Alternatives to Surgery for Chronic Pain

Chronic pain can significantly impact quality of life. When pain is a constant, even daily tasks can feel nearly impossible. According to statistics, over 100 million Americans live with some type of chronic pain, making it the leading cause of disability among adults in our country. In the USA, chronic pain is one possible side effect affecting between 3 and 6% of hernia surgery patients. Some patients have chronic pain before the hernia repair, while some patients did not.  Sometimes surgery can help patients with chronic pain after hernia repair, but in up to 30% of those patients, even corrective surgery or mesh removal surgery does not alleviate the suffering.  The more we have dealt with the issue of chronic pain (and the opioid crisis created by pharmaceutical intervention), the more pain specialists realize that chronic pain is intrinsically connected to ways in which the brain processes pain signals from the body. We now know that medication cannot and should not be the focal point of treatment for every patient. This has led to research into a number of alternative therapies for pain management.

What are alternative treatments to chronic pain?

Patients with chronic pain who have exhausted the more traditional methods of treating chronic pain (including working with pain medicine physicians, rehab, physical and occupational therapy, massage therapy, and traditional behavioral therapy and psychiatry), who are interested in pain management options that do not focus solely on medication may benefit from one or more alternative therapies. Popular options include meditation, acupuncture, reiki, and psychedelic assisted psychotherapy.

Meditation

There are several forms of meditation that have been developed over hundreds, if not thousands of years. The form that has been identified as a promising treatment for chronic pain is referred to as mindfulness meditation. The goal of this alternative therapy is to help a person gain psychological control over their pain through deep breathing and relaxation. The concept originated from the understanding that there are two aspects of pain: the physical (electrical signals from body to brain) and the emotional (the psychological response to pain).

Mindfulness meditation practices, which can be found online or in smartphone meditation apps, teach people how to understand the types of pain and then “turn down the volume” of their unpleasant physical sensations. Mindfulness meditation for chronic pain has been shown to reduce symptoms by 57 percent, and to also reduce the stress, anxiety, and depression that often accompany chronic pain.  You can ask Dr. Jacob for a referral to a meditation specialist.

Acupuncture

Acupuncture is a branch of Traditional Chinese Medicine that has been practiced for over 3,500 years. The concept of the therapy is to release or redirect the body’s natural qi (chi), energy, to promote physical and emotional well-being. In Traditional Chinese Medicine, the belief is that pain and illness originate from imbalances or blockages of the life force energy (qi). In the area of pain management in Western medicine, it is believed that acupuncture  stimulates the Vagus nerve, which tells the brain to produce more beta-endorphins. These are the body’s natural opioids that can reduce sensations of pain. There is also a theory that the insertion of the tiny acupuncture needles changes the cells in the connective tissue of the treatment site in lasting ways that reduce pain.

Reiki

Reiki is a type of energy medicine that originated in Japan. For the person who has heard the term “laying on of hands,” Reiki may feel familiar, for this is what a provider may do. The purpose of Reiki is energy transfer. During a session, the provider may never touch the body, but may hover their hands a few inches away, beginning at the head or feet and moving in the opposite direction. By guiding the energy through the body, the practitioner promotes self-healing, both emotionally and physically.

Studies have shown that Reiki may be a beneficial therapy for chronic pain because pain is not only physical, but also emotional. By healing the emotional aspects of pain, Reiki can help decrease the brain’s perception of it while also reducing stress and anxiety. An article published in The International Journal of Behavioral Medicine discussed various studies in which strong evidence of the benefits of biofield therapies on pain intensity was found. A review of 24 studies confirmed that touch therapies were successful at reducing pain. Of them, Reiki had the most success.

Psychedelic Assisted Psychotherapy

Psychedelic assisted psychotherapy (PAP), is the use of prescription psychedelic medication, in combination with behavioral therapy to help treat PTSD, depression, anxiety, addiction, chronic pain, and suicide ideation. This combination treats the whole patient and provides a very holistic approach to chronic pain. There are several university centers around the country that now offer this method of treatment under study protocols, as well as some other centers that offer ketamine assisted therapies.  For more information on this, you can ask Dr. Jacob about this, or we prefer to refer you to the nonprofit organization called Multidisciplinary Association for Psychedelic Studies (MAPS).

Others

Dr. Jacob is well versed in all of the alternative treatments for chronic pain.  Please feel comfortable to reach out to him with any questions you may have.

How do I know which treatment is right for me?

It is difficult to predict which alternative therapy may feel the most effective for every person. You may need to have a few sessions of each to determine how you respond. One of the most beneficial aspects of determining the right therapy for you is how you feel in the presence of your provider. Your sense of emotional safety is paramount to your response to any therapy. It can be helpful to:

  • Inform your clinician of your concerns and goals regarding pain management.
  • Ask the clinician about their direct experience treating people with chronic pain.
  • Discuss potential emotional or physical effects during the course of treatment.
  • Ask about the expected timing for potential improvements and what you might do to maximize the effects of your therapy.
  • Remember that alternative therapies do not work in the same way as medication. It can take time to notice the positive effects of any drug-free therapy, so be patient.

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Is there recovery or preparation involved for any of these treatments?

No. Each of these alternative forms of pain management are designed to work with the patient’s physical and psychological systems, so are very gentle. There are no physical side effects associated with meditation, acupuncture, or Reiki. These modalities, as well as medication assisted psychotherapy, may release old emotional traumas in the form of irritation, crying, or other symptoms. It is important to discuss the expectations and potential emotional release that may occur so that thoughts and feelings do not create unnecessary psychological disturbance.

Alternative pain management therapies work on body, mind, and spirit. They may come with a few unanticipated responses, but none are permanent, and all are in the interest of healing.

Schedule a Visit

Dr. Jacob is regarded by peers as one of the top surgeons in the United States for the diagnosis and treatment of chronic pain in the groin and pelvis, including pain after hernia repairs or sports injuries. For more information about the services we offer, or to schedule a visit to our New York City office, contact us at 212-879-6677.

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