Swallowing pills isn't the only way to treat pain

The storm of controversy over commonly used painkillers is giving doctors and advocates a chance to remind patients there is no magic bullet to end aches and pains, but that even simple lifestyle changes can significantly improve their quality of life.

"I think the golden rule is to use pain medicines in moderation, to work closely with your physician, to follow a healthy lifestyle as much as possible, diet and exercise, and use some common sense," said Dr. Gordon Novak, director of the Pain Management Center at Caritas St. Elizabeth's Medical Center.

He stressed that daily activities like taking a walk, doing the groceries, and interacting with others could contribute to a healthy lifestyle that decreases pain. Often, people who face chronic pain become sedentary and isolated, leading to weight gain that may increase the stress on their body, and loneliness that could make them depressed -- further worsening their suffering.

Losing weight by eating well and exercising can decrease the burden that arthritic joints have to bear. Physical therapy can also improve pain levels, allowing patients to resume a normal life.

Another key, said Penney Cowan, founder of the American Chronic Pain Association, is to decrease life stress.

For those in chronic, extreme pain, surgery also remains an option.

As for alternative cures, doctors remain skeptical of herbal cures and say that it is essential for patients taking supplements of any kind to alert their doctors because they might interfere with other drugs or have other side effects.

Acupuncture recently has been shown to provide effective pain relief in some patients. A study sponsored by the National Institutes of Health and released last week found that acupuncture gave a significant number of patients with arthritis of the knee a 40 percent reduction in pain. Doctors warn that it doesn't work for everyone.

Another method of pain reduction -- biofeedback -- teaches patients to learn how to focus on things other than their pain.

"Pain management is really an art form; it really depends on the relationship between doctor and patient," said Dr. John Goodson, a primary-care physician at Massachusetts General Hospital who deals with patients facing chronic, daily pain.

CAROLYN Y. JOHNSON