YOUR HEALTH AT WORK:
ALTERNATIVE APPROACHES TO JOB-RELATED AILMENTS
By Carol Milano

If a health problem is affecting you on the job, the familiar, logical response is to see a doctor. But did you know that today, almost any physical or psychological difficulty can also be treated with a wide array of non-traditional, yet highly effective, approaches?

While some of these complementary and alternative methods may not be universally known, they have become accepted and respected — even by most health insurers. In fact, many plans welcome them, partly because complementary and alternative medicine (known as CAM) is usually far less expensive than a mainstream approach, such as costly prescription drugs.

Some of the major CAM institutions prefer to describe their work as Integrative Medicine, believing that it complements the best traditional medicine by adding the most effective and proven alternative approaches. Other facilities may specialize in just a few CAM methods, or even a single one. Two respected California institutions offering an array of Integrative Medicine services are the Osher Center at the University of California in San Francisco and the Scripps Center for Integrative Medicine in San Diego.

Some Well-Known CAM Approaches

Our bodies respond very individually to any type of treatment -- whether mainstream or alternative -- so you may want to try more than one method to see which brings you the greatest relief. Three often-recommended approaches are massage therapy, chiropractic care and acupuncture.

Therapeutic massage helps relieve several different conditions. "Massage increases the body’s natural feel-good chemicals, such as oxytocin, which elevates your mood and decreases pain," explains Robert Bonakdar, MD, director of integrative pain services at Scripps Green Hospital. Research shows that massage therapy can lower both blood pressure and heart rate. By hand or with a special instrument, the massage therapist manipulates an affected area (through rubbing, stroking, tapping or kneading), as a remedy for a particular disorder.

The basic premise of chiropractic care, another popular and effective integrative therapy, is that a lack of normal nerve function causes many physical problems. Specific structural adjustments, muscle stretches and trigger-point pressure can relieve a particular discomfort.

Acupuncture, which originated in China, is also a frequent alternative method. An acupuncturist inserts tiny needs at specific points of the body, to reduce pain or stimulate healing of an affected area.

When CAM Can Help

Here’s a brief guide to some common work-related health problems and a few specific CAM approaches that often ease each situation. We’ve also noted the qualifications which identify a professional who provides each service.

Back or Neck Pain -- Chiropractic care can be particularly effective for these two problem areas. Doctors of chiropractic (DC) attend a chiropractic college and can be licensed in all 50 states. In many cases, acupuncture also helps. It can be safely performed by either a medical doctor with acupuncture training, or by one of the 20,000 certified U.S. acupuncturists. Some people find massage therapy extremely helpful for back pain. Massage therapists are licensed in 29 states, and many of the training institutions certify their graduates.

Back pain is sometimes treated with osteopathy, a medical practice in which the doctor manipulates the part of the body that isn’t working properly. Treatment may also include medication, or recommendations about diet and lifestyle. A doctor of osteopathy (OD) is a licensed physician who has had the same training as an MD, plus 300-500 additional hours of studying the body’s musculoskeletal system. Some MDs also take further training so that they can be certified in osteopathy and include its techniques in their practices.

Carpal Tunnel Syndrome -- A painful repetitive stress injury affecting the wrists and arms, this is commonly caused by using a computer keyboard for long stretches of time. Effective CAM alternatives to surgery include acupuncture, chiropractic care and yoga therapy, in which a trained specialist designs a program based on individual needs. Yoga therapy works well for pain management. [Details on yoga therapy appear in the Stress section.]

Depression -- Prescription drugs are often used as treatment for various types of depression. As another option, many people find that they feel better after using one of the alternative methods shown to be effective for this condition. These include acupuncture, massage therapy and osteopathy. Another useful approach is following specific exercise and nutrition recommendations, often from a Registered Dietitian (RD), who has had specialized training in dietary supplements, herbal medicines and lifestyle modification. An RD earns a Bachelor’s degree in order to receive their professional designation. MDs and DOs can choose to become Certified Nutrition Specialists (CNS). Other recognized professional titles are Human Nutrition Specialist, Licensed Dietitian and Licensed Nutritionist.

Music therapy is another depression treatment that works well for some people. It uses vibrations to restore balance by affecting blood pressure, breathing, pulse, body rhythms and tension. Music therapists earn a Bachelor’s, Master’s or Doctoral degree, and are certified by a national examination.

Headaches -- Several treatments can help eliminate headaches, such as acupuncture, chiropractic care, hypnosis, nutritional changes and massage therapy. Clinical aromatherapy often soothes pain or inflammation. It is based on the chemistry of concentrated "essential oils" from various plants, and their effect on specific conditions. First used 60,000 years ago, medicinal aromatherapy is provided by practitioners who are certified by the educational training programs they have attended.

Meditation can also help alleviate the pain and tension of headaches. One form, Progressive Muscle Relaxation, is a structured process, which involves tensing and releasing alternate muscle groups. Meditation has been in use for over 3,000 years. No formal credential is required, but several leading institutions, including Harvard and the University of Massachusetts, offer training programs.

Some headaches are relieved through Homeopathy, which uses minute doses of carefully selected natural ingredients to enhance the body’s natural healing process, without side effects. Each remedy is carefully chosen for a particular ailment. The American Institute of Homeopathy recognizes over 2,000 homeopathic remedies. Homeopathy is licensed in the U.S. Medical doctors, osteopaths and doctors of naturopathy can be certified to include it in their practices. Some states allow other health care providers, such as nurse-practitioners and podiatrists, to use homeopathic treatments.

Smoking Cessation — Acupuncture, hypnosis, massage therapy and nutritional changes can assist with this process. Guided imagery, an inexpensive and simple activity, also helps some smokers kick the habit. Its most basic approach is listening to a relaxation tape, which can be purchased at many book or record stores. "Guided imagery involves using auditory clues to get you into a more relaxed state," says Dr. Bonakdar. [More details are in the next section.]

Reducing Stress

Stress responds particularly well to certain CAM approaches, including aromatherapy and osteopathy. The Osher Center at UCSF uses Tai Chi, Yoga and Acupressure to help reduce stress. Also known as "moving meditation," Tai Chi uses breathing and relaxed, but structured, body movements to develop strength and awareness of control over your own body. Its calming effect leads to lower anxiety and an improved mood. In use for over six centuries, Tai Chi has no official licensing procedure: "grand masters" teach trainers.

For yoga therapy, a trained specialist customizes a program to individual needs. Its underlying principle: chronic stress can lead to such serious problems as increased heart rate and breathing, higher blood pressure, more muscle tension and a weaker immune system. To restore the body’s natural state, yoga uses breathing, stretching, relaxation and meditation. Research has proven yoga’s restorative effects for stress and related health problems. Professional yoga teachers are certified by well-established schools requiring 300-500 hours of training. A RYT (Registered Yoga Therapist) meets these professional standards.

Acupressure is a massage technique in which the fingers apply pressure to the same specific "trigger points" used in acupuncture. It can relieve tension, improve circulation, strengthen a weakness and relieve certain ailments. Usually, the specialist has trained at a massage therapy school, which provides certification. Often, a practitioner is licensed in another health care field (such as nursing, massage therapy, acupuncture or chiropractic care).

The Scripps Center treats stress with Tai Chi, meditation, music therapy and yoga. Dr. Bonakdar also recommends aerobic exercise, which helps reduce stress because of the hormones it releases. He’s also found biofeedback to be especially effective. A biofeedback therapist uses sophisticated electronic equipment to measure physical changes (such as fluctuations in breathing, muscle activity, heart rate and blood flow) in response to a stressful situation. "Then we’ll work with the patient to control stress — for example, giving them a three-step breathing technique. As they see their muscle tension decrease on the monitor, they see that they can control their stress," Dr. Bonakdar reports.

Guided imagery also brings impressive results in stress management. In a study by Blue Shield of California, stress was reduced in 45% of people who listened to a guided imagery tape. Among surgery patients, only 5% felt anxiety after they had heard the tape. Even more remarkably, 57% of patients said they felt less pain from their surgery. Patients who used guided imagery before surgery had a 4.5% decrease in total hospital charges, as well as an 8.4% decrease in pharmacy charges.

"An $18 tape saved the hospital $654 on each surgical patient," Dr. Bonakdar notes.

Finding a CAM Provider

If you’re bothered by one of the work-related problems in this article and would like to consider an alternative approach, begin by checking the Directory of Approved Providers for your health plan. These are qualified practitioners who meet state or national licensing requirements in their specialty.

When choices are available, an Integrative Medicine center at a well-known medical facility is likely to have practitioners with excellent credentials. Often, you can visit the web site of a medical center (or private practice) to learn more about the specialties offered, and the qualifications of the people providing them.

It’s always worth asking co-workers if they have ever visited, or heard anything about, a particular provider in your vicinity. Some physicians are already familiar with Integrative Medicine, and may be able to recommend, for example, a licensed massage therapist or acupuncturist in your area.

In Resources For Readers, we’ve gathered sources for finding a professional in any CAM specialty, or learning more about it.

RESOURCES FOR READERS

Many of these articles appear on the publication's website, which are often password-protected or members-only. For your convenience, I've gathered them on my own website.