To Your Health

Managing Chronic Pain

One in five Americans suffers from it--here, some strategies for relief

-Susan Crandell

Maybe the recession is hurting us in more than our wallets, but I've read an awful lot of interesting things about pain relief and managing chronic pain recently.

Two were in a very useful little newsletter called Bottom Line. In a recent issue, Russell K. Portenoy, M.D., chairman of the department of pain medicine at Beth Israel Medical Center in New York, explains which over-the-counter pain relievers to use. Because people respond differently to them, it's trial and error to see what works best for you. Portenoy recommends beginning with the one with the lowest risk of side effects, acetaminophen, before progressing to the others (ibuprofen and aspirin).

The current issue of Bottom Line offers another doctor's prescription for relieving back pain. Lee Hunter Riley III, M.D., director of the orthopedic spine division at Johns Hopkins in Baltimore, recommends this plan of attack: Take an OTC anti-inflammatory such as ibuprofen, naproxen or aspirin. Take it for two weeks, even if the pain subsides; the effect takes time to build.

After a few days, you should try to stay active, though not to the point of intense pain. Riley reports that 95 percent of the time, even acute back pain diminishes over two months. To soothe your aching back, he recommends a heating pad, walking, a warm bath or a diverting visit with family or friends. To keep pain at bay, try Pilates or other exercises to strengthen the back and abdominal muscles, and walk or swim to keep your joints flexible.

After suffering neck and shoulder pain, Wall Street Journal reporter Melinda Beck investigates the connection between stress and pain. When stress triggers the body's fight-or-flight response, muscles contract and the body is bathed in stress hormones, creating headaches and neck, shoulder and back pain. What to do? Working out can blunt these effects, and biofeedback can teach you how to manage your own stress levels. Finally, cognitive behavioral therapy can disarm negative emotions that increase the perception of pain.

Lynne Greenberg knows from pain, and she's written a book that's a must read for anyone else suffering chronic discomfort. The Body Broken chronicles the legacy of a car accident: hideous, nearly unbearable pain, and Greenberg's search for relief. She tries fusion surgery to mend her damaged neck vertebra, nerve-block injections, a daunting list of prescription painkillers, even marijuana and methadone.

Ultimately, she combines soul searching, literature (Milton is a favorite) and a stint in an in-patient pain clinic to ease her agony and develop a new outlook on her life. What's most powerful about this memoir is that despite consults with dozens of doctors, she does not cure her pain. She manages an even more difficult thing: learning to live with it. "I continue to move forward," she writes about managing chronic pain, "learning better ways of coping with my pain, still not certain of my final destination."