Opiates offer pain relief but have numerous side effects, not the least of which is the potential for addiction. One option that’s now available, says Latov, is a spinal pump for delivering opiates. “Unlike an oral tablet, in which a relatively small amount actually reaches the spinal cord or brain, the pump allows the medicine to be injected directly into the spinal fluid.” That means you need less of the opiate to be effective, but the pump requires surgery to insert and carries its own risks.
Nowadays, more and more people experiencing neuropathic pain, as well as some doctors, are willing to explore less traditional pain fighters. “Some people do better with holistic therapies,” Smith acknowledges. “If the person has already used a certain therapy, it’s more likely that that therapy will relieve their neuropathic pain,” he says. So, for example, if you’ve used acupuncture previously to fight knee pain, consider that for your neuropathic pain as well.
A number of botanical and dietary supplements have been studied for neuropathic pain relief, perhaps most notably the antioxidant alpha-lipoic acid. But while some studies have had promising results, at present, no dietary supplements are routinely recommended by most health-care practitioners for the treatment of neuropathic pain. If you wish to explore this option, discuss it with your doctor to make sure you’re using a safe approach and are not taking any medicines that could interact with a dietary supplement. You can also learn more about the use of complementary therapies and nutritional supplements for neuropathic pain in these resources:
- The Web site of the National Center for Complementary and Alternative Medicine, http://nccam.nih.gov/
- The book “The American Diabetes Association Guide to Herbs and Nutritional Supplements” by Laura Shane-McWhorter, PharmD, BCPS, FASCP, BC-ADM, CDE, published by the American Diabetes Association in 2009
(For more neuropathy resources, click here.
Beyond supplements, there are many other complementary therapies that may offer pain relief. “It could be self-hypnosis, visualization, deep breathing, yoga, prayer,” says Susan Ouellette, CRNP, a mental health professional at the VA Medical Center in Baltimore, MD. There are all sorts of alternatives and the key is to find one that works for you.
What about surgery?
Many people figure when all else fails, try surgery. One option mentioned earlier is a spinal pump, but that doesn’t truly cure the pain; it only masks it. A similar approach is a procedure performed in pain centers called interventional therapy. “A spinal stimulator produces an electric current, which interferes with other pain sensations. The stimulator is implanted next to the spinal cord and produces pulses which you can control remotely,” says Latov.
Before doing this or any surgery, though, you must get an accurate diagnosis. “You don’t want to operate, after all, if the pain isn’t likely to respond to surgery,” says Jack Stern, MD, assistant clinical professor of neurosurgery at Yale University School of Medicine in Connecticut. “Patients with neuropathic pain usually describe it as ‘burning’ or ‘gnawing.’ Many pains that are more likely to respond to surgery, like a herniated disc, are felt as ’sharp’ and ’shooting,’” he says.
Recognizing and treating the physical aspects of chronic neuropathic pain is important, but so is finding ways to cope with the mental health aspects of the problem.