Pain is a complex issue involving nutritional, psychosocial, biochemical, neurological, and physical components. Despite this multifaceted nature, the traditional national medical model typically addresses pain through a unidimensional approach—primarily using medications. This method often overlooks the broader context of pain and its diverse contributing factors.
Opioid Dependence: A National Health Crisis
Americans use 80% of the world’s opiate medications while comprising only 5% of the world’s population. In 2012, 259 million prescriptions were written for opioids, more than enough to give every American adult their own bottle of pills (CDC, 2014). This widespread availability has led to a steep rise in addiction and death due to overdose from both prescribed and street-sourced opioids.
The Grim Statistics
- Drug overdose is the leading cause of accidental death in the US: In 2015, there were 52,404 lethal drug overdoses, with 20,101 related to prescription opioid pain relievers and 12,990 related to heroin (ASAM, 2016).
- A 200% increase in opioid-related deaths: From 2000 to the present, the rate of death from opioids (illicit and prescription) has risen by 200% (Rudd, 2016).
- Women are particularly affected: From 1999 to 2010, the rate of death from prescription pain medication for women rose by 400%.
- Prescription misuse leads to heroin use: Four in five new heroin users started by misusing prescription painkillers. A 2014 survey revealed that 94% of people in treatment for opioid addiction chose to use heroin because prescription opioids were “far more expensive and harder to obtain” (Cicero, 2014).
Integrative Medicine Therapies: A Multifactorial Approach
The traditional approach to pain management with escalating use of opioids has not only proven insufficient but also harmful. Integrative medicine (IM) offers a multifaceted strategy that addresses the various components of pain.
The Efficacy of Integrative Medicine
- 2017 ACP Recommendations: The American College of Physicians strongly recommended integrative medicine therapies as the first line of standard care for low back pain (Qaseem, 2017).
- Comprehensive Strategies: Pain is one of the most critical areas to use comprehensive IM strategies and techniques. Despite its potential, IM is still in its infancy, and practitioners lack consistent training on when and how to recommend IM treatments for pain.
Understanding Pain: How It Is Experienced
Pain is a complex process that involves the conversion of stimuli into electrical signals by pain receptors (nociceptors). These signals travel through various pathways to the brain, where they are processed and perceived.
Pain Sensitization and Amplification
Chronic pain is not just prolonged acute pain; it involves pain sensitization or amplification. This transition can occur within 3-6 months and involves the following mechanisms:
- Peripheral Sensitization: Facilitates pain signals to the CNS with little or no ongoing stimuli. Nociceptors become hyperactive, and the transmission threshold is lowered, leading to spontaneous pain signaling.
- Central Sensitization: Causes neuroplastic changes, remodeling neuronal architecture from the spinal cord to higher CNS centers. This results in hypersensitive pain responses and perception.
Factors Influencing Pain Sensitization
- Age of Pain Onset: Younger individuals are more susceptible.
- Gender: Females are more prone to pain sensitization due to hormonal shifts.
- Genetics and Epigenetics: Certain genetic polymorphisms and epigenetic modifications can heighten pain sensitivity.
- Diet and Nutrient Deficiency: Diet plays a significant role in pain sensitization, with deficiencies in nutrients like magnesium increasing inflammation and pain.
- Mood and Sleep Disorders: These conditions can cause neuroplasticity, leading to pain sensitization.
The Role of Integrative Medicine
Integrative medicine incorporates a variety of approaches to manage pain, focusing on reducing dependency on opioids and addressing the root causes of pain.
Nutritional Approaches to Pain
Diet plays a crucial role in managing pain through the following strategies:
- Reduce Glycemic Load: Reducing sugars and refined carbs can decrease inflammatory markers.
- Increase High Fiber Intake: Helps in reducing systemic inflammation.
- Mindful Eating: Stress and speed eating increase inflammatory markers; therefore, a mindful pace, portion control, and timing are essential.
Current WHO Guidelines and Rational Opioid Prescribing
The WHO recommends a stepwise approach to pain management, starting with non-opioids and progressing to stronger medications as needed. Rational opioid prescribing involves standard approaches and validated tools to assess the risk of abuse and ensure appropriate use.
Conclusion
Integrative medicine provides a holistic, multifaceted approach to pain management that addresses the limitations of conventional methods and the opioid crisis. At Spark Health, under the guidance of Dr. Sangeeta, we specialize in personalized integrative medicine strategies to help manage pain and improve overall well-being. By embracing a comprehensive approach, we aim to revolutionize pain management and provide sustainable, effective solutions for our clients.
Explore integrative medicine at Spark Health and discover how we can help you achieve optimal health and wellness. Contact us today to learn more about our personalized treatments and start your journey to a pain-free life.