CHRONIC PAIN — pain that lasts longer than six months — afflicts some 50 million Americans and is the third most common health problem in the United States, behind heart disease and cancer.

Considering the money and research dedicated to pain medications and interventions, how can so many people still be suffering?

“Conventional medicine is the first place Americans turn to for help, but Western medicine doesn’t provide adequate relief for many people in chronic pain,” says James N. Dillard, M.D., D.C., C.Ac., assistant clinical professor at Columbia University College of Physicians and Surgeons in New York City, and author of The Chronic Pain Solution. “The solution to chronic pain for most people lies in a combination of old and new — using the very best pain medications along with appropriate alternative remedies.”

If you suffer from chronic pain, learning about its nature and the rationale for integrating conventional and alternative treatments may be your best bet for taking back your life from pain.

Pain Is Different
Pain is more complicated than most people realize and is different than many conditions doctors treat.

For starters, no tool exists that can measure pain, and it can’t be located with an MRI or X-ray. Another difference is that pain isn’t a disease in and of itself.

“Pain is classified as a symptom,” says Dillard. “But in most cases of chronic pain, the cause isn’t known, and sometimes, if the pain is internal, it’s not even possible to pinpoint the organ or tissue that’s hurting.”

In addition, chronic pain is complex. Like heart disease, its causes and complications are numerous, and even the most effective medication may not solve the problem.

“Just as treatment for heart disease involves medication along with dietary changes, exercise and stress management, effective treatment for chronic pain often requires medication along with an individualized assortment of therapies, such as acupressure massage, physical therapy or meditation,” says Dillard.

Because a combination of conventional medicine and alternative remedies often is the most successful treatment for chronic pain, Dillard believes it’s important to understand the strengths and weaknesses of both.

Conventional Medicine
When it comes to severe pain, the strength of Western medicine is hard to beat, according to Dillard. In addition to effective pain relief, conventional medicine also can provide nerve blocks, joint replacements, ultrasound, electro-thermal stimulation, physical therapy, deep injections of cortisone and more.

In severe cases, procedures including gamma knife surgery to deaden nerves with radiation, or nerve-ablation, which uses microwaves to deaden nerves, are effective.

However, despite its successes, Western medicine can’t always provide relief.

“Often this is because conventional medicine fails to consider the whole person and focuses solely on the body part that hurts, when in fact the pain the person feels is made worse by his or her fears, attitudes, hormones and other factors that aren’t being treated,” says Dillard.

Alternative Medicine
Alternative medicine is composed of health practices not traditionally taught in Western medical schools. They include yoga, meditation, acupuncture, massage therapy, visualization and chiropractic.

According to Dillard, the following are some reasons people with chronic pain should consider including alternative therapies in their pain-management plan:

• Alternative medicine advocates gentle, natural therapies. This is important because people with chronic pain often need to have ongoing treatments for months or years.
• Alternative medicine may not cure your pain, but it could heal your life. Good alternative healers work to make people whole again, to bring balance to their fractured minds and bodies.

One of alternative medicine’s drawbacks is the number of options and the difficulty most people have sorting out which treatments — acupuncture or yoga, for example — would be best for them to try.

And, of course, not all alternative therapists are reputable or well-trained, which requires pain sufferers to check a practitioner’s references and accreditations carefully.

Alternative practitioners should have a license to practice if one is required from your state, and national certification when available. Acupuncturists and chiropractors all must pass national exams in order to practice.

The Best of Both
When properly used, conventional drugs and procedures can function as the basis of an effective pain-management plan, according to Dillard.

“And when you’ve found the drugs, pain blocks or other treatments that provide some relief, you then can determine which alternative treatments will complement these options,” he says.

Here are several ways Dillard’s patients have used the two approaches to control and relieve their pain:

• Using yoga, exercise and meditation for day-to-day pain management but adding a prescription pain reliever for intense pain flare-ups.
• Taking over-the-counter pain relievers daily but adding massage, acupuncture or biofeedback during times of severe pain.

“Finding the combination of conventional and alternative therapies that gives you the most relief will likely involve some trial and error,” says Dillard. “But as long as you’re willing to be actively involved in your self-care, your pain and your life will more than likely improve.”

Barbara Floria spoke with James N. Dillard, M.D., D.C., C.Ac., assistant clinical professor at Columbia University College of Physicians and Surgeons in New York City, and author of The Chronic Pain Solution, Bantam Books, 2003, $13.95.

More Information
Information and Support Groups for People in Pain

• AMERICAN ACADEMY OF PAIN MEDICINE, www.painmed.org, 847-375-4731.
  This is the primary organization for pain specialists. The Web site provides an online member directory.
• AMERICAN CHRONIC PAIN ASSOCIATION, www.theacpa.org, 800-533-3231.
  This is an advocacy and consumer-education group for people in pain.
• AMERICAN PAIN FOUNDATION, www.painfoundation.org, 888-615-7246.
  This is an advocacy group and information resource for people in pain.
• BETH ISRAEL MEDICAL CENTER DEPARTMENT OF PAIN MEDICINE AND PALLIATIVE CARE, www.stoppain.org, 212-844-8970.
  This treatment center for chronic pain specializes in creating a better quality of life for pain sufferers, including those who are unresponsive to treatment.
• NATIONAL HEADACHE FOUNDATION, www.headaches.org, 888-643-5552.
  This organization provides information on prevention and treatment, and sponsors support groups nationwide.
• PAIN.COM, www.pain.com.
  This site is a resource for pain sufferers.

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