Back to Top Skip to main content

Breaking the pain cycle

Ashley Blake, an acupuncture nurse at Naval Hospital Pensacola’s Pain Management Clinic, treats a patient with Battlefield Acupuncture (BFA), one of many opioid alternatives offered at many treatment facilities in the Military Health System. BFA consists of inserting five tiny and sterile 2 mm needles into specific points of the ear where they can remain for up to three days. (U.S. Navy photo by Petty Officer 1st Class Brannon Deugan) Ashley Blake, an acupuncture nurse at Naval Hospital Pensacola’s Pain Management Clinic, treats a patient with Battlefield Acupuncture (BFA), one of many opioid alternatives offered at many treatment facilities in the Military Health System. BFA consists of inserting five tiny and sterile 2 mm needles into specific points of the ear where they can remain for up to three days. (U.S. Navy photo by Petty Officer 1st Class Brannon Deugan)

Recommended Content:

Prescription Monitoring Program | Mental Wellness | Mental Health Care | Substance Abuse | Physical Disability | Warrior Care | Opioid Safety | Pain Management

The pain in Marjorie Ann McLaughlin’s feet from plantar fasciitis made walking difficult, and the inactivity led to a cycle of back and knee pain. This physical pain led to relationship pain with her husband and family because she couldn’t cook dinners or make it upstairs most nights to sleep in her own bed. The former Air Force sergeant couldn’t even work in her garden, a favorite pastime.

McLaughlin didn’t like the way prescription opioids like hydrocodone made her feel. Her provider recommended pain management services available at Walter Reed National Military Medical Center – services with a common goal of easing patient discomfort while also reducing or eliminating the use of opioid medications.

“Providers continually collaborate to help ensure patients get the right level of care and treatment,” Army Lt. Col. Sharon Rosser said. Rosser, director of the Army Comprehensive Pain Management Program at Defense Health Headquarters in Falls Church, Virginia, leads efforts with other clinical experts to optimize pain management practices across the Military Health System.

According to Rosser, embedding primary care pain champions and additional providers like physical therapists, behavioral health consultants, and clinical pharmacists into primary care is just one way the MHS is delivering evidenced-based pain management for patients with acute and chronic pain.

“We’re dedicated to supporting our health care professionals with education and training so they may form effective, individualized patient treatment plans for acute and chronic pain,” Rosser said. “MHS leaders continue to look for opportunities to increase access to evidence-based pain care and non-pharmacologic therapies.”

Providers reinforce the lifestyle benefits of a nutritious diet and of daily movement in the presence of both acute and chronic pain, Rosser said. Problems caused by injury, illness, or surgery can include tense muscles, psychological stressors, emotional reactions to pain, or poor sleep – a combination that can contribute to persisting pain, called a pain cycle. MHS pain management services can offer patients alternative treatments to help.

Dr. Christopher Spevak, director of the opioid safety program for the National Capital Region, and a pain physician at Walter Reed, feels the more options for patients, the better. Pain clinics may offer procedures such as trigger-point massage, dry-needling, advanced injections like epidurals and facet blocks, spinal cord stimulation, and acupuncture. These therapies, along with yoga, biofeedback, cognitive behavioral therapy, mind-body techniques, ice or heat, and electrical stimulation modalities (TENS, Alpha-Stim, Calmare, and Inter X) can make a big difference in a pain cycle.

“The literature continually demonstrates there is very minimal indication for opioid use for chronic pain outside of end-of-life and cancer-type pain,” said Spevak, adding that the goal is to give patients control over their pain and their lives with as little medication as possible. “We help taper their medication, introduce them to acupuncture, and offer other physical and behavioral based modalities, such as cognitive behavior therapy and mindfulness.”

Pain and treatment experiences vary across individuals due to the sensitivity of nerves and brain reactions. For McLaughlin, the path toward relief included sessions with a pain management psychologist to talk over treatment options. Recommendations included yoga and a non-opioid muscle relaxant. The provider also introduced her to acupuncture, which she said opened up “a whole new world.”

“We should consider date night at acupuncture,” said McLaughlin, joking with her husband who suffers from shoulder problems. “Acupuncture is everything.”

While acupuncture helped McLaughlin sleep, other treatments worked better to treat Navy Petty Officer 1st Class Peter Kendrick’s upper back problems. Years of what he calls “wear and tear” had taken their toll. Deteriorating discs were pinching nerves and causing pain in both arms.

“It was to the point where I couldn’t sit in a car, and I couldn’t move my left arm at all,” said Kendrick.

Kendrick was prescribed an opioid for pain, which helped. However, like McLaughlin, he didn’t like the way it made him feel. “I didn’t like the residual effects of the medication,” said Kendrick. “I took it for three months when I really needed it.”

Kendrick’s provider referred him to a pain management team, where he started receiving epidural steroid injections a month or two apart. After receiving his fourth injection, he reports “the pain comes back intermittently, but it’s by no means as intense as before.”

The steroid shots helped Kendrick handle physical therapy – just one of a variety of non-medication options offered to manage his pain. He was also given Alpha-Stim electrotherapy, a high-tech product resulting from research by the Department of Defense, Department of Veterans Affairs, National Institutes of Health, and others. Alpha-Stim uses the Cranial Electrotherapy System and addresses pain, anxiety, insomnia, and depression by sending a current via ear clips to nerve cells in the brainstem. After 10 treatments, Kendrick was prescribed a CES unit that he uses at home almost daily for up to an hour. “It really helps with sleep,” he reported.

Spevak believes the news media’s attention on the national opioid epidemic and its potential dangers may lead some people to seek alternatives. “At Walter Reed, we’re able to offer treatments to active duty service members that may be difficult to get in the civilian sector due to reimbursement constraints.”

Kendrick agrees with trying out different options and encourages alternative therapies when recommended by a care provider. He said the breathing and meditation he learned from yoga helps him concentrate on something else other than the pain. “It breaks the pain pattern,” he said.

You also may be interested in...

Year in Review: Innovations aid warfighters, families

Article
12/26/2017
Blue light produced by smartphones and computer monitors interferes with the brain’s production of melatonin, the hormone that makes people sleepy. The Navy’s Bureau of Medicine is working on lens tinting to block blue light and enhance the sleep of service members. MHS announced this innovation among many others in 2017. (U.S. Air Force photo by Greg L. Davis)

MHS explores world-class solutions for beneficiaries

Recommended Content:

Military Health System Electronic Health Record | MHS GENESIS | Warrior Care | Medical Research and Development

2017 Year in Review: Places where Military Health System leaders, experts gathered

Article
12/21/2017
Navy Vice Adm. Raquel Bono, director, Defense Health Agency, speaks at the Defense Health Information Technology Symposium, July 25, in Orlando, Florida. Conferences like this one help MHS and other health care personnel to exchange ideas and information to help improve care to beneficiaries. (Courtesy photo)

Conferences offer opportunities to focus on the best health care for beneficiaries

Recommended Content:

Innovation | Military Health System Electronic Health Record | MHS GENESIS | Extremity Trauma and Amputation Center of Excellence | Warrior Care

Your military family: The key to beating holiday blues

Article
12/20/2017
Airman Adrianna Barelas, 4th Space Operations Squadron system administrator, displays her Grinch side for the holiday season at Schriever Air Force Base, Colorado, Dec. 1, 2017. Many things can cause stress during the holidays, including travel, financial strain from gift buying, and the expectations of friends and family. (U.S. Air Force photo by Airman 1st Class William Tracy)

Lift your mood with healthy basics

Recommended Content:

Mental Health Care

2017 Year in Review: A look at inspiring individuals who help shape the MHS

Article
12/20/2017
Staff Sgt. Matthew Crabtree, a medic with the 285th Medical Company (Area Support) and a registered nurse, performs a medical assessment on an infant less than one month old Oct. 27, 2017, in Jayuya, Puerto Rico. Military medical personnel were critical to disaster response related to hurricanes Harvey, Irma, and Maria. (Ohio National Guard photo by Sgt. Joanna Bradshaw)

MHS highlights the contributions of veterans, advocates, providers

Recommended Content:

Mental Health Care | Humanitarian Assistance and Disaster Relief | Research and Innovation

Four tips for staying healthy this holiday season

Article
12/15/2017
The simple act of washing your hands will decrease the risk of illness for you and your family this holiday season. (U.S. Air Force photo by Michelle Gigante)

Simple ways to make this the best time of the year for wellness

Recommended Content:

Public Health | Integrative Wellness | Mental Wellness

Invisible wound, visible effects: TBIs need medical help – and the sooner, the better

Article
12/13/2017
Traumatic brain injuries can happen anywhere. Regardless of how or when, all TBIs need medical attention, experts warn. (Photo courtesy of Walter Reed National Military Medical Center)

The road to recovery for a traumatic brain injury starts with an evaluation. Regardless of severity or cause, all TBIs require medical attention, experts warn.

Recommended Content:

Traumatic Brain Injury | Warrior Care

Invisible Wounds, Invisible Care

Infographic
12/8/2017
Invisible Wounds, Visible Care: A Road to Care and Recovery. 1. Seek Care: Are yo or someone you know showing symptoms of an invisible wound? Seek care early and often. Many resources are available to support you and your family. 2. Receive Care: Connect with medical and non-medical services that will assist you throughout the care process, help you build a care management team, and support your recovery. 3. Continued Care: Continue recovery while reintegrating into your unit or transitioning into civilian life.

This infographic outlines the Air Force Invisible Wounds Initiative and offers a list of resources for wounded warriors and their families.

Recommended Content:

Warrior Care

Osseointegration

Video
12/8/2017
Osseointegration

Doctors at the Walter Reed National Military Medical Center in Bethesda, Maryland, are adapting technology developed in Europe called Osseointegration. The technology allows the attachment of prosthetics directly to a patient's skeleton.

Recommended Content:

Extremities Loss | Warrior Care

Community, innovative collaborations are themes at third annual International Warrior Care Symposium

Article
12/6/2017
Air Commodore Rich Withnall, United Kingdom WC21 co-chair (left), Harjit Sajjan, Canada’s minister of national defence (center left), Dr. Dorothy Narvaez-Woods, special assistant to the assistant secretary of defense for health affairs (center right), and Mr. Bret Stevens, U.S. WC21 co-chair (right) pose for a photo following Minister Sajjan’s  keynote address. Senior representatives from 14 attending nations discussed their nations’ strategic priorities for warrior care. (Canadian Armed Forces photo by Corporal Lisa Fenton)

Community, innovative collaborations are themes at International Warrior Care Symposium

Recommended Content:

Warrior Care

Doctors use cutting-edge research at Navy hospital

Article
12/6/2017
Chad Rodarmer, traumatic brain injury clinic program manager, demonstrates tracking a patient's eye movement at Naval Medical Center San Diego, California. (DoD photo by EJ Hersom)

The Navy is developing and using cutting-edge research to better help service members, their family members and retirees

Recommended Content:

Technology | Warrior Care | Traumatic Brain Injury

Acupuncture: Ancient technique complements modern medicine

Article
11/29/2017
Army Col. Dean Hommer (left), a visiting instructor from Brooke Army Medical Center at Fort Sam Houston, Texas, observes as Navy nurse Lt. Rachael Wheelous (right) practices the battlefield acupuncture technique on Navy nurse Lt. Brent Pavell (center) during training at Naval Health Clinic Corpus Christi, Texas. (U.S. Navy photo by William Love)

Procedure has a role in easing pain, advocates say

Recommended Content:

Warrior Care | Pain Management

Care Loop

Video
11/29/2017
Care Loop

Air Force Tech. Sgt. Mariana Carrano’s business is patient care. She’s one of four Air Force liaison officers with the 86th Medical Squadron at Landstuhl Regional Medical Center, a short drive from Ramstein AB. As an LO, as they are often called, Carrano is responsible for taking care of a patient throughout the entire care loop – from the moment he or she arrives at Ramstein AB until the moment he or she leaves.

Recommended Content:

Access to Health Care | Warrior Care

Service members share ‘art’ of healing

Article
11/28/2017
Air Force veteran Adrianna Ruark works on a drawing. (DoD photo by Roger L. Wollenberg)

Service members, veterans and caregivers shared how using art helps their recovery

Recommended Content:

Warrior Care

Active duty amputee

Video
11/28/2017
Active duty amputee

More than 1,500 service members have lost limbs in the wars in Iraq and Afghanistan since 2001. For those faced with this traumatic injury, the Department of Defense medical system has adapted in the last 20 years to speed up the recovery process and improve prosthetics.

Recommended Content:

Warrior Care | Physical Disability | Extremities Loss

Let's talk about sex, occupational therapist says

Article
11/22/2017
Occupational therapist Kathryn Ellis meets with a patient at Walter Reed National Military Medical Center in Bethesda, Maryland. (Courtesy photo)

Silence on topic no help to wounded warriors

Recommended Content:

Warrior Care
<< < ... 6 7 8 9 10  ... > >> 
Showing results 76 - 90 Page 6 of 12

DHA Address: 7700 Arlington Boulevard | Suite 5101 | Falls Church, VA | 22042-5101

Some documents are presented in Portable Document Format (PDF). A PDF reader is required for viewing. Download a PDF Reader or learn more about PDFs.