By Thomas Meade, E.A.M.P, Dr. Mitzi Ferrill, D.C., and Laura Mills, L.P.T.

Did you know that most people will experience some chronic pain at some point in their lives? For example, more than 80% of the population have or will experience low back pain. Pain has always been a difficult problem for humans to fix or cope with and our current medical systems are trying to keep pace with rising rates of pain and illness. Our medical system is based in concepts of mechanics: if a part is broken- fix it; if there is too much of something- remove it; or if there is something missing- add it. Modern medicine has flourished on this linear thinking to the point where many in society believe that we should simply take a pill when something is wrong, or cut something out when it shouldn’t be there.

The body is much more nuanced in its functions and this linear approach can only take healthcare so far. For example, pain medication can block a pain signal, or augment the experience of a pain signal, or reduce inflammation that is causing pain; but that pill only masks and does not address the root cause of the pain. Unfortunately, chronic pain literally changes the brain- the brain rewires itself over the course of a long period of pain to expect that the pain will be there and the nervous system obliges. The opioid epidemic is rooted in this idea that you take the pill and feel better- and we have been conditioned to believe that medications are the first answer to health problems. Taking a pill for pain cannot help the brain and nervous system return to its pre-injury state- other treatments are needed to help the body heal itself. Most importantly, pain medication does not help the body engage its natural ability to heal itself and can actually hinder this process.

The good news is there are other practices in medicine that do help to facilitate the body’s ability to heal and regenerate. One major step in reducing our reliance on pain medications like opioids (and thus reducing the opioid epidemic) will be reconditioning ourselves to first look to Conservative Therapeutics, rather than medications that often mask a problem instead of fixing it. You may be wondering what makes a treatment conservative? These are treatments where the risk of adverse side-effects is low in comparison to high chances of improvement: low-risk and high reward. Opioids are the opposite- high risk and temporary reward.

Conservative therapeutics are incredible tools for restoring health and function. It may seem whimsical and far-fetched to think that a highly effective treatment with low risk exists, but remember; we are all conditioned to look for the easy button, or in this case, the easy pill. Conservative therapeutics do require some effort- a patient has to go to the medical therapists and do the work to heal. But the reward is worth the effort and lack of negative side effects. Conservative treatment is meant to be less aggressive, less invasive, and in the context of our times, opioid-sparing. Conservative treatment is also individual- what one person needs for their recovery is different than someone else with the same condition. Furthermore, an individual’s choices also play a role. Diet and life-style changes in conjunction with conservative treatment can maintain long lasting results. The conservative therapeutics highlighted in this article are readily available and widely covered by insurance: Acupuncture, Chiropractic Care, and Physical Therapy. Each of these medical disciplines interact and affect pain in different ways.

Acupuncture is the insertion of very small needles into specific points in the soft tissue of the body. Acupuncture helps to reduce pain with subtle stimulation of the nervous system to release our feel-good chemicals, like endorphins and oxytocin. At the site of the needles, there is a local reduction in inflammation and increased blood flow that promotes tissue health. Lastly, there is evidence that shows acupuncture can help the brain rewire its tendency towards chronic pain.  A 2017 study of acupuncture for carpal tunnel syndrome found changes in the white matter of the brain (using MRI) in patients who received acupuncture for their wrist pain (https://pubmed.ncbi.nlm.nih.gov/28334999/). Acupuncture is a very a safe procedure when performed by a qualified and licensed acupuncturist and has the added benefits of reduced stress and overall improved health.

Another branch of conservative treatment is Chiropractic care. Chiropractic adjustments are specific motions applied with controlled force to the joints of the body. These manipulations are great for the musculoskeletal system- helping to improve joint function and mobility, increase range of motion, breakdown scar tissue/ adhesions, and decrease muscle tension. Adjustments increase blood flow to manipulated tissue, promoting healing and slowing joint degeneration that comes with age and overuse. Chiropractic care also directly affects the nervous system, by improving neuromuscular functioning and decreasing pain. The goal of every Chiropractic treatment is to help the body adapt to the physical stresses of everyday life, reduce pain by addressing the root causes, and allow the body to move and function the way it’s meant to – freely, and without pain.

One more healthcare profession that conservatively manages pain is Physical Therapy. Physical Therapy is a vast field of physical medicine with therapists specializing in different regions of the musculoskeletal system or just neurology. Physical Therapists work in a variety of healthcare settings and may see patients before or after surgeries, after strokes or major injuries, or individuals suffering from chronic pain. Physical Therapists use a variety of modalities to help rehabilitate patients and reduce pain. These include (but are not limited to) myofascial release, soft tissue manipulation, stretching, ultrasound, functional movements, and exercise. The benefits of Physical Therapy for chronic pain include reductions in use of pain medication; increased strength, stability and range of motion; and less pain with movement. Physical Therapy patients tend to maintain higher levels of activity and exercise, and research shows that these improvements in movement can have long-lasting impacts on our physical and mental health.

With the high probability of improvement in health and the low risk of adverse effects, acupuncture, chiropractic care, and physical therapy are all worthwhile treatment modalities for you to consider. Don’t just reach for the pain medications, meet with local practitioners of these conservative therapeutics in our area to learn how they can help reduce your pain and get you on the path to feeling great.

Thomas Meade is a licensed acupuncturist and owner of Skamania Acupuncture Clinic & Yoga Studio. Dr. Mitzi Ferrill is a Doctor of Chiropractic and owner of Skamania Chiropractic and Rehabilitation. Laura Mills is a licensed Physical Therapist who practices throughout the Gorge.