Integrative Approach to pain management.
Once thought to be on the fringe and/or ineffective, current medical research confirms that an integrative approach to pain management using the techniques below can be effective. Using multiple modalities for treating pain and a team of care providers ensures that the least invasive, more comprehensive care is given. Below are a few examples.Talk to your doctor about exploring a new path.

•  BIOFEEDBACK

•  MINDFULNESS

•  COGNITIVE/BEHAVIORIAL THERAPY

•  MASSAGE

•  MEDITATION

•  ACUPUNCTURE

As an osteopathic physician and integrative medicine practitioner I often see patients with chronic pain. They have been bounced around from primary care physician to specialist to specialist. Most have had a range of tests. Some have undergone painful invasive procedures, including surgery or device implants. Many people who consult with me have not found significant relief from any of those procedures. Some folks have ended up in more pain after the procedures.

As a chronic pain sufferer myself, I can often relate. Most people with chronic pain have been frustrated, are exhausted and are desperate to find relief. They are also brave and determined. They try painful, often expensive surgeries in their quest to find relief. They are not willing to give up, and their determination and resolve are admirable. For medical professionals to tell these people “you’re going to have to live with the pain” is not acceptable. Finding a way to live the fullest life possible is the goal of most people who live with pain.

Bravery or Desperation?

Despite their admirable determination, chronic pain patients commonly have a misconception about what it takes to get better. The misconception is that they are going to get better from external influences. In other words, most people in pain think they will get better by having things done to them (pills, injections, implants, surgery). It may be part of an American “fix me” culture, or a function of our health care system, or both.

As a physician trained in family medicine, I know that traditional medicine can effectively treat certain ailments; but when it comes to chronic pain, it’s time to try a new perspective.

Pain Management: Paradigm Shift

What if physicians and patients are looking at pain, and the path to achieving pain relief, all wrong? If so, then physicians and patients should play an equal part in adjusting the course. Patients have come to expect to be given the answers, and physicians feel the pressure and obligation to “do” something, even when the effectiveness of a given treatment is modest at best.

Over the past ten years I have treated more and more people who live with pain, and over this time I have developed a more integrative approach to medicine. Integrative medicine blends traditional and nontraditional medical practices into a holistic approach with the aim of promoting health and wellness. A physician who practices integrative medicine considers the whole person, not just a specific disease or symptoms. A critical part of integrative medicine is the belief that the human body has the inherent ability to heal itself. Integrative therapies facilitate this healing.

Heal Thyself

Healing begins within us. The goal of integrative therapies is to encourage people with pain to become independent of the treatment administered. Prescribing a pain medication is viewed as a temporary solution, because for many conditions, once the medicine stops, the pain returns. In fact, recent research finds that some pain medications may be making the brain more sensitive to pain so that when the pain medication is stopped, people end up in even more pain than before.[1][2]

When we don’t support the body’s natural healing process, advanced technology and expensive medications can fail. Surgery can leave the body in even more pain if the body wasn’t able to heal from the original insult.

The question to consider is what is not happening in a person with chronic pain that prevents the body from healing. Why do some people develop chronic pain and others recover from the same injury without pain?

As modern medicine begins to understand the limitations in the traditional standards of care, more research is being devoted to answering this question. Treatments previously viewed as placebo are being given a second look.

healing4Imbalances, Inflammation & Emotions: Looking for Healing Answers

Healing can be promoted by addressing physical, emotional or nutritional imbalances. These imbalances can be either excess or deficient states. Consider a person who continues to experience pain in their knee following surgery, even when traditional medicine would consider that the knee is healed. For a number of possible reasons, the central nervous system continues to bombard the brain with pain signals from the knee. In other words, the central nervous system’s switch for pain is stuck in the “on” position. Cutting nerves or placing electrical override signals at the peripheral nervous system have not shown to be consistently effective, as they do not reach as deep as the “on” switch. For reasons we’re still discovering, pain medications, antidepressants and other chemically mediated routes are equally ineffective. As soon as the chemical is withdrawn, the pain returns—sometimes even worse than before. But acupuncture, considered by some to be an alternative treatment option, has been proven effective at managing chronic pain by restoring balance in the central nervous system.

We are also starting to learn more about the role of inflammation in healing. Inflammation can be triggered by physical or emotional insults. Physical causes of inflammation can be injury, diet, or chemicals entering our body—such as pollutants in our water, air and foods. Even lotions and makeup can introduce harmful chemicals into our body that can cause inflammation.

Emotional insults, much like some physical insults, can also be a factor in the ability to heal and process pain. Years of emotional pain can be cumulative, building up and ultimately preventing us from healing well. A seemingly minor event can trigger a strong pain response.

The person in pain and the practitioner often focus on trying to figure out the immediate cause of the physical pain and try to remedy it, but that can be a mistake.

Both practitioner and patient need to consider that the most recent event has only tipped the scales; our body’s ability to recover from injury has been slowly diminishing over time without our knowledge. Often, attempts are focused on solving the short-term problem (injury, for example), but debilitating pain can further disrupt our life. To reduce pain, the most common solution is to increase doses of pain medications, even though that may only sedate and serve as a temporary fix. Injections, implants and even surgery are also common strategies to reduce pain, but these may mask the underlying physical condition and leave emotional “baggage” unchecked.

healing5Most patients and practitioners agree that stress makes chronic conditions worse, yet we find it difficult to accept that various forms of stress, building up over time, may be at the root of what’s causing the pain. It’s worth considering that perhaps emotions—deep, complex and complicated—are part of what makes successfully managing chronic pain such a challenge.

Seek Healing Remedies First

I encourage people suffering with chronic pain to look within and first seek a safe, integrative approach that considers your entire being and not just symptoms. While tests, MRI findings and other external tool can help, healing begins with reflecting on self and the source of pain. Even if you don’t find complete relief, exploring integrative therapies may prepare your mind and body to heal faster, and better. {PP}

Sources

[1] W. Supornsilpchai, S.M. le Grand, and A. Srikiatkhachorn, “Involvement of Pro-Nociceptive 5-HT2A Receptor in the Pathogenesis of Medication-Overuse Headache,” Headache 50, no. 2 (February 2010): 185-97, www.ncbi.nlm.nih.gov/pubmed/20039957.

[2] S.J. Tepper, “Medication-Overuse Headache,” Continuum 18, no. 4 (August 2012): 807-22, www.ncbi.nlm.nih.gov/pubmed/22868543.[3] Wu MT1, Sheen JM, Chuang KH, Yang P, Chin SL, Tsai CY, Chen CJ, Liao JR, Lai PH, Chu KA, Pan HB, Yang CF. Neuronal specificity of acupuncture response: a fMRI study with electroacupuncture. Neuroimage. 2002 Aug;16(4):1028-37. www.ncbi.nlm.nih.gov/pubmed/12202090