minutes. Now 15 minutes is all she needs.

Bonus: McBride was so impressed with the program, she and her literary agency helped Egoscue get published. He now has two books out: The Egoscue Method of Health Through Motion (HarperCollins, 1992) ^[ 1 ] The Egoscue Method of Health Through Motion: Revolutionary Program That Lets You Rediscover the Body's Power to Rejuvenate It
ISBN-10: 0060924306
ISBN-13: 978-0060924300 and Pain Free! (Bantam Books, 1998) ^[ 2 ] Pain Free: A Revolutionary Method for Stopping Chronic Pain
ISBN-10: 0553106309
ISBN-13: 978-0553106305 . --C.H.

Related Article: In Pain? Or Just Thirsty? ∞

In Pain? Or Just Thirsty?, by Clare Horn

Related Article: Why Rage Is a Pain ∞

Why Rage Is a Pain, by Clare Horn

Related article: The Right Therapy for You ∞

The Right Therapy for You, by Clare Horn

Related Article: Therapy for the Pain in Your Head ∞

Therapy for the Pain in Your Head, by Clare Horn

Related Article: More Choices in Pain Relief ∞

More Choices in Pain Relief, by Clare Horn

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Clare Horn [C.H.] is the research editor at Natural Health. She has found success using yoga for her neck pain.

COPYRIGHT 1999 Weider Publications
COPYRIGHT 2000 Gale Group