RE: NEWS: Painkiller alerts give alternatives a boost

January 11, 2005

Just wanted to let everyone know that last night my son and his wife had a

little boy. His name is and he weighed 8 lps. 4 oz. and he is 22

inches long. I think he is going to be tall.

Lynn MeMom

Original Message:

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From: a54 a54@...

Date: Tue, 11 Jan 2005 09:30:34 -0500

Subject: [ ] NEWS: Painkiller alerts give alternatives a boost

Painkiller alerts give alternatives a boost

BY JANUARY W. PAYNE

THE WASHINGTON POST

January 11, 2005

Gwenn Herman knows chronic pain - the backaches, stiffness and freezing of

her neck after her 1995 car accident, the pain that didn't respond, or

responded inconsistently, to prescription and nonprescription painkillers.

That's why she learned, long before last month's rash of safety alerts about

three commonly used pain medications, to explore alternative treatments like

meditation, guided imagery and breathing exercises. Today, she teaches the

techniques to support groups sponsored by the Pain Connection, a Potomac,

Md.-based nonprofit she runs.

" What works for one person doesn't work for another, " Herman said. " The more

alternatives, the better. "

That view is likely to find more adherents after last month's crush of

sometimes-conflicting reports linking the highly advertised pain drugs Vioxx

and Celebrex and, more recently, the popular over-the-counter painkiller

Aleve (naproxen) to potentially life-threatening side effects. The safety

concerns led to Vioxx's removal from the market at the end of September and

the halting of a major clinical trial for Celebrex last month.

See a doctor

Experts advise patients not to stop pain medications without consulting

their doctor, noting that further analysis of the data is needed, and

acceptable health risks must be evaluated individually. The drugs now

subject to so much publicity may remain the best choices for some patients.

Palliative effects of some of these techniques, like meditation, have been

shown in several studies. Other methods, like guided imagery, so far tend to

rest on anecdotal evidence.

Debate on effectiveness

Still to be established is to what extent any of the treatments can

effectively relieve the chronic, often daily pain of those with such

conditions as arthritis, severe headaches, lupus and fibromyalgia.

Pain sufferers confused or upset by recent painkiller news got a small dose

of hope last month from a study funded by two branches of the National

Institutes of Health: the National Institute of Arthritis and

Musculoskeletal and Skin Diseases and the National Center for Complementary

and Alternative Medicine. That study found that acupuncture - a

2,000-year-old Eastern practice that involves insertion of thin needles at

specific points on the body - appeared to help relieve pain and improve

function for knee osteoarthritis.

The large study, in the ls of Internal Medicine, assigned about 190 of

570 patients ages 50 and older to receive acupuncture. By Week 8, these

participants functioned better than those receiving sham acupuncture or

educational therapy. By Week 14, those who were getting acupuncture reported

less pain than the others, but the sham treatment group also reported pain

reduction, at a slightly lower level.

Researchers plan to analyze data to see whether pain relief with acupuncture

was reduced or eliminated need for pain medications. " From clinical

experience, that's what we do think is happening, " said study author

Berman, director of the University of land School of Medicine's Center

for Integrative Medicine. " They may need less of the medication, which may

mean less side effects. "

There are other basic steps that doctors and experts say may help ease pain.

Weight loss, for example, can help relieve the pressure on arthritic joints,

according to the National Institute of Arthritis and Musculoskeletal and

Skin Diseases. Several non-drug approaches besides acupuncture that some

doctors regard as helpful - or at least promising - are listed below. But

pursuing alternative treatments in place of necessary conventional care can

create additional dangers. Experts advise against stopping or starting any

therapy - traditional or alternative - without consulting a physician.

Mind-body therapies

Meditation: Some studies suggest that meditation may relieve pain from

arthritis and other conditions, but the pain relief reported by participants

also could have resulted from other therapies they were receiving. Clinical

trials are investigating the pain-relieving effects of meditation on

patients with rheumatoid arthritis and other chronic conditions.

Biofeedback: This technique teaches patients to control functions such as

heart rate, muscle tension, breathing, skin temperature and blood pressure

to relieve stress and chronic pain. Sensors track changes in pulse, skin

temperature and muscle tone, among others, and signal patients. Biofeedback

therapists teach patients to recognize such changes on their own.

Biofeedback has been shown to be helpful in treating about 150 medical

conditions, including migraines, arthritis and fibromyalgia, according to

the Mayo Clinic.

Hypnosis: " You can learn to change the perceptions of pain, " said

Weil, professor of internal medicine and director of the Program in

Integrative Medicine at the University of Arizona. A clinical trial funded

by the National Center for Complementary and Alternative Medicine is

exploring whether hypnosis and other nontraditional therapies can ease

muscle tension in children with spastic cerebral palsy. Studies suggest

hypnosis helps patients with many different types of pain, including low

back, tension headache, osteoarthritis and chronic pain. But larger,

better-designed studies are needed to confirm early findings, according to

Harvard Medical School, through its online partner Aetna InteliHealth.

Cognitive behavioral therapy: " Thoughts and emotions can affect pain, "

Berman said, so cognitive behavioral therapy - a kind of talk therapy that

helps people recognize and change negative behaviors - may help relieve the

depression, stress and chronic pain that can accompany disabling diseases.

Duke University researchers have developed a talk therapy program for

arthritis patients and their spouses to see whether this helps patients cope

with the disease. They are exploring whether aerobic fitness or coping

abilities decrease pain or disability.

Hands-on treatments

Exercise and movement therapy: A regular program of physical movement

sometimes helps in relieving pain. But patients should use care when

selecting a workout regimen, as overexertion can cause additional pain,

according to the Institute of Arthritis and Musculoskeletal and Skin

Diseases. Light exercise, physical therapy, pool exercise and " movement

therapies " such as t'ai chi are recommended as good starting points.

Osteopathic manipulation: Manipulation of the joints " restores the normal

range of motion of a particular joint, [and] can restore the normal blood

flow and drainage to an area, " said Dr. Levine, an osteopath in New

Jersey and a member of the board of trustees for the American Osteopathic

Association. Growing evidence suggests that osteopathic manipulation may

ease low back pain and may aid various other conditions, including

depression, fibromyalgia, menstrual pain and neck pain, according to

Harvard.

Chiropractic treatments: Spinal manipulations, focusing on the relationship

between the body's structure (primarily of the spine) and function, are

mainly used to treat musculoskeletal conditions.

Harvard counts at least 150 published studies or case reports on

chiropractic manipulation therapy for low back pain, but many are poorly

designed, and results are mixed.

Several studies also have shown pain relief for patients with tension or

migraine headaches, but most of these studies also were poorly designed,

according to Harvard.

Massage: The stroking or kneading of sore muscles by a therapist can

increase blood flow to painful areas, sometimes providing relief, according

to the Institute of Arthritis and Musculoskeletal and Skin Diseases. But the

therapist should be trained in handling arthritis.

For more information

Find more information about alternative and non-drug pain relief therapies:

National Center for Complementary and Alternative Medicine,

www.nccam.nih.gov.

Offers treatments, research findings, safety advice for choosing herbal

supplements and tips for selecting a practitioner. The NCCAM Clearinghouse

(888-644- 6226) will answer general questions but not provide medical advice

or physician referrals.

Office of Dietary Supplements, www.ods.od .nih.gov

An arm of the National Institutes of Health, ODS has fact sheets on dietary

supplements. The office does not have a public information clearinghouse and

advises patients to consult their doctors for advice.

Mayo Clinic's Complementary & Alternative Medicine Center, www

..mayoclinic.com (Under " Health Centers " heading on left side of screen,

scroll down and select " Complementary & Alternative Medicine " ).

Provides information on a variety of therapies as well as advice on herbs

and supplements. Addresses safety concerns and which therapies are commonly

used for specific conditions.

- The washington post

January 11, 2005