4 O’s That Can Help Relieve Chronic Pain

By Barby Ingle, Columnist 

Each pain patient is different, even when we share the same disease or condition. How we treat, manage and find solutions for our chronic pain is also different, due to biological makeup and life experiences. A one-size-fits-all approach to treating pain is impractical and will not yield the best results. 

This month I continue my alphabet series on alternative pain therapies by looking at four O’s – oral orthotics, orthomolecular medicine, osteopathy and occupational therapy -- treatments that may help you or a loved one in chronic pain. 

Oral Orthotics

An oral orthotic (OO) device is a topic I have written about and made home videos of, as it is a treatment I personally have used since 2012. 

The OO is used to change the size, shape, and relationship of the bones in the face and jaw, to create a symmetry and balance that helps lower neuro-inflammation in your spine and brain. Many people with chronic pain don’t realize that their spinal nerves run right through the small space in their temporal mandibular joint (TMJ) before reaching the brain.

I underwent multiple tests before being fitted for my orthotics, including cat-scans, X-rays and other measurement tests. I also participated in an OO research study, which helped me learn how the device can work for chronic pain and other neuro-inflammatory diseases.


I didn’t fully understand in the beginning how creating the proper spacing and mechanics in my jaw could actually help the burning pain in my feet and legs. My orthotics have helped me reduce my pain levels and allowed me to stop taking daily pain medication. They work so well for me that I have even been able to cut back on my IV ketamine infusions. 


I have two orthotic devices, for use during the day and night. My day version snaps over my bottom teeth, and my night version has two parts for the top and bottom teeth. Each has different mechanics, which work to best fit my needs.

Every patient is different, and each device has to be measured and made specifically for you. For more information you can check out Dr. Gary Demerjian’s site: TMJ Connection.  

This type of treatment isn't cheap. It costs from $2,500 to $5,000 to start, and a few hundred dollars a year to maintain. But It helps me avoid paying for many other expensive therapies and medications. It is well worth the price and effort, when done by a competent neuro-dentist who understands chronic pain and the TMJ connection. 

Orthomolecular Medicine

Orthomolecular medicine is based on maintaining human health through nutritional supplements. Supporters of this treatment believe that vitamins, minerals, amino acids and other natural substances can be used to correct imbalances and deficiencies in the body that lead to illness.

Orthomolecular providers may also incorporate dietary restrictions and mega doses of vitamins and pharmacological medications.

Large doses of any substance can cause problems. For example, too much vitamin B12 can cause hypersensitivity and neuropathy pain. Some vitamins in large doses can also increase the risk of cardiovascular disease and cancer.

I personally have not tried this method myself, as all of my blood testing shows that my vitamin levels are fine and my providers recommend against it. I do know a few patients, including my mom, who have tried it.


My mom had complications from high doses of Vitamins B6 and B12. She experienced nerve damage and “pins and needles” pain in her hands from B6; while B12 caused side effects such as headaches, dizziness, diarrhea, indigestion, nausea, back pain, swelling, anxiety and lack of coordination. 

Most of the other patients I know who tried this method did it with high doses of Vitamin C pills or infusions. They believe it helped prevent their disease from spreading or getting worse. 


Osteopathy is a type of alternative medicine that emphasizes manual readjustments, myofascial release and physical manipulation of muscle tissues and bones.

I have had myofascial release and other physical manipulation treatments for my muscle and bone pain. They were helpful in lowering my pain levels, but the benefits were not significant or long-lasting.

Osteopathy medicine is recognized internationally in the treatment of many pain diseases involving muscle and bone. However, the profession has branched into two directions: non-physician manual medicine osteopaths and medical osteopathic physicians. They practice distinctly different techniques and function as two separate professions.  

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Doctors of Osteopathic Medicine (DO) are fully licensed physicians who practice in all areas of medicine. They emphasize a whole-person approach to treatment and care, and are trained to listen and partner with their patients to help them get healthy and stay well.

My general practitioner is a DO and many of the best practitioners I know are as well. I do see a difference in their approaches to care, how I am listened to, and in the treatments they offer.

Although many countries consider there is good evidence behind manual manipulation, they differ on the parts of the body where it is most helpful. Most believe that it is best for low back pain. There is limited evidence for other issues like neck, shoulder or lower limb pain, and in recovery after hip or knee operations.

I personally used the myofascial release after a knee surgery in 2001, as well as similar treatments after an auto accident in 2002. For me, they didn’t help with my headaches, migraines, digestive issues or nerve pain.

Occupational Therapy

Occupational therapy (OT) is often confused with occupational medicine, which deals with the maintenance of health in the workplace. Occupational therapy, on the other hand, is used to help a patient recover or maintain meaningful daily activities.

After a hospitalization with internal bleeding, an OT therapist would come to my home to help me learn and regain abilities to do daily activities around the house. When the therapist first arrived, I was a bit confused myself. I thought she was there to teach me new skills so I could find a job or go back to work. Instead she worked with me to make my daily life better.

She made suggestions like moving utensils to a place in the kitchen where there would not require reaching, and switching to paper plates and plastic cups so that when I dropped them it didn’t hurt me further. She taught me how to find ways around the challenges of my disabilities and impairments, and when to ask for help when needed. I was surprised when said she couldn’t help me with anything else on my body but upper extremity movement. My insurance covered the care and I didn’t have any out of pocket charges.

Other OT modalities include helping children with disabilities participate in school and social settings, injury rehabilitation, and helping older adults with Alzheimer's and other physical and cognitive changes.

Remaining open minded about alternative therapies and talking about them with your care team is very important. Don’t do any treatments you are not comfortable with for pain management, whether they are traditional or alternative therapies.

I wish you all knowledge, research and the best chance at positive outcomes possible for your daily pain care. I encourage you to find your own solutions and to keep working toward lower pain levels that can be managed through the right care.

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Barby Ingle lives with reflex sympathetic dystrophy (RSD), migralepsy and endometriosis. Barby is a chronic pain educator, patient advocate, and president of the International Pain FoundationShe is also a motivational speaker and best-selling author on pain topics.

More information about Barby can be found at her website. 

The information in this column should not be considered as professional medical advice, diagnosis or treatment. It is for informational purposes only and represents the author’s opinions alone. It does not inherently express or reflect the views, opinions and/or positions of Pain News Network.