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"The Everything Guide to Integrative Pain Management"

"The Everything Guide to Integrative Pain Management" is a 2016 IBPA Benjamin Franklin Silver Award Winner in the Health & Fitness category, and a 2015 Nautilus Book Awards Silver Award winner in the Health & Healing, Wellness & Vitality category. 

In it, you will learn about:

  • Complementary and alternative (CAM) therapies commonly used for pain, such as acupuncture, chiropractic, massage, music, biofeedback, diet, and more
  • What the science says about each therapy, and how to find a provider
  • An overview of commonly prescribed conventional treatments, including medications, devices, and surgery
  • How to use cognitive behavioral therapy (CBT) to help you decrease pain severity and improve mood and coping
  • How to communicate effectively with your health care team and loved ones about pain
  • Smartphone apps that can help you track and manage pain, learn to meditate, lose weight if necessary, and more
  • How to assemble the right pain management team for you, and when to change providers
  • The role of spirituality in coping with pain
  • The pros, cons, and politics of medical marijuana
  • How to assume your role as the most important person on your pain management team
  • And much more

The book is available via Amazon.com and Barnesandnoble.com, as well as from independent and online booksellers, and retailers such asTarget and Walmart. 

You can preview part of chapter 1 below:


CHAPTER 1

Integrative Pain Management


Having chronic pain, by definition, changes how “normal” feels. If you are in pain, how you feel physically and emo- tionally and how you function in daily life are different than they are for someone who does not suffer from chronic pain. For example, perhaps you suffered an injury or ex- perienced sudden discomfort. Like most people, your first question was probably, “What’s going on?”—especially if there was no clear event or injury triggering the pain. The next likely question was, “When will I feel better?” As your pain stretched on for weeks, and then months, you almost certainly worried about how you could “get back to nor- mal” and what might happen if your normal is never what it once was.

The Experience of Pain

Regardless of the treatment plan you choose to treat your pain, it’s important to have a good understanding of pain and pain-related terms. This will help you communicate more effectively with your providers, understand the par- ticular things that make your pain worse or better, and craft the approach that is best suited to you.

It’s hard to believe, but ongoing pain affects more people than cancer, heart disease, and diabetes combined. According to the American Academy of Pain Medicine, that’s almost one-third of the population, or 100 million people in the United States alone!

Pain is universally described as an unpleasant physical sensation that can vary with regard to both the severity of discomfort (how much it hurts) and the degree of emotional and cognitive distress that it causes (how much it bothers you). One thing about pain that surprises many people is that regardless of the type of pain or where you experience the sensation, pain is a brain-derived phenomenon. To put it simply, without your brain interpreting the signals from your body (or, in some cases, acting on its own despite a lack of input from the body), you would not feel pain at all.

One thing that makes it much more difficult to cope with chronic pain is that often it exists in the absence of objective evidence (i.e., medically iden- tifiable causes) that can be seen on X-ray, MRI, or other imaging. This issue tends to increase frustration for both patients and doctors as to how to best treat the pain. It also makes it more difficult for family and friends to “get it.” The lack of an image pinpointing the cause of your pain does not mean it isn’t real, however.


Describing Pain

There are many ways to describe the sensations that your brain files under the heading of pain. Depending on the type of pain you have, you probably find yourself using some labels more than others in an attempt to convey what you are experiencing.

The following table features the most common pain descriptors. It’s worth noting the terms you use most often, and perhaps circling them or writing them down before meeting with your doctor, as this information will be useful in helping her decide which treatments might be most effective for your type of pain.


PAIN LABELS

Sharp   Stinging      Pounding
Throbbing Intermittent Constant 
Electrical Aching Stabbing
Hot Cutting Tight
Squeezing    Crushing Tugging
Dull Burning Itchy
Radiating Severe Mild

Pain is awful! Why do people experience it at all?

Pain, though undeniably unpleasant and often distressing, is actually essential for your survival. Congenital analgesia is a genetic disorder where one can’t feel pain. People with this condition have more fre- quent and worse injuries and also die younger because they can’t feel the normal pain that tells the body to avoid harm.

Acute Pain

Acute pain is a time-limited response, usually regarding injury to soft tissue or bone. You could think of acute pain as “pain with a purpose” because it indicates that something is hurting you and thus requires you to react in some way. Pain is the body’s warning sign that damage has occurred or is taking place. It’s a signal to pay attention and either stop doing the action that is causing the pain (such as when you touch a hot stove and your brain tells you to jerk your hand away from it), or to do something to protect your- self and guard against further injury (such as running the finger you just burned under cold water).

Acute pain lessens as the injured area heals and returns to normal. This type of pain can be caused by minor trauma (such as bumping into some- thing), a major trauma (such as a serious accident), an illness (such as cancer, when a tumor may impinge on surrounding tissue), or result from an infection. Pain also occurs as a result of abnormal stretching of tissue (such as when a muscle is pulled or strained), too much pressure on a sensitive area (such as when you try to walk in shoes that are too tight, for too long), or when tissue is inflamed and in the process of healing. Other situations that generate pain but are not necessarily indicative of injury include muscles or organs cramping.

Acute pain often comes on suddenly (such as when you stub your toe) and is time-limited by definition. This type of pain usually lasts anywhere from a few seconds to a few weeks. Acute pain sometimes resolves as soon as the source of the pain is removed (such as when you remove the too-tight shoe). But again, acute pain has a purpose—it’s one way of your body doing its job to protect you from harm and keep you safe as you heal.


Chronic Pain

Chronic pain, depending on the definition used, has lasted three to six months or more—well beyond it serving any sort of useful purpose. There are many different painful conditions—too many to list completely here, but in the table is a sampling of some you may have heard of or be experiencing yourself.


EXAMPLES OF CHRONIC PAIN CONDITIONS

Gastrointestinal (Crohn’s Disease, Irritable Bowel Syndrome, Colitis, Gastroesophogeal Reflux Disease or GERD) Headaches (Tension-Type, Migraine, Cluster) 
Fibromyalgia Dental Pain
Myofascial Pain Temporomandibular Joint Disorder
Cancer Pain Musculoskeletal Pain
Arthritis Pain from Circulatory Issues
Sickle Cell Anemia Phantom Limb Pain
Endometriosis Pain Neuropathic Pain (Postherpetic Neuralgia, Diabetic Peripheral Neuropathy, Complex Regional Pain Syndrome)
Back Pain Carpal Tunnel Syndrome

An Integrative Approach to Pain

Integrative medicine combines conventional medical treatments, such as drugs, surgery, or medical devices, with therapies that fall under the head- ings “complementary” (used with conventional medicine) or “alterna- tive.” Mind-body approaches, such as meditation, hypnosis, and relaxation training; movement-based therapies, such as yoga and tai chi; nutritional approaches and dietary supplements; energy therapies, such as Reiki; and other systems of healing that fall outside Western medicine, can all be con- sidered complementary and alternative medicine (CAM). Many of these can be thoughtfully integrated with your medical treatment to help you manage pain and feel better overall—body, mind, and spirit.

In these pages, you will see “integrative” used to refer to the broad approach just described. Sometimes the term CAM will be used to indicate the use of a nonmedical treatment, whether on its own or as part of an inte- grative program. Understand that this book, rather than placing one type of therapy over any other for managing pain, encourages you to enhance your knowledge of treatments that may help in some way and create the plan that works best for you.

The National Center for Complementary and Integrative Health (NCCIH; formerly the National Center for Complementary and Alternative Medicine) is the U.S. government’s lead agency for conducting research into the use and effectiveness of CAM therapies. Much has been learned about CAM therapies and trends since the center’s creation in 1998. In fact, it’s estimated that more than one-third of adults and 12 percent of children use CAM in a given year. This amounts to about $34 billion annually that Americans spend, largely out of pocket, for therapies like massage, acupuncture, yoga, chiropractic, and others. When including dietary supplement use, the per- centage of adults increases to over 50 percent. Many, many of these con- sumers are using CAM to treat chronic pain conditions such as back pain, arthritis, and headaches.

Here is a list of the most popular CAM therapies used by adults, accord- ing to the National Health Interview Survey:

MOST POPULAR CAM THERAPIES

Omega 3 Supplements/ Fish Oil Glucosamine Echinacea Flaxseed
Ginseng Combination Herbal Pills Gingko Biloba Chondroitin
Garlic Coenzyme Q10 Deep Breathing Chiropractic and Osteopathy
Massage Yoga Diet-Based Therapies Progressive Relaxation
Guided Imagery Homeopathic Treatments    

Given that roughly 100 million U.S. adults have used at least one CAM therapy in the past year, the odds that you have used a CAM therapy, even if you weren’t thinking of it as such, are actually pretty good!

There are many more CAM therapies than the ones listed, or that can be covered in this book, but in these pages you will find overviews of those therapies that have several things in common:

  • Some evidence of benefit for managing pain
  • Low risk of undesirable effects
  • In many cases, can be combined easily with the conventional approaches you are already using
  • Lead to increased feelings of calm and relaxation

Although the term “integrative” primarily will be used throughout the remainder of this book in order to be as inclusive and current as possible, you should keep in mind that your personal journey may at different points be completely conventional, very integrative, or solely alternative, depend- ing on what you discover is most helpful for you at a particular time. Your medical team is the best resource for understanding the potential role of conventional therapies, and hopefully will continue to be a resource you can consult even if your treatment plan shifts to something more CAM in