Family Issues #7

On Fridays, I’ve been having a series of posts about family issues and your pain. Pain conditions affect not only you, but also your family… your husband or wife… your children… your Mom and Dad… even your friends.

These posts are excerpts from a handout for family members (and friends) of patients with pain that I’ve written with a colleague, Dr. David Kannerstein, who is the lead author.  These excerpts are reprinted with permission from Practical Pain Management, 2007, Vol 7, 48-52.  We’ve written this handout to provide information for family members and to help them with what they’re going through.

You’re invited to copy these posts and discuss them with your loved ones.  If you’d like a copy of the complete handout, information is available at the end of today’s post.

Last week we looked at medication.  This week we answer your family member’s question… What else helps besides medication?

Many other techniques have been found helpful with pain in addition to medication.

• Physical therapy includes exercise and other treatments.  Exercises can focus on strengthening, flexibility, and aerobic or cardiovascular functioning, and must be tailored to the individual to be effective.  Other treatments include heat and cold applications, Transcutaneous Electrical Nerve Stimulation (TENS), ultrasound, and massage.   
• Assistive devices like braces, canes, telephone headsets, and orthotics can help reduce pain.  So can making adjustments in seating arrangements at home or work.  Adjusting the placement of a computer keyboard, for example, can help reduce repetitive strain injuries.
• Surgery is an option when it can address a specific cause of the pain.   For example, some individuals with herniated discs or spinal instability may need spinal fusions (fusing vertebrae together) or discectomies (removal of the disc).  Less invasive surgical options are now available to help stabilize the spine without undergoing a formal fusion.  In addition to spinal surgery, surgery man be indicated to relieve nerve compression, e.g. in the wrist or elbow.
• Surgery may also be used to implant pain-relieving devices such as dorsal column stimulators or spinal medication pumps.  Patients’ and families’ coping strategies are important determinants of successful outcomes in these surgeries, and psychological evaluation is generally important to maximize non-medical coping strategies and chances for the success of the proposed implants.
• Alternative medicine includes a wide variety of approaches including chiropractic care, acupuncture, the use of herbal and other nutritional supplements, traditional techniques including yoga, Tai Chi, and QiGong.  These should be seen as working with and not as opposed to medical treatments, and their use should be discussed with the physician.  (Many herbs, for example, can interact with medications.)
• Psychological interventions can help individuals better cope with pain and can teach techniques to help reduce pain.  Therapy can change negative thinking styles and behaviors.  Through mind-body techniques such as hypnosis, meditation, biofeedback, guided imagery, progressive muscle relaxation and breathing techniques, pain can be reduced and/or the patient’s tolerance for pain can increase.  Mindfulness meditation and acceptance can be very useful.  Additionally, therapy may help the patient identify and stick to an appropriate activity schedule.  Therapy can be helpful for any patient with pain, and can be crucial if significant emotional distress, with anxiety and depression, has developed.

Successful coping with pain requires time, patience and persistence.  Finding health practiioners that are very familiar working with patients with pain is crucial.  And making sure that each person on your family member’s health team is aware of what everyone else is recommending is important, so the whole care plan can be right for your family member.

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Next Friday… Family Issues #8: How can I tell how my loved one is doing?  And, What should I ask the doctor?

You’re welcome to copy this handout from this site, with a notation that it’s from www.howtocopewithpain.org.  For a copy of the complete handout, you can contact my co-author Dr. David Kannerstein at dkanner@comcast.net.  David Kannerstein is a psychologist in private practice with Margolis Berman Byrne Health Psychology in Philadelphia and SRI Psychological Services in Jenkintown, PA.  He specializes in helping individuals and their families manage chronic pain.

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