Pain Management

Why should I use mind-body therapies for my chronic pain?

DEAR DOCTOR K: I suffer from chronic pain. My doctor suggested that I look into mind-body therapies. Why? Is it possible to think your way out of pain?

DEAR READER: I wouldn't describe mind-body therapies as "thinking your way out" of any kind of suffering. But mind-body therapies surely can help reduce chronic suffering, including chronic pain. Pain signals sent up the nerves from your body register in pain centers deep inside your brain. But signals from those pain centers then are processed by the "thinking part" of your brain. That part, in turn, is affected by your emotions, which come from a different part of your brain.

What can I do to ease the discomfort of hemorrhoids?

DEAR DOCTOR K: What can I do to ease the discomfort of hemorrhoids?

DEAR READER: Hemorrhoids are quite common, and they're not a "serious" medical problem. But, figuratively and literally, they're a real pain in the butt. Hemorrhoids develop when veins in the anus and rectum swell and widen. (I've put an illustration below) They can be extremely painful and uncomfortable, causing bleeding and painful bowel movements. There are surgical treatments that can help when you have recurrent, painful flare-ups of hemorrhoids.

What are alternative therapies for rheumatoid arthritis pain?

DEAR DOCTOR K: I have rheumatoid arthritis. Medications have helped, but only up to a point. Can you discuss alternative therapies that might help to further relieve my discomfort?

DEAR READER: Rheumatoid arthritis (RA) is a long-term disease in which the body's immune system attacks healthy tissue lining the joints. This causes swelling, pain, redness and stiffness in joints throughout the body. Drug treatments slow the effects of the disease, but alternative approaches can also help to reduce inflammation and relieve pain.

What happens during chiropractic treatment — what types of pain can it relieve?

DEAR DOCTOR K: I've been having back problems, and frankly, my regular doctor hasn't come up with treatments that help me much. So I'm wondering: What happens during chiropractic treatment? What types of pain can it relieve?

DEAR READER: Regular readers of this column know that I'm not very stuffy. I think treatments that are called "complementary" or "alternative" medicine should not be dismissed out of hand. Instead, those treatments that many people have found helpful -- and that are not clearly dangerous -- should be studied in the same way that traditional medical treatments are.

How can I relieve my knee pain without surgery?

DEAR DOCTOR K: I'm in my 60s. My knees have started to hurt, especially when I'm climbing stairs. Can you recommend any nonsurgical ways to relieve this pain?

DEAR READER: Knee pain is one of the most common reasons for doctor visits. As you get older, knee pain can limit your mobility and take away your independence. The keys to keeping your knees healthy? Strengthening muscles around the knees, improving balance and losing weight.

Should I stop drinking if I have chronic pancreatitis?

DEAR DOCTOR K: I have chronic pancreatitis. Will it help to stop drinking at this point? Or is it too late?

DEAR READER: It is never too late to stop further damage to the pancreas, but it may be too late to reverse damage done in the past. However, that's water under the bridge. What you want to do now is stop further damage.

How can I prevent addiction to my prescription painkillers?

DEAR DOCTOR K: My doctor has prescribed prescription painkillers -- opioids -- for my severe back pain. They relieve my pain, but how can I reduce my risk of becoming hooked?

DEAR READER: Simply being aware of the risk of addiction is a good first step in ensuring that you do not become addicted to prescription painkillers. I'll explain a little bit about painkillers. Then I'll describe some steps you can take to prevent addiction.

What are drug-free treatments to relieve osteoarthritis hand pain?

DEAR DOCTOR K: I have osteoarthritis in my hand. Could you recommend some drug-free treatments to relieve the pain?

DEAR READER: Osteoarthritis causes stiffness and pain in the joints. It develops when cartilage -- the connective tissue that covers the ends of bones -- deteriorates. In a joint, the ends of two or more bones come together. The softer and more flexible cartilage that covers the ends of the bones acts as a cushion. If the cartilage were not there, the hard bones would grind against each other.

What are some simple changes that help relieve neck pain?

DEAR DOCTOR K: I'm a woman in my late 40s, and I have mild but aggravating neck pain that flares up from time to time. Can you suggest simple changes I can make at home and at work that might help?

DEAR READER: There are many things you can do to minimize your risk of recurring neck pain. Start by keeping your neck in a neutral position whether you are sitting or standing. That means your head should balance directly over your spine and not lean forward or be cocked to one side.

How can I relieve knee pain from chondromalacia?

DEAR DOCTOR K: I saw my doctor because of aching pain in my knee, which sometimes buckles unexpectedly. He says I have chondromalacia. What is this, and what can I do to relieve the pain?

DEAR READER: The joints in your body are cushioned by cartilage. This tough, rubbery tissue covers and protects the ends of bones inside a joint, allowing them to glide smoothly against one another as the joint moves. With chondromalacia, the cartilage inside a joint softens and breaks down. The ends of the bones can rub together, causing pain. Chondromalacia can affect any joint, but the most common location is inside the knee, see the illustration on the right.