Specialized clinics combine traditional and alternative therapies for treating fibromyalgia and chronic pain. Discover new ways to overcome pain.
Open the newspaper or flip on the TV and you'll see accolades for doctors' many miraculous abilities. They can separate conjoined twins, reattach severed limbs, and shuffle organs between patients like peas in a shell game. But sit down with someone whose body is racked with the pain of osteoarthritis, migraines, or fibromyalgia, and the shortcomings of traditional medicine become blindingly clear. The humbling fact is that at least 50 million Americans live in chronic pain, and the vast majority are pretty much at its mercy. The hallmarks of daily life—work, sleep, raising families—become enormous challenges, and as if that's not enough, most pain patients also grapple with depression. "Chronic pain can swallow you up and steal your identity," says Penny Cowan, founder and executive director of the American Chronic Pain Association in Rocklin, California. "So many of us base who we are on what we do, on our abilities. When that is taken away, you become an un-person." Unfortunately, chronic pain patients have traditionally been the Achilles' heels of Western medicine. They're hard to diagnose—pain is by its nature subjective, and can't be located on an X-ray or under a microscope—and conventional treatments are fraught with risk. And painkillers like nonsteroidal anti-inflammatories, opioids, and morphine come packaged with a slew of side effects as well as some addictive properties, which can be more disruptive than the pain itself. No wonder pain sufferers are often perceived as "difficult": Who wouldn't get cranky under such frustrating circumstances?
The uneasy relationship many chronic pain patients have with doctors is driving them into the arms of alternative healers. In fact, pain is the number one reason people use alternative medicine, according to the Journal of the American Medical Association. Some therapies, such as acupuncture, biofeedback, and massage, are scientifically proven to reduce certain types of pain, while others, like reiki and meditation, can help a person get a handle on the emotional demons that chronic pain unleashes.
But while it's tempting to paint a two-dimensional picture—conventional medicine bad, alternative medicine good—it's also dangerously simplistic. A naturopath who tells a patient her pain will vanish with the right combination of supplements is just as irresponsible as a doctor who dashes off a prescription for opiates before running out the door. If ever there was a condition that calls for a truce between the two schools of thought, it's chronic pain.
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Enter James Dillard, a specialist in integrative pain management and the author of The Chronic Pain Solution. Trained first as an acupuncturist and chiropractor and only later as a physician, Dillard believes an integrative approach is especially important for people who struggle with chronic pain. "Because they suffer on so many levels—physically, emotionally, and psychosocially—you can't treat chronic pain with a single therapy," he says. "You have to have a compassionate, healing relationship with the whole person."
That's precisely what patients can expect at the Center for Health and Healing at Beth Israel Medical Center in Manhattan, one of several integrative pain clinics across the country, where Dillard practiced until recently. (He has since taken a position at Columbia University School of Medicine.) There, in serene feng-shuied offices high above the Midtown bustle, general practitioners, internists, and psychotherapists share space and information with acupuncturists, aromatherapists, and reflexologists. And the payoff is more than just feel-good reassurance. "By using conventional pain tools judiciously and adding complementary therapies," Dillard says, "you can lower drug dosages, reduce side effects, and often bring down medical costs."
Dillard's patients run the gamut from Upper East Side matrons to Lower East Side artists, and at the core of his approach is an open mind. "You don't have to wear robes, chant, or drink wheatgrass juice," he says. "Just take conventional medicine and shove it a little to the left."
Or shove alternative medicine to the right. In fact, Dillard often leans heavily on prescription drugs in the early stages of treatment. "Sometimes they're absolutely necessary just to get people going again and give them hope that they can feel better," he says. Once the pain has receded from center stage, Dillards brings up complementary pain management tools, such as acupuncture, chiropractic, meditation, and biofeedback. By covering all the bases—calming the mind, stretching the muscles, soothing inflammation, and manipulating the skeleton—Dillard hopes to begin addressing pain at its roots instead of just muffling its voice with painkillers.
Below are stories of three of Dillard's patients, all of whom suffered years of torment before finally getting a grip on their pain. By the time they got to the Center for Health and Healing, some had already begun to experience relief by way of alternative therapies they'd found on their own. In all cases, Dillard added some essential ingredients to the mix, and sent his patients on their way with tools for weathering the inevitable storms that chronic pain can stir up. Even the integrative approach is no easy fix—but for some it's clearly the best chance medicine has to offer.
In 1995, Fred Kramer, a 44-year-old registered nurse, was in a minor auto accident from which he walked away unhurt. Or so he thought. The next morning, his left shoulder was in such pain that he could barely move his arm, so he tossed back a couple of Motrin, put on an ice pack, and called in sick. After a couple of days on the couch, however, he grew impatient and hauled himself back to work, still in pain.
Two months after the accident, the searing pain had put an end to all but the mildest activities. On a friend's suggestion, Kramer saw an orthopedic surgeon, who sent him home with the pat advice to "give it time." But in the end, time became Kramer's biggest enemy.
A year after the accident, a coworker casually suggested Kramer's injury might be myofascial pain syndrome (MPS). Often accompanying another injury, MPS results when muscles lock themselves into place to protect a part of the body from injury, forming a shield of sorts. Over time the tension slows circulation to the muscles. Without sufficient blood, the cells become starved for oxygen, and strained nerves send the brain increasingly loud pain signals. As the muscles tighten, so do the surrounding sheaths of tissue, called fasciae. Unless the muscles are coaxed back into relaxing soon after the injury, the initial problem can spiral into greater levels of pain and continuing loss of mobility.