A debate on integrative vs. interventional approaches to chronic pain: does telemedicine play a role?

The biopsychosocial model of pain acknowledges that pain experiences are shaped by an interplay between biological, psychological, and socio-environmental factors. In clinical practice, two disparate avenues for addressing pain include the widespread interventional paradigm and the rapidly growing holistic model of lifestyle medicine. Traditional pain management often emphasizes pharmacological and invasive approaches. In contrast, lifestyle medicine focuses on optimizing factors such as nutrition, exercise, sleep, stress management, avoidance of toxic substances, and social connectedness to reduce the pain experience. Within the paradigm of lifestyle medicine, specific nutrition plans may help mitigate inflammation, physical activity can alleviate symptoms of chronic pain conditions, and improved sleep can improve pain thresholds. Avoidance of toxic substances like tobacco and illicit drugs, utilization of mind-body stress reduction techniques, and fostering social connections are crucial for enhancing overall well-being and decreasing pain perception. However, there may be some drawbacks to the lifestyle medicine approach. The perception of time investment, the specialized training required for physicians, and the financial aspect can pose significant barriers. Lifestyle medicine is typically more time-intensive, requires more consultation time from physicians and the healthcare team, necessitates stronger adherence from patients, and involves more coaching and follow-up from healthcare providers. The services, treatment, and coaching are often not covered by insurance, which is a financial barrier to providing this kind of care. Despite these challenges, lifestyle medicine offers promising benefits for chronic pain management. Addressing its limitations through telemedicine and integrating it with interventional methods, affords the potential for a comprehensive approach to managing chronic pain in the future.