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In a sense, treating chronic pain takes a village. Certain chronic spinal pain
cases may be successfully managed by a single physician, but the typical complexity
of most cases is optimally addressed by a team of specialists skilled in conventional
and alternative therapies. Outlined below are some conventional and alternative
approaches, along with the theories behind them, that might be incorporated
in therapeutic management of 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
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