Chronic Pain, Meet Whole Health


As a pain patient today, you’ve probably noticed that your physician has steered away from simply asking you where it hurts and handing you a prescription. Instead he or she is more likely to ask you about your overall health and what’s important in your life when assessing how best to help you manage a condition like chronic pain.

This shift away from just treating the pain toward a model that treats the whole person is rooted in a growing trend called patient-centered care. While this change may seem strange at first, in reality, it offers patients more options and increased independence for managing chronic conditions.

A Convergence of Healthcare Changes

It may be surprising to learn that the trend toward treating the whole person has actually been on the rise since 2001, when the Institute of Medicine (IOM) published a report saying that the current healthcare system was failing patients and a fundamental rethinking of care was needed. This took a movement that had been emerging slowly and thrust it into the national spotlight – which, in turn, created fuel in Washington, D.C. for the transition from “volume to value.”

This evolution was coupled with a growing realization in the medical community that opioids are highly addictive and alone are insufficient for treating complex conditions like chronic pain – opening the door to adoption of a broader spectrum of treatment options that include relaxation therapy, yoga, electrotherapy and movement practices (e.g., tai chi).

A Trend on the Rise in the Military

Another influential group that has been tapping into the promise of patient-centered care is the U.S. military. Specifically, the VA has established a program called Whole Health, which shifts away from the typical “find it, fix it” disease care model and focuses instead a range of physical, emotional, mental, social and environmental influences in Veterans’ lives.

This change stems directly from the VA’s objective to reduce patient dependence on opioids and the need to more effectively treat complex medical issues like chronic pain and PTSD. It dovetails with the scientific recognition that Veterans experience mental health disorders, substance use disorders, post-traumatic stress and traumatic brain injury at disproportionate rates compared to their civilian counterparts. 

As part of the Whole Health program, the VA now offers Veterans a PACT – that is, a Patient Aligned Care Team. This is a group of medical professionals assembled to attend to each Veteran’s healthcare needs. It generally includes a primary care provider, nurse care manager, clinical associate and other healthcare specialists as needed. The design is intended to give each Veteran a consistent team of providers familiar with his or her health.

Patient Independence Offers Keys to Relief  

Like all healthcare programs looking to reduce the use of opioids, the PACT model incorporates a variety of tools for helping Veterans manage chronic pain. Those include options that require one-on-one practitioner involvement – physical therapy, massage, acupuncture – and some that, with training, can be managed independently by the Veteran – exercise, electrotherapy, relaxation.

The inclusion of independently managed treatments is a key to on-going relief and/or recovery for many Veterans. If every pain therapy required one-on-one provider care, it would only serve to bog down the system – ultimately taking longer for patients to get the care they need. By having treatments that Veterans can self-manage – whether that’s during the day or especially in the middle of the night – they can get the necessary pain relief in their actual moments of need.

Take-Aways & Tools for Patients

Whether Veteran, active military or civilian, patients seeking pain management care now have more options embraced by the medical establishment available than ever before. While it may be confusing to navigate the choices, there are a few things to know:

  • As the patient-centered care model flourishes, it’s prompting individuals to be active participants. While the provider has always been a core part of the picture, now patients and their family members also play a big role. This new model fosters two-way communication, inspiring patients to get involved in the decision-making about their care.

  • Treatment options that give patients more direct control over their own healthcare are also on the rise. A study published in 2014 notes that “living well interventions” (i.e., self-managed therapies) instill individual responsibility and offer tools for patients to use in caring for their chronic conditions – ultimately allowing patients to address their own care at the moment of need.

  • Treatment programs for complex issues like chronic pain are increasingly incorporating an array of therapies and steering away from the use of opioids. For instance, the VA’s Whole Health program may include treatments like chiropractic sessions and electrotherapy in addition to acupuncture, mindfulness and yoga.

    o   Watch: Robert, Retired Army Veteran, Experiences Health for Life

    o   Read: Matt, Retired Army Veteran, Gets Relief from Neck & Back Pain

For any patient wondering if he or she might benefit from being more involved in their own care or wanting more self-managed therapy, the next step is to talk to a healthcare provider. Reading up on the subject prior to seeing someone is smart, as is developing a set of questions to ask during your visit.

For ideas about how to talk to your provider, click here.

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This blog provides general information and discussion about medicine, health and related subjects. The words and other content provided in this blog, and in any linked materials, are not intended and should not be construed as medical advice. If the reader or any other person has a medical concern, he or she should consult with an appropriately-licensed physician or other healthcare professional.