Integrative medicine successfully treats chronic pain (maybe)

As controversial as integrative medicine is, a new study indicates that complementary treatments like yoga and massages can treat chronic pain and other conditions successfully, according to a report from philanthropist community Bravewell Collaborative released yesterday.

Integrative medicine, by definition, is patient-centered care, addressing physician, emotional, mental, social, spiritual and environmental influences on a person's health, according to the report. It can include food and nutrition, supplements, yoga, meditation, traditional Chinese medicine and acupuncture, massage and pharmaceuticals, and any combination of those things.

The survey included 29 integrative medicine centers, including Cleveland Clinic, Mayo Clinic and Stanford University, and asked about integrative medicine results for adult, geriatric, adolescent, obstetric-gynecologic, pediatric and end-of-life care. The survey respondents reported that they had the most clinical success in chronic pain (75 percent), gastrointestinal disorders (59 percent), depression and anxiety (55 percent), cancer (52 percent) and stress (52 percent).

The survey results, however, were not necessarily objectively measured, Medscape noted. The report's measurements--which weren't uniform across the institutions--came from physician observation notes, patient comments and satisfaction surveys, assessment forms, biomarkers and electronic medical record captures.

Most of the centers said they didn't have information on specific patient outcomes because they didn't have the resources to capture or analyze that data.

Bravewell also surveyed nine of its own centers.

Integrative medicine, let alone the report, can be a hard pill to swallow for some.

"Integrative medicine" is really a marketing term, Steven L. Salzberg, professor of medicine and biostatistics in the McKusick-Nathans Institute of Genetic Medicine at Baltimore's Johns Hopkins University School of Medicine, told Medscape. He added that it might not actually help patients: "It's little more than quackery, a lot of it."

Or as David Gorski, associate professor of surgery at Wayne State University School of Medicine and the Breast Multidisciplinary Team Leader at the Karmanos Cancer Institute in Detroit, Mich., called it, integrative medicine is essentially an "elaborate placebo."

But skeptics haven't stopped the approach from taking off. Alternative medicine has been soaring over the last decade. Forty-two percent of hospitals reported they provide complementary and alternative medical services, according to an October 2011 report by American Hospital Assocication's Health Forum and the Samueli Institute. That number has tripled since 2000.

One of the reasons may be that integrative medicine incorporates patients' culture. For example, one in four Hispanics use complementary medicine, including high use of botanicals in urban areas, for a variety of ailments, such as a cold or upset stomach, according to Consumer Reports. For chronic conditions, though, Consumer Reports recommends patients seek board-certified physicians trained in integrative-medicine.

Proponents of the approach say integrative medicine can offer combinations of treatments for complex diseases and "if it works, why not?"

"One of the most striking, though perhaps predictable, conclusions of this study is that integrative medicine is, in fact, integrative. It integrates conventional care with non-conventional or non-Western therapies; ancient healing wisdom with modern science; and the whole person--mind, body, and spirit in the context of community," the report states.

For more information:
- read the Medscape article
- check out the Bravewell report (.pdf)
- read the Consumer Reports press release

Related Articles:
How mind-body program reduces stress, healthcare costs
Integrative medicines gaining momentum
Physicians fail to ask patients about complementary medicine despite demand
Hospitals offering alternative medicine tripled, based on patient demand
Docs prescribe yoga as last resort
Annual U.S. tab for alternative medicine hits $34 billion

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