UVM Integrative Lecture Series: “Integrative Health Approaches for Complex Pain Management”
Lecture Type: Online Video (Link Here)
Time: 60 minutes 50 seconds
Date: October 28, 2016
Speakers: Adam Perlman, M.D., M.P.H., F.A.C.P.
Topic: Integrative Pain Management
Introduction
Dr. Adam Perlman presents a lecture on integrative approaches to pain for the UVM Laura Mann Integrative Healthcare Lecture Series. Dr. Perlman is the Associate Vice President for Health and Wellness and Executive Director of Duke Integrative Medicine.
You can view the lecture on YouTube by clicking the link here.
You can download the PowerPoint presentation for this lecture by clicking the link here.
The goal of integrative medicine is to . . . “Implement and assess successful methodologies that transform health trajectory of the individual, the community, and the healthcare system.”
(Duke Integrative Medicine, 2016)
Addressing Suffering, Treating Pain
Chronic pain is a hot topic in the medical community. In conventional medicine, chronic pain is often addressed with medications and surgery – solely treating the physical symptoms of pain. These options may have associated debilitating side effects. For example, pain medications may cause constipation, increased risk of falls, and addiction leading to a potential overdose.
Dr. Perlman speaks to this unifocal approach to pain treatment through medications and suggests that physicians must balance this with a more holistic patient-centered approach. Integrative medicine fulfills this approach to care with a focus on addressing suffering associated with pain to improve quality of life.
Integrative medicine emphasizes the patient being at the center of the care plan. It is also inclusive of a wide array of therapies, like acupuncture and meditation. Finally, it focuses on optimizing patients’ health and well-being, rather than simply treating disease.
Integrative Medicine Approach:
- Mind, body & spirit
- Patient-centered
- Holistic
- Comprehensive
- Whole-person
A large part of integrative medicine is helping to improve patients’ quality of life. While many will not be able to return to a time without any pain, it can often be managed so that individuals can continue to do the things that bring joy into their lives.
Integrative Modalities to Treat Chronic Pain
Although more research is needed to determine the long-term benefits of integrative medical therapies, there is ample research today on multiple therapeutic interventions that have been shown to reduce reliance on pain medication, decrease pain scores, and decrease healthcare costs. The three modalities with the strongest evidence, according to Dr. Perlman, are acupuncture, mind-body techniques, and massage therapy.
Acupuncture can be used to treat a variety of conditions, including osteoarthritis, fibromyalgia, headaches, musculoskeletal pain, and pain associated with chronic conditions like ulcerative colitis and lupus. Acupuncture has also been shown to help treat withdrawal from opiates, including cravings and withdrawal, with the added benefit of improved abstinence in response to electroacupuncture. Physiological studies have shown that acupuncture causes an increase in endorphins, enkephalins, anti-inflammatory cytokines, and neurotransmitters like serotonin and dopamine. Rather than a one-time treatment, acupuncture is recommended for at least 10 sessions to see a benefit in pain control.
Mind-body medicine is an overarching category of therapies that may be beneficial for pain. Dr. Perelman goes into detail on specific therapies indicated for each condition, based on current research findings, in his lecture. Overall, these therapies address the experience of pain that is unique to each individual. This goes beyond our physiology to address the mental and emotional components of pain.
Mind-Body Medicine Therapies:
- Breathing
- Guided Imagery
- Relaxation Techniques
- Mindfulness Meditation
- Yoga
- Prayer
- Journaling
- Biofeedback
- Hypnosis
- Mindfulness-Based Stress Reduction (MBSR)
Finally, manual therapies have also been shown to be effective in treating patients. Research is growing in studying therapeutic massage. At this point, it is shown to be effective in the short term to treat osteoarthritis at a dose of 60 minutes of massage weekly. More research is needed to assess the long-term benefits of massage.
Concluding Thoughts
Dr. Perlman believes that physicians have the opportunity to help patients with chronic pain reach optimal well-being. During his lecture, he discussed Maslow’s Hierarchy of Needs. At the top of this pyramid is self-actualization; however, Maslow later wrote that there is one level above this – helping others achieve self-actualization.
Learn more about chronic pain and the need to develop a more holistic person-centered approach to care in the medical field.
You can view the lecture on YouTube by clicking the link here.
You can download the PowerPoint presentation for this lecture by clicking the link here.
Citation
Perlman, A. (2016, October 28). Integrative Health Approaches for Complex Pain Management. [Lecture Recording]. University of Vermont Laura Mann Integrative Health Care Lecture Series. https://www.youtube.com/watch?v=_4VTCU9JbNA
Disclaimer
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