Physiotherapy for chronic pain
People with pain are often referred to a physiotherapist more often in the early stages of their pain problem although sometimes later on. Physiotherapists are...
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.
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.
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 (IBS), 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.
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.
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.
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.
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.
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.
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.
People with pain are often referred to a physiotherapist more often in the early stages of their pain problem although sometimes later on. Physiotherapists are...
Chronic pain is difficult to treat and many of the people we talked to had tried a number of different medications before one, or more,...