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Harvard Commentaries
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Harvard Commentaries
Reviewed by the Faculty of Harvard Medical School


Treating Pain Without Medications or Surgery


July 08, 2013

Chronic Pain
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Take Action Now
Treating Pain Without Medications or Surgery
Treating Pain Without Medications or Surgery
htmPainOtherTx
Physical therapy, complementary and alternative therapies
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InteliHealth
2009-03-23
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InteliHealth/Harvard Medical Content
2011-09-10

Reviewed by the Faculty of Harvard Medical School

Treating Pain Without Medications or Surgery

Sometimes, simple approaches work best for those with chronic pain: rest, stretching, a change in your exercise routine, new running shoes. Devices such as a heating pad for sore muscles or a wrist brace for arm pain associated with typing may work well.

However, many people with chronic pain have already tried and failed these simple options. If you do not find relief after making such simple adjustments, you may need to further investigate ways to treat your pain that do not involve drugs or surgery.

Physical Therapy

Revisiting the simple approaches that you have tried may produce better results under the guidance of a health-care professional. A physical therapist may be able to tailor a fitness program exclusive to you that includes stretching, as well as strengthening. For example, certain types of exercise (such as swimming instead of running) can reduce or even cure chronic back pain.

Complementary or Alternative Therapy

Examples of complementary or alternative therapies include acupuncture, chiropractic care, biofeedback, meditation and massage therapy. Although complementary or alternative therapy may relieve chronic pain in some situations, there are two important things to keep in mind:

  • Many complementary or alternative therapies have not been proven effective. Many alternative therapies have not been carefully studied by researchers, at least not as thoroughly as many conventional treatments. Claims about their effectiveness are often based on stories from individual patients (some of whom may be paid spokesmen for the treatment they are praising), rather than on carefully conducted clinical trials. This doesn't mean that complementary or alternative treatments won't work for you, just that there is not yet scientific proof that these approaches are effective.
  • Occasionally, complementary or alternative therapy may be dangerous. Although most alternative therapies that people try for chronic pain are, at worst, harmless, a few may be dangerous. For instance, if you have chronic neck pain, having a sudden neck manipulation (a chiropractic procedure) can be dangerous if you do not know what's causing your pain. Thus, it's very important that you discuss with your health-care provider any alternative approaches that you are using. Ideally, you should talk with your health-care provider about alternative therapies before you begin any new treatment. Many health-care providers feel that if conventional treatments aren't working and complementary or alternative approaches seem safe, there's no harm — and there's possible benefit — in trying them.

Electrical Stimulation

Electrical stimulation may reduce pain. In electrical stimulation, a device (called a transcutaneous electrical nerve stimulator, or TENS unit) is applied to the skin to deliver an electrical current to a painful area. It is thought to trigger a response from the spinal cord that reduces pain signals. A similar effect probably occurs when you rub a painful area after an injury.

Counseling

Both group therapy and one-on-one counseling can be important in managing chronic pain by helping to lift depression and anxiety that can accompany the pain. Group therapy offers a forum for people with chronic pain to support and encourage each other. And it allows a newcomer to see others with similar problems getting better and to hear about coping strategies that can help. In addition, many people with chronic pain find that family and friends may have difficulty fully understanding or sympathizing with their condition; in time, family and friends may become less supportive or may be unwilling to listen. Counseling, group therapy in particular, can provide a sympathetic ear and the comfort of shared experience.

Relaxation

Whether on your own or in a supervised setting (such as with a psychologist), relaxation can have a beneficial effect for people with chronic pain. For some, simply going on vacation and being relieved of daily responsibilities leads to a reduction in pain or improved coping.

Application of Heat or Cold

For many people with chronic pain, the application of heat or cold to the painful area provides relief, although the reasons are not so clear. Examples of this include the use of ice for back pain and the use of a heating pad for neck pain.

Time

Finally, time itself may be a treatment option for those with chronic pain, because even chronic pain may be self-limited — that is, it can sometimes resolve on its own, even without treatment.

 

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