Complementary approaches for chronic pain
Complementary therapies have often not been tested using conventional scientific methods, so their effects have not been measured or proven. However, many people think that complementary approaches have a role in pain management and some are becoming increasingly popular. For some complementary approaches, such as acupuncture, there is accumulating evidence that it is beneficial but mainly for acute (rather than long-term) pain.
People with chronic pain tend to be broad minded when it comes to approaches to managing pain. Nearly everyone agreed that different approaches work for different people - even if they sometimes suspected it might be a 'pseudo' or placebo effect.
Has tried numerous different complementary therapies, with limited success. Considers that what...
Now you think about it, if you can't work you've not got the finances and they're asking you for a certain amount of money every week or twice a week for as long as they tell you, you can still go. Because I mean you tend to go week after week for the simple reason, this week will be different, this week will make the difference, I'll feel different this week, as I say it does work for some people it just didn't work for me, unfortunately.
Staying with the alternative health vitamins and things like that, I do take vitamin C for the simple reason I don't eat a lot of fruit I don't eat a lot of vegetables, I don't eat any vegetables actually, where I should, I don't eat a lot of fruit but to keep the vitamin C in my body because that I had a lack of something and they said it was vitamin C so I take that. I had another one that for me it didn't work either.
Where else did I go? I went to see some other health thing and they gave me something, I can't remember the name it was, but it didn't work anyway, and then I went to the shop up at [road] and it was like a mixture they gave you, it was disgusting, I don't know if I didn't take it long enough, see as I say I've got a funny body, for any kind of medication at all. What works on everybody else will not work on me, right, so it's a case of finding the right thing, and alternative therapy was not for me. I know somebody that does do it and she looks wonderful, it agrees with her, it's the way she survives that's fine, but if you don't try it, you'll never know.
But the alternative therapies I have tried, I've tried acupuncture, I've tried chiropractor, I've tried osteopath. I did, a friend of mine gave me some reflexology, and that worked I enjoyed that, I don't like anybody touching my feet but I had a good nights sleep after he did that. So there might be the odd thing that yes it will work but I can't honestly say alternative therapies are for me. I mean as I say they might work for everybody else.
I mean but if you don't try them, anybody should try, if its going to help you in the long run no matter what it is. Even if somebody says to you go and pick a pomegranate of that tree and that will help you, I would go and do it just to see if it did help, so if somebody suggests something, yes you sit with an open mind, you've got to.
If you've got chronic pain you must have a mind that can accept other things, you're not just stuck in where what the doctor tells you to take. Same with the Pain Association we all did the same thing. They'll tell you about their own, or if something new comes up, 'I tried that it was wonderful', so the next week you go back in and 'That was rubbish it didn't work for me'.
So what works for one doesn't work for anybody else so, find your own, but experiment, that's the one thing you should do you should try, no matter how, if its going to be costly that you prerogative you don't have to pay for it, but if you want to try something and it does work, what the hell, go for it, anything that makes your quality of life better, go for it.
Complementary approaches are widely discussed among friends and in support groups. For every therapy that was mentioned (homeopathy, chiropractic, osteopathy, reflexology, acupuncture, massage, herbal medicines, spiritual healing, reiki) there were examples of people who said they had benefited enormously and others who said it was no use for them.
People stressed the importance of getting as much information as possible about complementary approaches, from the GP, the Internet, and support groups and recommended choosing a therapist who was registered and personally recommended.
Suggests that people should use whatever complementary therapy works for them but cautions people...
Yes, I wouldn't, as far as osteopaths and Pilates teachers, chiropractors if, they need to be registered with the correct body because anyone can go on a brief course and then call themselves an osteopath. But unless their registered with the General Osteopathic Council or British Chiropractors Association, the same with physiotherapists.
Someone could have done a massage course and then tell people that they do sports massage and remedial therapy which is more, which is a more advanced course and then you go to them and they don't have any qualifications, well they don't have, they are not registered with a body. If the therapist is registered with a body then they are monitored, they have guidelines to stick to and you know you are getting proper treatment.
The same with Pilates if... a lot of gyms offer Pilates classes, then you go to them they are not really, they have got a bit of the Pilates principles in them but it is a mass group and the instructor's not looking at you and your back and your situation, she is just teaching you all a bunch of movements. Whereas with my Pilates I learnt from a physiotherapist and then got in touch with someone from the Body Control Pilates Association which is the biggest association training association for Pilates in this country.
So basically, as long as they have got the right accreditations then you should be fine. Some therapists don't have monitoring bodies, you know homeopaths do herbal, medical herbalists do, some massage you can, there is a British massage school that you have to, because if, you can learn your course on massage in a weekend but a true massage therapist would have done a longer course and known anatomy and I think with your back the fact that somebody's learnt their anatomy and physiology is very important. I wouldn't let someone who didn't know anatomy touch my back.
Some felt that it was important to keep their GP informed of different things they were trying as some may not be suitable or could affect the traditional treatments they were using.
Approaches such as massage and aromatherapy were sometimes valued because they made people feel better and thus more able to deal with the pain. Others said that massage helped them to relax and avoid muscular spasms, but that they needed a therapist they could trust not to hurt them.
People who are in pain often feel very protective of their bodies and may not be able to bear the thought of deep massage, manipulations, or having their feet or hands touched.
Dietary approaches and supplements were widely used. Those who knew that their diets were inadequate, or affected by problems such as irritable bowel syndrome, felt that vitamin and mineral supplements were a wise precaution.
One man thought that many people could benefit from seeing a nutritionist, though others said supplements were expensive and unnecessary if your diet is good.
Recommends nutritional approaches and massage as part of a broader coping strategy.
What advice would you have for other people thinking of using complementary therapy?
Certainly to try, I went to see an acupuncturist once on the advice of the surgeon that did my operation. Not on the advice, but he advised which one to go to when I'd said "Do you think, rather than go for surgery would it', what about acupuncture?". He said "Well you can try it". And he suggested a chap who immediately went through my history and said "No I don't think I can do anything for you". So that was as far as we got with that.
I'd certainly, because of my own experience, recommend massage. Whether somebody else does it or whether your partner does it, I'd certainly recommend it. Mainly because it is very soothing. It can be very relaxing. It can help the relaxation programme, process. And I have massage from [wife's name].
I have massage from my wife pretty regularly. We've actually got a massage table which we bought second hand last year. Now that gives me the most fantastic night's sleep, having massage. She's learned the rudiments of reflexology. The chap on the cruise ship actually showed her what he was doing and what to do. And this helps. So I'd certainly. Certainly I'd recommend that, because I've tried them myself.
I wouldn't recommend anything else because I haven't tried them. I'd certainly recommend everybody with pain getting a nutritional check-up. Going to see a nutritionist to see whether there's anything on the food side that is affecting them. Because you can have lots of hidden allergies and intolerances.
And I'd certainly recommend remedial massage and reflexology. They're not the whole answer I don't think, but if you're looking for a repertoire of, to be technical, a repertoire of coping responses, that's going to see you through your life, you need to take these into account and use them when you think they're necessary.
Feels nutritional supplements are expensive and probably unnecessary if your diet is balanced
I eat my five portions of fruit and veg every day. I eat oily fish, don't like it but I eat it, I eat, I try to sort of eat all the things that are good for you that are healthy. I've tried various different kinds of vitamins, minerals, amino acids, and usually for a period of two or three months at a time, but to be perfectly honest with you I don't really feel an awful lot of difference with the vitamins and things like that. I think that if you're eating relatively well the things you should be eating it more or less balances things out for you.
Acupuncture had been used by several people, who described the effects as noticeable, but not permanent. A man who disliked the sedative effects of his medication was given acupuncture by his GP as an alternative. In practice some people experience no effect from acupuncture whereas others may find they experience a prolonged pain relief.
Medication was making him too drowsy so his GP tried acupuncture, which was effective but short...
Even sort of looked at going to alternative therapists but nothing came of it. My Doctor decided to try some Chinese medicine on me in the way of acupuncture which in fact produced a remarkable improvement, didn't remove the pain but he was doing it in his spare time and doctors don't have much spare time, so he couldn't keep it up for a long time.
So you say that it was effective?
Very. If you can find someone to do it for over a length of'it doesn't last for long. It lasts a maximum a couple of days I find.
Chiropractic and osteopathy were by far the most commonly used complementary therapies. One woman described what happened when she went to see a chiropractor. Some had found 'wonderful' therapists who they trusted to treat their backs, necks and headaches, while others had found the treatments unpleasant, ineffective or too expensive.
Describes treatment by a chiropractor for a frozen shoulder, which she thought costly but money ...
So I asked around and there was someone I knew who'd injured their back actually cleaning the bath and had gone to a chiropractor and I asked around and I found out about which chiropractor and whether they'd a reasonable reputation, that seemed to matter.
So I went there just a few days after the doctor's visit and he took x-rays. I'm not sure I was terribly keen on the prospect of x-rays, but well it seemed necessary. He didn't seem to think he would find anything tremendously out of the ordinary but nevertheless to rule out any physical sort of problem that would be dealt with more appropriately some other way. And he found that as far as the right shoulder was concerned it was out of place, but no sort of discernible damage. That the base of my neck has rather more degeneration than usual for someone of my age and at the base of my spine also there was a bit more degeneration than he would have sort expected to find again for my age. Offended me thoroughly by saying that the state of the bottom of my neck was more consistent with somebody who's spent a lifetime boxing or playing rugger, neither of which I think were my preoccupations.
But however had I had a whiplash injury and I wasn't aware of anything like that I mean it could well be I don't know. Then he, for the first week I went five days a week and he spent a few minutes very gently manipulating the shoulder back into place but very little and progressively managed to work it back into place over about two weeks. Dropped it down to four times, the following week and thereafter it was three times a week for a few months just tiny little adjustments to move things back into place and to get them to move more normally.
Also got me a neck traction device, sort of wedge of foam with a tension sort of strap that goes across the forehead and pulls the neck back and stretches the neck out. Again that was quite difficult to use to start with, it's really quite painful and I could only stand a few minutes but I worked it up to 20 minutes a day and that made quite a difference in the way that my neck felt and it's actually quite soothing to use that so my neck feels sort of compacted and all sort of squashed down and to pull it back is actually quite soothing so...
It was about 3-4 months when... or I went three times a week and then it went down to once a week after that. And then it went down to monthly, 5 weekly and that's just to check on things, or more frequently if I've got an acute injury again that I go more often and if anything is out of place he manipulates it back into place. He also suggested a series of exercises and to stretch the sort of... and to use the joints and so on. So that's, that's about the chiropractor.
Was the chiropractor... did you have to pay for that?
Oh yes, yes. It was fairly expensive but on the other hand he got the shoulder moving, he gave me rather more hope at that particular time. I got back to work so in the way of things I think it was money well spent. And nowadays it's not too expensive once a month, every five weeks and he discounts anyway for a lot of the appointments so it's nowhere near the cost of an individual appointment.
Sees an osteopath and finds that manipulations help her headaches and thinks complementary...
And he basically explained that, from an evolutionary point of view, we shouldn't be standing upright. We've only got sort of a tent pole, for want of a better word, holding us up. If you damage that in anyway, it won't repair itself fully, it will always be damaged. So if, depending on what the problem is, when I first went to him he said 'Do you have any problems with your neck or between your shoulder blades', this was 12 years ago, 11 years ago, and I says 'Well no'. I do now!
I do get quite a lot of bad headaches actually and I tend to find, when I go to him, he puts the vertebrae back sort of, it sounds like there's a crack, it's not painful at all, it sounds horrible when he's doing it, but it's very good and the headache will go virtually straight away. It's absolutely fantastic.
So I'm all for saying to people 'Look, you know, well I know somebody that can help you' because the GPs are very good at giving out anti-inflamatories, but that isn't always the answer. Not everybody wants to pop pills and, in fact, tonight I start a college course in reflexology, because I think alternative and complementary medicine is getting quite popular because I think people do want that. They don't necessarily want to pop a pill because it doesn't always work, 'cos that doesn't work with me. So if I think, you know, if he can do that then that's brilliant from everybody's point of view isn't it?
Saw a chiropractor and got temporary relief of painful muscle spasms but didn't think that it was...
When you get back pain you, you tend to guard it a lot and it does go into spasm and they were able to relieve that but that's about it.
The other side of it was it was getting very expensive. When you're going 2-3 times a week and it's sort of '15 a time, and you're on a sort of reduced income, it's just difficult to keep going. So something I had to stop going.
Found manipulations uncomfortable and although she got some relief didn't think it was worth the...
It was really frightening to find that happening to your back. However, I have to say after sort of, I had about 3 session of that, which again, you know, horrendously expensive, it was something like '60 a session with this chap, but I have to say that did make a bit of a difference but, cost wise, I just could not continue with that.
Tried an osteopath. That, oh, just made me worse. Tried reflexology. Oh that didn't work out for me either, that, I think that just works for some people and not for others, but that just wasn't for me either. I now treat myself to an aromatherapy massage once a month. That's my treat, that keeps me going.
Many people said that they had 'tried everything' but were now much more cautious about spending money because they recognised that it was unlikely that anything would totally get rid of their pain. One woman had almost given up trying new therapies, but was still open to the idea that there might be something else worth trying.
Has tried numerous approaches and spent lots of money, but now believes there is no 'Holy Grail'...
Which sorry, was another hit because once you finish up, you're not getting the wages or the overtime and all that, you're getting a basic, what would you call it incapacity, or whatever they called it at that time, money so you wouldn't worry how much you have or not have, and that's where the support of your family and partner came in financially, you would think, oh I haven't tried it, what is it, oh its some cream based on this herb or something, so off you go and pay about '19.99 or something for a wee tube and rub it furiously and apply it, and next day you'd wake up and there'd be no cured, and you'd think, oh.
And so it went on, I mean I must have spent my family and my partner's money, I think over 2 years or, even say to the present, anything between '2,500 to '3,000, I mean I tried acupuncture, costly, reflexology, costly, aromatherapy, which worked slightly but only for a day, and at that time I think I was paying about '28 for three quarters of an hour in '96.
So you tried all these and even to this day when somebody says, 'Oh have you heard of this new thing?' Now you're a bit more wary because you know there is no Holy Grail, because you know you've fallen over so many hurdles because you know, you know, it might not work, you don't really build your hopes up so you try them but you're a bit more careful, I mean if its '79 you think well, I've had this for 10 years, I'm not going to spend that money on this cure, if its about '15/'20 or even '30 you think, well I'll give it a shot, but what I'm trying to say is after a number of years and so many false dawns, you're a bit more careful in what you try, especially with the financial limitations.
So I've tried everything and people were amazed that you knew about these things, but you had to if you were genuinely interested in trying to solve your problem. You researched and you went down every avenue, but sadly, to this day, nothing's really worked for me.
Has tried numerous complementary approaches, with varying success, but is still open to ideas....
So yes I'd love to see something like that, that you can go to your GP's surgery and get at least once a week but it's pricey. If you can afford it, do it, because it is wonderful. It's something I would do on a regular basis if I could afford it but it's just not affordable and I go as and when I can.
I've tried chi-hatsui which made my muscles even more painful. I've tried Reiki, 3 sessions of that and I didn't feel I was getting anywhere. At '40 a session it's a lot of money, I think. Some of the alternative therapies, while I think they could be quite good, some of them can take a wee while to work and you really need to have a fair amount of money that you want to spend because they are not cheap.
I consulted a herbalist who made up a potion for me. '35 consultation fee for an hour. Very good, took all my medical history and various things like that. Made up a potion for me which cost about '18 I think which lasts for 3 weeks. After 3 weeks you go back for a follow up consultation that was '20 and then you had your potion again which was changed slightly I think the second and third time, again you had that to pay for so it works out quite pricey and to be honest I didn't, well I probably slightly alleviated my symptoms, it didn't feel worth what I was paying for.
I also tried Chinese herbal medicine. Spent about '300 on that and again I don't feel, I really, slight, very, very slight improvement but not what I would say was really worth paying for. A couple of things that I haven't tried. I've tried things that you can buy out of homeopathic chemists, but I haven't actually spoken to a registered qualified homeopathic person to get any of their remedies. I have heard they can be helpful and then I've heard from other people they're not. I suppose it maybe something to think about for the future.
And then I've also heard as well you can actually get a referral to a homeopathic doctor on the NHS. I haven't actually queried that with my own GP yet but I've heard it can be done. And I think the other thing which can be quite helpful and that's another thing I'm going to ask my GP about, acupuncture I believe can. But it has to be not something you go for just once or twice like you maybe would with sciatica and things like that. It's something you've got to sort of get on a regular basis so again unless you could afford to pay privately you'd hope you'd maybe get something on the NHS.
What other alternative therapies have I tried? I think that probably rounds it up but there's quite a few there that I have had tried. If you find something and it works and you can find the money to pay for it then you know, stick with it, but anybody can set themselves up as doing alternative therapies so be careful about who you consult. Take recommendations and etc. etc., I think from other people is probably the key because there's so many of them about now.
But I would be quite happy to pay for, I'd be quite happy to find the money and pay for some kind of alternative therapy if I knew I was going to get more out of it than anything else but so far, no, I haven't actually found that. Me, personally, I haven't whether other people have I don't know, but I certainly haven't to any degree which is unfortunate but at least I have tried. I'm open to ideas.
People were concerned that unscrupulous private therapists would find it easy to exploit those who are desperate and vulnerable because of their pain. A woman who has had pain for 22 years explained that it is very hard for people to know what they should try.
Says people with chronic pain are vulnerable and need to know which complementary therapists are...
You know, 'Why don't you try and go and see Mrs. X who does, you know, such and such a therapy. She helped Mr. Bloggs terribly' you know and so forth. And you meet that a lot. So first of all you have a problem with what you start with is appropriate for your condition and there's no real way of choosing.
A number of pain clinics now use acupuncture but there's no real research as far as I know as to why it works for some people and doesn't work for others. It seems to be a higher than placebos response but nobody seems to know why.
So the pain patient finds himself in a situation where they are trying a therapy, they are normally hopeful about it, have a lot of hopes pinned on it being successful and it may work for them or unfortunately, it may not, and if it doesn't they are plunged back again into this sort of cycle of despair, disappointment, depression and so forth, until they try the next thing.
So it becomes a sort of a situation where you ricochet to one therapy and if it doesn't work for you ricochet to another one and there's no rhyme or reason to it, or you can spend an awful lot of money and that's even if you have good therapists and unfortunately it's often very difficult to know who are good, reliable therapists unless you are prepared to do quite a lot of research.
There are some ways of finding out using professional registers for people like acupuncturists for instance, or chiropractors but you have to be quite a knowledgeable and dedicated patient to sort of find out all that information and of course at the very worse you become, you may find yourself in the hands of someone who is a complete charlatan or who actually does you damage in the very worse scenario.
So it is very problematical and although personally I think it is worth trying things, I think you should do your research, try to go into it with realistic hopes and try not to be too disappointed if it doesn't work for you.
There was some scepticism about complementary therapists because, as one woman suggested, they 'never say don't come back'. However, this had not been everyone's experience. Some people had entered into ongoing 'maintenance' treatment with their therapists, but several others were told that they were unsuitable for acupuncture, or reassured to hear that an improvement should be evident after their first three osteopathic treatments.
Some had decided to avoid complementary approaches and preferred to use traditional approaches or pain management techniques.
The biggest deterrent to using complementary therapies is the cost. Almost everyone who had used therapies said that this had been a problem, and for some people who were living on low incomes or benefits it was an absolute barrier. Some could not understand why these treatments are not available on the NHS. Although some Clinical Commissioning Groups pay for patients to see practitioners this is relatively unusual, as one woman found when she changed doctors.
Used to live in an area where the GP practice paid for complementary therapies. Advises asking...
I think in terms of advice for complementary therapy the best thing, from my experience, is to find out as much as you possibly can, both about the therapy that you're looking into and the practitioner that you're thinking about going to. Because the more you know, the more you can then evaluate what's on offer, has it worked for other people?, what's the person like who's going to be treating you?, and all of these kind of things.
I also think, from my experience, it's good to go to a practitioner that's been recommended by somebody that you trust. Obviously we're not all in a position where we have friends with a similar, with a similar complaint to ours but even if you approach a local support group for your disability or a support group that deals with chronic pain, then they may well have resources to direct you to somebody that is going to be helpful.
Because I think the problem with looking in the phone book and picking someone out is you never know how much training they've had and whether or not they're a trustworthy person, which is always important if you're giving them your body, you want to be able to trust them.
Is it something you ever talk to your GP about it?
I've talked to my GP about complementary therapies at great length. My previous GP, whilst I was at university, was fantastic and fully supportive of any complementary therapy that I could think of and wanted to try, and I think I was just particularly lucky there because the Trust that they were part of actually had some budget for complementary therapies and I know that's really unusual. I think also it spoilt me somewhat because, now I've moved to a different area, I talk to my GP about complementary therapies and they think I'm having a laugh really, because they don't have any funds for it and because they don't have any funds, they haven't really spent any time looking into complementary therapy as a viable option.
I think it's unfortunate that NHS Trusts that don't allocate funds to things, don't even investigate treatment options, because sometimes that's all you need, somebody to say that this is going to be helpful, why not explore it. Even if it does cost you money as a patient, to have the recommendation of a GP is a constructive thing.
One woman had found that she could get cheaper treatment by visiting trainee therapists working under supervision and a man was so impressed with Reiki that he had trained as a therapist and now offered treatments on a voluntary basis. Others had trained in reflexology and massage after having treatments and traded treatments with other therapists.
Last reviewed August 2018.
Last updated August 2018.