Alternative Strategies for Pain Management


Photo Credit: Shutterstock – Jon Bilous


By: Ziya “Z” Altug, PT, DPT, MS, OCS, CSCS


A 2018 perspective in the New England Journal of Medicine states that “in 2016 more than 11 million Americans misused prescription opioids, and opioid-related deaths have more than quadrupled since 1999.” Clinicians need to be knowledgeable about integrative health for either direct use in the clinic or for establishing a good rapport and therapeutic alliance with the patient/client through techniques such as meditation, mindfulness, music and art therapy, aromatherapy, self-hypnosis, self-acupressure, light therapy, labyrinth walking, yoga, Pilates, tai chi, qigong, Feldenkrais Method, and the Alexander Technique.

The following are some evidence-based examples of integrative care approaches:

  • Yoga: Yoga may improve pain in individuals with chronic pain and Type 2 Diabetes Mellitus (Schmid et al. 2018).
  • Tai Chi: Tai Chi lowered pain severity and reduced fear of falling in older adults with multisite pain (You et al. 2018).
  • Qigong: “Mindfulness-based Baduanjin exercise [an easy-to-learn health-Qigong form with 8 movements) may be effective for alleviating musculoskeletal pain and improving overall sleep quality in people with chronic illness” (Zou et al. 2018).
  • Pilates: “This trial demonstrated the effectiveness of the Pilates method for the treatment of chronic mechanical neck pain, resulting in improvement of pain, function, quality of life, and reduction of the use of analgesics” (de Araujo Cazotti et al. 2018).
  • Feldenkrais Method: “The Feldenkrais method has comparable efficacy as Back School in chronic low back pain” (Paolucci et al. 2017).
  • Alexander Technique: “Alexander lessons promote self-efficacy and self-care, with consequent reductions in chronic neck pain” (Woodman et al. 2018).
  • Mindful Walking: “Mindful walking in nature may be an effective way to maintain mindfulness practice and further improve psychological functioning” (Gotink et al. 2016).
  • Self-hypnosis: “Self-hypnosis can be used in clinical practice as an adjunct to the gold standard of local anesthesia for pain management” for individuals with dental pain (Wolf et al. 2016).
  • Labyrinth Walking: Labyrinth walking may be used in a mental health facility for reflection, stress reduction, and the exploration of personal wellness (Heard et al. 2015).
  • Music: “Music may be beneficial as an adjuvant for chronic pain patients, as it reduces self-reported pain and its common comorbidities. Importantly, the analgesic effect of music appears higher with self-chosen over researcher-chosen music” (Garza-Villarreal et al. 2017).
  • Light Therapy: “Light therapy even in low dose could improve depressive symptoms and reduce pain intensity in chronic nonspecific back pain patients. Further research is needed for optimizing parameters of frequency, dose, and duration of therapeutic light exposure” (Leichtfried et al. 2014).

Join me for my live Pain Management: Using an Integrative, Mind-Body Approach to Maximize Patient Function and Overall Quality of Life course, starting in November, to learn evidence-informed techniques that you can use immediately with patients, wellness clients, athletes, or older adults. Let’s provide patients and clients with a well-rounded integrative approach to clinical care and overall wellness and health.

References are available upon request.

Z. Altug, PT, DPT, MS, OCS, CSCS, is a Doctor of Physical Therapy and integrative wellness specialist with more than 28 years of experience. He currently works at a private physical therapy clinic in Los Angeles. Dr. Z has taken workshops and classes in yoga, Tai Chi, Qigong, the Pilates method, the Feldenkrais Method, and the Alexander Technique. Dr. Z taught classes at a university setting in therapeutic exercise and manual therapy as an assistant professor. He also has extensive experience in fitness programming, sports performance, lifestyle medicine and wellness. Dr. Z has authored the book Integrative Healing: Developing Wellness in the Mind and Body (2018), and coauthored the books Yoga Forma: A Visual Resource Guide for the Spine and Lower Back (2018), The Anti-Aging Fitness Prescription (2006), and the Manual of Clinical Exercise Testing, Prescription and Rehabilitation (1992). Dr. Z earned a Doctorate in Physical Therapy from the College of St. Scholastica in Duluth, Minnesota, a MS in Sport and Exercise Studies and a BS in Physical Education from West Virginia University, and his BS in Physical Therapy from the University of Pittsburgh. Dr. Z is a long-standing member of the American Physical Therapy Association and National Strength and Conditioning Association and a recent member of the American College of Lifestyle Medicine. Dr. Z is licensed in California and is a Certified Strength and Conditioning Specialist (CSCS) and certified by USA Track & Field as a level 1 coach and by USA Weightlifting as a level 1 sport performance coach.

You can learn more about Dr. Z, including his books Integrative Healing (May 2018), Yoga Forma (July 2018), and other free resources he shares on integrative wellness, at his website which links to his social media.