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    Mayo Clinic Q and A: Alternative treatments for chronic pain

two hands pressing on a bare backDEAR MAYO CLINIC: What are the best alternative treatments for chronic back and neck pain? I am not able to take pain medication. Are there any supplements that are safe and known to work?

ANSWER: Alternatives to medication for chronic pain exist. Research shows that, when they’re included in a comprehensive treatment plan, those techniques can be quite effective in lowering pain. Together, these approaches to pain management often are referred to as integrative medicine. Talk with your primary health care provider about possibilities for pain control beyond medication. If he or she is not familiar with integrative medicine, ask for a referral to a health care provider who specializes in pain management.

Chronic pain is a common problem. According to the National Institutes of Health, chronic pain affects more Americans than diabetes, heart disease and cancer combined. Chronic pain is the most common cause of disability in the U.S.

Traditionally, the first step in treating chronic pain has been medication, including strong painkillers such as opioids. But these drugs can be problematic. Not only are opioids powerful drugs, they can have serious side effects and pose a significant risk for addiction when used long term. The problems associated with using opioids for pain relief make it crucial that other strategies be considered when managing chronic pain.

In some situations when medication wasn’t a good option, surgery was recommended as the next step. Fortunately, there now are a wide range of choices available beyond medication and surgery that have been shown to be useful in easing chronic pain.

One common form of integrative medicine that’s used frequently at Mayo Clinic is acupuncture. The technique involves inserting extremely thin needles through your skin at strategic points on your body to reduce pain. How often you need this treatment depends in large part on the type and severity of your pain.

Massage therapy can help reduce pain, too. Several studies suggest massage can be effective as part of an overall strategy for managing chronic neck and back pain. Mayo Clinic has conducted more than a dozen clinical trials on massage and found it valuable for a wide variety of pain conditions. Mayo Clinic now regularly offers massage therapy to patients.

Clinical trials have shown mind-body therapies are another approach that can significantly affect chronic pain. The purpose of these treatments is to help you relax and improve the communication and connection between the state of your mind and the health of your body. Yoga, tai chi, meditation and guided imagery fall under this category.

You also asked about supplements. There are two in particular that show promise for easing pain. The first is S-adenosylmethionine, usually called SAMe. It’s been studied for its ability to reduce inflammation and relieve arthritis pain. The second is curcumin, a substance found in the spice turmeric, which also may help reduce inflammation. Initial research seems to point to a benefit in people with some forms of chronic pain who use these supplements. Be careful if you take supplements, though, and don’t start taking anything before you discuss it with your health care provider to make sure it’s right for your situation.

Although all of these treatments may help lower chronic pain, none provides a cure. Instead, they help control pain symptoms. To be most effective, they should be integrated into an overall treatment plan that includes conventional approaches to pain management, such as physical therapy, exercise and balanced nutrition. When placed in the context of this type of integrated approach, many people see significant benefits from using evidence-based alternatives to medication for chronic pain management. Dr. Brent Bauer, Integrative Medicine and Health, Mayo Clinic, Rochester, Minnesota