LOUISVILLE Chronic pain affects about 100 million Americans. Women experience certain painful conditions more than men. Fibromyalgia, irritable bowel syndrome, migraine headaches, chronic neck and back pain, and pelvic pain are the most common conditions. The causes of these conditions remain largely unknown and treatments have been mostly symptomatic, giving only partial relief.
Fortunately, we are beginning to understand why some people develop chronic pain and how to better prevent and treat it. People who experience sexual, physical, or emotional abuse as children are almost three times more likely to develop chronic pain, post-traumatic stress disorder, depression, and general poor health as adults. People with low coping skills, little social support, and high levels of stress respond poorly to treatment for chronic pain. The degree of suffering from chronic pain is heavily dependent on the sufferer’s perceptions, beliefs, expectations, and resiliency. People with chronic pain often experience re-victimization as they seek treatment, and undergo many unnecessary, unhelpful, expensive, and even dangerous diagnostic studies, surgeries, and drug treatments. Particularly troubling is the potential for chronic pain suffers to develop addiction to narcotics and other prescription drugs, leading to more disability and suffering. Kentucky is among the states with the highest numbers of deaths from prescription drug overdose.
Chronic pain is now understood as a disorder of body, mind, and spirit that is best treated by addressing all three components.
Integrative Medicine (IM) offers new hope for chronic pain sufferers because it treats the whole person – body, mind, and spirit. It emphasizes lifestyle changes, self-help, and non-drug, non-surgical approaches whenever appropriate. IM incorporates evidence-based therapies from all healing traditions such as acupuncture, yoga, transcendental meditation, and herbs. IM offers a wide variety of personalized treatments that are much less invasive, expensive, and risky than surgery or addictive drugs.
At the International Research Congress on Integrative Medicine and Health, May 12–16, 2014, researchers presented growing evidence that IM therapies such as anti-inflammatory diet, exercise, massage, psychotherapy, acupuncture, yoga, tai chi, meditation, and spinal manipulation can help chronic pain sufferers. Recent research shows that people with chronic pain have loss of gray matter in their brains and may be less responsive to dopamine, an important neurotransmitter in depression, addictions, and pain perception. In one study, people with chronic pain who underwent cognitive behavioral therapy for 12 weeks not only felt better but also showed increases in the gray matter in their brains. Other studies show that hopeful people who believe in a treatment experience much more relief from the therapy than non-hopeful people. Physicians used to dismiss the placebo effect, but IM practitioners seek to enhance the mind’s ability to lower pain perception as part of their treatment. IM practitioners understand that people can unlearn pain behaviors and favorably alter the structure and function of their brains.
In the fall of 2013, The American College of Physicians issued new guidelines concerning the treatment of chronic pain and recommended that IM therapies be considered for people with chronic pain.
KentuckyOne Health is the first health care system in the region to offer integrative medicine centers where people with chronic illnesses, including pain, can receive comprehensive evaluation and treatment by a team of providers including physicians, physical therapists, nutritionists, exercise physiologists, acupuncturists, yoga, tai chi, and meditation teachers.
RECENT RESEARCH SHOWS THAT PEOPLE WITH CHRONIC PAIN HAVE LOSS OF GRAY MATTER IN THEIR BRAINS AND MAY BE LESS RESPONSIVE TO DOPAMINE.
Dr. Deborah Ann Ballard is a board certified internist whose 22 years in medicine spans primary care, endocrinology, clinical research, and prevention and wellness. Ballard is board certified by the American Board of Integrative Holistic Medicine. She is a certified Tai Chi for arthritis instructor. Ballard joined KentuckyOne Health in June 2013 with a primary care practice affiliated with Flaget Memorial Hospital in bardstown. In her new role, she is providing integrative medicine consultations and focusing on prevention and wellness initiatives across KentuckyOne Health and its service area.