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Ask Stanford Med, Complementary Medicine

Ask Stanford Med: Pain expert taking questions on integrative medicine

organic produce and Whole FoodsIntegrative medicine – the combination of traditional Western medicine with evidence-based, complementary approaches to health improvement, symptom management and disease prevention – encompasses many disciplines. The National Center for Complementary and Alternative Medicine (NCCAM), one of the 27 members of the National Institutes of Health, oversees scientific research and informs decision-making in the area. NCCAM’s mission “to define, through rigorous scientific investigation, the usefulness and safety of complementary and alternative medicine interventions and their roles in improving health and health care” is upheld by a number of academic medical centers, including Stanford’s Center for Integrative Medicine.

If you’ve downed a spoonful of fish oil, taken vitamins or probiotics, visited a chiropractor, or engaged in deep breathing to manage pain, you’ve experienced a practice of integrative medicine. But for many, there’s a shroud of mystery around the subject, and while peer-reviewed research studies have been conducted on some aspects of the discipline, other practices require further study.

So for this edition of Ask Stanford Med, we’ve asked Emily Ratner, MD, a clinical professor of anesthesiology, perioperative and pain medicine and co-director of medical acupuncture and the resident wellness program at Stanford, to respond to your questions on integrative medicine.

Ratner’s research interests include the use of acupuncture to manage medical conditions and to address pain and side effects from surgery and cancer. She also studies physician and trainee burnout and resilience.

Questions can be submitted to Ratner by either sending a tweet that includes the hashtag #AskSUMed or posting your question in the comments section below. We’ll collect questions until Sunday, November 10 at 5 p.m.

When submitting questions, please abide by the following ground rules:

  • Stay on topic
  • Be respectful to the person answering your questions
  • Be respectful to one another in submitting questions
  • Do not monopolize the conversation or post the same question repeatedly
  • Kindly ignore disrespectful or off topic comments
  • Know that Twitter handles and/or names may be used in the responses
  • Ratner will respond to a selection of the questions submitted, but not all of them, in a future entry on Scope.

Finally – and you may have already guessed this – an answer to any question submitted as part of this feature is meant to offer medical information, not medical advice. These answers are not a basis for any action or inaction, and they’re also not meant to replace the evaluation and determination of your doctor, who will address your specific medical needs and can make a diagnosis and give you the appropriate care.

Previously: Director of Stanford Headache Clinic answers your questions on migraines and headache disordersStudy shows complementary medicine use high among children with chronic health conditions,Ask Stanford Med: David Spiegel answers your questions on holiday stress and depressionReport highlights how integrative medicine is used in the U.S. and Americans’ use of complementary medicine on the rise

22 Responses to “ Ask Stanford Med: Pain expert taking questions on integrative medicine ”

  1. Steve Says:

    When a patient who becomes hospitalized and who has a baseline high tolerance for pain medication and therefore a high dosage at home, when a hospital doctor despite the patient being in writhing pain for days in the hospital refuses to match the home dosage in the hospital, what do you recommend the patient and caregivers/nurses etc. do when their advocacy fails

  2. Lisa H Says:

    I have low back pain around the sacrum and have been told I have still SI joints. Some days are good and some days I am in back spasms. I really would like to take a holistic approach to healing and recovery. Any recommendations?

  3. Michelle Says:

    I’m curious about the use of eye movement desensitization and reprocessing (EMDR) to help with PTSD and anxiety. How widespread is its use, and how does it work?

  4. Maureen Says:

    Why does my heart race after eating?

    What’s the best way to support a bunion so it doesn’t get worse?

  5. Mark Says:

    What are the criteria in integrative medicine for including body-mind practices in your research, and treatment or preventive medicine programs for patients? I’ve practiced yoga, meditation and Feldenkrais and had bodywork such as Rolfing and acupressure massage, all with noticable results. But I wonder about energetic practices such as Rosen Method, Reiki, and EFT/meridian tapping (which I’ve also tried and liked). Where do you draw the line between medically sound and useful, and perhaps helpful for some but not something you’d prescribe to patients or recommend that insurance cover?

  6. Fred Says:

    My blood pressure frequently fluctuates 10-15 points in short time frames. It can drop this amount in twenty minutes. It does not seem to be equiptment or operator experiece that makes the difference. My wife is the same way. I have also ruled out stress as an underlying mechanism. What is the physiology behind this kind of change?

  7. Fran Says:

    Can you address the benefits of acupuncture for osteo arthritis, especially in the knee and hip areas? And are there different types of accupuncture?

  8. kimberly Says:

    What are some ways I can treat muscle pain from ehlers-danlos syndrome (either classical or hyper mobile). I’m really afraid of physical therapy as I have tried it before and I still hurt from it. And how should we approach our doctors who think “its all in our head”? Thank you for your time :-)

  9. Jen Lafty Says:

    Good morning. I had 2 procedures done for my ic and both times my symptoms were aggravated and never let up. I am now afraid to try or have anything further done out of extreme fear of making my symptoms even worse. My question is, have you come across this before and do you have any suggestions for me.

  10. margreet Says:

    Do you recommend low dose Naltrexone for interstitial cystitis??
    My IC bladder pain was almost gone after 1 year on LDN but in the beginning and every time I highered the dose I got more pain..probably mast cell degranulation

  11. Dodie Jenkins Says:

    I have had bladder lesions removed 2 times in 5 months..My vagina burns and so does my tongue, along with normal bladder pain..I am on pyridium it is not helping..Can’t take this burning much longer..I don’t know what to do..I have kept up on a food journal but no connections..It starts as soon as my eyes open every day..PLEASE HELP ME..

  12. jill m Says:

    Husband has end stage IC dx’ed in 2008 but problems b4. His hydrodistension showed an atrophied small bladder (100 cc) complete with streaking, glommers and many hunner’s ulcers. Uro told him to never let anyone touch his bladder again, and to go home and do whatever works. Tried everything, every med, instills, PT, etc. Currently on 100mcg Fentanyl q 48 hrs, 90 mg oxycodone q 4-6 hrs prn and medicinal marijuana prn, so maxed on pain meds. His pain usually hovers around 6, but on “good” day may be 2-3, bad days 8-9. Uro says he has extensive nerve damage surrounding bladder and all of his urethra to the tip of the penis, where most of his pain is concentrated, so uro says bladder removal would do no good, the pain would remain. At the end of the line for standard treatment options. Acupuncturist said she would try to help him, but probably couldn’t do much for the pain, just make him feel better in general. Our NP said we might want to see a naturopath. He is also on many meds for other issues, clotting disorder w/weekly INR check, unstable, fluid retention, COPD, depression, anxiety. Also takes aloe vera juice, prickly pear juice and, alpha hydroic acid, B complex and magnesium which we hear are all good for inflammation. Has been months with no relief. His frequency is pretty much constant and he will sleep on the toilet which is very bad as his legs swell up so badly they weep. Very sleep deprived, at the most an hour at a time, maybe 2 if he gets a good strain of medicinal MJ, but the pain wakens him and is at a 10 level, so he is almost afraid to go into a deep sleep. To your knowledge, will herbal treatments help with this, insurance won’t cover the naturopath or acupuncturist, money is very tight and we can’t be wasting a dime if this is going to be fruitless. He is also prediabetic, he could not tolerate the medication made his bladder flare horribly, trying to control with diet, he is overweight. He tends to be somewhat noncompliant as he is just disgusted now, if something doesn’t work quickly, he just gives up. I have faith in naturopathy and alternative medicine. He thinks he wants to get hypnotized as well. Are we grasping at straws here, should we not pay the light bill and pursue this instead? Will try it if there is hope, will be very tight, but his comfort of course comes first. What is your opinion, should we just carry on and appreciate the good day as it comes or chase this down further? Done with uros, have seen them all same answer. Research is encouraging for women with IC, not so for men. Hub is 58, yes he smokes and blames it on the narcotics, and as I said he is pretty noncompliant so something like yoga or any routine thing just would not fly. He couldn’t even do the mild exercises the PT gave him to do at home. We try to watch diet, herbal teas, no caffeine, little red meat, no acidic foods or chemicals/preservatives, and he takes prelief if we do have a food that is questionable. Is there any hope, we can’t just afford to try a whole lot of alternative options if they won’t work, and wanted your opinion if it is worth it. Thank you for your time.

  13. Emily Says:

    Are there any integrative medicine apps or wearable self-tracking devices? If so, any that you would recommend? If not, what kinds of technology would be useful to integrative medicine practitioners and their patients?

  14. Terry Says:

    What integrative medical treatments are best for nerve pain caused by vertebral osteophytes and degenerative disc disease?

  15. Laura Says:

    What treatments (diet, supplements, medications, etc) do you recommend for severe yeast overgrowth?

  16. Marie Says:

    I had a total hip replacement 6 months ago and I am worse off than before the surgery. I have tried everything the surgeon has said to do, although I am having trouble staying away from cigarettes. I did get a second opinion who saw on the x-ray that the initial surgeon had placed the cup too far in. I’m going to continue exercising,although painful, but what kind of diet should I be on. Is it normal to be in so, so much pain after 6 months?

  17. JC Says:

    1. Would you recommend trying psychedelics like DMT or magic mushrooms to help with chronic pain (e.g. failed spinal fusion)?

    2. Do you know any treatment options for removing “knots” in the psoas or myofascial area in the lower abdomen? Maybe something electrical or ultrasound? Foam and ball rolling is not working and this area is very unnaturally hard after lumbar spinal fusion.


  18. Colleen Davis Says:

    Can you address the benefits of facial acupuncture, and can it/should it be used frequesntly as an anti-aging treatment?

  19. Ellen Says:

    I have recently been diagnosed with IC, had a bladder distention and am undergoing treatment with bladder cocktails. I have changed my diet, and I am taking Tramadol to relieve the pain. I have heard that accupunture can be helpful, can you give me your thoughts on this treatment. I am doing as much research as possible in order to try to control the IC, by the way, I also have Fibromyalgia, which was diagnosed over 35 years ago and I have been able to keep it under control by knowing my body and what triggers an episode. I am hoping I will have the same success with the IC. I know it will not happen overnight, but I am willing to try anything available to me so that I am able to cope with this condition. Thank you.

  20. Mary Says:

    Please speak about efficacy of integrative medicine to alleviate multi-point pain from a variety of causes (itp, oa, aging). Relative has doctor fatigue as well, and is not interested in anything else.

  21. Joey Says:

    If your juicing and eating fruits and veggies are you still getting enough fiber and vitamins? Do you still get the full amount of vitamins from juicing as with eating whole food? Can juicing cause bloating? Have been juicing for 8 months now and am finding myself bloated.

  22. Michelle Brandt Says:

    We are no longer taking questions on this topic.
    -Scope editor


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