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New Breakthroughs in Chronic Pain

Advances include nerve pain relief, virtual reality for back pain and a new use for an older drug

spinner image heath haug with two of his miniature donkeys
Heath Haug strokes one of his miniature donkeys in Radford, VA, on Friday, August 18, 2023. Haug developed chronic pain from serving in the infantry for most of his 22 years in the Army and National Guard, followed by more than a decade as a police officer. He is part of Salem VA Medical Hospital’s ‘Whole-Health’ PREVAIL Program to ease pain.
Shuran Huang

Heath Haug served for 22 years in the Army, Marine Corps and National Guard, followed by two decades as a cop. “I beat my body up,” he says. “My back, feet, my knee. It takes a toll.”

But Haug, 54, of Christiansburg, Virginia, has found relief through the Salem Veterans Affairs Health Care System’s (VAHCS) innovative Prevail Center for Chronic Pain. The program gives veterans basic coping strategies through an online or face-to-face “pain school,” after which they meet for an hour with a caregiving team — made up of a psychologist, a pharmacist, a dietitian, a physical therapist and a physician specializing in pain — that creates a personalized, six-month treatment plan focused on healthy eating, exercise, spirituality and reducing stress.

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Haug has lost 12 pounds by eating more produce and less packaged food. He’ll soon start cognitive behavioral therapy for insomnia and has received injections to ease arthritis in his spine. Soon he hopes to get back to hiking with his wife. “The pain’s going to be there,” he says. “I’m learning ways to minimize it to lead a normal life.”

Taking control of pain

Haug is among Prevail’s first group of 280 participants, who have reported that their pain is no longer controlling their life, says clinical psychologist Rena Courtney, director and creator of Prevail.

“We start by asking, ‘If you were in less pain, what would you be doing more of?’ We get answers like ‘I’d be playing with the grandkids,’ or ‘I’d be hunting or fishing,’ ” Courtney says. “We tell them that’s how we’re going to know if we’re successful — if you’re doing more of that in six months.”

Chronic pain affects approximately 37.8 million midlife and older Americans, and nearly a third have high-impact pain that makes daily life difficult. In 2019, the Department of Veterans Affairs called on the National Academies of Sciences, Engineering and Medicine to study the potential of the whole health care model that Courtney and others at the VA are using to address chronic pain.

Prevail is offered only at the Salem VAHCS; Courtney suggests civilians with chronic pain look for pain programs affiliated with medical schools or ask their doctor for referrals for help with diet, exercise, stress, sleep and mental health. The VA’s free, online Personal Health Inventory can help you get started.

What matters is taking a holistic approach to pain management, Courtney says — one that treats the biological and emotional aspects.

“When I ask, ‘What happens to your pain when you’re stressed,’ every single person says it gets worse,” she says. “If pain were just biological, that wouldn’t matter.”

spinner image woman wearing a virtual reality headset holding her hands out in front of her body

More Chronic Pain Breakthroughs

Drug-free help for diabetic nerve pain

Early in 2023, the FDA approved use of the Abbott's Eterna, Proclaim Plus and Proclaim XR Spinal Cord Stimulation (SCS) Systems to relieve lower-extremity pain caused by diabetic peripheral neuropathy (DPN). The devices send mild electrical signals to the spinal cord, reducing pain by an average of 53 percent in studies.

Virtual reality for back pain

A virtual reality program called RelieVRx, by AppliedVR, successfully reduced back pain by half for 46 percent of users who followed the program daily for eight weeks. Users of the prescription-only system put on a VR headset to learn cognitive behavioral skills for pain management such as deep relaxation and breathing exercises. Sessions last two to 16 minutes. The program is available in some health systems and through the Department of Veterans Affairs.

On the horizon

New uses for naltrexone

Once prescribed for alcohol and opioid overuse, the drug naltrexone is getting new attention for its potential to ease pain from Crohn’s disease, fibromyalgia, rheumatoid arthritis and more. University of Kansas Medical Center scientists recently reviewed naltrexone, concluding that it shows promise, but more research is needed.

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