Anthony squints at himself in the bathroom mirror, the sensation of a knife stabbing sideways through his lower back. The empty bottle of Oxycontin stands on the lip of the sink, offering none of its usual assistance. He had hoped the last Vicodin after dinner would have held him over until morning when he could finally refill his prescription.

However, the piercing pain at 2:38 a.m. has Anthony hobbling out of bed and scouring the medicine cabinet for a “quick fix” – the last five pills from Timmy’s bottle of children’s aspirin.

For Anthony, life after the car accident has revolved around one thing: a rotary of painkillers taking up residence on his beside table, in his glove compartment, even at his desk at work. Initially, he tried to tough it out. He had seen what opiates had done to his father after his construction-site accident, and Anthony had no intention of putting his family through the midnight sweats, vomiting, and mood swings that came from eventual withdrawal.

However, when each morning began with crippling back pain that kept him from returning to work, Anthony felt he had no choice but to give into the medication.

Contrary to popular belief, pain can kill. Physical pain produces high levels of hormones, which stress the heart and lungs. Intense pain can also cause blood pressure to spike erratically, creating a higher susceptibility for heart attacks and strokes.

The body’s various chemical reactions to counteract pain can also consume so much of the body’s energy that the entire immune system begins to degrade, allowing other illnesses and bacterial infections to take residence. Severe, chronic pain sometimes can lead to depression in patients, and in extreme cases, suicide.

Many healthcare professionals prescribe a number of opioids – OxyCotin, Dilaudid, Vicodin, and Percocet – to dull a patient’s pain until a definitive cure can be found. However, without a cure in sight, many patients simply continue to depend on painkillers, which may diminish their available working hours or prevent them from returning to work altogether.

Seeking to overcome both chronic pain and drug dependency, many patients are turning to branches of complementary therapy in order to return normalcy to their lives.

A Mindful Approach

For many individuals, pain is a purely physical disorder – a synaptic response residing completely within the body and, therefore, completely out of a patient’s control. However, if the classic adage of “mind over matter” has any validity, pain is entirely within a person’s sphere of control.

In the face of chronic pain, medicine has lapsed in its ability to identify and neutralize the mechanisms behind an epidemic affecting nearly 130 million Americans; many professionals are beginning to question how interrelated the physical expression and mental perception of pain has become.

Following this thinking, a wide array of mind-body therapies has arisen to tackle chronic pain – what some healthcare professionals have labeled an “untreatable” disorder.

According to Ellen Adelman, PhD, a Philadelphia-based psychologist and founder/director of The Sage Healing Institute, mind-body therapy “is a systematic psychological approach that addresses both emotional and physiological healing. [It] combines mindfulness meditation techniques, mindful movement techniques, healing meditation practices, and Western and Buddhist psychology. It is based on the premise that there is a therapeutically accessible interface between mind and body.”

Chronic pain is serious problem, even more so for people who cannot allow their bodily senses to become dulled by painkillers if they are to continue to work. Professional athletes, office workers, truck drivers, accountants, high-steel construction workers. and those operating heavy machinery are just some professionals who would would need a firm grasp on their cognitive abilities.

Mind-body approaches to pain include a gamut of therapies, such as cognitive behavioral therapies, mindfulness-based approaches, thought field therapy, Reiki, guided imagery, psycho-dynamic approaches, and relaxation therapies.

“Researchers are now viewing chronic pain as a disease in and of itself,” says Michael Ellner, DD, CHT, MSH, a certified medical hypnotist. “Chronic pain is not only unnecessary, it can seriously undermine ones health, and even reduce the effectiveness of rehabilitation and/or other therapies. There are many mind-body approaches that are very effective for helping people learn how to take the suffering out of their painful conditions or experiences.”

Working Toward Acceptance

Like other complementary rehabilitation techniques, mind-body therapy has been slow to reach acceptance among more traditional healthcare professionals. However, the lack of suitable alternatives – including the dead-end solution of painkillers – has promoted an open-minded perspective in those chronic pain sufferers who refuse to settle for merely ignoring or muffling their symptoms.

“From the medical perspective, [healthcare professionals] see increasing interest in the field of ‘psycho-neuroimmunology’, the impact of the mind on the functioning of the sympathetic nervous system, and the effects of stress on the body’s ability to cope with disease,” says Adelman.

“Significant decreases in psychiatric symptoms, such as anxiety and depression, has [been shown]. In general, both patients and normal subjects have demonstrated significant benefits through increased quality of life, decrease in pain symptoms, and increase in sleep quality”

Among the individuals who cannot afford to settle into painkiller dependency are many of today’s athletes, several of whom have acquired chronic pain symptoms either during sporting events or during the course of their training.

Working with this particular demographic is Ming Chew, LPT, a Manhattan, N.Y.-based physical therapist and soft-tissue specialist who manages pain by stretching and strengthening the body’s connective tissues called the fascia.

With a combination of an anti-inflammation diet, which includes fish oils, glucosamine sulfate, and filtered water, – plus spinal decompression stretches, and self-therapy techniques – Chew has worked with various professional athletes to reduce pain without the use of painkillers.

“I get many queries all the time from therapists that want to know about my techniques,” says Chew. “Usually when they hear how fast my patients [recuperate], it makes them very curious. Others who are not aware of other techniques – other than the ones taught in physical therapy school – may be a bit more skeptical, but that usually doesn’t last long once I explain to them the theory behind it.”

Battling Pill Dependency

One of the most difficult aspects of mind-body rehabilitation that therapists are confronted with is the patient’s dependency on opiods and other painkillers. Some patients are so addicted to pain pills that they believe they simply cannot survive without them.

Also, many patients in severe pain have already put their hopes in previous practitioners experimenting with ultrasound techniques or exploratory surgery, only to be disappointed again and again. Eventually, several of these patients develop the demeanor of helpless victims or evolve into skeptical and help-rejecting nit-pickers.

“These patients are usually very difficult to treat,” says Chew. “They have extremely high levels of pain. Their medications already mask the pain to some degree, so the actual amount of pain is greater. I usually ask the patient to go back to the [physician] to see if it is appropriate to be weaned off, or to get off the medications entirely."

Chew continues, "Medications have many serious side-effects so it’s usually a good idea to consider reducing [them] with the approval of [their physician]. Also, medications make it difficult to assess the true level of pain and damage, and – more importantly – it clouds my ability to assess how the therapy is going.”

A survey in a recent issue of The Journal of Pain reports that there are only an estimated six board-certified pain specialists per 100,000 chronic pain sufferers in the United States. Pain practitioners are scarce in rural areas, and not all pain specialists treat chronic pain conditions, creating a sizeable lapse in healthcare.

Due to this, many primary-care physicians are forced to take on the additional burden of managing patients with chronic pain, usually turning to painkillers or experimental invasive treatments due to a lack of alternatives.

“Most of my pain clients have had chronic pain for more than a year before they find their way to me,” says Ellner. “The unwanted and limited benefits of the drugs are why these people are seeking relief. Millions of people are running around desperate for pain relief, but even though they are going through the motions, they often have given up hope that they will find it.”

Ellner continues, “I am able to help these clients help themselves as soon as they understand that their suffering is caused by the way they are reacting to a signal. As they begin to understand [this], they discover that they are able to change the way they react to the signal, which takes the ‘suffering’ out of the painful signals and really improves their quality of life.”

— Bob Stott is a staff writer for Therapy Times. Questions and comments can be directed to bstott@therapytimes.com.