Patients & Visitors

Pain Clinic

A17

Non-Drug Treatments for Pain

Exercise
non-drug treatment image The overall message for patients is that it is important for them to stay active. This is helpful for all patients suffering from intractable pain, but is particularly so for patients who suffer from low back pain. The vertebral column is essentially supported by the cylinder of muscles around the trunk, and so any muscle wasting will be likely to have a detrimental effect on back pain.

Exercise also improves mood, promotes socialisation, inherently provides pain relief and acts as a distracter from pain or other negative emotional experiences.

Physiotherapy assessments are of great potential benefit, particularly for patients who suffer from musculoskeletal pain. However, the assessment must be carried out by a physiotherapist with a good understanding of pacing and the importance of a very gradual programme. Patients with chronic musculoskeletal pain frequently run into difficulties if rehabilitation programmes are too ambitious for their needs.

Pacing
Pacing involves the break-up of tasks, or exercise, into manageable amounts. It encourages a gradual achievement of goals, and avoids the ‘boom and bust’ that often accompanies efforts to take advantage of good days by doing more.

Walking responds very well to a paced approach. Patients should start with distances (or durations) that they know they can manage, however short that is. They can then build up the distance or time very gradually from there.

Household chores can also be broken up. Vacuum cleaning can be done one room at a time, for example, and ironing can be done over a number of days – while sitting down, perhaps.

Relaxation
Pain is aggravated by stress and muscle tension. It also causes tension and stress. To break this vicious circle, consider information about relaxation, as well as relaxation tapes, as tools to help reduce stress and muscular tension.

The Pain Clinic offers instruction in relaxation on a group basis.

TENS
The Bath Pain Clinic provides a TENS clinic. TENS machines are battery operated devices, about the size of a pack of playing cards. They deliver a tingling sensation via two or four pads, which stick to the skin over or near the site of pain. This sensation is believed to work via the Pain Gate, meaning that it over-rides other, more noxious and painful, sensations. It can be worn all day. Rechargeable batteries are recommended.

Patients are invited to try a TENS machine on loan initially. If they get benefit from it and wish to keep it, they need only send a cheque to the manufacturers.

The Pain Clinic in Bath provides two appointments for patients, which covers the initial visit and instruction on the machine as well as a follow-up appointment to help with any problems that might arise.

Acupuncture
Acupuncture appointments are offered at the Bath Pain Clinic. Initially four appointments are provided, which gives patients an opportunity to decide if acupuncture is likely to be helpful to them. If it is successful, we encourage patients to continue to receive acupuncture from a local practitioner.

Symptom Management
Symptom Management is effectively an individually based Pain Management Programme. It is most suitable for patients who are unlikely to do well in a group situation. Reasons may include difficulty hearing, anxiety about joining a group, or other problems such as emotional distress. The elderly often attend Symptom Management instead of the Pain Management Programme. Symptom Management can be combined with other non-drug therapies, such as acupuncture, as well as affording an opportunity for review of drug treatment.

Other complementary therapies
Although other therapies are not available from the Bath Pain Clinic, we encourage patients to take responsibility for managing their own pain. For many people, this may involve trying out other complementary therapies, and this is something that we would, within reason, wish to encourage.

Weight loss stabilisation
Many patients who suffer from Chronic Pain are overweight. This may be in part the cause of their pain, or a consequence of it. Advice given should include an explanation of the importance of reducing fat and sugar in the diet, and increasing the proportion of fruit and vegetables. Drinking plenty of water can help to reduce the need to eat as often.

The goal of eating sensibly will need to be reinforced often, as the habits, often of a lifetime, can be very difficult to break. Goals must be realistic, to avoid a sense of failure and disappointment that frequently will lead to an abandonment of the effort.


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