Healing in Pain Management Analysis

¶ … Healing in Pain Management Analysis

Annotated Bibliography

The Use of Natural Healing Methodology in Pain Management: A Realistic and Acceptable Alternative to the Use of Traditional Pain Medications in Today's Society

The problem to be considered in this study concerns identifying efficacious natural healing methodologies that can be used to manage pain. Virtually everyone suffers from various amounts of pain during their lives, but many practitioners and consumer advocates suggest that mainstream clinicians typically fail to address the levels of pain experienced by their patients, and much pain remains under-treated, undiagnosed or simply ignored by these conventional healthcare practitioners. Therefore, identifying alternative, and natural, approaches to pain management represents a valuable addition to the repertoire of techniques currently available to pain sufferers. Of special interest will be identifying specific natural healing methodologies in the proposed study that complement existing conventional medicine approaches, and what natural healing methodologies tend to work best with which types of pain-causing conditions. Other areas of interest will include providing an overview of the etiology of pain as it relates to various health conditions and what researchers conclude must be accomplished to alleviate these conditions.

This study is considered important because pain management has assumed new importance in recent years and has received increased attention from national healthcare accrediting agencies such as the Joint Commission on the Accreditation of Healthcare Organizations (Craig & Hadjistavropoulos, 2004, p. 37). A recent report from Pomfret (2005) indicates that more than two-thirds of healthcare consumers in the United Kingdom believe that popular complementary therapies, such as Chinese medicine and naturopathy, are as valid as traditional conventional medicines. "In fact," Pomfret adds, "only 24 per cent of people believed Western medicine is the only legitimate way of diagnosing and treating health problems, according to new research.... People have become more accepting of alternative medicine partly because of their frustration at the limitations of Western medicine" (p. 47).

Given the foregoing trends and the significance of the fundamental issues involved, identifying efficacious natural healing methodologies and what types of pain-related conditions they are particularly effective with has assumed new relevance and importance. For instance, as the U.S. population continues to age, there are going to be more elderly people in the years to come who will undoubtedly experience pain-related conditions as a concomitant of the aging process. According to Lindsey and Tobin (1999), the mainstream nursing profession has long recognized the importance of effective pain management, and this influx of older Americans will undoubtedly compel many conventional physicians to reevaluation their perspectives on pain management as well. These authors emphasize that, "The importance of pain management has always been obvious to the nursing profession. As palliative comfort care becomes integrated into mainstream health care delivery, doctors will increasingly come to recognize its importance" (Lindsey & Tobin, 1999, p. 140).

A background and an overview of the problem and issues to be considered by the proposed study are provided in Section II below.

II. Background.

According to Whorton (2004), early alternative systems of practice appeared in America during the early 19th century in response to the lack of available mainstream practitioners in many parts of the country. This author adds that, "Systems of practice is specified because while there had been a variety of methods available as alternatives to conventional medicine before the nineteenth century, the practitioners of folk medicine, the so-called root-and-herb doctors, the purveyors of Native American remedies, and other informally trained medicos had not been professionalized to any significant degree" (p. 8). Despite this lack of professionalization, alternative systems of medical practice to mainstream medicine that relied more on nature to heal pain sufferers than conventional drugs became increasingly popular during the early 19th century in the United States (Whorton, 2004).

Today, natural healing approaches to pain management include practices such as natural healing such as classical naturopathy and homeopathy, as well as some other less well-known applications. For example, Wilke (1997) reports that, "Alternative medicine, the umbrella classification for treatments such as chiropractic, aromatherapy, homeopathy, naturopathy, acupuncture and herbology, relies on preventive and holistic measures to heal the body. Alternative medical practices use a 'down to Earth' approach that combines a variety of 'building up' and support techniques for the body's natural immune system" (p. 42). According to James (1995), while natural healing approaches vary, a common theme that characterizes these therapies is that they work from the inside out, rather than from outside in, as do "adversarial" or drug therapies. "In other words," James advises, "the focus is on building from the inside, strengthening the natural healing energies of the mind-body, rather than fighting something originating outside" (p. 131). This author also suggests that natural healers can help invoke positive changes by educating the sufferer in the etiology of the disease process: "Disease can then be seen as a positive, transformative experience. The role of the physician is to support the body with homeopathic medicines and to engage the patient's mind toward awareness of what needs to be done in consciousness, that is, learning the lesson the illness is trying to teach" (James, 1995, p. 23).

Given their heavy reliance on mainstream medicine in the past, most patients in the United States today tend to frame their pain in a traditional dualistic model involving either a pathophysiological or a psychological etiology; however, while many pain complaints are not associated with any specific, measurable biological insults, healthcare consumers typically continue to seek a biomedical explanation and treatment of their pain (Block, Fernandez & Kremer, 1999). In these cases, "Continued pursuit of a medical solution to their pain problem is generally inconsistent with a self-management approach. Adoption of psychologically based interventions and self-management techniques may threaten patients, implying that they are weak, histrionic, or malingering, or that others (including health care providers) do not believe their pain is 'real'" (Block et al., 1999, p. 102).

On the one hand, authorities such as Hocker, Mick, Petersen and their colleagues (2005) maintain that it may be unnecessary to first reduce painful sensations experienced by individuals with certain medical conditions in order to attain changes in overt behavior that are instrumental in improving their quality of life in pain management regimens. On the other hand, according to Greenhalgh (2001), in order for natural healing techniques to be successful, healthcare consumers must first change their way of thinking about the healing process and their role in it: "The master key to natural healing," Greenhalgh writes, "is a mental shift to an attitude of acceptance, submission, surrender. Most people...are in a state of perpetual confrontation, trying by the imposition of will to shape events and control situations" (p. 215).

Natural healing methodologies are not without their detractors, though. In spite of numerous scientific studies that suggest these techniques are effective, many healthcare providers argue that some healthcare consumers may not recognize which ones are legitimate and which ones are not. Furthermore, to the extent that such inefficacious healthcare alternatives are pursued will likely be the extent to which the consumer fails to receive any benefit as well as missing out on the opportunity to receive the potential benefits of other natural healing methodologies with proven track records or a combination of such techniques with conventional medicine approaches. In this regard, Mccracken (1999) emphasizes that, "The pursuit of a useless remedy, even if it is in itself harmless, may close the way to an efficacious course of treatment" (p. 24).

Moreover, because pain may represent a life-threatening warning sign in some cases, healthcare consumers who fail to receive timely diagnoses and effective treatment may well be risking their lives: "If the condition being addressed is life-threatening, the danger is commensurately graver. The stated indications for many supplements are phrased in terms of symptoms: chronic pain, headaches, faulty digestion, and so on. Alternative medicine is not terribly concerned with what lies behind symptoms, but many of these can be the warning signs of diseases like cancer" (Mccracken, 1999, p. 24). Despite these criticisms, the fact remains that natural healing methodologies combined with various conventional approaches have been subjected to empirical study and have been shown to have demonstrable effects on a variety of pain sufferers. According to Christensen and Jacobsen (1996), techniques such as psychotherapy have been studied in this fashion with proven results: "These effects are not only statistically significant but also clinically meaningful. Psychotherapy not only speeds up the natural healing process but also often provides additional coping strategies and methods for dealing with future problems" (p. 1032).

Annotated Bibliography

Block, a.R., Fernandez, E., & Kremer, E.F. (1999). Handbook of pain syndromes: Biopsychosocial perspectives. Mahwah, NJ: Lawrence Erlbaum Associates.

Authors concluded that practitioner expectations that patients practice skills such as relaxation exercises or employ specific techniques such as self-monitoring may not be met during the course of treatment; such lack of adherence to natural healing methodologies is not surprising, they noted, based on the complex, multimodal approach of chronic pain treatment requiring several behavioral adaptations. "As regimens become more complex, they demand more effort and planning," they added (p. 102).

Christensen, a., & Jacobsen, N.S. (1996). Studying the effectiveness of psychotherapy: How well can clinical trials do the job? American Psychologist, 51(10), 1032.

Authors emphasized that pain sufferers should not limit themselves to one approach, but should rather seek to identify a broad range of therapies that may result in appreciable gains for the healthcare consumer.

Craig, K.D., & Hadjistavropoulos, T. (Eds.). Pain: Psychological perspectives. Mahwah, NJ: Lawrence Erlbaum Associates, 2004.

Authors emphasized the continuing risk of unnecessary or undermanaged pain because of an inadequate knowledge base, underdeveloped assessment procedures, and inadequate pain management.

Gersten, R., Schiller, E.P., & Vaughn, S. (2000). Contemporary special education research: Syntheses of the knowledge base on critical instructional issues. Mahwah, NJ: Lawrence Erlbaum Associates.

Authors noted that the introduced of computer-assisted statistical analytical tools has contributed greatly to the conduct of meta-analyses in recent years.

Greenhalgh, S. (2001). Under the medical gaze: Facts and fictions of chronic pain. Berkeley, CA: University of California Press.

The point was made that successful incidents of natural healing are most common among those healthcare consumers who are persistent in their regimens and refuse to give in to the disease process. Several strategies for accomplishing this level of determination are provided.

Hocker, T.R., Mick, K.A., Petersen, C.L., Scofield, B.E., Song, H., Sudarijanto, R.P., & Zettle, R.D. (2005). Differential strategies in coping with pain as a function of level of experiential avoidance. The Psychological Record, 55(4), 511.

Authors conducted clinical experiment to determine efficacy of acceptance and commitment therapy for pain management purposes and concluded that changes in the way pain sufferers think about their pain can facilitate natural healing.

James, W. (1995). Immunization: The reality behind the myth. Westport, CT: Bergin & Garvey.

Author stated that the natural healing methodology includes appropriate diet, exercise, and positive thinking, all of which are necessary to overcome the rigors of the sedentary lifestyles common in the 21st century because people's immune systems "have become weakened and need extra support" (p. 131).

Jonassen, DH (2004). Handbook of research on educational communications and technology. Mahwah, NJ: Lawrence Erlbaum Associates.

In his discussion of triangulated research methodologies, author concluded that this approach provides researchers with a variety of sources that allow the formulation of specific recommendations rather than simply arriving at conclusions.

Lindsey, K., & Tobin, D.R. (1999). Peaceful dying: The step-by-step guide to preserving your dignity, your choice, and your inner peace at the end of life. Cambridge, MA: Perseus Books.

Authors emphasized the need to adequate pain management regimens, particularly among the elderly, and strongly recommend that if a pain sufferer fails to receive relief through one pain management regimen to seek alternative guidance and techniques for other healthcare providers rather than suffer needlessly.

Mccracken, S. (1999, June). The new snake oil: A field guide. Commentary, 107(6), 24.

Author emphasized need for more research and a reconsideration of current trends toward the incorporation of alternative medicine into conventional healthcare regimens by mainstream practitioners who may not fully understand the techniques involved and who may not be willing to invest the time or effort to do so.

Pomfret, E. (2005, February 12). Weighing up the alternatives; have traditional medicines and treatments had their day? The Birmingham Post, 47.

Author provided overview of various natural healing techniques and how they can be used by healthcare consumers in lieu of conventional medicine approaches.

Whorton, J.C. (2004). Nature cures: The history of alternative medicine in America. New York: Oxford University Press.

Author stated that the perspective of alternative practitioners has been that they are well- intentioned healers struggling to provide viable options to harsh medicines and unnecessary surgeries; however, the response from the mainstream medical community has historically been ambivalent or even violently opposed based on fear of competition and to maintain their power and cultural authority.