Integrative Multimodal Treatment of Chronic Pain: West Adopting East

Agnès Mazic - de Sonis, Neuroscience, Chirec Delta Hospital, Belgium

Background:

The principles of traditional Chinese medicine link three major themes: nutrition and microbiome, neuroplasticity, and homeostasis while considering the side effects of medication.

Accumulating evidence suggests that microbiota is involved in the physiology and pathology of cellular organisms and has implications in both health and disease. Gut microbiota has been shown to modulate the development and homeostasis of CNS in context to immune, circulatory, and neural pathways. The composition of the gut microbiota contributes to various inflammatory diseases via regulation of innate immunity, especially via NF-κB signaling. Thegut-brain axis is actively explored. Recent studies showed that microbiome impacts the properties and function of microglia involved in pain sensitization. Neurovegetative system (NVS) actively participates in the bidirectional interactions between gut microbiota-brain to maintain homeostasis in both cerebrum and intestine. The stimulation of NVS by electro acupuncture promotes the expression and proper localization of tight junction proteins, thus decreasing intestinal permeability and exerting protective effects in intestinal epithelium barrier.

Administration of pre/ probiotics to modify NVS function could be a promising strategy in the future for the treatment of CNS disorders

Methods:

We retrieve the information on diagnostic steps, and the management plan of patients with chronic refractory pain, highlighting the reasoning of the traditional Chinese medicine that is integrated with the chronobiology and the epigenetics factors. Acupuncture is used to address chronicity and the modified parameters such as sleep, nutrition, reactive depression and the different vicious circles induced by chronic pain (peripheral and central sensitization).

Results:

The treatment algorithm including pharmaco-nutrition, and acupuncture, focusing on intestinal mucosa and microbiome, in association with an adapted analgesic regimen shows a significant improvement of the parameters involved in the chronification.

Conclusion:

Acupuncture proved to be a multimodal pain regulator. The therapeutic and post effects are augmented by the cellular physiological rehabilitation.