Integrative Medicine as an Adjunct to Orthopaedic Surgery

James R. Ficke, MD; Nathan M. Moroski, MD; Steven D. Ross, MD; Ranjan Gupta, MD


J Am Acad Orthop Surg. 2018;26(2):58-65. 

In This Article

Integrative Medicine in the Military Health System

The use of integrative medicine in active military members and veterans has been studied for overall utilization and to determine which modalities are most common.[8,36] Recent reports on the efficacy of integrative medicine have been published, but they relate less to musculoskeletal conditions than to behavioral health and wellness.[8,37] A US Department of Defense Veterans Affairs taskforce identified pain management best practices and published the Pain Management Task Force Report: Final Report in 2010 and the validation in 2012.[38] The Comprehensive Pain Management Campaign Plan called for the establishment of an interdisciplinary pain management center at each Army medical center.[38] These pain management centers would be staffed with MD/DO physicians, psychologists, pharmacists, physical therapists, occupational therapists, chiropractors, licensed acupuncturists, massage therapists, and yoga therapists. One study analyzed use among Iraq and Afghanistan War veterans extracted from a database of >20,000 US servicemembers and noted patterns largely consistent with civilian use of integrative medicine: mostly women, nonpoor, and those who are white.[39] The conditions treated in the study focused on back problems and chronic pain, and the modalities most commonly sought were chiropractic manipulations, acupuncture, and relaxation. Currently, the US Army has employed chiropractors and alternative medicine specialists qualified in acupuncture in several sites across the Military Health System. Data collection has begun on the comparative effectiveness of multimodal interdisciplinary pain management strategies used at these sites, but no published data are yet available. Given the large population and utilization patterns similar to civilian reports, these efforts present the possibility to critically assess outcomes for chronic pain conditions.