Ramova EP1* and Ramov L2
1Training implementation center Bitola, Macedonia
2 MIT University Skopje, Macedonia
*Corresponding author: Ramova EP, MIT University Skopje, Macedonia
Submission: October 28, 2018;Published: November 22, 2018
Volume1 Issue4 November 2018
Pain is an unhealthy feeling and only a person without pain is a happy person. In physical medicine more physical modalities are used for the treatment of subacute and chronic pain. We as doctors also use medical therapy in all forms, in the treatment of acute pain. After setting the diagnosis and the aetiological treatment, in the treatment of acute pain and stress as a reason for its occurrence, we use a number of alternative methods, which are used by top surgical centers such as aromatherapy, music therapy and acupuncture.
Material and method: in our research we list more physical modalities, alternative methods and assistive devices that we use in nonpharmacological treatment of pain.
Results: The effects of interferent currents, diadynamic currents, TENS, cryotherapy, and light therapy in the reduction of pain were analyzed. As well as the effects of some alternative methods.
Discussion: The use of medication for pain can have multiple side effects, due to the risk of bleeding or addiction. Before applying Physical modalities and alternative methods, knowledge of their mechanism of action and evaluation of the effect before and after treatment is necessary.
Conclusion: Physical medicine is the oldest but most modern branch of medicine, which has success in the treatment of painful conditions where drug therapy is limited.
Pain is an unhealthy feeling and only a person without pain is a happy person. In physical medicine more physical modalities are used for the treatment of subacute and chronic pain . To learn the benefits and risks of each, physical modalities is the responsibility of physical and medicine specialist. We as doctors also use medical therapy in all forms, in the treatment of acute pain. After setting the diagnosis and the aetiological treatment, in the treatment of acute pain and stress as a reason for its occurrence, we use a number of alternative methods, which are used by top surgical centers such as aromatherapy, music therapy and acupuncture . To treat pain, we must know the complexity and medical history of it. Physical therapy modalities and alternative medicine methods can be used in many pain conditions like patients with cancer, on palliative care, before and after surgery treatment, central and peripheral neurological pain  We have our own experience published in few studies [4-6]. The purpose of this research is to represent non pharmacological treatment of pain in physical medical and rehabilitation department by medicine based on science [7-13].
We have used retrospective analyze of studies published for treatment of muscles skeletal pain in physical medicine and alternative medicine, published in less 15 years. The research was done with keyword alternative methods and physical modalities in the treatment of muscular skeletal pain [14-21]. The systematization of data was in two groups: A (physical modalities with analgesic effect), and B (Alternative medicine methods). The each modality or treatment method was analyzed by indication, contra indication and evaluation of effect. 0 In group A, were analyzed: interferential current, diadynamic currents, TENS, cryotherapy, and light therapy (low level laser). In group B, were analyzed: acupuncture, aromatherapy, music therapy, color therapy, and typing (functional typing). As a measure of pain reduction included mobility of the joint and scales for measuring the pain NAS or VAS [22-24].
In analyze of Group A and B ware included 10 studies published in last 10 years for each group.
Results are showing in (Table 1&2).
The use of medication for pain can have multiple side effects, due to the risk of bleeding or addiction  Before applying Physical modalities and alternative methods, knowledge of their mechanism of action and evaluation of the effect before and after treatment is necessary . Physical medicine is the oldest but most modern branch of medicine, which has success in the treatment of painful conditions where drug therapy is limited . Physical therapy modalities and rehabilitation techniques are important options and must be considered when pharmacotherapy alone is sufficient or have interaction of drugs . Patients’ beliefs and financial barriers may affect the uptake of different treatments. Many patients may be using complementary and alternative approaches with limited evidence to support their use, highlighting the need for clinicians to discuss with patients the range of prescribed and non-prescribed treatments they are accessing and to help them understand the benefits and risks of treatments that have not been tested sufficiently, or have inconsistent evidence, as to their efficacy in improving pain outcomes . Chronic pain is the silent epidemic of our times. The economic costs of chronic pain in some countries are estimated to exceed the costs of heart disease, cancer and diabetes . Individuals undergoing medical procedures frequently experience pain and anxiety. Music-based interventions have the potential to help alleviate symptoms .
Table 1:Effect of some physical therapy modalities on pain relive.
MS*: Multiple Sclerosis; PD*: Parkinson Disease
Table 2:Effect of some alternative medicine methods on pain relive.
Patients with Chronic Musculoskeletal Pain rare use alternative medicine methods. Low back pain is one of the most frequent pain conditions. Patient use complementary interventions to reduce pain also. CAM prescriptions and most notably the extensive current integration in conventional medicine is problematic in several respects. There is not in health system regulation and standards for it application, and no follow up involved instruments. In case of pain it is safe if we know exactly mechanism of it positive effects by physiological way, and evaluate it effect . The pain assessment must address multiple domains of pain, including the sensory and affective qualities of pain, temporal dimensions of pain, and the location and bodily distribution of pain. We can use the same standards, like assessment of drugs effects. Nominal and visual pain assessment scales are gold standard but are not unique. We in physical medicine use some parameters like size of edema or swelling and range of motion, before and after treatment to access the effect of applied therapy [4-6]. Pain like a complex syndrome, without clear guidelines, clinicians are left wondering how a bio psychosocial assessment to administer it. It is need a practical guide, based on scientific research and clinical experience, for the bio psychosocial assessment of patients with chronic pain in physiotherapy practice. The purpose of this guide must be to look on pain from all factors: somatic, cognitive, emotional, behavioral, social and motivation for treatment . Alternative methods are not in any time effective, for example the use of acupuncture has little or no impact in rheumatoid arthritis . Acupuncture has been a popular alternative medicine in the United States for several decades. Its therapeutic effects on pain have been validated by both basic and clinical researches, and it is currently emerging as a unique non-pharmaceutical choice for pain against opioid crisis.
Physical medicine and alternative medicine have more options for treating pain without the use of drugs. Treatment and dosing should be proven and the effect evaluated on the basis of measurable parameters.
© 2018 Ramova EP. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and build upon your work non-commercially.