Aromatherapy

(source : Managing Chronic Pain) Reflexology This therapy like acupuncture, represents a revival of an ancient practice. The therapy is based on the idea that every part of the body has a reflex point in the foot and hand. Therapists use their fingers and hands to produce simple, safe pressure. When an area of tenderness is found, the therapist concentrates on that area by pressure in a specific manner to either stimulate or sedate the reflex. It is claimed that the therapy can bring pain relief by normalising organ function and can be particularly useful for dysmenorrhoea, constipation, irritable bowel syndrome, urinary retention and premenstrual symptoms. (source : Managing Chronic Pain) Acupuncture The technique involves placing fine solid needles into the skin at acupoints along energy pathways termed meridians, which are described in classical Chinese medicine. There is evidence that acupuncture needles stimulate sensory nerves in the skin and muscles, and that these signal to the spinal cord and midbrain. This type of stimulation results in pain modulation, probably via the release of the bodys own opioids endorphins. It is also thought that the use of acupuncture may cause the pituitary to discharge pain-blocking chemicals and anti-inflammatory agents into the circulation. Acupuncture should always be conducted by those trained in its art as a range of adverse effects, such as pneumothorax and infection, have been associated with its use. It is a therapy that can be valuable for many conditions other than pain relief (Mann, 1999). (source : Managing Chronic Pain) Laser therapy Low laser light therapy can be used in a variety of acute and chronic pain conditions, although its efficacy has generally not been well demonstrated, partly due to the different types of lasers and different doses used in studies. The magnitude of effect appears to depend on the laser wavelength. Laser therapy appears to have a specific therapeutic effect in posttraumatic joint disorders, myofascial pain and rheumatoid arthritis. It is also used in dental pain conditions. There is moderate but contradictory evidence for and against laser therapy in the treatment of chronic pain. (source: Managing Pain The Canadian Healthcare Professionals Reference) Thermal therapy

Thermal therapy techniques are generally divide into superficial heating techniques, deep heating techniques, and cooling techniques. The effects of heat and cold may be similar in some condition (source: Managing Pain The Canadian Healthcare Professionals Reference) Mobilization and manipulation therapy Manual therapies and exercise remain the most widely utilized methods of treating musculoskeletal pain and disability 1. Mobilization with stretching refers to manual procedures, which attempt to increase the range of motion of a joint beyond the resistance barrier limiting the passive range of motion and therefore the ability to exercise. 2. Manipulation (adjustment) is the application of a high-velocity, low amplitude thrust to the joint, although many practitioners will include low-velocity muscle energy techniques in the definition of manipulation. The high velocity techniques force the joint beyond physiologic range of motion to the anatomical limits of motion. Manipulation may affect pain through a number of possible mechanisms, including : a. Mechanical mechanism (freeing up joint restrictions due to scar tissue, meniscoid/synovial tissue block or muscle tightness) b. Stimulation of joint mechanoreceptors, producing inhibitory effects at the spinal level as well as in central descending inhibitory pathways c. A possible effect on muscle spindle activity, which helps to restore muscle tone d. Endorphin release and facilitation of immune system response Effectiveness of manipulation therapy Some studies have documented that 80 to 90 % of people seek chiropatic treatment for relief of spinal pain and headache. Demonstrating moderate evidence that manipulation is more effective than placebo treatment for chronic low back pain in the short to intermediate term, and more effective than bed rest, usual care by a general practitioner, analgesic or massage in short to intermediate term. (source: Managing Pain The Canadian Healthcare Professionals Reference) Behavioral and cognitive-behavioral therapy In the cognitive-behvioral approach, there is interest in the nature and modification of a patients thoughts, feelings and beliefs regarding his or her pain, as well as modification of the learned behavioral responses to the pain. The primary objectives of cognitivebehavioral treatment programs are to :

1. Assist patients to change their views of their pain and suffering from overwhelming to manageable 2. Teach coping techniques and skills to help the patient adapt to the pain and associated problems 3. Change the patients perspective from one of passivity, helplessness and loss of control over his/her life, to activity, resourcefulness and competence to manage suffering and regain some degree of control 4. Help patients to learn the associations between thoughts, feelings and behaviors and to identify and change maladaptive pain-related behaviors 5. Teach patients specific coping skills, such as distraction, relaxation skills, shaping, pacing, etc 6. Bolster the patients self-confidence to take credit for successful outcomes due to his/her own efforts 7. Help patients to anticipate problems and plan solutions within their abilities. It is important to note that these programs are not designed to eliminate pain, but rather to assist patients to learn to live more meaningful lives despite persistent pain. This is a rehabilitative lifestyle adaptation approach designed to improve quality of life and level of function by regaining a sense of control, by reducing the suffering associated with pain. (source: Managing Pain The Canadian Healthcare Professionals Reference)