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Comprehensive Pain Management

Updated: Oct 9, 2021



During my 20+ year tenure as a Naturopathic Medical Doctor, I have discovered that pain management is definitely a wholistic (considering the whole person) endeavor. Below, I will outline my approach to pain management.


Most of the patients that I see in my clinic are people who are athletes in their spare time, part-time gym rats for strength and fitness, auto accident victims and baby boomers or near baby boomers who have pain in their spine or joints. The commonality amongst these individuals is their desire to avoid going under the knife and are looking for the least invasive treatment for their pain or instability of their joints.


Although current conventional medicine will often opt for medication and/or surgery during the treatment regime, the approach I have discovered that works best to prolong our functional capacity as a healthy individual is a wholistic/holistic approach to pain management especially because there appears to be a correlation between the physical health of an individual relative to the mental health of an individual. In short, my observation is that when the body fails, the brain functions deteriorate over time. Conversely, when the brain function fails, the body eventually falters as well.


What are some of the components of this method of treatment? Consider the following:


I. History of Injury:

- When did the accident occur?

- How long ago was this accident sustained? Was it a day ago? A couple of months ago? 5 years ago? 20 years ago?

How we treat this patient will vary relative to the age of the injury.

- How did the injury occur? What was the mechanism of injury?

- Was there structural damage to the joint?

- Was there any imaging performed?

- What has the person done so far to treat this injury?


II. Treatment

- Consider treatment of any joint damage

- Consider treatment of any dysfunctional muscle/neurological “memory” issues (proprioceptive dysfunction).

I describe these as being “functional dysfunctions” which have no lab tests or imaging that identifies this. Only functional exams that tests how well your joint or your body part works will identify this type of dysfunction.


III. Consider the person’s state of health.

Any of the items listed below can impede the person’s rate of recovery and the extent of recovery.

- If the person is elderly

- If the person is a smoker

- If the person is obese

- If the person is diabetic

- If the person is in a hypothyroid state , exhibits adrenal dysfunction or any other hormonal imbalances

- If the person is in poor health in general

- If the person is under undue stress


IV. Consider the Person’s Diet

- If the person is consuming large amounts of sugar

- If the person is consuming large amounts of starches

- If the person is consuming inflammation causing foods.


Some of what’s listed above may appear to be common knowledge, however, I have observed that doctors of all faiths generally fail to consider neuromuscular “memory” issues that may be the cause of pain. I have found that there may be more of these cases where proprioceptive or neurological dysfunction is the cause of the pain than not. Simply stated, the structure often is not the cause of the pain. It may have once been the cause, but over time, the adaptive processes of the body will compensate for the injury and cause the neuromuscular coordination to be dysfunctional. This compensatory mechanism may now be the cause of the pain.


What choices do you have besides drugs and surgery? If you want to be exclusively treated under your insurance plan, your resources may be limited. Conventional medicine will consider structural issues first; many times leading to medication and surgery. While these options are necessary at times, to approach conservative therapies first would be my preference if I were the patient. Surgery is final. Once your joint or body part is altered beyond the structure that you were born with, your function may never be the same.


The following modalities have proven to consistently produce significant results in pain conditions. Since everyone responds differently to the various treatments, if surgery is still needed, it will still be an option.

  • Spinal Manipulation

  • Fascial Manipulation

  • Acupuncture

  • Cupping

  • Cold Laser

  • Joint Injections of substances that rejuvenates and supports your joints

  • Trigger Point Injections

  • Perineural Injection

  • Functional Joint Rehabilitation with exercise and specific movements that will normalize joint function

  • Nutritional Intervention

Summary:


In writing this short essay, my intention was to introduce some key concepts in what I consider the comprehensive approach to pain management. Should you want or need a deeper understanding of some of the terminology or treatment options that I mentioned above, an internet search will provide voluminous amounts of information in all the terminology and treatments that I mentioned. I also welcome phone calls to answer any questions you have regarding

this article.


We are multidimensional beings. Our body and mind are infinitely intricate. If we consider the whole person and the many causes of pain, one or even two approaches to managing pain may be shortsighted, limited and potentially short-lived. I have learned in my years in practice that for lasting results, a multifaceted, multisystem polytherapy approach is most effective to maintain lasting results.


Vance Inouye, N.M.D.

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