Health care looks to alternative pain control

Pain control in health care is an emerging science, likely because it hasn't received enough attention in the past. With 80% of surgery patients experiencing moderate to severe pain and millions of others suffering from more obscure forms of chronic pain, there's a need to sharpen the science. Pain control is the ultimate patient-centered metric of health care success, and until now, health care has focused much more on metrics of success that carry meaning for doctors and healthcare systems, rather than patients. For example, survival or improvement in mobility after orthopedic surgery are easy for a doctor to measure. To evaluate improvement in quality of life or level of pain, you have to ask and trust your patient.  Doctors may be unwilling to routinely trust this type of data. And patients may be unwilling to admit or accurately describe the level of pain they are experiencing.

Compounding the problem, many meds used to control pain either have powerful side effects, or are frequently-abused narcotics. Policies intended to stem such abuse may also unintentionally reduce the drugs' availability to those with clinical need for them.

Now a new study suggests that improvements in pain management may be made using integrative, or alternative, medical practices. Researchers at the Penny George Institute in Minnesota worked with patients who had undergone any of several procedures, including cancer, orthopedic or general surgery, providing them with various forms of massage, guided imagery or relaxation techniques.  They found that patients undergoing such therapies experienced an average of a 2-point pain reduction on a 10-point pain scale. Since the initial amount of pain varies, this amounted to an average of a 50% reduction in the level of pain being experienced.

Other studies released last week tested specific practices for specific forms of pain. One small study of 43 women being treated for breast cancer found that compared to those receiving sham needling, women treated with acupuncture experienced significant reductions in joint pain and stiffness commonly associated with their cancer treatment. In addition to improvement in overall physical wellbeing, pain decreased enough that 20% of women no longer needed pharmaceutical pain control. Previous studies support acupuncture's pain relieving prowess.

A second placebo-controlled study tackled knee pain from arthritis using an electromagnetic device developed by Ivivi Health Sciences in New Jersey. Treatment for 15 minutes a day twice daily for six weeks reduced pain symptoms by some 40%. Unlike the other two studies, these results have not been published yet.

Integrative or alternative medical practices have long been ignored by health care researchers, and without good evidence of safety or efficacy they should generally be avoided. But as these new studies show, they are increasingly receiving the scientific scrutiny they richly deserve.

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