Alternative Pain Treatments

Most doctors want to help people in pain. Ideally, the care would be provided in such a way that there would be little or no risk to our patients. If we could wave a magic wand (or don an enchanted stethoscope), we would be happy to replace opioids with alternative, non-pharmacologic treatments.

The media frequently reminds us of many possibilities for alternative pain treatments such as TENS (Transcutaneous Electrical Nerve Stimulation) devices, yoga, meditation, mindfulness, stress management, self-hypnosis, and biofeedback. Some of them work for some people, some of the time.

The Secret Life of Pain

The New York Times recently published an article called “The Secret Life of Pain.” In it, David C. Roberts, a former physicist and diplomat who worked at an embassy in Bangkok, shares his story as a chronic pain patient. His doctors told them that he was hypersensitive, and that he could choose how to experience the pain. I think “hypersensitive” meant he was experiencing more pain than others with the same condition. Mr. Roberts tried meditation, which provided him with remarkable pain relief. Meditation wasn’t able to eliminate the pain completely, but it helped him to keep it “at a greater distance” so he could go on with his life.

It is great to hear these type of stories. The danger, however, is that some people might think what works for one person should work equally well for others.

Ability to Use Alternative Treatments Is Individualized

Some people may very well have found a way to manage their pain that works for them. But that doesn’t mean they have the answer for others who must deal with their own pain.

Mr. Roberts and many others probably don’t realize that the ability to successfully use meditation and other alternative approaches is very individualized. I have often heard people say, “I had back pain, but I just exercised, and it went away.”

That’s great. Every time I hear one of those anecdotes, I think of how lucky the individual is.

But, as a scientist, I also recognize that the results cannot necessarily be reproduced at will by everyone. A personal testimony of success with any treatment cannot be generalized to others with similar problems.

Some people have the ability to distract themselves from their pain using conscious breathing or other mindfulness techniques. And others do not. The ability to manage pain and stress depends on genetics, environment, attitudes, and emotional stability, among other factors.

We’re not all born with the capacity to manage life’s challenges or achieve all of our ambitions equally. For example, I tried very hard to be an excellent tennis player when I was younger, but I had limited success. This wasn’t because I didn’t work hard enough. It was because I didn’t have the innate ability.

Too many behavioral and physical aspects of our lives, including my failure to compete with John McEnroe, depend on biological realities. Nature plays an important role in determining our capacity to deal with problems.

Some people who would like to use mind over matter to control their pain might lack visualization skills or the ability to concentrate. Or their brain might interpret pain differently from the way someone else’s brain would, turning one person’s level 3 pain that can be managed by meditation into a level 10 pain that simply cannot be handled that way.

Pain is an individual experience. The capacity for an individual to benefit from any therapy is also individualized. It is unhelpful and inappropriate to judge people who do not respond positively to a treatment that may help others.

This isn’t about judgment. It’s about understanding that we need to accept each other’s differences and treat pain patients with compassion, regardless of the treatment their condition requires.