A small but interesting new study of pain in patients with heart failure suggests alternative/integrative methods of treatment are sometimes much better than medicines – and provide much more opportunity for people to have control over their own pain destiny.
Treatment of pain is a hot button issue. A lot of it has to do with patients on opiate pain medicines, which, because of their addictive potential are heavily regulated and scrutinized by the FDA – causing doctors a lot of anxiety when caught in the middle between fear of prescribing on one hand and, and the demands of some possibly addicted, possibly abusing patient on the other.
I talk about “the pain patient” as one category of “difficult” patient in my book Managing Your Doctor.
Obnoxious though it may sound, there tends to be a subset of chronic pain patients who have some very sketchy (or very un-documentable) condition that is supposedly causing them lots of pain. And, as a doctor, one is always paranoid about them “diverting” (selling) their medicines rather than taking them, or getting addicted to them and wanting to take them even though the cause of their pain has got better. And these bad apples tend to make doctors and the authorities super-cautious about prescribing for the genuine pain patients.
The study I’m talking about was published in Heart Lung, September 2015 (you can get the whole article from Pubmed at http://www.ncbi.nlm.nih.gov/pubmed/26088386 but the bums will make you pay for it – the alternative is to go to Clinical Pain Advisor site at http://www.clinicalpainadvisor.com/treatments/section/4616/ and look under ‘Treatments’ and then ‘Heart Failure Patients Choose Pills Over Alternative Therapies for Chronic Pain’ for a good synopsis of the study by Michael O’Leary).
In the study they were dealing with a different problem with pain medicines – the looked at people with heart failure who were inappropriately taking NSAID pain medicines (like ibuprofen as in Motrin and Advil, or naproxen as in Naprosyn and Aleve), and other pain medicines, like gabapentin, that cause fluid retention and make heart failure worse.
They suggest walking, stretching, use of heat and cold, massage and yoga as alternatives or adjuvants to medicines. With the lead author noting we should be paying more attention to these alternative treatments – which I would certainly agree with.
Non-pharmacological treatments would not only provide a much safer alternative than addicting or fluid retaining medicines, but would give a person much more self control over their pain.
Making them much more medically emancipated.