Are You Ready for Alternative Medicine: Non Pharmacologic Pain Management Lisa Sigsworth RN, CHPN, CHt, CHI Lsigsworth@ameracare.com What are Alternative Pain Methods The term ''alternative therapy'' generally is used to describe any medical treatment or intervention that is used in place of conventional medicine. When alternative therapies are used in conjunction with conventional medicine, it is called complementary medicine. Alternative therapy encompasses a variety of disciplines, including acupuncture, guided imagery, chiropractic treatment, yoga, hypnosis, biofeedback, aromatherapy, herbal remedies, massage and reiki Psychosomatic pain management works with mind over matter ** WebMD 1
Accupuncture Acupuncture is a form of traditional medical treatment that has been used for hundreds, even thousands, of years. Acupuncture originated in Asian medical practices. That s why many licensure and oversight boards use the term Oriental Medicine to classify acupuncture. Acupuncture may be useful as an accompanying treatment for many pain related conditions, including: headache, low back pain, menstrual cramps, carpal tunnel syndrome, tennis elbow, fibromyalgia, osteoarthritis and myofascial pain. Acupuncture also may be an acceptable alternative to or may be included as part of a comprehensive pain management program Experts are trained for 3 4 years. Testing from a national board AMA accepts acupuncture as a medical treatment and some insurances cover the cost. The fundamental belief of acupuncture is that illness is the result of blocked or interrupted chi. Chi provides your body with healing energy. Acupuncture seeks to remove these blockages and return your energy flow to a state of balance. Pain, headache and menstrual cramps Osteoarthritis, joint pain Nausea and vomiting Some allergies Addiction and chemical dependency **Healthline 2
Dry Needling Dry needling is a modern treatment designed to ease muscular pain. Its popularity is growing. During dry needling, a practitioner inserts several filiform needles into your skin. Filiform needles are fine, short, stainless steel needles that don t inject fluid into the body. That s why the term dry is used. Practitioners place the needles in trigger points in your muscle or tissue. Dry needling is also sometimes called intramuscular stimulation. The points are areas of knotted or hard muscle. Dry needling practitioners say the needle helps release the knot and relieve any muscle pain or spasms. The needles will remain in your skin for a short period of time, often between 10 and 30 minutes. This technique relies on the idea that pain is the result of a greater nerve or muscular issue, not a focused one only in the main area of pain Dry needling is most often performed by physical and sports injury therapists. Currently, dry needling practitioners don t need extensive training to perform dry needling. No regulatory agency controls training, licensure, or supervision for this procedure Most of the existing research for dry needling supports the practice for relieving mild to moderate pain. 3
Biofeedback a technique used to improve your health by learning to control certain internal bodily processes that normally occur involuntarily, such as heart rate, blood pressure, muscle tension, and skin temperature. These are referred to as the autonomic or involuntary functions of the body Activities of the Autonomic Nervous System are measured with electrodes and displayed on a monitor to see how actions/motion and stress affect the body systems. Identification of the issue can allow the person to control the processes to stop or decrease pain or the symptoms. 4
Biofeedback Options Electromyographic biofeedback (EMG) may be used to treat muscle tension headaches as well as neck pain, jaw pain, etc. Temperature biofeedback helps you learn to increase blood flow into various parts of the body. Having a head injury may cause temperature dysregulation. Many individuals report feeling very hot or very cold. Electrodermal response (EDR) is a way to measure the body s tendency to go into a fight or flight response. This may happen after a traumatic event. Pneumographic biofeedback (breathing biofeedback) is a modality used to measure chest versus abdominal breathing. This can help you learn to breathe more deeply and regularly to improve your relaxation response. Heart rate variability biofeedback brings the cardiovascular and physiological systems into harmony, which may positively affect conditions, such as depression and anxiety. EEG neurofeedback or brain wave biofeedback is a form of biofeedback in which surface electrodes are placed on the scalp to measure specific brain wave frequencies and provide feedback to the individual. You may learn to suppress or enhance specific brain wave frequencies, thus enabling you to learn to focus, relax, and increase flexibility of thinking 5
Yoga is a group of physical, mental and spiritual practices or disciplines which originated in ancient India. It is one of 6 orthodox schools of Hindu philosophy developed in the 5 6 th century BCE. In the western culture it is mostly physical exercise Yoga Controlling the body and the mind Physical exercise for stretching the body muscle groups and controlled movement Physical strength building exercises and poses Mind, body and spiritual alignment to achieve balance, pain relief, relieve constipation, reduces blood pressure and pulse rate and improves working of internal organs 6
Holistic healing of the physical body and soul (spirit) Healing with use of scent (aroma) and touch (body massage) Aroma (smell) triggers an area of the brain called the limbic system. When stimulated, it releases endorphins, neurotransmitters and other feel good chemicals, Aromatherapy Relaxation and stress relief Enhance mood Used with massage it promotes relaxation Extracts come from plants trees, flowers and roots Used for thousands of years Massage Massage is to work and act on the body with pressure. Massage techniques are commonly applied with hands, fingers, elbows, knees, forearms, feet, or a device. The purpose of massage is generally for the treatment of body stress or pain. A person who was professionally trained to give massages was traditionally known as a masseur (male) or a masseuse (female). The title massage therapist has been recognized as a business norm. In professional settings', clients are treated while lying on a massage table, sitting in a massage chair, or lying on a mat on the floor. In amateur settings, a general purpose surface like a bed or the floor is more common. Aquatic massage and bodywork is performed with recipients submersed or floating in a warm water therapy pool. 7
Reiki Reiki is a Japanese technique for stress reduction and relaxation that also promotes healing. It is administered by "laying on hands" and is based on the idea that an unseen "life force energy" flows through us and is what causes us to be alive. If one's "life force energy" is low, then we are more likely to get sick or feel stress, and if it is high, we are more capable of being happy and healthy. The word Reiki is made of two Japanese words Rei which means "God's Wisdom or the Higher Power" and Ki which is "life force energy". So Reiki is actually "spiritually guided life force energy." "spiritually guided life force energy." treats the whole person including body, emotions, mind and spirit creating many beneficial effects that include relaxation and feelings of peace, security and wellbeing Reiki is not dependent on belief at all and will work whether you believe in it or not Mikao Usui, the founder of the Reiki system of natural healing, recommended that one practice certain simple ethical ideals to promote peace and harmony, which are nearly universal across all cultures 8
Hypnosis The induction of a state of consciousness in which a person apparently loses the power of voluntary action and is highly responsive to suggestion or direction. Its use in therapy, typically to recover suppressed memories or to allow modification of behavior by suggestion Hypnotherapy is a use of hypnosis in psychotherapy. [84][85][86] It is used by licensed physicians, psychologists, and others. Physicians and psychologists may use hypnosis to treat depression, anxiety, eating disorders, sleep disorders, compulsive gambling, and posttraumatic stress, [87][88][89] while certified hypnotherapists who are not physicians or psychologists often treat smoking and weight management. Hypnotherapy is a helpful adjunct having additive effects when treating psychological disorders, such as these, along with scientifically proven cognitive therapies. Hypnotherapy should not be used for repairing or refreshing memory because hypnosis results in memory hardening, which increases the confidence in false memories. means of communicating with the "unconscious" or "subconscious" mind focused (conscious) attention upon a dominant idea (or suggestion "sub hypnotic", "full hypnotic", and "hypnotic coma" stages useful tool for managing painful HIV DSP because of its history of usefulness in pain management, its long term effectiveness of brief interventions, the ability to teach selfhypnosis to patients, the cost effectiveness of the intervention, and the advantage of using such an intervention as opposed to the use of pharmaceutical drugs Addictions [92][93] Age regression hypnotherapy (or "hypnoanalysis") Cognitive behavioural hypnotherapy, or clinical hypnosis combined with elements of cognitive behavioural therapy [69] Ericksonian hypnotherapy Fears and phobias [94][95][96][97][98][99] Habit control [100][101][102] Pain management [103][104][105][106] Psychotherapy [107] Relaxation [108] Reduce patient behavior (e.g., scratching) that hinders the treatment of skin disease [109] Soothing anxious surgical patients Sports performance [110][111] Weight loss [112][113][114] IBS, tricholamania, etc Ukhypnosis.com 9
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