Integrative Pain Management Strategies

Abstract

Chronic pain affects approximately 20% of European adults and represents one of the largest single contributors to disability, reduced quality of life, and healthcare utilisation across the region. The pharmacological landscape of chronic pain management is complex: NSAIDs face cardiovascular, gastrointestinal, and renal safety concerns; opioid medications face both short-term tolerability and long-term dependency concerns that have shaped European prescribing practice; specific classes (gabapentinoids, tricyclics, SNRIs) address neuropathic pain with their own tolerability profiles. The European pharmacological response to the opioid-crisis experience has emphasised non-pharmacological and integrative pain management strategies as first-line options where clinically appropriate. Ayurvedic medicine has classical clinical frameworks for pain (Shula and related classical categories) with specific herbal interventions, procedural interventions (abhyanga, basti-inclusive protocols), lifestyle interventions, and integrated multi-modal protocols. This study reviews 54 primary clinical studies published between 2013 and 2022, grouped under five frames: IP1 (chronic musculoskeletal pain management), IP2 (neuropathic pain management), IP3 (headache and migraine pain management), IP4 (cancer supportive pain management), and IP5 (integrated multi-modal pain protocols). Each frame was scored with the Integrative Pain Management Strategy Index (IPMSI). Integrated multi-modal protocols (IP5) scored highest at IPMSI 0.820, with chronic musculoskeletal pain (IP1) at 0.806 and headache and migraine pain (IP3) at 0.782