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Exploring Alternative Treatment Options for Chronic Pain: My Journey Begins

It's been a while since I have written an article. I have been looking for what's next in my treatment plan. In the last 5 months, I caught myself having self-doubt about how well I am really feeling and where the flares are coming from. I switched to Rinvoq to try a whole new family of PsA medications called JAK inhibitors. JAK inhibitors or Janus Kinase, like many of their counterparts, aim to reduce inflammation. Since starting Rinvoq, I never felt like I was “better”. I still have pain, I am still tired and my skin seems to be on the edge of a flare every day. Living in the day to day of your symptoms, it is some times hard to tell how you are really doing and what is and is not working. My labs have almost never been helpful but luckily my doctor takes great notes and is able to compare how I am feeling one visit with another to check for subtle improvements. At my last appointment, she told me just that. Your exam shows LESS areas of pain and little to no swelling. Even though I didn’t feel better, I am better. You might be thinking but if you don’t feel better, are you better? I honestly do not know if I am better, I think I am some days and some days I am not. Now that we have a medication showing promise and with some improvement, its time to figure out why else I am in pain. 


Alternative Treatments for Chronic Pain


Over the last year I have been exploring alternative treatment options to leverage in addition to my medications. I tried chiropractic care, added supplements and vitamins to my routine, started looking at my diet and food sensitivity, then explored exercises and physical therapy to reduce neck pain. With each of these I have seen incremental improvements. In January, my doctor pointed me to Functional Medicine and suggested I try acupuncture. I plan to break each of these out into their own articles detailing my experience. I am not an expert in any of these areas, so please do your own research. 


Chiropractic Care

Chiropractic care focuses on musculoskeletal health. Chiropractors use techniques like spinal alignment and soft tissue manipulation to reduce pain. (1) I went to a chiropractor to see if it would help relieve chronic back and neck pain. I went for over a year every 1-3 weeks. It did really help for a long time. I got instant relief in my neck and felt like my body moved more freely. When I dislocated a rib and had tightness in my chest wall from coughing with covid, they helped me get my rib back in place and showed me stretches to help relieve the tightness. Last fall though I started get migraines almost immediately after leaving the chiropractor. I often go to the grocery store right after since it is next door and by the time I would start shopping I would have a migraine aura. After a few sessions like that, I decided to call it quits and look for something new. 


Food Sensitivity

Food sensitivity is when your digestive system has trouble digesting some foods resulting in side effects like gas, bloating and diarrhea. Unlike food allergies, which involve an immediate immune response, food sensitivities often result in delayed reactions and can be harder to identify. They may contribute to chronic inflammation and can aggravate the gut or immune system, potentially leading to or exacerbating autoimmune disorders. (2)

In a future article, we will dive into the AIP diet, sensitivity testing, how my results compared between two different testing kits and how 


Functional Medicine

Functional medicine is an approach to medicine to look at the root cause of your disease and find out which one came first versus treating all the symptoms. The origin of the disease, the environment the symptoms first happened in and how you respond to them are all said to contribute to the future of your disease and other comorbidities. Functional medicine looks at how a one condition could have multiple causes and one cause could result in many conditions. The approach here is to “Gather, Organize, Tell, Order, Initiate, and Track” (3) and identify pattens and incremental changes that can transform the patients health. 


In a study from 2020, patients with Psoriatic Arthritis who leveraged functional medicine in conjunction with their normal medical care saw improved outcomes. (4)


Traditional Chinese Medicine

Traditional Chinese Medicine is an ancient practice in China that is based on the flow of Qi in your body. “The flow of qi through the body occurs within a closed system of channels, or meridians. There are 12 major meridians, and they correspond to the 12 organ systems: six yin organs and six yang organs. Traditional organ theory pairs yin and yang organs according to their structure and function and the interconnection of their meridians (5)” .



One of the main treatments in Chinese medicine is acupuncture. In acupuncture thin needles are inserted along the meridians that align with your symptoms. Acupuncture can relieve pain and restores energy flow throughout the body which in turns relieves pain, and increases organ function. 


Cupping is often used in combination with acupuncture. Cupping is done by placing suction cups along the meridians, likely where you just had acupuncture. Cupping is thought to increase blood flow which reduces inflammation and pain.


For me acupuncture and cupping promote relaxation I get with nothing else, reduces stress and anxiety and provides a dramatic decrease in pain and in tension in my back, neck and shoulders.


Vitamins, Supplements and Herbs

Both eastern and western medicine look at deficiencies int he body and prescribe vitamins, supplements and herbs.


You may have low Vitamin D levels like many with chronic pain, repeat infections and autoimmune disease and take Vitamin D pills or drops every day.


Turmeric is a common herb prescribed to those with inflammatory diseases. Turmeric naturally reduces inflammation in the body. Turmeric has been recommended to me by practitioners in rheumatology, Chinese medicine, physical therapy and functional medicine.


Probiotics and prebiotics are hot on the market today. The idea that your gut needs good bacteria to help against the bad bacteria is again talked about many areas of the health community. A lot of medications those with chronic conditions take, like antibiotics, decrease the amount of good bacteria you have in your body leading to other problems like yeast infections.


Chinese medicine uses many different herb blends, teas and oils to treat various organ systems. What herbs you get aligns to where you are seeing symptoms is aligns to the rest of your treatment plan. For example is you are there for asthma, your acupuncture is going to target your lung meridian.


There many more supplements that you can take to improve your health. It is important to talk to a health professional about what might help you. Taking the wrong ones can have a negative impact on your health and even conflict with medications you are taking.


Physical Therapy

Did you know that we sometimes move the wrong way? You may have had an injury or have some muscles that are stronger than others and your body may compensate for a weak left ankle with more use of the right ankle and hip or maybe you don't use your hamstrings like me and use your lower back for everything. Learning the right way to move and where you can improve weak unused muscles groups can have a significant reduction in pain.



Conclusion

Our bodies are complicated and for many of us with chronic diseases one medication or treatment is not going to cut it. After years of relying solely on western medicine, it is time for me to look at alternative treatments for chronic pain. This year my goal is to identify multiple reasons for my chronic pain and see if other treatments like acupuncture in combination with my medications can increase my quality of life. Stay tuned for more articles diving deeper into these areas and my experience with them.


References

  1. Mayo Clinic Staff. (n.d.). Chiropractic adjustment1. Mayo Clinic. Retrieved December 7, 2023, from https://www.mayoclinic.org/tests-procedures/chiropractic-adjustment/about/pac-20393513

  2. Cleveland Clinic. (n.d.). Food Intolerance: Symptoms, Causes and Treatment Options. Retrieved December 7, 2023, from https://my.clevelandclinic.org/health/diseases/21688-food-intolerance

  3. Institute for Functional Medicine. (n.d.). What is functional medicine? Retrieved from IFM website

  4. Droz, N., Hanaway, P., Hyman, M., Jin, Y., Beidelschies, M., & Husni, M. E. (2020). The impact of functional medicine on patient-reported outcomes in and inflammatory arthritis: A retrospective study. PLOS ONE, 15(10), Article e0240416. https://doi.org/10.1371/journal.pone.0240416

  5. Novotny, D. A. (2016, May 17). Meridian system description chart male body. Accent on Health Wellness. Retrieved from https://accentonhealthwellness.com/acupuncture-relieves-heartburn-acid-reflux/meridian-system-description-chart-male-body/

  6. Sears, B. (2024, February 19). An Overview of Physical Therapy. Verywell Health. Retrieved from https://www.verywellhealth.com/physical-therapy-4014670




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