Killing the pain
Scientists are recognizing that narcotic painkillers are ineffective for the long-term treatment of chronic pain, but alternatives such as stretching and relaxation exercises can help those who are suffering.
Laura Winslow, who suffers from chronic pain herself, teaches local classes on yoga, the graceful and focused movements of tai chi, progressive muscle relaxation, deep belly breathing and other techniques for reducing pain.
Such techniques can offer an alternative to opioid painkillers, which are addictive, cause withdrawal symptoms and can increase people's sensitivity to pain over time, according to researchers.
"For long-term chronic pain, opioids are more harmful than helpful," Winslow said. "There's much that can be done to manage the pain. But health care providers don't have adequate time to explain all this to patients. It's become a challenge for patients to get information."
Dr. John Loeser, an expert on multidisciplinary pain management, said opioids are effective in treating acute, temporary pain caused by injuries such as a broken bone. They are also useful in treating cancer pain, which is actually a form of protracted acute pain caused by continuing tissue damage as cancer spreads.
With chronic pain, there is often an unclear relation between pain and the bodily injury. Chronic pain often involves injury to nerves or the spinal cord. A person who suffers a stroke, for example, may experience pain on one side of the body when there is no injury to the body, Loeser said.
Acute pain fades over time as tissue heals, but chronic pain lingers on, he said.
Those with chronic pain should adopt appropriate exercise programs, Loeser advised.
"People stop exercising because they don't want to hurt their backs. It's hard to get across to patients they shouldn't lie down every time their back hurts. They should get up and move," he said. "We strongly recommend using your body."
Patients lose function if they don't use their muscles and joints, he noted.
Dr. Darryl Inaba, the director of Clinical and Behavioral Health Services at Addictions Recovery Center in Medford, said long-term opioid use can create hypersensitivity to pain. Pain gets worse over the years, until patients report problems such as shower spray feeling like needles being driven into their bodies.
Over-the-counter medications such as ibuprofen, muscle relaxers and biofeedback can yield better results in the treatment of chronic pain, he said.
Inaba said the United States is in the midst of an opioid abuse cycle.
In the Rogue Valley, physicians and others have banded together to tackle opioid addiction, which led to a peak number of 46 opioid painkiller deaths in 2006. Numbers have since dipped, he said.
"We need to treat pain effectively so people have a chance to manage their lives — instead of throwing pills at them," Inaba said.
Health care providers need to recognize chronic pain is real. He said brain imaging scans that show areas of the brain lighting up from pain match well with people's self reports of pain on a 1-to-10 scale.
"We have to go on what people are telling us they're feeling," Inaba said.
Penney Cowan of the American Chronic Pain Association said the emotional toll of chronic pain can be as bad as the physical toll.
"People with pain are very hopeless. They've been told there's nothing that can be done," said Cowan, who battled chronic pain before attending a program on how to cope. "I was told to learn to live with it. No one told me how. Don't tell me how to live with pain. Teach me how."
She said people usually must accept a certain level of pain.
"Our expectation is pain can be eliminated with a pill or simple procedure," Cowan said. "There may always be some level of pain."
Appropriate exercise, relaxation, prioritizing activities and focusing on what can be done rather than what cannot be done are among the steps that can help. People with chronic pain also should recognize they are not alone, she said.
"One in three people suffer from chronic pain," Cowan said. "Reach out to others."
Oregon Pain Advisors offers aid through its Pain Resiliency Program, which helps sufferers increase their quality of life, learn stress reduction techniques and restore function through movement training. Classes are held at the Jackson County Health and Human Services Building, 140 S. Holly St.
Oregon Pain Advisors also offers a Peer to Peer Support Group for Persistent Pain. Call 541-774-3855.
Winslow offers classes on gentle movement, body awareness, deep breathing and the impact of lifestyle, stress and diet on pain levels. Call 541-210-1952 or visit www.breakingfreeofchronicpain.com.
For information on medical conditions, medication, treatments and pain management tools, visit the American Chronic Pain Association's website at www.theacpa.org.