Integrative approaches to the treatment of pain and fatigue


Author: Anna-Li Schönenberg-Tu
Page Range: 99-113
Published in: Journal of Pain Management, 16#2 (2023)
ISSN: 1939-5914

Table of Contents


Chronic pain is one of the biggest health problems concerning public healthcare at present. It is often associated with other complaints like fatigue, anxiety and depression and one of the major causes for inability to work and loss of productivity in general. Conventional therapy of chronic pain consists of elaborated treatment approaches that are often costly and limited in their generalizability as they come with severe risks and side-effects when employed long-term. Concerns about feasibility, sustain-ability and effectiveness raise the need for better under-standing the processes involved with long-term pain and developing innovative treatment concepts. This narrative review aims at giving an overview of emerging fields of research like psycho-neuro-immunology, stress economy and fascial tension that are relevant to modern pain therapy, thus stressing the importance of including stress response, increased inflammatory activity, adverse childhood events, lack of personal resources and proprioceptive identity into a sustainable treatment approach. It further explores those clinical strategies and practices like manual therapy, acupuncture, body awareness techniques and psychotherapy which have already been well-researched and found effective, but are not part of regular treatment yet. Especially the intersection of trauma, ongoing psychol-ogical stress and pain can be understood by the idea of crystallization of inner tension into fascial adhesions and the modulation of the proprioceptive self. These avenues of experimental and clinical research are then discussed within the framework of integrative therapy that allows to include aspects of psychosomatics, salutogenesis, spirituality and traditional medical knowledge in an inclusive and approachable way.

Keywords: Integrative medicine, public health care, psycho-neuro-immunology, stress economy, chronic pain, fatigue, trauma, fascial manipulation, acupuncture, psychotherapy, psychosomatics, salutogenesis

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