Integrative medicine (IM) can be seen as an attempt to combine regularacademic medical therapies with more evidence-based compelementary andalternative medicine (CAM). In any IM approach one should not simplyadd CAM to conventional medical care. IM treatment should emphasizehealth and healing rather than disease and symptomatic treatment, andpatient coaching plays a central role.

World wide we see an increased number of medical training programs on CAM and Integrated Medicine (IM) as well as academic centres and hospitals integrating selected CAM into their IM services and research. The consortium of academic health centers for integrated medicine support a comprehensive and compassionate health care system offering seamless integration of effective complementary and conventional approaches to promote healing and health in every individual and community.

These trends show a narrowing of the gap between conceptually opposing domains, as a result of patient preference and pressure of patient organisations, politics and emerging evidence of effectiveness and safety. Furthermore there is increasing pressure of students to teach CAM and IM at universities. This student demand contributed to the first academic CAM courses and the establishment of an academic IM centers in the USA and now progresively in Europe, such as the Unit for Studies of Integrative Health Care at Karolinska Institute in Sweden.

Integrated medicine approach in neuropathic pain

In our institute we have explored how to integrate various CAM modalities into the mainstream treatment of neuropathic pain, by selecting certain evidence based approaches from CAM and integrating these into the regular pharmacotherapeutical therapy for treating neuropathic pain.

Neuropathic pain is a pain modality which is very difficult to treat and its impact on quality of life is significant. Single, isolated forms of treatment very often are not sufficient, and only one out of ten patients suffering from neuropathic pain is well treated. Inn order to treat patients adequately, more treatmentmodalities are required.

In our institute we combine the following treatment modalities in the treatment of painful neuropathy due to diabetes mellitus, CIAP and cis-platin treatment for cancer:

acupuncture administered as PENS (percutaneous electrical nerve stimulation),

supplements such as alpha lipoic acid, acetyl-l-carnitine, and

the body-own compound palmitoylethanolamide (Normast), 

vitamines such as vitamine D3,

topical creams such as amitriptyline cream, baclofen, ketamine and gabaopentine cream,

anagesics such as gabapentine and amitriptyline,

physiotherapy for balance, stability, muscle strenght and endurance,

Using this treatment scedule, in an individualized way, helped us to decrease pain intensity scores in the majorities of patients with 50% or more.  

March 2010, Jan M. Keppel Hesselink, MD, PhD, David J Kopsky, MD, revision march 2012, JMKH