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Exploring Alternatives

Pain management physicians, always looking for ways to reduce discomfort so patients can better heal, often recommend what peers in other fields might consider alternative medicine.

Patients, however, should be informed when they seek treatment in specialties outside the scope of mainstream medicine, says anesthesiologist Jay Lasner, co-founder of Anesthesia Pain Care Consultants, which has seven locations in Broward County.

The pain management field, for instance, includes physiatrists (who treat acute and chronic pain and musculoskeletal disorders), chiropractors, acupuncturists, massage therapists, physical therapists, hypnotherapists and others. Instead of shunning these specialists, Lasner's practice recommends them.

"We're very open-minded," he says. "They all bring different perspectives, ideas and techniques in helping someone to reduce, eliminate or cope with chronic pain."

Mainstream medicine is constantly changing to adapt to new methods, Lasner says. One of the most prevalent procedures at his practice involves injecting medicine into the patient's spine using a fluoroscope, sort of a moving

X-ray, to guide doctors. Just 10 years ago, fluoroscopy was considered outside the mainstream, but today it has become the norm.

He gives these tips when considering complementary and alternative medicine:

? Consider off-label use.
Ask your physician whether there are medications effective for your condition that were not originally studied or intended for it. For example, some seizure medicines are used to relieve nerve pain.

? Find the right practitioner.
Ask for referrals. What is the person's training? Does this person typically see patients with your condition?

? Do your research.
The National Institutes of Health has a division dedicated to complementary and alternative medicine at http://nccam.nih.gov.

? Consult your doctors.
What are the alternatives, what are the benefits and risks, and how do the alternatives fit in with what you're already doing?

? Ask for explanations.
Anyone treating you should take time to understand your symptoms, outline any treatment and answer your questions. HEALTH TIPS

Health Tips:
The CAM Approach

Non-conventional approaches to healing are considered complementary and alternative medicine, or CAM. Complementary medicine is used jointly with conventional treatment, and alternative medicine is used instead of it. CAM therapies are divided into five categories:

Alternative medical systems:
Built upon complete systems of theory and practice. Examples: Homeopathic, naturopathic, traditional Chinese medicine, Ayurveda.

Mind-body interventions:
Enhance the mind's capacity to affect the body's symptoms. Examples: Meditation, prayer, mental healing.

Biologically based therapies:
Use substances found in nature, such as herbs, foods and vitamins. Examples: Dietary supplements, herbal products.

Manipulative and body-based methods:
Based on manipulation and/or movement of parts of the body. Examples: Chiropractic, osteopathic manipulation, massage.

Energy therapies:
Work with energy fields inside or outside of the body. Examples: Qigong, Reiki, therapeutic touch.