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Five ways to manage chronic pain for military wellness

Military personnel fighting through the pain after a 12 mile ruck march A soldier Washington fights through the pain after completing a 12-mile ruck march April 11, 2019, at the Vicksburg National Military Park in Vicksburg, Mississippi (Photo by U.S. Army National Guard photo by Sgt. DeUndra Brown).

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Chronic pain remains a common experience shared across military and civilian populations. This pain can result from injuries, surgeries, joint conditions or side effects from other conditions.

The good news is that there are many treatments, techniques and therapies to help a patient manage your pain and bring relief.

"As part of the DoD Pain Management Task Force 2010 effort, DVCIPM recommend a number of pain-management strategies that you can use alone or with other treatments to help you manage your pain," explained Dr. Chester 'Trip' Buckenmaier III, program director at Uniformed Service University of the Health Science's Defense & Veterans Center for Integrative Pain Management. "These five treatment methods are consistent with the Department of Veterans Affairs and Department of Defense Stepped Care Model of Pain management."

Massage

Therapeutic massage can help reduce pain in your lower back and neck. There are many different massage techniques such as Swedish massage, deep-tissue massage, and sports massage. During a massage, a licensed therapist applies pressure and other forms of manipulation, such as kneading, circular movements, or tapping, onto muscle and soft tissue. Massage can increase blood circulation, which can help reduce pain. Massages also help you feel calmer or less anxious, which in turn, can also reduce pain.

Massages can be more effective at reducing lower back pain when combined with a strengthening and stretching program. Massages are generally safe, but make sure you seek treatment from a trained professional.

Yoga

If your lower back hurts now and then, or if you struggle with ongoing pain in this area, consider yoga to help relieve the pain, lower your anxiety, and feel more relaxed. Lower back pain is common. For most people, the pain goes away in less than three months without treatment. For others, though, lower back pain doesn't go away. When pain lasts longer than three months, it's called "chronic" pain.

Yoga typically includes three benefits. First, breathing retraining can help calm and focus your body and mind. Second, yoga can increase your flexibility, coordination, and strength. Lastly, meditation exercises can help you become more aware of your actions and feelings, lower your stress levels, and improve your mood.

Yoga isn't a replacement for seeing your doctor about your pain. If you have a medical condition, talk with your healthcare provider before you start doing yoga. Adding yoga to your existing pain-management plan can help ease pain from injury or other painful conditions. As a mind-body approach, it often combines meditation and breathing with exercise and stretching.

Sailors attending a yoga class
Sailors attend a yoga class on the flight deck of the aircraft carrier USS George H.W. Bush (CVN 77) in the Persian Gulf (Photo by: Navy Mass Communication Specialist 3rd Class Margaret Keith).

Transcutaneous Electrical Nerve Stimulation (TENS)

Transcutaneous Electrical Nerve Stimulation is a sort of "electrical massage" that works by sending more "traffic" to the brain to block pain signals. A TENS system includes a small power unit connected by wires to a pair of electrodes. The electrodes are placed on the skin near the location of pain. A mild, generally painless electric current stimulates the nerves in the skin when the unit is switched on.

Most people experience a sensation of tingling and sometimes warmth during TENS treatments. This stimulation is thought to block or interfere with pain signals as they travel to the brain. That is, TENS sends more "traffic" overriding the pain. It's also thought to increase endorphins, or the body's natural painkillers, during treatment sessions.

Sessions typically are short, and TENS can be applied as often as needed depending on how bad the pain is and recommendations from your medical provider. TENS is non-invasive, meaning, it doesn't go into your body. While offering very little long-term benefit, it does provide short-term relief.

Trigger Point Injections

Trigger points, commonly called "muscle knots," are tight spots in your muscles. Not everyone with trigger points experiences pain, but some people have painful trigger points. Often times, you can treat trigger points on your own. At-home treatments include massage, using your hand or a massage ball, and foam-rolling exercises.

But what if your painful trigger points don't go away? You might need further attention from a healthcare professional, which could include trigger point injections directly into the affected muscle. Trigger point injections (TPIs) are when a fluid or medication is injected directly into the trigger point. This injection can reduce pain or discomfort caused by irritated and stiff muscle fiber. TPI needles helps to reduce muscle inflammation so that the muscle fiber relaxes and lengthens, which causes the trigger point to get smaller or go away.

The effectiveness of TPIs for types of pain is still unclear, although some diagnosed with neck and shoulder pain, sciatica pain, or connective tissue pain benefit from TPIs.

Acupuncture

Buckenmaier also suggests, "Acupuncture as a low-risk treatment that may improve pain for some people with certain types of pain conditions and involves the use of thin needles inserted through the skin into muscle or other tissue at specific points on the body." It's an ancient practice that is routinely used throughout the world today. Acupuncture can be effective in improving migraines, nausea, back pain, chronic pain, and more.

Whereas battlefield acupuncture, he explains, is "a form of acupuncture using needles in just the ear, rather than in various parts of the body as with traditional acupuncture, so that is easier to transport and administer in the field." Acupuncture should not be a replacement for treatment by a physician, so make sure to discuss with your doctor as it may be able to be used in conjunction with other treatments.

Human Performance Resources by CHAMP at the Uniformed Service University of the Health Sciences (USU) provides holistic, performance optimization resources that help members of the military community achieve Total Force Fitness.

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