LAMORINDA WEEKLY | Ways to Reduce Your Pain Without Medications


Dr. Richard C. Shinaman, of Pain Medicine Consultants, is board certified in anesthesiology and pain medicine. Dr. Shinaman trained in anesthesiology and critical care medicine at Stanford University. He completed an accredited pain medicine fellowship at the Mayo Clinic. He has been a very busy and valued member of the medical community in Northern California for over a decade. His overall goal is to try and help people to suffer less and live more. He has published book chapters and a number of scientific articles on the treatment of painful diseases and how to treat them. More information can be found out about his current medical clinic at painmedicineconsultants.com. Most patients can request a consultation through the online web portal. His practice contact number is (925) 287-1256.

In the face of an ongoing effort for state and federal governments to limit access to opioid containing pain relieving medications, a number of guidelines have been recently enacted that recommend that doctors prescribe less or even no pain medication. Many patients find that despite years of pain relief from pain medications, their doctors are suggesting that they stop their medication or even refuse to prescribe them anymore. Primary care doctors in particular have become very reluctant to prescribe any pain medication to even long-term patients.

Many patients want to know what to do and how they can treat the pain conditions that they have in light of these new recommendations and restrictions. All too often, we have found that a patient is asked to reduce or stop the amount of medication they are taking, but the doctor does not have enough time to review alternative treatments that may replace the use of the pain medications that the patient relied upon in the past. The following are two of several options to alleviate pain without medications. I'll highlight additional options in future Lamorinda Weekly issues. I hope that the information below can be helpful to patients looking for ways to reduce pain from any number of pain related conditions.

Number One: Move Your Body

When we hurt, we tend to move less. Over time moving less leads to contracted muscle and more spasm. It is important to remember that we don't all have to be Arnold Schwarzenegger. Generally, we all try to do too much at one time. What counts most is moving the muscles consistently each day.

Our bodies have been designed to have muscles that contract and extend many times per day. There are lots of types of activity that can achieve the same goal so I recommend finding some type of movement that appeals to you personally. Activities such as dancing, yoga, tai chi, Pilates, and even swimming all have a lot of the same types of motion involved.

Several studies have shown that tai chi and swimming may be the best sorts of activity for people with painful conditions, and have also shown that doing these exercises outside is very good for physical and mental health. It seems that human beings do better in many ways when we are outside in the natural world, so starting a simple activity like going for a walk with some stretching outside can do quite a bit in regard to relieving pain. Certain conditions may limit your ability to walk longer distances, but if this is the case it is important to still use parts of the body in ways that you can manage.

Several local community centers have classes on "chair yoga" or other low impact activities. If you are able to do more and want a bit more of a challenge, then high intensity training may be very good for your muscles, your heart, and your brain. Researchers have concluded that short periods of very intense exercise can ultimately result in better gains for people over the long term. There are several apps and books discussing this type of exercise further.

Number Two: Mindfulness Approaches

Most of us that grew up in a busy locale such as the Bay Area got used to hearing "Don't just sit there, do something!" Nevertheless, when I am trying to discuss alternative healing techniques with my patients I like to remind them "Don't just do something, sit there."

We all need time out from our frantic and hectic world that surrounds us. Mindfulness exercises are easily one of the easiest, least expensive, and effective techniques for almost all modern medical conditions including stress, insomnia, and chronic pain. Many people have preconceptions about meditation or mindfulness training, but it is important to know that the practice is not based on religion and there is no "perfect" way to do it.

My own research at Stanford University showed that what matters most is consistency of practice. Believe it or not, simply sitting and concentrating on the breath while not allowing oneself to be constantly distracted results in clear and long-lasting health benefits. Regular mindfulness practice results in less pain, better sleep, and fewer incidence of stress related events like heart attacks and strokes.

There are a large number of techniques to try and I have found that most people should try a few different types of techniques until they find one that appeals to them. There are a large number of books, audio recordings, and even smart phone apps that can be used to guide the way.

Breathwork is one technique that many people may find helpful if regular sitting "feels boring" or if someone feels that they need "something to do" rather than just sit. I often recommend heart rate variability sensors as a tool to help people learn the right type of techniques for "active relaxation." Our clinical experience is that guided imagery, body scan meditations, and loving kindness-based meditations tend to work the best for pain-related conditions.

The term metta refers to the concept of cultivating warm and compassionate interactions between all living things. I think that if each of us worked just a little to bring more metta into each of our daily interactions we would all suffer from less typically Western stress-based illnesses.

Disclaimer: The opinions and statements above are the opinion of Richard Shinaman, MD and are not intended to diagnose or treat any patient or person with a medical condition. No person can determine what might be best for you as an individual without evaluating you and hearing your individual story. Everyone is different. Using any or all of the techniques described is done so at your own risk. You should discuss starting or stopping any treatment with your own medical provider. Only you are ultimately responsible for your own health.