An Integrative Health approach to chronic pain explains how complementary and integrative approaches such as supplements, acupuncture, and manipulation therapies can be incorporated into a health care plan to manage the physical and emotional components of chronic pain.

Integrative Health emphasizes mindful awareness and self-care along with conventional and integrative approaches to health and well-being. The Circle of Health highlights eight areas of self-care:  Physical Activity, Surroundings, Personal Development, Nutrition, Recharge, Family Friends, & Co-Workers, Spirit & Soul, and Mind and Emotions. The narrative below shows what an Integrative Health clinical visit could look like and how to apply the latest research on complementary and integrative health (CIH) to chronic pain.

Meet the Patient

Elena is a 55-year-old woman who began visiting a primary care clinician three years ago, but does not come in frequently because she has historically been in good health.  In the past year, however, she has developed ongoing neck pain and right knee pain.  An X-ray and MRI of her neck showed some degenerative changes but were otherwise normal.  An X-ray of her right knee showed some osteoarthritis.  Traditional over-the-counter analgesic medications provided minimal relief.  Six weeks of physical therapy was also not helpful.  Because of these treatment failures, she was seen in pain management and started on twice-daily oxycodone.  Although this does help her pain when she takes it, her function has not improved.  The medications cause some fatigue.  Despite these limitations, she is concerned about stopping the opioid medication because it is the only thing she has found to be even temporarily helpful.

Elena feels the pain is having a negative impact on her life, as the neck pain is making driving her car and riding her bike more difficult.  In addition, the mild depressive symptoms that she had dealt with intermittently in her life to this point have become more persistent over the past few months.  Her sleep quality is decreasing and she has gained 10 pounds in the past year.  She is frustrated with these negative changes and poor treatment options and is looking for a better approach to her health.

Personal Health Inventory

On her Personal Health Inventory (PHI), Elena rates herself as a 2 out of 5 for her overall physical well-being and a 1 for overall mental and emotional well-being. When asked what matters most to her and why she wants to be healthy, Elena responds: