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Integrative Approaches to Comprehensive Pain Management

For many people with chronic pain, traditional medical approaches to treatment can be frustrating and ineffective. Pain medications can have serious side effects, and they often fail to address underlying issues that contribute to the pain in the first place. The integrative healthcare community has been a tremendous force for ensuring non-pharmacologic approaches are available and included in national healthcare legislation and research initiatives. However, the integration of these therapies into patient care requires a deeper understanding of their effectiveness and how they interact with other forms of pain management. To that end, this webinar brings together people with pain, healthcare providers, researchers, and payers to discuss innovations in integrated pain management. A person-centered approach to chronic pain is a key element of the comprehensive pain program developed by UVM’s Osher Center for Integrative Health. Using a variety of holistic modalities—such as acupuncture, massage, and mindfulness—this approach is designed to help people manage pain effectively. The program also teaches patients to take an active role in their own pain management by developing personalized strategies to reduce the burden of their condition and improve their quality of life. Despite the lack of clear definitions or a standard model of care for pain, most stakeholders agree that a person-centered, multimodal, integrative approach is best practice – and that nonpharmacologic treatments should be tried first before considering more potent drugs. Nevertheless, most individuals with chronic pain do not have access to integrative medicine or the services that are available to them. This is largely due to the fact that integrative therapies are typically not covered by insurance and can be prohibitively expensive for those who do not have adequate coverage. To this end, the Osher Center for Integrative Health recently signed a partnership with Vermont Medicaid to provide a new whole-person integrated pain program for adults with chronic illnesses and disabilities, including fibromyalgia, osteoarthritis, and lower back pain. The program includes shared medical appointments and group visits, where participants receive acupuncture, guided meditation, stress reduction techniques, stretching exercises, and education on healthy nutrition, sleep and physical activity. A recent study examined the effectiveness of various integrative pain practices, including yoga, tai chi, qigong, and mindfulness meditation, for managing chronic back and neck pain. It found that these practices were associated with a decrease in pain intensity and improved function, with some of the more effective interventions being acupuncture, music therapy, and massage. However, the quality of the evidence is mixed and further studies are needed to determine how these practices compare with pharmacologic treatments, particularly in perioperative or postoperative settings. Practical Pain Management sat down with Robert Alan Bonakdar, MD, director of pain management at Scripps Center for Integrative Medicine in San Diego, to discuss which integrative pain practices offer the greatest efficacy in evidence-based studies for a range of conditions, such as chronic low back pain, neuropathic pain, migraines, and osteoarthritis. The study’s methodological design was complex, with the majority of the identified trials being randomized controlled studies. These studies compared integrative pain management approaches to either placebo, sham interventions, other conventional treatments, or no intervention at all. For more details on pain management visit

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