Sharon Harris was barely out of college when she got a devastating diagnosis: She had lupus, a chronic autoimmune disease that causes pain, inflammation, and damage to various parts of the body. Harrisâ€™ doctors limited her pain-relief drugs to over-the-counter versions, so she soon figured out she had to find other ways to cope with â€œflaresâ€ when her symptoms worsened. â€œIâ€™ve always been skeptical of taking medication [so] I enlisted the help of yoga and massage experts,â€ remembers Harris, now 34 and living in Detroit. â€œI read countless stories about how the two techniques helped minimize pain.â€
At the start, Harris found yoga painful and difficult to do, but over time it got easier. â€œYoga encourages you to stretch muscles that you never knew you had,â€ she says. â€œIt also pushes you to meditate and visualize â€˜pushing outâ€™ your pain using concentrated breathing techniques.â€ After a class Harris says she feels â€œrenewed, more aware, and more relaxed,â€ adding that she goes for a massage once a month: â€œI carry a lot of pain in my back and neck; massages tend to alleviate those aches and pains.â€
For many of the millions of Americans dealing with chronic painâ€”the American Academy of Pain Medicine puts the total at 100 millionâ€”Harrisâ€™ pain management program, which combines few or no drugs with alternative and mind-body therapies, isnâ€™t at all unusual. One reason is that abuse of painkillersâ€”especially powerful opioids like oxycodoneâ€”are becoming harder than ever to get, even if you have a legitimate reason to use them. Recently, the Food and Drug Administration (FDA) decided against approving a generic version of oxycodone, which goes by the brand name Oxycontin. That means, among other things, that the price of this powerful narcotic painkiller will remain high.
The FDAâ€™s decision to only allow a brand-name, abuse-resistant version of oxycodone is based on data showing that painkiller abuseÂ is rampant and growing. According to the Harvard School of Public Health, the 2009 National Survey on Drug Use and Health found that nearly two million Americans were dependent on or abusing prescription pain relieversâ€”five times greater than the number of people addicted to heroin.
Between physicians prescribing these and other drugs less often or in lower amounts to avoid abuse, and the high and rising cost of many prescriptions, the upshot is that fewer pain patients who need relief are likely to get it. This means they need to turn to over-the-counter pain relievers like acetaminophen, aspirin, and ibuprofen, and drug-free approaches like Harrisâ€™ yoga-and-massage regimen, as well as acupuncture, biofeedback, and other therapies.
Akash Bajaj, M.D., a pain specialist in Marina del Ray, California, says concerns about addiction have pushed him to often try other modalities instead of starting with narcotic pain relievers. Thatâ€™s especially true, he says, with patients in their 20s and 30s, who could be on pain meds for decades if injury damage is permanent, or they develop chronic pain conditions like arthritis or migraines. â€œAlways, my go-to is other types of pain relief, including physical therapy, chiropractic, and nerve blocks that go right to the source of the pain, as well as combinations of treatments for maximum effect,â€ says Dr. Bajaj. He says those patients for whom he does prescribe strong pain relievers must come back to see him again soon after the first visit so he can reassess their medication needs. â€œThat also allows me to give out just a few pills at first, which can lessen the likelihood of addiction, since then they donâ€™t have the pills on hand to use after theyâ€™re no longer needed for pain relief,â€ he explains.
Dr. Bajaj adds that while handing out drugs is a quick encounter between a patient and doctor, it can irretrievably alter someoneâ€™s life if addiction develops. So he also considers a patientâ€™s emotional state, because intractable pain affects mental and emotional health, too. â€œI tell my patients there are two models of pain reliefâ€”a rehabilitee model and a palliative model. With the palliative model, we only address the immediate pain relief. But with the rehabilitative model, the patient becomes a part of the team and takes on some of the responsibility for getting better.â€ Â
Thereâ€™s good evidence that taking a more action-oriented approach to pain relief works better for many pain patients. Itâ€™s certainly helped Harris, who says her spiritual beliefs have helped too. â€œAs I combat lupus I strongly believe that there is a spirit/mind connection,â€ she says. â€œIâ€™ve noticed that I always feel better after a church service or after Iâ€™ve read Bible scriptures.â€ And itâ€™s that holisticâ€”body, mind, and spiritâ€”approach that may offer the most lasting relief from a life full of pain.
Are you experiencing chronic pain? What has helped you find relief?
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â€¢Â Why Are Some Prescription Drugs So Hard to Get?
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â€¢Â Reformulated OxyContin Makes Abusers Switch to Heroin
Fran Kritz is aÂ freelance writer specializing in health and healthÂ policy and lives in SilverÂ Spring, Maryland. Takepart.com