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Chronic Pain

There are a lot of different types of pain but, when we look at physical pain (as opposed to mental or emotional pain), there are fundamentally two different broad types; acute and chronic.

Acute pain is a very important safety feature. It is an immediate pain which warms us of damage to our bodies, whether caused by a break, sprain, wound, illness or infection. It tells us broadly what is wrong and seeks to get us to take action to remedy a problem.

 

Chronic pain is a long-term concern and, unlike acute pain, continues either after treatment and healing have occurred, or because the underlying condition persists. Chronic pain is less well understood, and also generally less well treated, than acute pain. Sometimes it occurs because of a long-term disease, such as arthritis or lupus. Sometimes, it occurs because of the healing process, where an injury has healed but the way in which it has done so is such that it continues to cause pain, such as nerve damage (also know as neuralgia). Other causes of neuralgia include diabetes, AIDS, shingles and Lyme Disease. Fibromyalgia is another condition which includes chronic pain as a key element.

 

Chronic pain can be distressing, frustrating, and tiring. It can impact on every aspect of a person’s life.  It is relatively poorly understood by conventional medical practice and, as a result, many treatments for chronic pain tend to have alternative primary purposes.

 

Conventional treatments for chronic pain include the following:

 

  • Tricyclic antidepressant medication, such as amitriptyline, nortriptyline, or duloxetine, repurposed and often used in smaller doses as a muscle relaxant

  • Anticonvulsant medication, such as carbamazepine, gabapentin, lamotrigine, phenytoin, or pregabalin (Lyrica)

  • Mild analgesics, such as aspirin or paracetamol,

  • Non-steroidal anti inflammatory drugs (NSAIDs) such as ibuprofen, diclofenac or naproxen

  • Narcotic analgesics, such as codeine, Tramadol or oxycodone

  • Injections of local anaesthetic and/or cortisone (steroids)

  • Physical therapy, physiotherapy and prescribed exercise

  • Procedures such as radiofrequency lesioning, or nerve ablation using heat, balloon compression, or chemical injection to reduce feeling in the nerve

 

If success with the above treatment options is limited, then motor cortex stimulation (MCS) is sometimes used. This is where an electrode is placed over part of the brain and is hooked to a pulse generator under the skin.

 

Success rates with all of these treatments are variable, and there are many instances where these procedures may not improve symptoms and can cause loss of feeling or abnormal sensations as side-effects to the treatments. There is also a risk of chemical dependency with strong pain-relieving drugs.

 

The Pain Gate Theory suggests that our nerve pathways can only carry so much information at once, and that increased activity in one set of neurons will lower that activity in others. A simple example is that, if a nerve is transmitting the sensation of heat or cold, it is less able to transmit pain in the same place at the same time. It is on this theory that many complementary therapies are based.

 

Complementary Therapies for Pain

 

There are a range of complementary therapies which may help manage chronic pain. Many people approach complementary therapies when they have exhausted conventional treatment options and haven’t got the results they’d hoped for. However, looking at complementary medicine concurrently, as complementary treatment rather than alternative medicine, often gives the best results. Complementary therapies have become much more mainstream in recent years, and some complementary therapies are now recommended by GPs and other conventional healthcare professionals, and some are even available on the NHS. Please see below for some general information on a variety of complementary therapies which may be of use. Always discuss treatments with your GP or healthcare provider prior to trying any new treatment.

 

Aromatherapy

 

Aromatherapy is the use of volatile oils distilled from plants known as ‘essential oils’. These extracts are highly concentrated aromatic compounds containing a rich variety of active natural ingredients. These oils are usually massaged onto the skin or inhaled, although some can be taken internally. Aromatherapy is used for many different conditions, from helping relieve the symptoms of anxiety and depression to easing congestion and relieving headaches. It is important to dilute essential oils before skin contact, as they can cause reactions. 25 drops to 50ml of carrier oil is the recommended dilution for adults, although this should be further diluted for the elderly, pregnant women and children. Do not swallow essential oils or use them on the eye or genital areas unless on the advice of a qualified aromatherapist. 
 

Aromatherapy can be useful for pain management in several ways. The most general is relaxation. If the body is relaxed, it can reduce pain perception. In addition, muscle groups which are tense can amplify pain which exists within the muscle. Using massage, a warm bath, an oil burner, reed diffuser or even just oils on a handkerchief, the following oils are good for relaxation: vanilla, lavender, rosewood, valerian, bergamot, geranium, palmarosa, frankincense and chamomile. Our aromatherapy range and bath range have products with these relaxing oils. For chronic muscular skeletal pain and forms of neuralgia, the essential oils myrrh, rosemary, neroli, chamomile, cypress, eucalyptus, ginger, clove and sandalwood can all be beneficial when topically applied.   

 

In addition, oils can act both as counterirritants and warming agents to help reduce muscular pain. These include ginger, clove, cypress, chamomile, rosemary, sandalwood, myrrh, cedarwood, clary sage, marjoram, juniper, lavender and frankincense. Many of these oils also have anti-inflammatory properties. However, the greatest essential oil in the pain-relieving arsenal is arguably lavender. Lavender oil has been used for centuries, and was used extensively in battlefield medicine in both World Wars when medical supplies became scarce to prevent infection and as a pain reliever.

 

Yoga 
  

Yoga is a form of gentle exercise, but also known as a spiritual art. It was originally developed as a way to develop spiritual and physical awareness, using a combination of breathing exercises, meditation, physical postures/positions and visualisation. Yoga is often used as a method of pain relief, particularly for pain which is a result of muscular tension, including tension headaches, menstrual cramps and back/shoulder pain. It is also frequently used to help relieve digestive problems. Used properly, yoga can be a powerful tool in helping to improve mobility lost due to injury or illness such as arthritis. It is gentle, and can have many additional benefits such as relaxation and wellbeing improvements, improved circulation and suppleness and reduced anxiety and stress.  

 

Yoga should be practiced under supervision at first. There are classes in most towns and cities in most countries for all ages and ability levels. People with chronic pain conditions or illness/disabilities, especially those with heart or blood pressure conditions, should consult their healthcare provider before starting any new exercise regime, and should discuss their personal circumstances with their yoga instructor prior to starting.

 

Meditation

 

There are a wide range of styles of meditation, some linked to religious practice, and some outside of a religious framework. Meditation can be used to calm the mind, reduce anxiety and stress and (with regular practice) practitioners can even develop the ability to transcend pain. Far from being a ‘quick fix’, it takes time develop the techniques and to reap the benefits. However, the benefits are well documented. Anyone can meditate but learning from an experienced teacher initially can be helpful.  Wikipedia has a very comprehensive article to introduce meditation. One form of meditation is visualisation, which is effectively the use of the imagination to help the body. The idea is to visualise a creative way of removing that which is causing the problem. For example, someone suffering with a headache might picture wiping away the pain and shining their head clear, or a beam of light removing the pain, while a cancer patient might imagine healthy cells dressed as soldiers, attacking cancer cells and destroying them, rebuilding them into healthy cells. The results are, as you might imagine, varied. This seems to work best for people who are creative and imaginative, which might explain why it tends to work better for children and young people. This article explains a little more about visualisation.

 

Acupuncture

 

Acupuncture is an ancient Chinese practice, which is linked to the traditional eastern belief that the human body’s energy or chi flows along lines or meridians. Acupuncture involves inserting very fine needles at various points on the body to stimulate the flow of the energy. While many conventional medical practitioners do not accept the theories behind acupuncture, research has shown benefits and is now offered on the NHS in many parts of the UK, mainly for pain relief but also for the treatment of addictions. The British Acupuncture Council has plenty of useful information.

 

Herbal Medicine

 

Herbal medicine is one of the oldest medical traditions in most civilisations, as well as the only effective form of medicine in the Western world until the 18th century. It is still the most popular form of treatment in many countries around the World today. There are many herbal treatments used for pain relief, often in the form of tinctures, which are concentrated plant extracts in alcohol, or teas. Examples of herbal remedies used for pain include ginger, liquorice, peppermint, calendula, chamomile and parsley for stomach pain, colic, trapped wind and similar digestive disorders; myrrh and clove for dental pain and sore throats (clove extract also makes a good topical pain reliever) ; garlic and eucalyptus for respiratory pain; cramp bark, feverfew and chamomile for period pains and aloe vera, clove and arnica for external use on sprains and skin conditions. Herbal remedies are widely available for self-use from health food shops, apothecaries or herbalist shops, and also alongside conventional preparations in regular pharmacies. For more serious conditions, its best to consult a qualified herbalist. Some herbs can be powerful drugs, and can be dangerous if used incorrectly. This is particularly true if you are pregnant, are taking other medication, or have underlying health conditions.  The National Institute of Medical Herbalists provides background information and a register of practitioners who are members of the institute.

 

Bodywork Techniques & Manipulation

 

There are a wide range of practices which come under this umbrella, many of which are becoming increasingly used in mainstream medical treatment. The most simple bodywork technique is massage. There are lots of different styles of massage, including deep tissue, Swedish and sports massage, and massage can be carried out by professional therapists, or at home with a partner, friend or family member. Massage is used with all ages, from babies to the elderly. There are plenty of ‘how to’ books, videos and websites available to help people learn how to massage, and evening classes run by local colleges are popular. Massage aids are also available, from simple wooden devices to infra-red and vibrating gadgets. If you are massaging bare skin, a massage oil will help the hands glide more easily across the skin.  

 

More complex forms of bodywork include chiropractic (a technique which seeks to restore health and balance through manipulation of the body, and particularly the spine), osteopathy (a technique which also involves the manipulation of joints, muscles and soft tissues), and numerous less common and less well-studied or tested practices such as Rolfing and numerous other similar techniques. Chiropractic now enjoys inclusion in the NHS in some parts of the UK. The most common form of bodywork, however, is physiotherapy. This is available on the NHS in many circumstances, and was first popularised by Hippocrates over 2000 years ago. It is now very much part of modern conventional clinical practice.  

 

Hydrotherapy

 

Modern hydrotherapy was developed by the Austrian doctor Vincent Preissnitz in the 1800s. Hydrotherapy, as the name suggests, simply involves treating the sick using water. This treatment may take the form of swimming, hot and cold baths, sitz baths, saunas and steam rooms (or Turkish baths, as they are sometimes known), showers, jet sprays, douches, and hot and cold compresses. If you’ve ever gone to a steam room to ease a cold or respiratory problem, or taken a hot bath to ease muscle cramps, or a cold shower to soothe sunburn, you’ve used hydrotherapy. Hydrotherapy is gaining in popularity with mainstream physiotherapists, and you will often find hydrotherapy facilities in hospitals and clinics. Hydrotherapy has been shown to be very effective in treating chronic muscular/skeletal pain, rheumatism and arthritic conditions and pain from injuries. Taken to it’s most simple form, a hot bath  can be a very effective pain management tool, especially when combined with other therapies such as aromatherapy in the form of bath products. Why not try some of our range?

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