Chronic pain is defined as “long-lasting pain with episodic exacerbations.”1 It affects millions of Americans every year, and prescription pain relievers such as NSAIDs and opioids are among the most prescribed drugs in the US.2 Pharmaceuticals are effective in their ability to target pain receptors in the brain and reduce the sensation,3 but because of adverse side effects and the risk for chemical dependence as observed in long-term use in adults, these medications are advised only as short-term solutions.2,4
Due to the rise of opioid-related deaths in the US in recent years, much attention has been placed on non-pharmacological approaches to pain management and their effectiveness in treating both acute and chronic pain. Some studies report improved patient quality of life outcomes5 and even reduced opioid use when patients receive alternative pain-management therapies.6 Treatments such as acupuncture, massage, spinal stimulation, exercise, and mind-body practices may improve pain symptoms with minimal side effects.7,8 In particular, acupuncture has demonstrated significant qualitative improvements in physical, behavioral, and emotional function5 and is as effective as other physical modalities in lowering pain levels.8
Board-certified pain-management physician Elizabeth Board, MD, became disheartened with the pharmacological approach to pain management, especially in patients with chronic pain. Not seeing improvements in the pain levels or quality of life of her patients, some of which she observed as being in a constant state of sedation, Dr. Board turned to acupuncture as a way to expand the landscape of treatment options in her practice. Her approach to pain management looks at addressing pain without the need for opiates or NSAIDs, though she notes that, “There are cases where pharmaceuticals may be necessary, but a measured, thoughtful approach must be taken in every case.”
In the following video, Dr. Board describes the influence of the Functional Medicine Model on her practice and how she incorporates her background in pain management to treat patients.
Matching patients to an appropriate therapy is dependent on the desired outcome, the underlying issue causing the pain, and ultimately the patient’s preference, according to Dr. Board. “People interpret and respond to pain differently. I look for and recognize the impact of treatment modalities on the patient’s social, spiritual, and psychological health,” she said. Dr. Board no longer placates pain through medication but intervenes with a holistic and lifestyle-driven approach. “Although I came in as a pain-management physician, now I really treat the whole person.”
Dr. Board is an IFM Certified Practitioner and is the founder of Atlanta Functional Medicine in Alpharetta, Georgia. She holds board certifications in pain management and anesthesiology, has completed the Helms course in acupuncture, and holds a certification from the American Board of Integrative and Holistic Medicine. Dr. Board is passionate about teaching her patients and other physicians about opiate-free pain management using the Functional Medicine framework.
- Venes D, ed. Taber’s Medical Dictionary. F.A. Davis Company. https://www.tabers.com/tabersonline/view/Tabers-Dictionary/735288/all/pain. Published 2017. Accessed February 28, 2020.
- Dowell D, Haegerich TM, Chou R. CDC guideline for prescribing opioids for chronic pain—United States, 2016. JAMA. 2016;315(15):1624-1645. doi:1001/jama.2016.1464.
- Vanegas H, Vazquez E, Tortorici V. NSAIDs, opioids, cannabinoids and the control of pain by the central nervous system. Pharmaceuticals. 2010;3(5):1335-1347. doi:3390/ph3051335.
- Wongrakpanich S, Wongrakpanich A, Melhado K, Rangaswami J. A comprehensive review of non-steroidal anti-inflammatory drug use in the elderly. Aging Dis. 2018;9(1):143-150. doi:14336/AD.2017.0306.
- Davis RT, Badger G, Valentine K, Cavert A, Coeytaux RR. Acupuncture for chronic pain in the Vermont Medicaid population: a prospective, pragmatic intervention trial. Glob Adv Health Med. 2018;7:2164956118769557. doi:1177/2164956118769557.
- Lin YC, Wan L, Jamison RN. Using integrative medicine in pain management: an evaluation of current evidence. Anesth Analg. 2017;125(6):2081-2093. doi:1213/ANE.0000000000002579.
- Skelly AC, Chou R, Dettori JR, et al. Noninvasive Nonpharmacological Treatment for Chronic Pain: A Systematic Review [Internet]. Rockville, MD: Agency for Healthcare Research and Quality (US); 2018.
- Swedish Council on Health Technology Assessment. Methods of Treating Chronic Pain: A Systematic Review (Summary and conclusions) [Internet]. Stockholm: Swedish Council on Health Technology Assessment (SBU); 2006.
In the latest Ground Rounds lecture, Wayne Jonas, MD, executive director of Samueli Integrative Health Programs, discusses the determinants of patient healing within the context of today’s healthcare system. He explores a patient’s journey to wellness through an integrative healthcare approach.Read More