Conventional and Alternative Therapies in Managing Chronic Spinal Pain

Physical Therapy
Treatment for chronic spinal pain offered by physical therapists is individually tailored and based upon a multifaceted subjective and physical evaluation. Short- and long-term goals are incorporated in designing a plan of care. Among other things, treatment may include:

• Patient education about symptom management through specific exercise techniques and principles, postural alignment, proper body mechanics, breath control and awareness, and interpretation of symptom response to exercise and activity.

• Guidance in performing and progressing exercise and activity, geared toward an independent home program.

• Various manual therapy approaches, ultrasound, electrical stimulation, heat, cryotherapy and others, for facilitating active symptom management.

Yoga
“Hatha”Yoga is the most common form of yoga practiced in the West. Yoga works to integrate the mind, body and spirit, incorporating ethical disciplines, physical postures, gestures, breathing exercises and meditation. The benefits of Hatha yoga include:

• Relaxation. Yoga releases muscle tension, diminishes sympathetic nervous system activity and calms the emotions.

• Concentration. Practice of focused movement, body and breath awareness and balancing postures promotes attention and concentration.

• Toning. Holding yoga postures involves co-contraction of muscles, promoting joint stability, and enhances the function of internal organs.

• Healing. Yoga increases circulation to the glands, organs and endocrine system to stimulate metabolism, healing and elimination of toxins from the body.

• Flexibility. Yoga postures incorporate active stretching to enhance the length of muscle and to increase circulation to the tendons.

• Energy. Slow, controlled movements with deep breathing increase energy while relaxing the body and counteracting fatigue.

• Positive thinking and behavior. Practicing yogic philosophies and exercises facilitates an internal locus of control, positively and productively directing one’s thoughts and energies.

Pilates
Developed more than 90 years ago by Joseph H. Pilates, this unique system of stretching and strengthening exercises called matwork (exercises done on the floor). Pilates also involves exercises performed using specialized equipment that both supports and challenges various movements. Benefits of Pilates include:

• Mind/body connection. Pilates unites body and mind with focused movement and breathing, as well as body awareness, during exercises.

• Visual imagery. Imagery is used to engage mind and body, and to facilitate balanced, coordinated muscle reaction.

• Posture and body mechanics. Method exercises encourage good posture and body mechanics in daily function.

• Core stability. Exercises are designed to activate deep muscles in the body, creating a strong core (“the powerhouse”) that aids efficient functional movement.

• Flexibility. Visualization facilitates active inhibition of muscles being elongated during exercises.

• Reduction of stress and fatigue. Focused breathing and efficiency of movement and alignment diminish sympathetic overdrive and improve circulation for increased oxygenation to tissues.

• Self-determination. Understanding and following Pilates method philosophy leads to a sense of achievement and control over one’s physical and mental well-being.

Music Therapy
This nonverbal means of expression helps decrease anxiety and tension and reduce pain.

Art Therapy
Creating art and reflecting on the final product and process increases awareness of self and others, helps people cope with symptoms, stress and traumatic experiences, and enhances cognitive abilities. Art therapy offers:

• Self discovery - art therapy triggers an emotional release.
  
• Personal fulfillment - creating art builds self-confidence.
  
• Empowerment - the process allows people to gain some sense of control.
  
• Relaxation and stress relief, particularly when combined with guided imagery.
  
• Symptom relief and physical rehabilitation - patients cope with pain through the artistic expression of emotions.

Copyright (C) 2005. Cleveland Clinic Foundation. All rights reserved.

Heintz I, Patterson M. Conventional and Alternative Therapies in Managing Chronic Spinal Pain. Spinal Column. Fall 2005. Cleveland Clinic Spine Institute (CCSI)
http://cms.clevelandclinic.org/spine/documents/SpinalColumnF05.pdf