Integrative Approach to Chronic Pain Conditions

Chronic pain is one of the worst experiences a person can endure. It significantly reduces quality of life, and there are still few effective solutions. This is why all research aimed at pain management is essential.

Certain illnesses tend to generate chronic pain conditions that are very complex to treat. Dr. Beatriz Orts, part of SHA’s medical team, explains that these are often conditions with a multifactorial origin that affect multiple body systems or have poorly understood etiologies. Among these, the expert mentions fibromyalgia, a disease characterized by widespread musculoskeletal pain, fatigue, and multiple tender points.

Complex regional pain syndrome (CRPS), a neurological disorder that causes severe pain, skin changes, and motor dysfunction, typically following an injury, also often leads to chronic pain.

Dr. Orts also highlights some autoimmune diseases like rheumatoid arthritis or systemic lupus erythematosus; diabetic neuropathy caused by nerve damage from diabetes; certain degenerative spinal diseases such as spinal stenosis and degenerative disc disease; chronic headaches (migraines and chronic tension headaches); oncologic pain; and endometriosis.

“Chronic pain can be defined as persistent pain lasting between three and six months that does not subside after the expected healing of an injury or acute illness. Unlike acute pain, which is the body’s natural response to injury or illness and usually disappears with healing, chronic pain persists and may not have a clear cause,” Orts explains.

Several studies and reviews show that chronic pain has been associated with mild cognitive impairment, especially in patients affected by fibromyalgia or neuropathic pain. These patients also experience other processes such as anxiety, depression, sleep disorders, and the use of certain medications, all of which are common in chronic pain patients.

“Chronic pain conditions are especially complex due to their multifactorial nature. Pain is produced by a combination of biological, psychological, and social factors. This can include physical injuries and diseases, but it also affects the patient’s emotional state and social environment. It overlaps with changes in the central and peripheral nervous systems, such as central sensitization, where the nervous system becomes more sensitive to pain, amplifying pain signals,” says the SHA expert.

Dr. Orts also notes that chronic pain does not respond well to conventional treatments, requiring multidisciplinary and personalized approaches. “Medications must be combined with physical therapies, psychological interventions, and lifestyle changes. This can lead to depression, anxiety, stress, and other mental health problems, creating a cycle where pain and emotional issues reinforce each other. People with chronic pain often face misunderstanding and stigmatization, both from society and healthcare professionals, which can make it difficult to access appropriate treatment and support.”

For experts, the major challenge is determining the exact cause of chronic pain, which can be very difficult. It often requires a comprehensive evaluation by multiple specialists, including imaging tests, laboratory analyses, functional evaluations, and delayed diagnosis.

Effective treatment of chronic pain requires collaboration from multiple health professionals, including doctors, physiotherapists, psychologists, and occupational therapists, which can be logistically complex. The combination of these factors makes managing chronic pain a significant challenge for both patients and healthcare professionals.

The approach to chronic pain is so complex that mistakes are often made. Dr. Orts notes that it is common for healthcare professionals to downplay or not fully recognize the severity of pain reported by the patient, leading to insufficient treatment.

Another common mistake is relying solely on medications without considering additional therapies such as physical therapy, psychotherapy, and lifestyle changes. “This approach can be ineffective and increases the risk of dependence on painkillers without necessarily improving long-term pain control.”

Not involving a team of specialists (doctors, physiotherapists, psychologists, etc.) is a mistake that limits treatment options and overall effectiveness in managing pain, as physical therapy, acupuncture, exercise, and cognitive-behavioral therapy have scientific evidence supporting their effectiveness in relieving chronic pain, yet they are often underutilized.

According to the doctor, the most modern and scientifically supported approach to treating complex chronic pain conditions is the biopsychosocial model and multidisciplinary management. “This approach recognizes that chronic pain is a complex condition resulting from the interaction of biological, psychological, and social factors.”

In this model, the use of medications, medical interventions, and physical therapy is combined with psychological therapies like cognitive-behavioral therapy or stress management to support and educate the patient in pain management.

At SHA, chronic pain is addressed from an integrative perspective, using therapies backed by solid scientific evidence. “Numerous studies and systematic reviews have shown that biopsychosocial and multidisciplinary approaches are more effective than one-dimensional treatments. These approaches tend to improve the quality of life, functionality, and psychological well-being of patients with chronic pain, while also reducing dependence on opioid medications.” SHA offers comprehensive pain treatment from the perspective of different health professionals, with a structured pain management program that may include education, exercises, and physical and psychological therapies. The goal is to improve the patient’s quality of life and functionality.

SHA’s aim is for patients to leave with the belief that their pain can be managed and convinced that they can regain control of their lives.