The Veterans Hospital in White River Junction is trying out new programs designed to relieve pain without strong medications. VA doctors are now prescribing acupuncture, yoga and aquatic therapy as alternatives.
Acupuncture has not yet been fully integrated into the hospital’s menu of treatment options, but for about six months now, Dr. Freda Dreher has been inserting sterile needles not much thicker than a human hair into a few people looking for pain relief.
“So I will start with a needle right at the shoulder that’s been painful,” she said to Carol Hitchcock, Executive Assistant to the hospital Director.
Hitchcock is a veteran who has served in Afghanistan, but her excruciating shoulder injury resulted from a motorcycle accident many years ago.
“It just hurt so bad that I couldn’t do anything, and I tend to be pretty tolerant, but I couldn’t tolerate it any more,” Hitchcock recalled.
But she didn’t want to take powerful, potentially addicting pain killers either, especially since there is so much concern about opioids. So about once a month - it used to be once a week - she comes into this examining room and sits or lies down on a table to get non-medicinal relief.
After Dr. Dreher inserted about a half dozen micro-thin needles into her arm, the patient looked and sounded more relaxed.
“I sleep, which I hadn’t done for a number of years,” Hitchcock said. “I can actually sleep now because of this. The pain is not there. I guess it’s cyclical, right? So I feel better, so I am healthier, so I sleep better and my weight is under control now, so everything just aligns."
Sometimes, Hitchcock said, the pain disappears instantly. Other times, as on this day, it slowly wanes through the day.
“So right this second, I don’t feel any different, but the whole health approach is amazing. Changed my life,” Hitchcock said.
The VA is also trying to change lives and reduce opioid dependence with other techniques. Therapists say aquatic physical therapy is bringing results.
So is yoga.
In a large conference room, three Vietnam-era veterans sat cross-legged on rubber mats as instructor Brianna Renner—a former Marine--lead them through assorted poses.
“So welcome everybody, we’ll start by finding a comfortable seated position. Any there any areas you guys want to work on today?” Renner asked them.
“Body and mind,” came a voice from the back.
“Body and mind - that narrows it down,” Renner chuckled.
Collectively, these men have been suffering from back injuries and surgeries, depression, and arthritis. Some are taking prescribed pain pills but they would like to take fewer - or none.
Those are laudable goals, says Julie Franklin, an anesthesiologist who practices pain management at the VA Hospital.
“Patients who are addicted or who have problematic opioid use need to be helped to reduce or come off medication that actually may be providing more harm than good for that patient,” Franklin said.
A 2012 article in the Journal of American Medicine concludes that veterans of Iraq and Afghanistan with mental health diagnoses, including PTSD, were especially likely to receive opioids for pain, even though that population is also at the highest risk for abusing those drugs.
At the VA Hospital, Dartmouth Hitchcock medical residents are observing the alternative therapies for possible use with civilians. They say no one sees acupuncture or yoga as overnight solutions, but they would like to see more patients give them a try.
Those who do will be tracked, so that the Hospital can determine whether alternative methods do a similar job as prescription medicines.