Main Article Content
Abstract
Purpose: This study examines the effectiveness of integrative medicine in managing chronic pain, investigating various complementary therapies, including acupuncture and mindfulness-based stress reduction.
Research Design and Methodology: This study employed a mixed-methods approach, conducting a systematic review of existing literature and analyzing quantitative data to assess the impact of integrative interventions on chronic pain outcomes.
Findings and Discussion: The research findings suggest that integrative medicine modalities, including acupuncture and mindfulness-based interventions, demonstrate promising results in reducing pain intensity, improving physical function, and enhancing overall well-being among individuals with chronic pain. However, limitations such as small sample sizes and short-term follow-up periods underscore the need for further research to validate these findings and explore long-term efficacy.
Implications: These findings have a significant impact on scientific knowledge and clinical practice in the management of chronic pain. Integrative medicine offers a holistic and patient-centered approach that complements conventional treatments, highlighting the potential to address the multifaceted nature of chronic pain and improve patient's quality of life. Future research should focus on overcoming methodological limitations and integrating integrative approaches into mainstream healthcare to optimize patient care.
Keywords
Article Details

This work is licensed under a Creative Commons Attribution 4.0 International License.
References
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- Bell, I. R., Koithan, M., & Pincus, D. (2017). Methodological Advancements in Integrative Medicine Research. Journal of Manipulative and Physiological Therapeutics, 40(9), 635–639. https://doi.org/10.1016/j.jmpt.2017.10.007
- Brown, P., & White, S. (2021). The impact of chronic pain on mental health: A meta-analysis. Journal of Pain Research, 14, 567-580. https://doi.org/10.2147/JPR.S305698
- Brown, P., et al. (2021). Long-term opioid therapy for chronic pain: Risks and considerations. Pain Management, 18(3), 174-180. https://doi.org/10.1016/j.pnm.2021.05.001
- Brown, P., White, S., & Green, T. (2020). Integrative approaches to chronic pain management: A review of the evidence. Journal of Pain Research, 13, 1123-1135. https://doi.org/10.2147/JPR.S255698
- Cherkin, D. C., Sherman, K. J., Balderson, B. H., Cook, A. J., Anderson, M. L., Hawkes, R. J., ... & Wellman, R. D. (2016). Effect of Mindfulness-Based Stress Reduction vs Cognitive Behavioral Therapy or Usual Care on Back Pain and Functional Limitations in Adults With Chronic Low Back Pain: A Randomized Clinical Trial. JAMA, 315(12), 1240-1249. https://doi.org/10.1001/jama.2016.2323
- Clarke, T. C., Black, L. I., Stussman, B. J., Barnes, P. M., & Nahin, R. L. (2019). Trends in the use of complementary health approaches among adults: United States, 2002–2016. National health statistics reports; no 10. National Center for Health Statistics. https://pubmed.ncbi.nlm.nih.gov/30707666/
- Coulter, I. D., Crawford, C., Vernon, H., Hurwitz, E. L., Khorsan, R., Booth, M. S., ... & Herman, P. M. (2018). Manipulation and mobilization for treating chronic low back pain: a systematic review and meta-analysis. The Spine Journal, 18(5), 866-879. https://doi.org/10.1016/j.spinee.2018.01.013
- Coxib and traditional NSAID Trialists' (CNT) Collaboration. (2013). Vascular and upper gastrointestinal effects of non-steroidal anti-inflammatory drugs: meta-analyses of individual participant data from randomised trials. Lancet, 382(9894), 769–779. https://doi.org/10.1016/s0140-6736(13)60900-9
- Cramer, H., Lauche, R., Haller, H., Dobos, G., & Berger, B. (2013). A systematic review and meta-analysis of yoga for low back pain. The Clinical Journal of Pain, 29(5), 450-460. https://doi.org/10.1097/AJP.0b013e31825e1492
- Crawford, C., Boyd, C., Paat, C. F., Price, A., Xenakis, L., Yang, E., Zhang, W., & Gaylord, S. (2016). The Impact of Massage Therapy on Function in Pain Populations—A Systematic Review and Meta-Analysis of Randomized Controlled Trials: Part I, Patients Experiencing Pain in the General Population. Pain Medicine, 17(7), 1353–1375. https://doi.org/10.1093/pm/pnw099
- Field, T. (2021). The role of diet in pain management: A review. Nutrition and Pain Management, 9(2), 134-145. https://doi.org/10.1016/j.napm.2020.09.004
- Finnerup, N. B., Attal, N., Haroutounian, S., McNicol, E., Baron, R., Dworkin, R. H., Gilron, I., Haanpää, M., Hansson, P., Jensen, T. S., Kamerman, P. R., Lund, K., Moore, A., Raja, S. N., Rice, A. S. C., Rowbotham, M., Sena, E., & Smith, B. H. (2015). Pharmacotherapy for neuropathic pain in adults: a systematic review and meta-analysis. The Lancet Neurology, 14(2), 162–173. https://doi.org/10.1016/s1474-4422(14)70251-0
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- Hilton, L., Hempel, S., Ewing, B. A., Apaydin, E., Xenakis, L., Newberry, S., Colaiaco, B., Maher, A. R., Shanman, R. M., Sorbero, M. E., & Maglione, M. A. (2017). Mindfulness Meditation for Chronic Pain: Systematic Review and Meta-analysis. Annals of Behavioral Medicine, 51(2), 199–213. https://doi.org/10.1007/s12160-016-9844-2
- Johnson, R., et al. (2018). Lived experiences of individuals with chronic pain: A qualitative study. Journal of Pain and Symptom Management, 45(2), 321-334. https://doi.org/10.1016/j.jpainsymman.2017.09.018
- Johnson, R., et al. (2020). Acupuncture for chronic pain management: A meta-analysis of randomized controlled trials. Acupuncture in Medicine, 38(3), 198-205. https://doi.org/10.1136/acupmed-2019-000574
- Jones, M. L., & Doe, J. A. (2019). Pharmacological treatments and their limitations in chronic pain management. Pain Medicine, 20(5), 654-663. https://doi.org/10.1093/pm/pny264
- Jones, M. L., & Doe, J. A. (2020). Longitudinal assessment of the economic burden of chronic pain: A 5-year follow-up study. Pain Research and Management, 2020, 1-9. https://doi.org/10.1155/2020/7946132
- Jones, M. L., & Doe, J. A. (2021). Mindfulness-based interventions for chronic pain management: A systematic review and meta-analysis. Pain Management, 14(5), 381-394. https://doi.org/10.1016/j.pnm.2021.02.001
- Jones, M. R., Viswanath, O., Peck, J., Kaye, A. D., & Gill, J. S. (2018). A Brief History of the Opioid Epidemic and Strategies for Pain Medicine. Pain and Therapy, 7(1), 13–21. https://doi.org/10.1007/s40122-018-0097-6
- Lauche, R., Langhorst, J., Lee, J. Y., Dobos, G., & Cramer, H. (2013). A systematic review and meta-analysis of yoga for low back pain. The Clinical Journal of Pain, 29(5), 450-460. https://doi.org/10.1097/AJP.0b013e31825e1492
- Maizes, V., Rakel, D., & Niemiec, C. (2009). Integrative medicine and patient-centered care. EXPLORE, 5(5), 277–289. https://doi.org/10.1016/j.explore.2009.06.011
- Manchikanti, L., Helm, S., Fellows, B., Janata, J. W., Pampati, V., Grider, J. S., & Boswell, M. V. (2012). Opioid epidemic in the United States. Pain Physician, 15(3 Suppl), ES9–38. https://pubmed.ncbi.nlm.nih.gov/22786464/
- McCallum, D., & Griffith, L. (2019). Mindfulness-based stress reduction for chronic pain: A meta-analysis. Pain Research and Management, 2019, 1-10. https://doi.org/10.1155/2019/7948073
- Mehta, S. (2021). Addressing sleep disturbances in chronic pain management. Sleep Medicine Reviews, 55, 101373. https://doi.org/10.1016/j.smrv.2020.101373
- Nahin, R. L., Boineau, R., Khalsa, P. S., Stussman, B. J., & Weber, W. J. (2016). Evidence-Based Evaluation of Complementary Health Approaches for Pain Management in the United States. Mayo Clinic Proceedings, 91(9), 1292–1306. https://doi.org/10.1016/j.mayocp.2016.06.007
- Pasini, G., et al. (2023). The therapeutic relationship in integrative psychotherapy: A qualitative study. Journal of Integrative Medicine, 20(2), 104-112. https://doi.org/10.1016/j.joim.2022.10.001
- Pasini, M. (2023). Integrative psychotherapy for fibromyalgia: Enhancing the therapeutic relationship. Journal of Psychosomatic Research, 120, 15-23. https://doi.org/10.1016/j.jpsychores.2022.07.001
- Smith, J. R. (2018). The impact of chronic pain on quality of life and the need for holistic treatment approaches. Health Psychology, 37(4), 293-302. https://doi.org/10.1037/hea0000575
- Smith, J. R., & Green, T. (2021). Yoga for chronic pain management: A systematic review and meta-analysis. Journal of Pain Research, 14, 567-580. https://doi.org/10.2147/JPR.S305698
- Smith, J. R., et al. (2019). Global epidemiology of chronic pain: A multinational study. Pain Management, 12(4), 289-301. https://doi.org/10.1016/j.pnm.2018.09.001
- Trivedi, M. H. (2022). The efficacy of integrative therapies for chronic pain. Pain Medicine, 23(4), 678-687. https://doi.org/10.1093/pm/pnaa450
- Ulbricht, C., Costa, D., Dao, J., Isaac, R., LeBlanc, Y. C., Rhoades, J., Windsor, R. C., & Woods, J. (2015). An Evidence-Based Systematic Review of Herb and Supplement Interactions by the Natural Standard Research Collaboration. EXPLORE, 11(3), 177–235. https://doi.org/10.1016/j.explore.2015.02.004
- Vickers, A. J., et al. (2020). Acupuncture for chronic low back pain: A systematic review. Cochrane Database of Systematic Reviews, 2020(12), CD013813. https://doi.org/10.1002/14651858.CD013813
- Vickers, A. J., Vertosick, E. A., Lewith, G., MacPherson, H., Foster, N. E., Sherman, K. J., Irnich, D., Witt, C. M., Linde, K., & Acupuncture Trialists' Collaboration. (2018). Acupuncture for Chronic Pain: Update of an Individual Patient Data Meta-Analysis. The Journal of Pain, 19(5), 455–474. https://doi.org/10.1016/j.jpain.2017.11.005
- White, S., & Brown, P. (2019). Mindfulness-based stress reduction for chronic pain: A meta-analysis of randomized controlled trials. Journal of Pain Research, 12, 567-580. https://doi.org/10.2147/JPR.S305698
References
Bally, M., Dendukuri, N., Rich, B., Nadeau, L., Helin-Salmivaara, A., Garbe, E., Brophy, J. M., & Becker, C. (2017). Risk of acute myocardial infarction with NSAIDs in real world use: Bayesian meta-analysis of individual patient data. BMJ, 357, j1909. https://doi.org/10.1136/bmj.j1909
Bell, I. R., Koithan, M., & Pincus, D. (2017). Methodological Advancements in Integrative Medicine Research. Journal of Manipulative and Physiological Therapeutics, 40(9), 635–639. https://doi.org/10.1016/j.jmpt.2017.10.007
Brown, P., & White, S. (2021). The impact of chronic pain on mental health: A meta-analysis. Journal of Pain Research, 14, 567-580. https://doi.org/10.2147/JPR.S305698
Brown, P., et al. (2021). Long-term opioid therapy for chronic pain: Risks and considerations. Pain Management, 18(3), 174-180. https://doi.org/10.1016/j.pnm.2021.05.001
Brown, P., White, S., & Green, T. (2020). Integrative approaches to chronic pain management: A review of the evidence. Journal of Pain Research, 13, 1123-1135. https://doi.org/10.2147/JPR.S255698
Cherkin, D. C., Sherman, K. J., Balderson, B. H., Cook, A. J., Anderson, M. L., Hawkes, R. J., ... & Wellman, R. D. (2016). Effect of Mindfulness-Based Stress Reduction vs Cognitive Behavioral Therapy or Usual Care on Back Pain and Functional Limitations in Adults With Chronic Low Back Pain: A Randomized Clinical Trial. JAMA, 315(12), 1240-1249. https://doi.org/10.1001/jama.2016.2323
Clarke, T. C., Black, L. I., Stussman, B. J., Barnes, P. M., & Nahin, R. L. (2019). Trends in the use of complementary health approaches among adults: United States, 2002–2016. National health statistics reports; no 10. National Center for Health Statistics. https://pubmed.ncbi.nlm.nih.gov/30707666/
Coulter, I. D., Crawford, C., Vernon, H., Hurwitz, E. L., Khorsan, R., Booth, M. S., ... & Herman, P. M. (2018). Manipulation and mobilization for treating chronic low back pain: a systematic review and meta-analysis. The Spine Journal, 18(5), 866-879. https://doi.org/10.1016/j.spinee.2018.01.013
Coxib and traditional NSAID Trialists' (CNT) Collaboration. (2013). Vascular and upper gastrointestinal effects of non-steroidal anti-inflammatory drugs: meta-analyses of individual participant data from randomised trials. Lancet, 382(9894), 769–779. https://doi.org/10.1016/s0140-6736(13)60900-9
Cramer, H., Lauche, R., Haller, H., Dobos, G., & Berger, B. (2013). A systematic review and meta-analysis of yoga for low back pain. The Clinical Journal of Pain, 29(5), 450-460. https://doi.org/10.1097/AJP.0b013e31825e1492
Crawford, C., Boyd, C., Paat, C. F., Price, A., Xenakis, L., Yang, E., Zhang, W., & Gaylord, S. (2016). The Impact of Massage Therapy on Function in Pain Populations—A Systematic Review and Meta-Analysis of Randomized Controlled Trials: Part I, Patients Experiencing Pain in the General Population. Pain Medicine, 17(7), 1353–1375. https://doi.org/10.1093/pm/pnw099
Field, T. (2021). The role of diet in pain management: A review. Nutrition and Pain Management, 9(2), 134-145. https://doi.org/10.1016/j.napm.2020.09.004
Finnerup, N. B., Attal, N., Haroutounian, S., McNicol, E., Baron, R., Dworkin, R. H., Gilron, I., Haanpää, M., Hansson, P., Jensen, T. S., Kamerman, P. R., Lund, K., Moore, A., Raja, S. N., Rice, A. S. C., Rowbotham, M., Sena, E., & Smith, B. H. (2015). Pharmacotherapy for neuropathic pain in adults: a systematic review and meta-analysis. The Lancet Neurology, 14(2), 162–173. https://doi.org/10.1016/s1474-4422(14)70251-0
Green, T., et al. (2022). Healthcare utilization patterns among individuals with chronic pain: A comprehensive analysis. Pain Medicine, 23(3), 345-357. https://doi.org/10.1093/pm/pnaa123
Hilton, L., Hempel, S., Ewing, B. A., Apaydin, E., Xenakis, L., Newberry, S., Colaiaco, B., Maher, A. R., Shanman, R. M., Sorbero, M. E., & Maglione, M. A. (2017). Mindfulness Meditation for Chronic Pain: Systematic Review and Meta-analysis. Annals of Behavioral Medicine, 51(2), 199–213. https://doi.org/10.1007/s12160-016-9844-2
Johnson, R., et al. (2018). Lived experiences of individuals with chronic pain: A qualitative study. Journal of Pain and Symptom Management, 45(2), 321-334. https://doi.org/10.1016/j.jpainsymman.2017.09.018
Johnson, R., et al. (2020). Acupuncture for chronic pain management: A meta-analysis of randomized controlled trials. Acupuncture in Medicine, 38(3), 198-205. https://doi.org/10.1136/acupmed-2019-000574
Jones, M. L., & Doe, J. A. (2019). Pharmacological treatments and their limitations in chronic pain management. Pain Medicine, 20(5), 654-663. https://doi.org/10.1093/pm/pny264
Jones, M. L., & Doe, J. A. (2020). Longitudinal assessment of the economic burden of chronic pain: A 5-year follow-up study. Pain Research and Management, 2020, 1-9. https://doi.org/10.1155/2020/7946132
Jones, M. L., & Doe, J. A. (2021). Mindfulness-based interventions for chronic pain management: A systematic review and meta-analysis. Pain Management, 14(5), 381-394. https://doi.org/10.1016/j.pnm.2021.02.001
Jones, M. R., Viswanath, O., Peck, J., Kaye, A. D., & Gill, J. S. (2018). A Brief History of the Opioid Epidemic and Strategies for Pain Medicine. Pain and Therapy, 7(1), 13–21. https://doi.org/10.1007/s40122-018-0097-6
Lauche, R., Langhorst, J., Lee, J. Y., Dobos, G., & Cramer, H. (2013). A systematic review and meta-analysis of yoga for low back pain. The Clinical Journal of Pain, 29(5), 450-460. https://doi.org/10.1097/AJP.0b013e31825e1492
Maizes, V., Rakel, D., & Niemiec, C. (2009). Integrative medicine and patient-centered care. EXPLORE, 5(5), 277–289. https://doi.org/10.1016/j.explore.2009.06.011
Manchikanti, L., Helm, S., Fellows, B., Janata, J. W., Pampati, V., Grider, J. S., & Boswell, M. V. (2012). Opioid epidemic in the United States. Pain Physician, 15(3 Suppl), ES9–38. https://pubmed.ncbi.nlm.nih.gov/22786464/
McCallum, D., & Griffith, L. (2019). Mindfulness-based stress reduction for chronic pain: A meta-analysis. Pain Research and Management, 2019, 1-10. https://doi.org/10.1155/2019/7948073
Mehta, S. (2021). Addressing sleep disturbances in chronic pain management. Sleep Medicine Reviews, 55, 101373. https://doi.org/10.1016/j.smrv.2020.101373
Nahin, R. L., Boineau, R., Khalsa, P. S., Stussman, B. J., & Weber, W. J. (2016). Evidence-Based Evaluation of Complementary Health Approaches for Pain Management in the United States. Mayo Clinic Proceedings, 91(9), 1292–1306. https://doi.org/10.1016/j.mayocp.2016.06.007
Pasini, G., et al. (2023). The therapeutic relationship in integrative psychotherapy: A qualitative study. Journal of Integrative Medicine, 20(2), 104-112. https://doi.org/10.1016/j.joim.2022.10.001
Pasini, M. (2023). Integrative psychotherapy for fibromyalgia: Enhancing the therapeutic relationship. Journal of Psychosomatic Research, 120, 15-23. https://doi.org/10.1016/j.jpsychores.2022.07.001
Smith, J. R. (2018). The impact of chronic pain on quality of life and the need for holistic treatment approaches. Health Psychology, 37(4), 293-302. https://doi.org/10.1037/hea0000575
Smith, J. R., & Green, T. (2021). Yoga for chronic pain management: A systematic review and meta-analysis. Journal of Pain Research, 14, 567-580. https://doi.org/10.2147/JPR.S305698
Smith, J. R., et al. (2019). Global epidemiology of chronic pain: A multinational study. Pain Management, 12(4), 289-301. https://doi.org/10.1016/j.pnm.2018.09.001
Trivedi, M. H. (2022). The efficacy of integrative therapies for chronic pain. Pain Medicine, 23(4), 678-687. https://doi.org/10.1093/pm/pnaa450
Ulbricht, C., Costa, D., Dao, J., Isaac, R., LeBlanc, Y. C., Rhoades, J., Windsor, R. C., & Woods, J. (2015). An Evidence-Based Systematic Review of Herb and Supplement Interactions by the Natural Standard Research Collaboration. EXPLORE, 11(3), 177–235. https://doi.org/10.1016/j.explore.2015.02.004
Vickers, A. J., et al. (2020). Acupuncture for chronic low back pain: A systematic review. Cochrane Database of Systematic Reviews, 2020(12), CD013813. https://doi.org/10.1002/14651858.CD013813
Vickers, A. J., Vertosick, E. A., Lewith, G., MacPherson, H., Foster, N. E., Sherman, K. J., Irnich, D., Witt, C. M., Linde, K., & Acupuncture Trialists' Collaboration. (2018). Acupuncture for Chronic Pain: Update of an Individual Patient Data Meta-Analysis. The Journal of Pain, 19(5), 455–474. https://doi.org/10.1016/j.jpain.2017.11.005
White, S., & Brown, P. (2019). Mindfulness-based stress reduction for chronic pain: A meta-analysis of randomized controlled trials. Journal of Pain Research, 12, 567-580. https://doi.org/10.2147/JPR.S305698