Integrative Pain Care: When and How to Prescribe?



Integrative pain management is intended to complement current conventional treatments with a variety of alternative options including acupuncture and massage, as well as mindfulness and yoga. Research has been conducted to evaluate the usefulness of alternative care for treatment of chronic low back pain. The effectiveness of acupuncture, specifically electro-acupuncture has been impressive. Diet and exercise have also proven helpful in treating arthritis. 

In the case of one patient, who was presented with severe neuropathy and was not able to tolerate medications, relief was achieved through electro-acupuncture and hormone and vitamin supplements along with a carefully planned diet. In three months, the patient reported substantial improvement in pain, functional ability, and serum markers.

Despite the effectiveness of integrative pain treatments, wider use of the treatments are prevented and blocked by a lack of medical insurance coverage. Even with the evidence of clinical benefits from such treatments, insurers are still using outdated policies that deny reimbursement for certain therapies. Another obstacle is the lack of education of pain clinicians. Though clinicians attempt to stay current with conventional medical care, they often neglect their knowledge of integrative therapies which are not covered sufficiently in their medical training.  

Patients may also impede the use of integrative pain treatments due to the length of commitment necessary for patients to see improvement. The passive attitude of patients also obstruct the effectiveness of integrative pain treatments, as therapies such as biofeedback, mindfulness, or other mind-body training require a daily, active participation.

Integrative modalities may be incorporated into a physician’s offered therapies through self-training or by bringing in professional practitioners. Otherwise, building a network of referrals for integrative pain management specialists may be built based on patient feedback collected by office staff. 

Studies have shown that Mindfulness-Based Stress Reduction in treating chronic low back pain proved to have a high probability of being cost effective. Cognitive behavioral therapy also retained a high probability of being cost effective. 

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