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Ask Dr. Gott 9/12

Seek alternative forms of pain management

    DEAR DR. GOTT: As a chronic sufferer of sciatica and lower-back pain, I am always searching for nonsurgical and nondrug forms of relief. I've recently come across information on prolotherapy and Feldenkrais Movement Therapy. I have a friend who says the Feldenkrais has been miraculous in relieving her many back pain problems. Can you tell me anything about these treatments? Have any of your readers found help with them?
    DEAR READER: There are numerous therapy methods available that are based on body movement. Some of the more common ones include tai chi, yoga and the Alexander Technique, which uses a combination of verbal instructions and light touch, focusing on alignment of the spine, primarily between the head and neck. It is commonly used on people with posture problems.
    Prolotherapy therapy involves injecting a sugar solution into painful tendons and ligaments. The normal course takes between six and 10 sessions, sometimes requiring multiple injections during those sessions. Any pain experienced is mild and temporary. The procedure is intended to stimulate the production of connective tissue, but studies report conflicting evidence for effectiveness in treating chronic back pain unless the injections are combined with a program of exercise and spinal manipulation.
    From all reports, more research is necessary to determine whether prolotherapy is successful in the treatment of chronic lower-back pain.
    Feldenkrais involves a series of exercises through simple, pain-free movements. The two-part series involves lessons in movement provided by a teacher in group sessions and individual hands-on sessions guided by a practitioner.
    Recent studies indicate the practice may be useful for neck and shoulder pain and anxiety. Since your complaint is sciatica and lower-back pain, this choice might not be the most appropriate one for you.
    Both nonsurgical alternatives you have suggested would not be in your best interests. Initially, make an appointment with your primary-care physician. Explain that you prefer not to become involved with drugs or surgery. Ask whether you have any physical condition that would prevent you from seeking alternative help. If X-rays or other testing are in order, begin there. Then, depending on test results, your next step is to request a referral to either a chiropractor, the physical-therapy department of your local hospital, a sports-medicine specialist or a nearby pain clinic.
    Consider a second opinion, learn your options, and perhaps begin a regimen of light exercise under the guidance of a trained therapist. I admire you for considering options other than drugs and surgery. You're already on the right track.
    To give you related information, I am sending you a copy of my Health Report "Managing Chronic Pain."

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