Options for Patients with Pain
September 26, 2019
UH Connor Integrative Health Network offers many effective treatment modalities
UH Clinical Update | September 2019
Pain is a part of life for many patients, whether it be chronic low back pain, migraine, fibromyalgia, cancer pain or post-surgical pain. The clinicians at UH Connor Integrative Health Network offer evidence-based interventions that can help manage this pain. And they’re taking steps to make sure these interventions are seamlessly integrated into the care paths at UH – even in conditions and specialties one might not expect.
Music therapy is an instructive example.
“Music therapy is delivered to inpatients at UH as part of our Expressive Therapy department for cancer patients, palliative care patients, general medicine patients and behavioral psychiatry,” says Seneca Block MA, MT-BC, Expressive Therapy Program Manager at UH Connor Integrative Health Network. “Music therapy is an integrative service referred by nurses and physicians. The music therapist charts session progress within the medical record, which is an effective way to integrate within the clinical care team. Through the medical record, the treating physician or the charge nurse can see how their patients are progressing. These charts also give the care team additional treatment perspective from interdisciplinary team members such as music therapists, whom often include qualitative highlights and narrative that can help preserve the patient’s humanity.”
Jeffery Dusek, PhD, Director of Research at UH Connor Integrative Health Network, plans to use this clinical data to collaborate with the music therapy team to examine the effectiveness of music therapy in a future study across multiple UH sites.
“Across the different populations where music therapy is delivered, we will explore if there is a consistent response on measures like pain or anxiety,” he says. “We will examine the overall impact on pain and see if that information can assist providers to reduce the amount of pain medications required to manage the patient’s pain. We would also be interested to see if music therapy can influence a patient’s length of stay in the hospital, since we know that patients heal best when they heal at home.”
At UH Connor Integrative Health Network’s three outpatient clinics, UH patients receive acupuncture, chiropractic care and therapeutic massage. In addition to patients whose primary diagnosis is a form of pain, Dr. Dusek says UH Connor clinicians are seeing an increasing number of patients for whom pain is a secondary symptom of a different condition, such as some of the rheumatoid conditions.
“The chiropractic lead (Dr. David Vincent) reports getting referrals from rheumatology colleagues,” he says, “and getting great results.”
Another service that can be helpful in the clinic is an integrative medicine consult.
“In my prior work, we’ve shown that integrative consults significantly improve the mental and physical functioning of patients in relation to pain,” Dr. Dusek says. “An integrative consult can support patients with making lifestyle changes and also assist the patient with selection of another therapy.”
Over the years, UH Connor patients have anecdotally reported improvements in pain and anxiety. So starting in 2019, patients are now being asked to report their pain, anxiety and stress levels before and after their treatment. The goal is to systematically explore the effectiveness over a large sample of thousands of patients.
Another area of investigation is to introduce acupuncture in the Emergency Department (ED). A pilot project in the UH Broadview Heights Health Center last year yielded promising results, Dr. Dusek says, and is leading to a grant application to the National Institutes of Health.
“My prior pilot study has shown that acupuncture can help relieve pain in this setting and is very well accepted by patients and clinical providers,” he says. “Acute pain can be relieved without necessarily having patients receive narcotics. Our goal is to get the pain down in real time in the ED and ideally allow the provider to right-size the dose of whatever pain medication is given. It’s an area where people wouldn’t maybe think an integrative therapy would be useful, but we are establishing evidence that acupuncture can play an additive role that’s helpful to the patient.”
With all these interventions, Dr. Dusek says, the goal is to add value to the traditional care a patient receives – not replace it.
“UH Connor is not all or none when it comes to use of integrative therapies,” he says. “The idea is to match the combination of complementary and conventional therapies that works best for each patient. UH Connor practitioners use therapies that are evidence-based, and as a department we are increasingly focused on understanding outcomes.”
And the over-arching goal is to continue to integrate UH Connor services into the practice of medicine at UH.
“The UH Connor team is working hand in glove with primary care and other providers across UH as a means by which to really integrate patient care,” Dr. Dusek says. “And UH Connor is an essential part of the UH network.”