By Paula Tanksley, PT, MPT, and Curtis Turchin, MA, DC
Pain. We all experience it at some point in our lives, but for chronic pain sufferers, it’s a constant, ever-present shadow, affecting their jobs, families, friends, and overall quality of life.
It’s estimated that more than 100 million Americans suffer from chronic pain, according to the American Academy of Pain Management—more than diabetes, heart disease, stroke, and cancer combined. Even more painful is the high cost of caring for chronic pain, which ranges from $560 billion to $635 billion annually—much of which is shouldered by already burdened pain sufferers.
Those who experience pain explore multiple options for relief, from pain specialists and chiropractors to over-the-counter and prescription painkillers. But relief—for both the high cost of pain and the disease itself—can literally be found close to home, and not just in a pill bottle.
A growing concern about the overuse of pain medications has led the Institute of Medicine and other organizations to call for “a cultural transformation in how the nation understands and approaches pain management and prevention.” It recommends a combination of therapies and coping techniques, which has led clinicians and patients to explore a growing number of at-home tools.
Today, there is a wide range of noninvasive pain-management products available for home use at varying costs, but there remains one common factor: the clinician. For maximum compliance, the role of the clinician is critical in demonstrating these tools and educating patients about their use. In addition, having these tools available for purchase inside the clinician’s practice will increase the likelihood that the patient will actually buy and use them. Access, experts agree, has to be easy for pain patients who may have already experienced a great deal of frustration in locating appropriate therapies.
Following are examples of products available for cash-pay services that are designed as easy-to-use home care tools for pain relief:
The following companies also market key products to manage pain:
Adroit Medical Systems
Battle Creek Equipment
BioMedical Life Systems
Chattanooga, a DJO Company
Kinesio Holding Company
Medi-Dyne Healthcare Products
Multi Radiance Medical
Parker Laboratories Inc
ProMed Products Xpress
PHS Therapeutics by Pivotal Health Solutions
Sombra Professional Therapy Products
Sore No More
Zimmer Medizin Systems
Apollo Class IV Cold Laser Therapy System
Over the past 40 years numerous research studies and randomized blinded clinical trials have supported the efficacy of cold laser therapy (also known as low-level laser therapy). It has been shown to be analgesic, anti-inflammatory, and effective at stimulating healing—which is an important difference. Many modalities may be used for pain management, but what makes cold laser unique is that it not only reduces pain but also stimulates healing in all kinds of tissues, including bone, cartilage, spinal discs, and muscles. Cold laser also compares favorably against other electrotherapy modalities such as e-stim or ultrasound.
Another advantage is that patients can easily use cold laser at home. There is also virtually no learning curve in using cold laser therapy. Patients who visit a therapist two or three times a week for treatment can incorporate laser into home care up to two or three times a day. Patients do not have to apply a contact gel as they would with ultrasound, or worry about placing pads in the correct area—they would simply point the laser probe at the affected area for 1 to 5 minutes, depending on the power of the laser.
In addition, the therapy offers few side effects, so it would be very difficult for patients to overtreat themselves at home, compared to e-stim or ultrasound, which can sometimes cause shocks and burns. A number of studies have, in fact, recorded data about the long-term safety of low-level laser therapy.1,2
For patient use, Apollo offers a handheld cold laser therapy system available by prescription. The Apollo 2,000 mW cold laser fits in the palm of the hand, and its flat design makes it easy for patients to lie on it for at-home back or neck treatments. It is built to provide good value for its price point, and engineered to be up to 10 times more powerful than similarly priced devices. With its purchase, patients can also rely on 90 days of free support.
Patients are likely familiar with taping in the athletic training realm, with Olympic athletes, tennis stars, and football players often sporting the colorful tape in multiple configurations.
But any patient experiencing pain due to an injury can enjoy the benefits of taping at home. Taping will stabilize the joint or muscle and improve circulation, thus protecting patients from further injury and improving proprioception.
Tape can remain in place for 1 day to 5 days, depending on how it is applied. In the clinic, therapists can teach patients how to apply the tape in specific directions depending on the type of injury.
Interestingly, cold laser therapy and taping are often used in conjunction, as the laser’s ability to stimulate healing can help injuries heal more rapidly and provide further pain relief.
Costs of tape range widely, and can be found and purchased at most sporting good retailers or online.
Omni Cervical Relief Pillow
According to the American Academy of Pain Medicine, neck pain is the third most commonly reported pain condition in the United States. Anyone who works or studies using a computer or who commonly uses a smartphone can suffer compression in the joints of the neck, which can reduce range of motion and cause irritation and inflammation, leading to headaches, neck pain, and stiffness.
One solution is cervical traction, which returns the neck to a neutral position. Clinicians can employ devices such as the iTrac extension therapy system or DOC decompression table to offer traction in the office, but for at-home use, patients can complement their therapy with the Omni Cervical Relief Pillow.
The pillow’s molded contours cradle the head and neck to offer gentle passive positioning in cervical lordosis. This can be a gentle way to help restore lordosis to a cervical spine with a reverse curve. Gentle tractioning can be done on this pillow as well, if the patient is instructed to lie with the knees up and slowly pull the heels toward his or her tailbone until a pleasant traction force is felt in the neck. Patients with vestibular issues, facet syndrome, and disc pathology should all be instructed in the clinic on the use of this pillow.
At home, patients should use the pillow daily for 5 minutes to
30 minutes for the first week, then every other day until they experience relief. Another benefit of increasing movement between the vertebrae is the patient’s increased ability to perform stretching exercises as part of their home care.
The Omni Cervical Relief Pillow is available from online retailers.
Pressure Positive Self Care Tools
Self care tools are ergonomically designed devices crafted of metal, rubber, plastic, or wood that are handheld and made specifically for patients to use on themselves or for therapists to use in practice.
Also known as massage tools, these instruments provide muscle release for patients who have tight muscles, difficult ergonomic conditions at work, or who are suffering from chronic pain.
Clinicians should demonstrate these tools in the office setting, particularly for chronic pain patients who may be afraid of causing themselves more pain. Practice with these tools will help patients learn what feels best for their own bodies, avoid overuse, but also learn how to use the tools long enough for trigger-point release.
Self care tools may be used every day for up to three to four times a day to treat tight muscles. Patients who experience soreness or bruising should use the tools less frequently.
Pressure Positive offers a wide range of self care tools with different shapes and grips at multiple price points. However, it’s recommended that clinicians have these tools available in clinic for patients to try before they purchase so they can find the tool that is the right fit for them.
In 2006, a survey by the American Pain Foundation found that more than half of chronic pain respondents (51%) felt they had little or no control over their pain. While we will always have drug therapies, more people are beginning to realize that the more powerful the drug, the more powerful the negative effects it can cause.
With the move toward controlling healthcare costs and reducing overdependence on these medications, clinicians agree that a better practice is for patients to treat themselves at home with adjunct or maintenance therapies.
In the end, clinicians also recognize that patients do want to be in control of their own healthcare. If we can teach patients to take care of themselves using affordable, easy-to-use therapies, they will not only feel more empowered, but it is more likely that they will have positive long-term results. PTP
Paula Tanksley, PT, MPT, is owner of Tanksley Physical Therapy, located in the San Francisco Bay Area. Her specialties include myofascial release, scar tissue pain, neck pain, and other pain-related conditions. She teaches self care techniques and exercises as well as specific strengthening to correct movement dysfunction.
Curtis Turchin, MA, DC, has been using lasers for approximately 27 years, during which time he has published three books and more than 20 journal articles. Turchin is author of Light and Laser Therapy: Clinical Procedures. He is in private practice with a medical doctor in Redwood City, Calif. For more information, email PTPEditor@allied360.com.
- Tuby H, Hertzberg E, Maltz L, Oron U. Long-term safety of low-level laser therapy at different power densities and single or multiple applications to the bone marrow in mice. Photomed Laser Surg. 2013 Jun;31(6):269-73. doi: 10.1089/pho.2012.3395. Epub 2013 May 15.
- Myakishev-Rempel M, Stadler I, Brondon P, et al. A preliminary study of the safety of red light phototherapy of tissues harboring cancer Photomed Laser Surg. 2012 Sep;30(9):551-8. doi: 10.1089/pho.2011.3186. Epub 2012 Aug 1.