Combining Modern Pharmacology with Integrative Medicine: A Biopsychosocial Model for Comprehensive Pain Care

Abstract

The medical community recognized last decennia the multidimensional nature of pain and proposed multimodal biopsychosocial management. The most compelling reason to embrace integrative pain strategies is to mitigate patient risk. For patients with chronic pain and pain refractory to conservative medicine, it is essential to assess all factors involved with the chronicity. With significant themes, nutrition and microbiome, neuroplasticity, homeostasis, and the side effects of medication, acupuncture has progressively gained a place in this multimodal evaluation. Therapeutic multimodality approaches the perspective of physiological rehabilitation and chronobiological improvement of the quality of life. Illustrated by various clinical situations, the objective of management is to seek a synergy in the mechanisms of action of treatments to improve quality of life and reduce the need for xenobiotics and, consequently, the side effects. The mechanism of action of integrative medicine, and acupuncture improved with a better understanding of genetics, and epigenetics. As opposed to sham and placebo, acupuncture activates other brain regions. In controlled trials, the strict inclusion and exclusion criteria result in the treatment of a “selected” patient population, which is not always comparable to the patients seen in daily practice. The integrative approach is better illustrated by case reports.