Can Homeopathy Treat Chronic Pain?

By Cindy Perlin, Guest Columnist

Homeopathy was developed in 1827 by Dr. Samuel Hahnemann, a German physician, and is based on the principle that “like cures like.”

This theory means that any substance capable of producing symptoms in a healthy person can cure similar symptoms in a person who is sick. This idea is referred to as the “law of similars.” For instance, an onion makes your eyes water and your nose burn. If you are having an attack of hay fever with watering eyes and a burning nose, a homeopathic remedy made from onion can relieve it.        

A second homeopathy principle is that you should administer the least amount of medicine necessary to evoke a healing response. This is called the “minimum dose.” To prevent side effects, Hahnemann began successive dilution of his medicines to find the point at which they would be therapeutic, but not toxic. He also discovered that in many situations the best cure was achieved by the highest possible dilution.

Homeopathy has been controversial, partly because homeopathic medicines in high potencies are so diluted that theoretically there should be no measurable remnants of the starting materials left.

In a 2010 study, researchers demonstrated for the first time the presence of nano-particles of the original substance in these extreme homeopathic dilutions.

Homeopathy was very popular in the U.S. in the late 1800s and early 1900s.  There were 44 homeopathic medical schools and over 100 homeopathic hospitals in the U.S. by 1892. 

Homeopathy proved its worth as a powerful treatment in the swine flu epidemic of 1918-1919.  During this epidemic, which killed 22 million people worldwide, deaths in patients treated with homeopathy were rare. 

In an effort to eliminate the competition, the American Medical Association teamed up with the pharmaceutical industry to set standards for hospitals and medical schools that homeopathic institutions could not meet. This caused the closing of all the homeopathic institutions and virtually eliminated the practice of homeopathy in the U.S.  Homeopathy has remained popular in most of Europe.  It is currently enjoying somewhat of a resurgence in the U.S. as Americans look for safer medical treatments.

Homeopathic treatment is traditionally based on the principle that the whole person, rather than a specific symptom, needs to be treated, and is based on a detailed assessment of the patient.  Two patients with the same symptom may get prescribed different remedies.  Randomized, controlled studies of individualized homeopathic treatment of rheumatoid arthritis, migraine headaches, osteoarthritis and fibromyalgia all demonstrated significant pain relief and improvement in functioning and quality of life.

In more recent years, combination homeopathic drugs have been developed that contain multiple homeopathic remedies for more general use.  One, called Lymphdiaral basistophen, was found in a double-blind, randomized controlled study to significantly improve functional ability of patients with low back pain compared to a placebo. 

Traumeel, a topical ointment that contains 12 homeopathic remedies, has been available over the counter in Germany for over 60 years and is currently available in more than 50 countries. Traumeel was demonstrated in a 1989 doubled-blind randomized controlled study to speed healing of acute ankle sprains, including restoration of full range of motion and resolution of pain during movement.

Traumeel is frequently used with good to very good results in acute musculoskeletal injuries, as well as for degenerative and inflammatory conditions such as osteoarthritis, frozen shoulder, carpal tunnel syndrome, and tennis elbow, according to multicenter drug surveillance studies in Europe. It works as well, or better, than NSAIDs, with no adverse effects.

In the United States, homeopathic remedies are regulated by the FDA. Thanks to the efforts of homeopathic physician Royal Copeland, the U.S.Senator from New York when the Federal Food, Drug, and Cosmetic Act was passed in 1936, homeopathy’s own standards, as expressed in the Homoeopathic Pharmacopoeia of the United States (HPUS), were incorporated as part of the Act.  Homeopathic remedies are generally recognized as safe. Most are sold over the counter. They can be found in health food stores and online.

There are currently relatively few homeopathic practitioners in the United States. Since homeopathic remedies are not toxic, it’s safe to try them on your own if you can’t find a practitioner. There are many books, and even apps, that can help you pinpoint the appropriate remedy.

Some other homeopathic remedies to consider, based on their most common uses: arnica montana for muscle sprains and soreness, ruta graveolens for tendonitis and other inflammatory conditions and hypericum perforatum for nerve pain.  These homeopathic remedies have been my “go to” treatments whenever I feel the need to medicate pain for over 35 years, with good success.

Cindy Perlin is a Licensed Clinical Social Worker, certified biofeedback practitioner, chronic pain survivor and the author of “The Truth About Chronic Pain Treatments: The Best and Worst Strategies for Becoming Pain Free.” 

For the last 25 years Cindy has helped her clients improve their emotional and physical well-being through her private practice near Albany, New York.

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

Insurers Should Cover All Types of Pain Treatment

By Cindy Perlin, Guest Columnist

Many chronic pain patients who have depended on opioids to manage their pain have posted comments critical of the CDC's draft guidelines and rightfully so.  No patient who is in severe chronic pain should be required to reduce their pain medication unless and until they have been provided with access to treatment that is at least as effective as their current opioid regimen.

Efforts to reduce use of opioids have driven legitimate pain patients to use of heroin and have not stemmed the opioid abuse epidemic. In fact, addiction and overdoses have only increased. 

Preventing addiction is the key to saving lives. The best way to do this is to reduce the number of new prescriptions for opioids unnecessarily dispensed to pain patients. Fortunately, curtailing opioid prescriptions can be done without harm to pain patients because safer, more effective treatments exist.

However, significant barriers to access to alternative pain treatments exist. Financial obstacles because of lack of insurance coverage, inadequate availability of services, and lack of knowledge of alternatives by both patients and their physicians prevent patients from receiving the most appropriate care. 

A significant factor that has led to inadequate availability of many pain treatments is the fact that non-physician in-network providers who are reimbursed by health insurers have not, for the most part, received any fee increases in over 35 years; whereas physicians have received numerous increases. These providers include chiropractors, physical therapists, occupational therapists, and mental health practitioners.

Availability of these services has decreased as more providers are leavingand fewer providers are entering these disciplines, because of a 65% decline in real wages owing to inflation.

To reduce these impediments to effective pain treatment, I propose a Pain Treatment Parity Act (PTPA), which would require all entities that pay for treatment of chronic pain -- including public and private insurers -- to cover all pain treatments that have credible evidence of effectiveness to the same degree that they cover pharmaceutical treatment of pain.

This includes both qualitative and quantitative limitations on care, such as equivalence in pre-treatment authorization requirements, limits on number of visits or dosage restrictions, copayment requirements, as well as equivalent fee schedules.

Provisions of the PTPA

1. All pain treatments with some credible evidence of effectiveness must be covered when provided by a licensed or certified provider. This includes any treatments with at least one well-designed randomized, controlled trial showing a significant benefit from the therapy and a good safety profile or any other reasonable evidence of safety and effectiveness.

Therapies that currently meet this standard include chiropractic, physical and occupational therapy, acupuncture, biofeedback, massage therapy, homeopathy, nutritional counseling and supplements, herbal therapy, psychotherapy, energy medicine therapy, supervised exercise programs, and multidisciplinary interventions, including coordination of services.

2. There can be no restrictions on the number of treatment visits or length of treatment for nonpharmaceutical pain treatment, unless there are similar restrictions on dosage or length of treatment for the preponderance of pharmaceutical treatments for pain.

3. Copays for visits to nonphysician pain treatment providers cannot exceed the copayment for primary care physician visits.

4. There cannot be a separate deductible for nonphysician pain treatment providers.

5. Preauthorization for visits to nonphysician pain treatment providers cannot be required unless preauthorization is required for pharmaceutical treatments for pain.

6. Medical necessity reviews cannot occur with greater frequency for nonphysician pain treatment providers than for physicians who provide pharmaceutical treatment for pain.

7. Fee schedules for in-network chiropractors, physical therapists, occupational therapists, psychologists, social workers, mental health counselors, acupuncturists, massage therapists, and all other nonphysician pain treatment providers must be increased by the same percentage as the average increase in fees for physicians for all specialties since 1980.

8. If an insurance plan has out-of-network benefits for medical and surgical treatments, it must also cover nonphysician out-of-network pain care providers at the same level of reimbursement.

9. All medical schools must offer a required course in pain management that covers all currently available treatments and the evidence supporting their use.

10. All physicians who treat chronic pain patients who have not completed a course in pain management in medical school must complete a 12-hour CME course about the safety and efficacy of all currently available treatments for chronic pain.

The Centers for Disease Control And Prevention (CDC) should champion this or similar legislation along with its opioid prescribing guidelines.

Cindy Perlin is a Licensed Clinical Social Worker, certified biofeedback practitioner, chronic pain survivor and the author of “The Truth About Chronic Pain Treatments: The Best and Worst Strategies for Becoming Pain Free.” 

For the last 25 years Cindy has helped her clients improve their emotional and physical well-being through her private practice near Albany, New York.

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