In 2019 one in 5 adults was living with chronic pain. For many of these people, their daily activities and work life were very limited. Chronic pain has a way of forcing you to slow down and disrupting your plans. But these days no one has time for illness and so it is not uncommon to see people turning to the many different readily-available medications to manage their pain.
Prescription Pain killers Making People Sick?
Almost one third of U.S. workers take prescription pain medications but ironically, instead of helping them to function and go to work, these medications end up causing people to take even more sick days than those who don’t use them. Is this because people are so sick that they would have missed even more sick days without taking medication? Or could it be that the medications are not helping people as much as they should?
A new study by the Integrated Benefits Institute found that users who do not suffer from medication-related problems took more than “twice the number of sick days” than those who do not use prescription pain relievers at all. Those who did suffer from medication-related problems took more than three times the number of sick days than those who refrained from using medication to manage their chronic pain. The study went on to report that the use of prescription pain medications is “associated with approximately 261 lost work days per 1,000 per month”.
What Are Prescription Pain Relievers?
Prescription pain relievers are drugs that are prescribed by medical professionals to help manage and reduce chronic pain. These drugs are also often known as opioid pain relievers or prescription painkillers and include such drugs as OxyContin, codeine, fentanyl and Vicodin. While there are legitimate reasons for using these medications, there is also, unfortunately, a massive opportunity for them to be misused. The misuse of prescription pain relievers is now a national epidemic in the U.S. and is a public health crisis. Sadly, thousands of people die from overdosing on these drugs every year.
Problems with Prescription Pain Relievers
Prescription pain relievers are often very powerful medications and, while they have the ability to significantly reduce pain, they are often associated with some serious side effects. Some of these side effects include:
Alternatives To Prescription Pain Killers
An interesting fact when it comes to managing chronic pain conditions such as lower back pain, is that opioids are only effective for managing non-cancerous pain in about 30% of cases. With an effectiveness rate that is so low, combined with a very high risk of side effects and addiction, medical guidelines are now urging healthcare professionals to consider non-pharmacological interventions for managing low back pain wherever possible.
Non-Pharmacological Interventions For Managing Chronic Pain
During biofeedback therapy clients are connected to electrical sensors that help them receive information about their bodies. Biofeedback is a mind-body therapy that uses auditory or visual feedback from the body to help people recognize the physical signs of stress and anxiety like increased muscle tension, heart rate, and body temperature. When clients see that their bodies react to certain things with these responses, they can then learn how to combat these physical reactions by using techniques such as relaxation and meditation to lower heart rate and relax muscles. This in turn, reduces sensations of pain within the body.
Using techniques such as mindfulness or meditation, focusing on breathing and relaxing the muscles, clients can actually learn to control their stress responses, retraining their bodies on how to respond to stress. What appeared to be an involuntary response to stress now becomes something that the individual can control. When we can see the measurements happening on a screen, in real time, it is easier for patients to really see what is happening to their bodies, as well as the positive effects when they use relaxation techniques.
Biofeedback therapists use a variety of different approaches to achieve these effects, including deep breathing techniques, mindfulness, exercises, or guided imagery. When patients can identify that they are tensing their muscles, they can then implement the relaxation techniques to relax the muscles, reduce pain, and reduce the chances of injury.
Types of Biofeedback
There are several different types of biofeedback including:
Electroencephalograph (EEG) - brainwave monitoring
Respiratory - breathing monitoring
Electrocardiograph (ECG) - heart rate monitoring
Electromyograph (EMG) - muscle activity monitoring
Electrodermograph (EDG) - perspiration monitoring
Benefits Of Biofeedback
Biofeedback is a great way to manage chronic pain as it has the following advantages:
Reduces the need for medications
Safe during pregnancy
No medication interactions
No side effects
Safe for all populations
Long term results
Mindfulness is a type of meditation, an awareness that arises by being present in the moment and acknowledging feelings that may be there, without judgment. Research has found that mindfulness principles and practices can help people manage symptoms of stress, anxiety, and depression, along with several other mental health conditions. Mindfulness has also been found to help reduce pain sensations, making a great alternative to medication for chronic pain conditions.
Mindfulness exercises can be a great way for people to focus their mind and body in the present. People with chronic pain often worry a lot and have negative thoughts, especially regarding the pain they are feeling. While these thoughts are completely normal it can lead to feelings of depression and negativity which can in turn increase feelings of pain. When we focus our attention on our breathing and our bodies, and we accept ourselves just as we are, our bodies relax, our minds quieten, and the worrisome thoughts tend to fade away a bit. Science has shown that this process reduces pain sensations while simultaneously reducing depression and anxiety.
In clinical trials, Mindfulness Based Stress Reduction (MBSR) and Cognitive Behavioral Therapy (CBT) were found to be “significantly more effective at reducing pain intensity and reports of pain…when compared to usual care”. These findings occurred at 8, 26 and 52 weeks of the study, showing that the positive effects of this treatment occur soon after treatment is started, and that the results are sustained to a whole year.
Mindfulness meditation engages unique brain mechanisms that actually change the person’s experience of pain. In the early stages of practicing mindfulness, patients experienced significant reductions in pain intensity and unpleasantness, while in the long term the treatment seems to affect the unpleasantness component more significantly, meaning that people begin to see, and experience, their pain quite differently. Mindfulness is another type of treatment that has no side effects, is medication-free, cost effective, and easily self-managed, making it an important consideration for those living with chronic pain.
Music therapy might sound like a strange alternative to medication for chronic pain conditions, but the science behind this treatment is sound. Music therapy helps to reduce chronic pain in sufferers by providing sensory stimulation that evokes a physical and emotional response in the patient. Music activates sensory pathways that compete with the pain pathways for the brain’s attention. Music stimulates emotional responses from the brain and engages the brain’s attention.
A clinical study involving 60 veterans (44 completed the study) with back pain was conducted to see the effects of music therapy on their condition. These veterans were scheduled to receive Lumbar Radiofrequency treatment, a treatment that kills off stabilizing muscles by cutting off the muscle’s nerve supply. Music therapy was used to treat these patients to see what improvements they might experience with their condition. Patients were randomly assigned to music treatment or to no music treatment.
The study results found that pain and anxiety were significantly reduced in the total sample, with the mean decrease being 2.80 points on a visual analogue scale of 0-10 points. In the music intervention group pain and anxiety decreased by 3.22 points and 1.00 point respectively while the no-music group had decreases of 2.33 and 0.69 respectively.
Although the differences were not statistically significant, a 2-point reduction in self-reported pain or anxiety is considered to be clinically important and it is something that has been supported in previous studies. It is also meaningful that 87% of the music participants reported that they found listening to music to be helpful.
The science supporting music therapy to help with pain and discomfort is widely accepted. The benefits of music therapy compared to pharmaceutical interventions are that it is low risk, inexpensive, does not require special training and it can reduce the need for moderate sedation in certain medical procedures.
Chronic pain can be debilitating and it is understandable that sometimes reaching for a pill for quick relief can feel like the answer. But knowing that medications are sometimes only around 30% effective at relieving pain and that they can often do more harm than good has led to more healthcare providers recommending alternative treatments for low back pain sufferers.
Treatments such as biofeedback, mindfulness, meditation and even music therapy have the data to prove their effectiveness when it comes to managing chronic pain. These treatments are generally safe for everyone, are often inexpensive, and are healthy for you. Making use of these treatments instead of medication can bring about better pain relief and assist with the long term management of low back pain - plus they are also super fun and relaxing - what more could you ask for?