The National Academy of Medicine estimates that 100 million Americans now have some form of chronic pain. Just to put this number into perspective, around 25.8 million Americans have diabetes, and another 11.9 million suffer from cancer. Yes, you read that correctly; there are more chronic pain sufferers in the USA than cancer and diabetes patients combined.
Unfortunately, many chronic pain sufferers seek relief through legal and illegal opioids. Medical authorities now believe 90 people die of an opioid-related overdose every day in the USA. These staggering figures prompted President Donald Trump to declare the opioid epidemic a national health emergency.
So, how did this problem start and, more importantly, what can be done to reverse this troubling trend? Most experts believe the roots of the opioid crisis can be traced back to the 1990s. During the 90s, doctors started prescribing opioids more often to chronic pain patients. A study in the 80’s stated that “the development of addiction is rare in medical patients with no history of addiction”. Ever since the 90s, however, the rate of opioid-related deaths has only increased, and more evidence shows that these drugs are indeed habit-forming. We also now know that people who misuse opioids are far more likely to transition to harder drugs like heroin. About 80% of people who try heroin today have first misused prescription opioids.
The mind-body alternative: A new prescription for pain?
While there has been a steady flow of new research on the dangers of opioid addiction, there’s also a surge of research being published on effective alternative treatment techniques for chronic pain sufferers that are safe and non-invasive.
One of the most influential doctors in bringing mind-body techniques to pain treatment was Dr. John Sarno. Dr. Sarno, who worked as a doctor at New York University until his death in 2017, is perhaps best known for his book, Healing Back Pain. In this book and others, Dr. Sarno developed the theory of tension myoneural syndrome (TMS) to explain and treat chronic pain conditions. Sarno believed that a majority of chronic pain cases in the USA were psychosomatic in nature and caused primarily by emotional blockages. He went on to develop this theory in works such as The Divided Mind and The Mindbody Prescription.
Since Sarno believed back pain had as much to do with the mind as with the muscles, he told the majority of his patients to become more aware of their thoughts, journal every day, and continue their daily activities despite the physical sensations of pain. Sarno never said the pain his patients experienced wasn’t “real”. Instead, he believed the brain created the pain in another area of the body as a distraction from consciously processing strong emotions.
Perhaps Sarno’s greatest contribution to modern medicine was the re-evaluation of the important role emotions play in our physical well-being. And while Sarno’s ideas were met with some skepticism early on, there are many doctors, such as Srini Pillay, MD, who agree that people with chronic back pain often have psychological issues linked to their pain rather than physical abnormalities. Research published in the Journal of General Internal Medicine also shows that a mind-body approach to chronic pain results in “an immediate decrease in pain level, similar to what one might expect when using opioids.” Again, Sarno’s approach doesn’t mean that nothing is related to biomechanics, but it certainly highlights the importance of the brain’s role in the treatment of chronic pain.
Mind-body therapy: The answer to America’s chronic pain problem?
In addition to Sarno’s research, scientific studies have consistently shown the effectiveness of treating chronic pain with “mind-body therapy”, which is the name for a treatment approach that combines cognitive behavioral therapy techniques with education on the science of pain, journal writing, mindfulness meditation, and other “brain training” techniques.
In one study published in The Journal of Pain, Acceptance and Commitment Therapy (ACT), which focuses on behavior change instead of pain reduction, showed positive results and improvements in about 65% of study subjects who suffered from chronic pain. Another study published in Advances in Psychiatric Treatment showed that expressive writing resulted in many beneficial effects in both physical and psychological health.
In chronic pain research conducted with patients at both Cincinnati Children’s Hospital Medical Center and Wake Forest School of Medicine, doctors showed that meditation reduces pain signals sent to the brain without relying on the pathways used by opioids. Interestingly, when doctors gave meditators a drug to block opioid receptors, mindfulness meditation still worked to reduce pain signals in the meditator’s brain, suggesting that there are natural ways of affecting these pain pathways that are still not fully understood.
Making mind-body a habit
In light of all this new research, pain management clinics across the nation have started to integrate mind-body therapy into their practice. And while historically, mind-body therapy has been an expensive proposition requiring a specialist and the reading and re-reading of guidebooks, easy to find resources and technology are now making it more accessible than ever.
Keeping a pain journal or writing about your pain, in general, can be beneficial to both your doctor (if you’re being treated by one) and in managing your pain on your own. Check out how to keep a pain journal here. The American Chronic Pain Association has also developed some tools for Cognitive-Behavioral Therapy (CBT) on their website, including free video lessons, which aim to help you change your thoughts and behaviors towards pain, and if you’re interested in meditation, the UCLA Mindful Awareness Research Center offers a number of free guided meditations as well.
Curable, a guided mind-body pain therapy app, combines education, journaling, brain training, and guided meditation into one package, and offers a free guided session on their website.
It’s important to incorporate all aspects of mind-body therapy so it is critical to be educated on all the different exercises chronic pain sufferers can practice. Having a good well-rounded program is essential for the improvement of both physical and psychological symptoms.
Join the mindfulness revolution
There’s no denying the healing benefits of mind-body therapy for treating conditions like chronic pain. While opioid medications have their place in the medical establishment, we can now see that overusing and over-prescribing these drugs can have disastrous effects on both individuals and society. Mind-body healing techniques like journaling, talk therapy, and meditation will increasingly become more mainstream as patients seek more affordable and effective alternatives to drug therapy. As more information on mind-body therapy becomes available, public health officials are hopeful that the rates of opioid addiction will begin to decline for good.