Fifty million Americans, or just over 20 percent of the population, experience some form of chronic pain. According to recent studies from the Centers for Disease Control and Prevention, more than 1 in 5 adults in the U.S. experience chronic pain. Approximately 8 percent of adults have high-impact chronic pain and most (84 percent) of high-impact chronic pain patients are unable to work outside of the home. Chronic pain is the number one cause of disability and disease burden globally.

The 2021 Health Wellness and Lifestyle Expo team wanted to learn about Integrative Medicine/Pain Management and went straight to the source, Exclusive Healthcare Partner, Stamford Health, and Dr. Marc E. Brodsky, MD, MBA, MPH of the SHMG-Center for Integrative Medicine and Wellness.

What does Stamford Health offer with regard to Integrative Medicine/Pain Management departments? 
The Center for Integrative Medicine and Wellness (CIMW) is a medical subspecialty group of Stamford Health. The non-opioid pain management service accounts for the majority of patients seen at CIMW. Most patients with pain are seen for myofascial neck pain and associated symptoms to include headache. Other conditions include low back pain, osteoarthritis, neuropathy, fibromyalgia, occupation-related overuse injuries such as from sports and performing arts, and autoimmune-related and cancer-related pain conditions. Over the past year, we have provided care for pain and other functional symptoms like fatigue in “long haulers” who have recovered from COVID.
 
How do healthcare providers work with their patients to address individual needs and healthcare philosophies such as alternative medicine versus conventional medicine? 
Our Integrative Medicine approach incorporates safe and evidence-based therapies to complement standard care. We partner with our patients in their care and emphasize lifestyle aspects such as exercise, diet, sleep, finding joy in life and stress reduction behaviors. Patients’ specific pain conditions and their preferences direct drug and non-drug options.
 
What are some non-pharmaceutical therapies for pain management? 
The patient evaluation begins with a thorough history and a hands-on physical exam which may identify trigger points in the muscles. Our therapies for pain include lifestyle behaviors, mind-body stress reduction and non-opioid pain management.

Anti-inflammatory foods may include elements of Mediterranean cuisine; avoiding processed foods, restricting added sugar and considering an elimination trial of gluten and dairy; and consideration of dietary supplements such as turmeric and ginger, which have chemical properties similar to over-the-counter non-steroidal anti-inflammatory pain relievers without the potentially adverse effects on the digestive system and kidneys. Other lifestyle suggestions are exercise such as walking for 30 minutes, five days a week per CDC guidelines and sleep hygiene, which may include a referral to check for a sleep disorder such as sleep apnea and advising standard of care of stimulus control, sleep restriction and cognitive behavioral therapy for insomnia per American Academy of Sleep Medicine.

Mind-body stress reduction interventions include instruction in common sense, no side-effect, self-care techniques to reduce anxiety which may contribute to pain conditions. Non-opioid pain management addresses often overlooked muscle knots which contribute to pain conditions with trigger point injections and acupuncture. We also instruct patients on how to perform self-care acupressure and gain self-efficacy with strategies that they may use on their own to ease their pain symptoms. For instance, over-the-counter topical capsaicin, made from hot peppers, may alleviate pain by a complex cascade of events after binding with nerves in the area of the pain.

While a patient undergoes pain management therapies, how do doctors monitor drug intake and signs of addiction and depression? 
In general, we ask our new patients to follow up each one to two weeks for four visits and spread out appointments as they improve. At each visit, the physicians at CIMW collaborate with their patients to agree on treatment goals, set realistic expectations and evaluate efficacy of treatments. Throughout the therapeutic process, physicians monitor for complicating factors such as problems related to medications or procedures, psychological contributors or a more serious underlying condition. 

Exhibitors at this year’s Health Wellness & Lifestyle Expo, held September 11 and 12, include integrative medicine/pain management professionals, products and services, including Cassena Care at Stamford and Cassena Care at Norwalk, Bemer Group, Cefaly Technology, Evolution Physical Therapy and Fitness, Restore Hyper Wellness, Salerno Wellness, Select Physical Therapy, The Vital Stretch, Upper Cervical Chiropractic of NY and the Vein Institute. Attendees can learn from the experts, explore pain management therapies and get their life back.

For a complete list of sponsors and exhibitors and more information about the HWL EXPO 2021, visit HWL-Expos.com.

Location: Harbor Point Boardwalk, 1 Harbor Point Rd, Stamford. See Passport for Life event program, page 21.