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Ancient Practice, Modern Revival: How Integrative Medicine is Reshaping Chronic Pain Management 

By Priyasha Itani 

As I was growing up, my grandmother preached ayurveda, ancient South Asian holistic medicine, any chance she’d get—from meditation for stress relief to massage therapy for growing pains. But as I listened to her long ramblings about the practice, I was always quick to judge. Compared to the new technology and quantitative image I had of medicine, a holistic approach seemed outdated. Back then, my hesitation seemed natural. Western medicine has always been skeptical of holistic practices, adopting instead a central dogma of pharmaceutical and surgical repair—conventional methods that showcase dosage curves and recovery timelines. 

But years later, what I originally thought to be growing pains grew into something much more persistent, and I found myself in hospital rooms more often than I hoped. I was one of the patients who did not fit the normal expected recovery, and despite the various prescriptions, I was in a constant state of confusion, searching for something to help with my pain. After two years, my physician brought up a new course of action: “Have you heard of integrative medicine?” I was still a little skeptical, but this time, I decided to try it.  

In recent years, we have seen a surge in chronic pain, long-standing pain that persists beyond the usual recovery period. The rate of chronic pain and high-impact chronic pain (HICP) among US adults was approximately 21% and 8%, respectively, in 2023. Many chronic pain patients, myself included, have found that conventional methods of pain management do not fully encompass our needs. Integrative medicine is a medical approach that bridges complementary therapies from alternative practices and conventional methods into individualized patient care. In recent years, this field has emerged as a new tool against chronic pain.  

There has been a surge in public interest in integrative medicine, with 42% of the US population using some form of integrative medicine. Integrative medicine has even made its way to Pittsburgh with the UPMC Center for Integrative Medicine (CIM), the first hospital-based center in Pittsburgh to combine holistic practice with conventional medicine. To gain some insight into this program and field, I spoke to Dr. Ronald Glick, the Medical Director of CIM since 2002, five years after the center’s establishment in 1997.  

Dr. Glick is a psychiatrist with a specialization in physical medicine and rehabilitation, who is interested in pain management, with the goal of using integrative medicine to build independence and self-management skills for chronic pain patients. The clinic has a primary demographic of 25–55 year-olds, with two-thirds facing chronic pain, a quarter facing stress, anxiety, and depression, and the rest facing various fatigue or chronic health problems. “More commonly, patients that come in have a diagnosis, but there is not a clear medical treatment. So they are struggling to figure out what other things they can do. So, patients come to the center looking for specific methods or a consultation.” Dr. Glick describes these consultations as “pointing patients in the right direction,” and patients can choose to have further periodic advising sessions. 

The clinic offers various disciplines like acupuncture, meditation, and chiropractic therapy, as well as emphasizing lifestyle changes that focus on what Glick notes as “the big three”: diet, exercise, and stress management. “We encourage patients to also explore things that are more self-management—so that they are taking an active role in their care,” explains Glick. For example, CIM offers Mindfulness Based Stress Reduction (MBSR), led by its program director, Dr. Carol Greco, which focuses on encouraging patients to learn, practice, and implement stress management and has found many successes: “That [the program] helps for pretty much every kind of problem that we see—pain, stress, anxiety, depression, GI issues, migraines, and sleeping problems,” says Glick.  

CIM’s philosophy also extends into bridging patients’ understanding of their physiological and psychological triggers and responses. “So we’ll try to engage patients with things they know they should be practicing in good health, but put it in the context of knowing it will actually help with their disease and their symptoms.” For example, Dr. Glick works with formulating anti-inflammatory diets for inflammatory conditions and maintaining weight for those with osteopathic arthritis.  

Dr. Glick also emphasizes the importance of patients truly understanding what integrative medicine is: “It's more a matter of weaving together a combination of, whether it’s medications, or nerve blocks, or physical therapy—things that Western approaches have—along with the other things like acupuncture, mind-body approaches, and nutritional supplement.” It is important to mention that integrative medicine is not an alternative to medical treatments, and the clinic only accepts patients that are also following their necessary medical treatments such as medication for severe mental health conditions and modifying drugs for severe health conditions like cancer, multiple sclerosis, lupus, and arthritis.  

However, in order to properly establish a plan with patients that encourages self-management, a patient must acknowledge one crucial fact. Dr. Glick notes that overall portrayals of medicine, including even representation on medical shows like House, give us the  impression that there is a solution for every problem. “When it comes to chronic illness, that is not necessarily the case. There is often a challenge if a chronic pain patient is at a point where their focus is on finding a diagnosis and the medical treatment that will cure this problem.”  

Accepting that there is no easy fix for chronic pain is difficult. For myself, when I got diagnosed with Amplified Musculoskeletal Pain Syndrome, it felt impossible to have a condition that, by definition, could not be cured; it made me feel powerless to my pain. But it is through validative care, like integrative medicine, that I began to understand my body, explore various methods of managing my symptoms, and take control in the ways I take care of myself—even if that doesn’t entail taking a single “one-and-done” pill. As Dr. Glick puts it, “We want people to see that whatever they’re going to have to do to manage this, they have to piece together themselves and learn things that can be helpful.”  

Despite the progress integrative medicine has made and its ability to educate patients, the field still faces larger-scale obstacles affecting its accessibility. As Dr. Glick states, “The biggest obstacle is that a lot of these are not covered by health insurance.” When asked what he would like to see in the future, Dr. Glick explained he would like to see insurance coverage, “For example, MSBR should be an automatic thing that if someone is experiencing any kind of chronic physical or mental health problem that their insurance should pay for mindfulness. There’s enough research that shows that it benefits so many different health conditions. Massage therapy has a lot of research and benefits for musculoskeletal pain and stress, anxiety, and depression.” As we know, the cost of modern health care is high; the total incremental costs of health care due to chronic pain ranged from $261 to $300 billion. However, the use of integrative medicine has been shown to reduce the medical costs of other treatments, including a 4.1% lower increase in drug costs for veterans receiving integrative health care from 2018 to 2019. Still, Glick sees this process happening slowly, piece by piece, with some feats already being made. Since 2018, UPMC has been covering acupuncture for certain conditions like sciatica, chronic migraines, and osteoarthritis. Integrative health resources have also expanded, with the University of Pittsburgh becoming the first public institution to offer a Doctorate of Chiropractic Program, beginning in the fall of 2025.  

When I ask my grandmother now why she loves ayurveda so much, she credits its emphasis on connectivity—to find balance between the mind, body, spirit, and the world affecting us. As more people begin to explore its modern-day successors, like integrative medicine, we are slowly shifting our perspective on healing that not only strives for medical excellence but also prioritizes comprehensive care built on patient experiences and capabilities. I am excited to see the growth integrative medicine will continue to make—to rediscover novelty in the old, redefine wellness, and to reshape patient autonomy in health care.