What is Integrative Pain Medicine?
Chronic, unmanaged pain can leave sufferers feeling helpless, angry, and at the mercy of treatments and interventions that tackle an isolated condition rather than the whole person. Integrative pain medicine seeks to change that by offering alternative or complementary treatment modalities alongside more traditional therapies. If you have ever done yoga or gotten a massage while taking opioid or non-opioid pain medication, then you’ve used an integrative approach to pain management.
The ultimate goal of the integrative approach to pain medicine is to treat the whole patient, not just their underlying injury or condition. This is accomplished by combining the best practices of “standard” medicine (also known as allopathic medicine) with the best practices of other, less conventional approaches to treatment. These are therapies that have a reasonable amount of high-quality evidence to support their use but have not quite yet broken through to mainstream acceptance.
What is Pain Management for Joint Pain?
Simply put, pain management is the branch of medicine solely dedicated to relieving pain and suffering in patients’ lives. As it applies to joint pain, pain management is a body of evidence-based diagnostic and curative treatments and procedures aimed at minimizing the pain caused by joint degradation without the need for surgery. This is accomplished using non-invasive treatment modalities like physical therapy and medication, as well as minimally-invasive procedures like injections, platelet-rich plasma therapy, and radiofrequency ablation. Additionally, an integrative pain medicine approach to treating joint pain would also include such complementary treatments as yoga, massage, and acupuncture.
Non-Invasive Management of Joint Pain
Physical Therapy
Physical therapy is the first-line treatment for joint pain. It includes a variety of strengthening, stretching, and cardiovascular exercises that work together to help strengthen and stabilize the joint in pain. Physical therapy has a very good track record of helping control joint pain and has the added benefit of helping overall health by improving cardiovascular health and total body strength.
Topical Creams
There are a number of creams that can be rubbed into a painful joint to provide immediate relief from joint pain. These generally include ingredients like capsaicin, menthol, or salicylates, which work by warming the joint to attract blood and promote healing. While this relief is short-term, topical creams can be safely used for a long period of time, so they can be used for as long as they provide relief.
Medication
Opioid and non-opioid pain medication can be used to reduce or eliminate joint pain. While there is increased scrutiny being placed on the long-term administration of opioid pain medications, the treatment absolutely can be used in certain situations. And other, non-opioid, pain medications like Tylenol, non-steroidal anti-inflammatory drugs (NSAIDs), or steroids can also be used to reduce inflammation and control joint pain.
Massage
Massage is a very popular complementary therapy that aims to use soft tissue manipulation to reduce pain and inflammation in the muscles that support the spine. There are a number of different kinds of massage, including deep tissue, Swedish, relaxation, and trigger point, each of which can be used to target specific types of pain.
Acupuncture
Acupuncture is a complementary treatment modality that has been used for centuries in traditional Chinese medicine and has emerged as a popular therapy in the West in the last twenty to thirty years. The goal of acupuncture is balancing the extremes—“yin” and “yang”—of “qi,” the body’s life force. This is accomplished using strategically placed needles along the meridians, pathways through which “qi” flows through the body.
Joint Pain Management Procedures
Injections
There are a number of pain management injections that can be used to treat joint pain. These include steroid injections, trigger point injections, and hyaluronic acid injections. These injections seek to reduce or eliminate joint pain by either blocking pain signals from the joint or helping to repair or replace the damaged soft tissues that help cushion the joint space.
Platelet-rich Plasma (PRP) Therapy
Platelet-rich plasma therapy is a regenerative medicine procedure that uses the body’s own platelets, coupled with their healing growth factors, to promote healing in a damaged joint. A PRP injection is created by drawing blood and processing it in a centrifuge to get an injection with a much higher concentration of platelets than would normally be present. This preparation is then injected into the joint space under imaging guidance to promote healing in the damaged cartilage.
Radiofrequency Ablation
Radiofrequency ablation is a pain management procedure that uses high-frequency sound waves to ablate, or burn, the nerves that relay pain signals from a joint to the brain. Once ablated, these nerves are no longer able to relay pain signals, which provides significant joint pain relief.