• Psychotherapy, acupuncture provide alternatives to opioids

    March 21, 2019 | BLOG
  • Local, state and national leaders continue to grapple with ways to combat the opioid epidemic. Two Middle Tennessee professionals are offering potential answers by focusing on alternative treatments for chronic pain.

    Dr. Alicia Batson is a psychiatrist trained in internal medicine. She works at Centerstone in Nashville, where she treats mental health conditions including chronic pain and anxiety.

    Dr. Mark Kestner is a Murfreesboro chiropractor. He is a licensed chiropractic physician and clinical acupuncturist who helps patients find drug-free solutions to challenging clinical problems including chronic pain, joint and spine problems, and neurological issues such as migraines.

    Kestner, a regular columnist for the Murfreesboro Post, specializes in providing alternative treatments for patients.

     

    Opioids overused

    “In cases of severe pain, opioids are often the only or best choice for physicians to help patients find relief,” Kestner said. “The drugs have a number of problems, though, with side effects. Some side effects can be extremely dangerous and possibly lead to fatality. Perhaps the most dangerous side effect is the profound risk of addiction to the drugs.”

    “Unfortunately, because the drugs work so well for pain, the medical profession has relied on these drugs too much in recent years,” Kestner said. “This is especially a problem for patients with chronic pain. Opioids are often used for patients with a wide range of chronic pain problems, and this creates terrible risks for patients as they often need higher and higher doses of the opioids to find relief.”

    Kestner’s clinic provides services from medical acupuncture, medical pain-relieving laser treatment, non-surgical spinal disc decompression and manual treatments to alleviate pain. He said many patients as a result avoid taking any pain medicines.

    “The partnership with the pain medicine specialists has been very successful for the patients,” Kestner said. “Some have been able to get off opioids entirely, even after taking the narcotics for years. Others have been able to reduce their opioid use to one half or less, even while their activities are increased.”

     

    Personal pain battle

    For Batson, fighting chronic pain is personal — chronic pain can even stump a professional such as herself. She once struggled with chronic pain caused by repetitive strain injury, dizziness, neck, shoulder and more, she tried many conventional and alternative treatments with little to no success, she said.

    After finishing her residency, Batson started working at a clinic but was under stress from the job and at home. One day, a pain shot through her elbow. The other elbow began experiencing the same pain a month later. The problem spread to her forearms, back and neck and was so severe she could not work — the pain came after constantly using the computer at her job.

    Batson visited a number of medical professionals for diagnosis, but the tests came back normal. She quit her job and could not find a job as a doctor that did not involve working with a computer.

    “I quickly realized they did not have any adequate treatments for me,” she said. “The medical community was starting to label me as this chronic pain patient. Having been a physician, I didn’t want that.”

    Her doctors did not want to keep treating her, so she sought alternative treatments for more than nine years, from massages to chiropractors to supplements to acupuncture.

     

    Breakthrough

    Batson developed severe anxiety and panic attacks. A clinical therapist guided her to Dr. Howard Schubiner, founder and director of the Mind Body Medicine Program at Providence Hospital in Southfield, Mich. His website educates about Mind Body Syndrome (MBS). Within months, Batson had no pain. She completed her first triathlon, a life-long goal, a couple of years later.

    Batson said she has been back at work about four years. She uses psychotherapy to treat others for chronic pain, which may manifest as fibromyalgia, irritable bowel syndrome, chronic neck or back pain, or chronic headaches or urinary symptoms.

    Batson’s treatments are founded on the premise that the brain causes acute, or short-term, pain. Pain is the only way the brain can communicate with the body; the “fight or flight” pain acts as a danger signal when there is a problem like a broken bone or a burn.

    Chronic pain is different, she said. After three to four months, when an injury would normally heal, the pain from the sympathetic nervous system becomes chronic. This long-term pain may be caused by adverse childhood experiences, adult trauma like divorce or such behaviors as self-criticism or constant worry.

    To treat this pain, Batson may do one or more of several things. Psychoeducation is teaching patients how and why the brain causes pain. You have to understand how your body works so you will not be afraid of what’s going on.

    “If they can come to the conclusion that your brain’s not broken, your body’s not broken, everything is actually OK, then that can begin to turn off the signals,” she said.

    Secondly, a person can learn cognitive behavioral tools to change their relationships with pain, she said. Chronic pain patients begin to think constantly about their pain and how to stop it. The patient can stop the cycle by observing the pain, acknowledging it is there and accepting it. That tells the brain you are OK.

    Thirdly, the patient may learn how to process repressed emotions. Patients may need to learn how to treat themselves with compassion and take better care of themselves.

     

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