Interdisciplinary approach to preventing and treating pain

Chronic pain is a major health problem and disease in its own right, said Mylene Huynh, MD, MPH, FAAFP, IFMCP, at the 2021 Institute for Functional Medicine Annual International Conference held virtually June 3-5.

According to Huynh, pain can be defined as, “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage…Always subjective…always unpleasant; therefore, also an emotional experience.”

It can also be described, “a warning, a signal that something is wrong… pain is protective and sometimes even essential for survival. Pain is uniquely individual and subjective experience that depends on a variety of biological, psychological, and social factors; different population groups experience pain differently.”

Huynh said chronic pain is described as lasting longer than three to six months, and pain no longer serves an adaptive or protective function. Chronic pain is a major public health challenge, with an economic cost of $560 to $635 billion in the U.S. and immeasurable costs in quality of life or family and societal impacts.

When it comes to treating pain, an interdisciplinary approach provides the best results, Huynh said. Prevention and early intervention is key. A multimodal, integrative approach may include:

• Modifiable lifestyle factors
• Movement therapies
• Manual therapies
• Physical therapy or occupational therapy
• Behavior therapies, including cognitive behavioral therapy
• Acupuncture and other energy therapies
• Interventional pain management

An initial assessment may include a pain score, biopsychosocial impact, a medical symptoms questionnaire (MES), and an adverse childhood experience (ACE) questionnaire. Beyond considering physical pain, practitioners should take time to understand mental, emotional, and spiritual influences that may impact how a patient experiences pain, Huynh said. ACE and MES should be addressed as part of the treatment plan.

One question to begin the MES discussion is, “what’s the worst thing that ever happened to you, physically or emotionally?” This can be incredibly informative for the practitioner, Huynh said.

Practitioners can play an essential role in early, effective care to prevent chronification of pain, Huynh said. Apply a systems biology, multimodal, interdisciplinary approach early on, utilizing non-pharmacological and pharmacological approaches when appropriate. Nutrients that may offer some relief and target inflammation include omega-3 fatty acids, vitamin D, and vitamin C. Other multimodal approaches may include yoga, as well as acupuncture and microcurrent as adjunct therapies.

Additionally, practitioners must show compassion for pain patients. Pain is not merely a lifestyle issue. Assess and promote mental, emotional, and spiritual wellbeing with patents.

“We are in the healing profession,” said Huynh. “It is our moral duty to care for pain patients. By doing so, we can mitigate the opioid crisis, prevent suffering, and improve wellbeing for all.”

Editor's note: This article is part of our live coverage of the 2021 Institute for Functional Medicine Annual International Conference. Click here for a list of full coverage.