Integrative Approach

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Unpleasant feelings such as stress, anxiety, etc (endogenous chemicals)

eg room sprays, perfumes, cleaners, household chemicals, soap

eg bisphosphonates, analgesics, anti-hypertensives, NSAIDs, statins

eg sugar, too much red meat (especially processed), alcohol, food intolerance (eg dairy, wheat, nightshade family)

Promotion or exacerbation of inflammation

Hypertonicity (excessive muscle tension)

Response to injury or pathogens (eg germs)

Lowering of interstitial fluid*/blood pH

* Interstitial fluid fills the spaces between the cells in our bodies

Proprioceptive organs *

Repetition

* Proprioceptive organs allow us to have a sense of where we are in space, our weight, how much our muscles are contracting and so on.

1- Automatic Mechanism

Based on repetition

Affects physical and mental levels

2- Body language mechanism

Body-mind connections

Affected by ‘perception’

3- Subconscious* mechanism

Image matching

Focus

One way to reduce pain (or even achieve 100% relief) is to understand the three mechanisms in the brain outlined below and their relationship with all of the above.
Those mechanisms are inseparable (ie whatever happens within one of them affects the other two).

This is why pain management has to be multidisciplinary and tailored to individuals

Pain

There is no sensation or emotion that is not translated into a muscular and physiological response of some kind; and the collection of those responses form the primary bases of our habitual postures and our individual patterns of behaviour. Everything that we feel through all of our senses have to be decoded and translated in our brain. Our perception of this process depends on how we filter those external events with our minds making them a unique, personal experience. No single event is perceived in the same way by two people.

* ‘Subconscious’ here also means ‘unconscious’ as both affect this mechanism in similar ways.

eg posture, repetitive movements, lack of movement, lack of exercise, cigarettes

Some evidence in support for an integrative approach to pain management
	Multidisciplinary Treatment May Benefit Patients With Chronic Low Back Pain	Spine. 2007;32:3060-3066
	Effect of integrated care for sick listed patients with chronic low back pain	BMJ 2010; 341:c6414 doi: 10.1136/bmj.c6414
	Early management of persistent non-specific low back pain	NICE
	Musculoskeletal Disorders and Labour Market Participation ("failure to undertake a multidisciplinary approach, poor advice on pain management, and a lack of clear integrated pathways")	The Work Foundation, September 2007, p32
	Integrative medicine: non-drug treatment options for pain management	American Pain Foundation
	A Guide for People Living with Pain	American Pain Foundation
	Towards multidisciplinary team working in musculoskeletal care: evolution of a service	Musculoskeletal Care, DOI: 10.1002/msc.62,pages 113–119
	Pain as the 5th Vital Sign - Toolkit	National Pain Management Coordinating Committee - Department of Veteran Affairs, USA
	Musculoskeletal Services: Adding Life to Years	NHS Ealing, 2009
	Pain: breaking through the barrier	Sir Liam Donaldson, Chief Medical Officer March 2009
	Auricular acupuncture for pain relief after ambulatory knee surgery: a randomized trial	CMAJ • January 16, 2007; 176 (2). doi:10.1503/cmaj.060875
	Management of Abdominal Pain and IBS in Children and Adolescents: Complementary & Alternative Therapies	Expert Rev Gastroenterol Hepatol. 2010;4(3):293-304
	And others

Everything we repeat over and over again becomes automatic (like driving, walking, learning a musical instrument and so on). This is controlled by the ‘automatic mechanism.

The mechanism that controls body language. Everything we feel reflects on our anatomy and physiology

Works like a photocopier - it ‘copies’ any ‘image’ we focus on.

Protection from and relief of pain and suffering are a fundamental feature of the human contract we make as parents, partners, children, family, friends, and community members, as well as a cardinal underpinning of the art and science of healing.

Pain is part of the human condition; at some point, for short or long periods of time, we all experience pain and suffer its consequences. While pain can serve as a warning to protect us from further harm, it also can contribute to severe and even relentless suffering, surpassing its underlying cause to become a disease in its own domains and dimensions.

We all may share common accountings of pain, but in reality, our experiences with pain are deeply personal, filtered through the lens of our unique biology, the society and community in which we were born and live, the personalities and styles of coping we have developed, and the manner in which our life journey has been enjoined with health and disease.

Preface to ‘Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research’ - Institute of Medicine of the National Academies (USA)

eg nerve compression, dislocated bones, twisted spine, damaged tendons, hypertonicity, worn joints, fibrosis (scars), disease related (eg diabetes naturopathic pain), non-communicable diseases

“If alternative pain management services are not provided by the NHS, the demand will need to be fulfilled elsewhere”.

(Rao et al 1999, Haetzmann et al 2003) and (NHS Practice Improvement Scotland, The Management of Chronic Pain in Adults, Best Practice Statement Feb 2006)