Along with mind/body therapies to de-stress, massage helps to relieve depression and anxiety, an increase in the number of natural “killer cells” in the immune system, lower levels of the stress hormone Cortisol, and reduced difficulty in getting to sleep. For those who have neck or back pain, massage therapy can help relax sore muscles and increase mobility. This form of drug-less therapy has also been shown to increase circulation, give relief from musculoskeletal pain and tension, act as a mind/body form of stress release, increase flexibility, and increase mobility.


There is good evidence that biofeedback might help to relieve many types of pain, including tension and migraine headaches, according to a consensus statement from the National Institutes of Health. This therapy is based on the idea that when people are given information about their body’s internal processes, they can use this information to learn to control those processes. In one study by researchers at the University of South Alabama, 80 percent of children who suffered with migraines were symptom-free after receiving intensive biofeedback training. In other research, some headache patients who were able to increase hand temperature using thermal biofeedback, also experienced fewer and less intense migraine headaches.

With biofeedback, you are connected to a machine that informs you and your therapist when you are physically relaxing your body. Using sensors placed over specific muscle sites, the therapist will read the tension in your muscles, heart rate, breathing pattern, and the amount of sweat produced or body temperature. Any one or all these readings can let the trained biofeedback therapist know if you are learning to relax.

Over time, the ultimate goal of biofeedback is to learn to relax outside the therapist’s office when you are facing real stressors. If learned successfully, electronic biofeedback can help you learn how to control your heart rate, blood pressure, breathing patterns, and muscle tension when you face pain or stress—even when you are not hooked up to the machine.


Meditation involves sitting still in a quiet place while placing your ultimate focus on the moment. During this time of personal solitude, you let all the day’s worries leave your attention and only experience the moment. Meditation is believed to result in a completely “free” mind while affording you a chance to recover from the day’s pain, interruptions, and stress. Because pain is a complex interaction between sensations, thoughts, and emotions, meditation can help self-regulate the pain you feel and increase your ability to handle stress.

Meditative techniques are a key element in the Arthritis Self-Help Course at Stanford University. More than 100,000 people with arthritis have taken this course and learned meditation-style relaxation exercises. Graduates report a 15 to 20 percent reduction in pain.

To learn to meditate, find a quiet place indoors or outdoors with no distractions. While sitting in a comfortable position, close your eyes and focus on your breathing, keeping it very slow and intentional. You should notice the sensation of air passing in and out of your nostrils during this moment of solitude. It’s difficult to reach the stage of complete “mindfulness,” where your thoughts are focused entirely on the moment instead of your past or future. But as you practice this repeatedly, you will learn how to focus on your breath, which will keep your mind from wandering. After 10 to 15 minutes, stop the meditation and return to your normal activity.


I have many patients who are interested in yoga for exercise purposes and also for managing their daily stress. This ancient discipline originated in India more than four thousand years ago, and is quite popular in the United States. Hatha yoga, the most commonly practiced branch used in the West, emphasizes specific postures, active and relaxation poses, breath control, concentration, and meditation.

If practiced regularly, yoga can relieve muscular tension or pain by improving range of motion, relaxing tense muscles, and increasing muscle strength. Practicing yoga when you are feeling anxious may help to reduce stress when you are on the job or at home. In fact, findings show that, for some, just three months of weekly yoga training results in an increase in physical well-being, significant improvements in perceived stress, and a marked reduction of headache and back pain. Yoga also reduces blood levels of Cortisol, which is important for reducing inflammation, as discussed on page 4.

There have been several recent studies on yoga and pain, and the findings are all encouraging:

image  In one study, researchers concluded that yoga was effective at improving function and reducing back pain and the benefits persisted for at least several months.

image  Another study revealed that yoga improved carpal tunnel syndrome after just three weeks of practice.

image  A revealing study of patients with rheumatoid arthritis found that hand grip strength of both hands increased in patients following yoga practice.

image  Perhaps the most intriguing findings are on the effect of yoga on body weight, blood pressure, and insulin resistance. In one study, just 8 weeks of yoga practice resulted in 1.5 to 13.6 percent reduction in body weight, while even relatively short-term practice of yoga was found to reduce blood pressure. More than ten studies that evaluated the effects of yoga on markers of insulin resistance show significant improvements.

Of course, there are dozens of other studies, but the point is that alternative therapies like yoga can be extremely healing for pain sufferers.

Practicing a simple pose known as corpse pose is an easy and relaxing way to meditate. The more you practice meditation in this pose, the easier it will become to quiet your mind. With time, the practice of meditation becomes more calming and you will feel more rejuvenated.

1.   Lie on your back on a comfortable surface, and stretch your arms and legs out straight. Keep your arms down by your sides, and extend your legs straight from the hips. Your feet should be about 12 inches apart, with both feet turned out slightly to keep the feet, ankles, and legs relaxed.

2.   With palms facing upward, keep your arms 8 to 10 inches from the body. Lengthen your back on the floor and feel all your muscles stretching and releasing.

3.   Notice your shoulder blades and hips, and adjust the body until you feel balanced on both the left and right sides of your body. Scan your body and consciously relax every muscle group, including your throat, face, and eye muscles. Continue this scanning as you he down and relax, and become aware of areas in which you might hold chronic tension.

4.   As you he there, feel the breath take you into a deeper relaxed state.


Figure 1—The Corpse Pose

Increase Your Social Network

Having intimate relationships with family and friends helps us to feel accepted and maintain optimism and aids in stress management. All of these emotional benefits lead to stronger immunity, which is vital to staying well and functioning optimally. In fact, it is well documented that people who are happily married and/or have large networks of friends not only have a greater life expectancy compared with those people who do not, but they also have fewer incidences of just about all types of disease.

Support groups such as those sponsored by the Arthritis Foundation are geared toward meeting the unique needs of those who suffer with pain. Although support groups are not psychotherapy groups, they do provide patients with a safe and accepting environment to vent their frustrations, share their personal stories, and receive comfort and encouragement from one another. In many such groups, the latest medications are discussed and coping suggestions are shared among members. Assurance is given that someone else knows what you are going through as people share their struggles in living with pain. After joining a support group, you may realize that the best experts on treating pain are those men and women who live with it daily, although it still remains critically important to talk your doctor before trying any treatment suggested by other patients in the group.

I have listed support organizations for individuals with different types of pain on pages 262 to 265.You can call or write to these organizations for literature, or check out their Internet sites. These groups are focused on educating consumers about pain-related disorders, along with giving the latest methods to diagnose, treat, and prevent pain.

On a different note, social support does not have to be just with other people. You might form emotional attachments with your animals. I have many patients who live alone yet find comfort and camaraderie with a pet—an attachment that is every bit as strong as that between a parent and a child. There are countless papers published in the area of animal-human bonding revealing the health benefits of this type of interaction.

Interestingly, even having a plant can be beneficial. In a study at Yale University, researchers found that when people had a plant present in their room they had speedier recoveries compared with people who did not. I have patients who live alone yet are positive and optimistic about their lives because of a connection to their gardens. These patients find meaning and purpose from being outdoors and enjoy the healing benefits of nature.

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