By Ashlie Teixeira-Smith, APRN

Looking beyond the use of standard pain treatments.

Chronic pain management is a hot topic in today’s world. Many of our patients at Sierra Neurosurgery Group (SNG) are looking for answers to solve their pain and want these treatments to be low risk and effective. Traditional spine treatments include the use of various medications, injection therapies, and sometimes surgery. Unfortunately, these treatments all carry certain risks or potential side effects.

The good news is that there are several other options available to patients who are looking for alternative ways to help manage and cope with chronic pain.

At SNG we receive questions from our patients on a routine basis about complementary and alternative ways to help manage pain. The advantages of nontraditional approaches are that they can be used alone or in combination with more traditional treatments. Additionally, they generally carry a lower risk profile than current western medical treatments.

Your providers at SNG strongly encourage the use of alternative therapies as part of a multimodal integrated approach to pain management. There are a wide variety of complementary and alternative approaches to pain management and this discussion will review 6 of the most common therapies available including behavioral treatment, acupuncture, chiropractic manipulation, prolotherapy, neuro-reflexotherapy and herbal treatments.

If you wish to pursue any of these treatments talk to your provider at SNG to make sure it is right for you. We can connect you with a provider in our preferred network.



One of the biggest challenges to managing pain effectively includes managing the psychological changes that occur. This is because pain takes a toll on a person’s mood and overall outlook in life because pain interferes with daily activities, social as well as personal relationships, work and adapting to new physical limitations. Thus potentially leading to depression and anxiety, which may exacerbate the underlying pain condition.

Behavioral therapy focuses on adjusting the way one engages in physical activity, their thought process, emotions, experiences and challenges faced by a patient with pain. Being able to manage mood changes with fluctuations in pain control is key and a very vital component to successfully managing your pain. Behavioral therapy is typically managed by a psychologist or psychiatrist of whom you may need a referral to by your surgical, pain management, or primary care physician.



A complimentary therapy that has grown in popularity over recent years is the use of acupuncture. Acupuncture comes from the Chinese philosophy related to the flow of life force or energy called Qi (pronounce Chi) as it travels throughout the body. The thought is that disease manifests from an interruption of this energy flow of which may be restored with the use of special needles. Therefore, restoration of the energy flow is thought to diminish disruptions of flow thus diminishing the disease. Acupuncture is performed by a trained practitioner who places special needles in various locations depending on symptoms and needs. Studies have shown that use of acupuncture in conjunction with other treatment modalities can reduce pain in the short term and intermediate term follow up.



Another complimentary therapy is spinal manipulation also known as Chiropractic therapy. There are two different ways of spinal manipulation; low velocity versus high velocity. The exact mechanism as to how spinal manipulation therapy works is not clear; however, it is believed that manipulation may change anatomic, physiologic or biomechanical function of the vertebrae. Studies have found that spinal manipulation in conjunction with other treatment modalities showed improvement. To find out if spinal manipulation therapy is appropriate for you please consult with your pain management



Prolotherapy is another alternative therapies for chronic pain. This involves injection of various types of solutions into damaged joints. The goal of injecting these solutions is to promote the body’s natural healing properties through the inflammatory response. The inflammatory response is what promotes healing of damaged tissue. Studies have shown that the use of prolotherapy in conjunction with other treatment modalities is beneficial.



Neuroreflexology is a newer alternative therapy for low back pain. It involves implantation of epidermal staples and subcutaneous burins (small metallic punches) along dermatomes with concurrent implantation of staples at referred tender points in the ear. It is thought to work by inhibiting 3 neural processes of which inhibit the pain signals. Some studies show that this therapy may substantially improve a patient’s ability to perform daily activities through reduced pain severity for nonspecific low back pain and myofascial pain.



The last complimentary therapy we will discuss is the role of herbal medicines in the context of managing pain. The use of herbs for the treatment of various illness or disease processes has been around for thousands of years. Certain herbs can be used to decrease inflammation and/or provide an analgesic type effect. This can be done through the use of creams or gels applied to the direct site of pain or through ingestion of pills. Ask your provider if the use of herbal medications is appropriate for you.






Marlowe, Dan. (2012). Complimentary and Alternative Medicine Treatments for Low back Pain. Primary Care Clinic Office Practice. 39, 533-546. DOI: 10.1016/j.pop.2012.06.008


National Center for Complementary and Alternative Medicine. Visit http://nccam.nih.gov/health/


Urrutia, G. et al. (2005). Neuroreflexotherapy for nonspecific back pain: A systematic review. Spine. 30(6), E148-E153. DOI: 10.1097/01.brs.0000155575.85223.14


Vlaeyen. JW and Morley, S. (2005). Cognitive-behavioral treatments for chronic pain- What works for whom? The Clinical Journal of Pain. 21(1), 1-8.