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Lifestyle Medicine

Lifestyle medicine and why it’s needed for lowering disease activity

By:

Dr. Beth Biggee, MD

What is Lifestyle Medicine?

Lifestyle medicine focuses on the whole person, and even whole communities, by addressing the pillars of health to prevent, treat, and often reverse chronic diseases. The pillars of health include:

Whole-food, plant-based nutrition
Regular physical activity
Restorative sleep
Stress management
Social connection
Avoidance of toxic substances such as drugs and alcohol

Lifestyle medicine, like standard medical care, is rooted in evidenced-based practices, but it differs by first using the least invasive behavioral strategies to improve health. Techniques are human-centered rather than disease-centered, addressing the whole person.

Narrative medicine is used to get to the root of problems. Narrative medicine is relatively new and was pioneered beginning in 2000 at Columbia University’s Department of Medical Humanities and Ethics. It involves the training of providers to receive and incorporate patient stories of their life and family history into the assessment of a diagnosis, and the best treatments for a care plan.

How will I work with my Lifestyle Medicine provider?

Lifestyle medicine practitioners use empathy, compassion, inclusion, deep listening, and education to address and improve human whole health. Such interventions may include:

Working one-on-one with a nutritionist
Exploring customized exercise plans appropriately tailored to achievable goals
Addressing healthy sleep habits
Introducing mind-body techniques
Working with therapists to reduce stress and improve connection
Guidance on reducing substance usage.

Building on the therapeutic relationship, lifestyle medicine educates, facilitates, and empowers you to promote behavioral changes using the pillars of health. This approach aligns with the Quintuple Aim of better health outcomes, lower cost, improved patient satisfaction, improved provider well-being, and advancement of health equity.

How is Lifestyle Medicine Connected to Chronic Disease & Autoimmune?

Chronic disease is at an all-time high. Six out of ten adults in the U.S. suffer from chronic diseases. Many chronic diseases are driven by unhealthy lifestyle practices, such as poor nutrition, reduced physical activity, reduced restorative sleep, increased stress, lack of coping skills, and smoking.

Many chronic diseases arise due to genetics, but genetic variants alone do not explain disease risk in total. Many environmental factors, such as unbalanced nutrition or environmental exposure such as smoking may lead to and exacerbate chronic diseases, especially autoimmune diseases.

Autoimmune diseases affect up to 50 Million U.S. residents, and the rate of new autoimmune diseases each year keeps increasing. The exact reason that autoimmunity and autoimmune diseases are on the rise remain unclear. A theory is that certain multiple environmental interactions adversely affect certain genetically susceptible individuals. According to one recent study, “The increasing prevalence of autoimmunity and autoimmune diseases: an urgent call to action for improved understanding, diagnosis, treatment, and prevention” (Current Opinion in Immunology 2023), possible environmental interactions could be changes in our food, contacts with xenobiotics, air pollution, infections, unhealthy lifestyles, psychosocial stress, and climate change.

Lifestyle medicine, by addressing the pillars of health, is an excellent tool to address, prevent, treat, and minimize disease activity in autoimmune conditions. If there is a link between infections and onset of certain autoimmune conditions, lifestyle medicine can help foster healthy habits to try to prevent infections such as adequate sleep, eating healthy balanced nutrition, and reducing stress.

How can Lifestyle Medicine improve my health and symptoms?

Starting with the pillar of nutrition: a high animal fat, high refined sugar Western diet has been linked not only to heart disease, but also certain autoimmune diseases. Alternatively, a plant-based Mediterranean diet high in fiber and antioxidants has been shown to reduce pain, increase function, and lower disease activity in patients with rheumatoid arthritis¹.

Next, the pillar of physical activity: for ankylosing spondylitis, a review of ten studies showed that an exercise program compared to no exercise program improved pain, function, and lowered disease activity².

For the pillar of restorative sleep: Patients with sleep disorders are at high risk of developing autoimmune conditions such as rheumatoid arthritis, ankylosing spondylitis, systemic lupus, and Sjögren’s syndrome. Addressing sleep is a crucial pillar of health in Lifestyle Medicine.

In the pillar of stress reduction: stress is another pillar that has played a role in the causation and worsening of autoimmune diseases. Many patients with systemic lupus recall a traumatic event before the onset of their diagnosis. High stress has been shown to worsen disease severity in lupus patients contributing to flares and organ damage³.

On the pillar of substance usage: Smoking has been related to many autoimmune condition diagnoses, in particular rheumatoid arthritis. Not only is smoking a risk factor for developing rheumatoid arthritis, but a smoking patient has an increased risk of worsened disease activity, and lack of response to certain medications. Lupus patients respond poorly to certain medications if smoking as well.

Lifestyle medicine is real-life medicine with a team approach. Collaborative visits are not only with the lifestyle medicine provider but usually with a nutritionist, psychologist, and care coordinator. Options are presented for a care plan, and a whole team helps and works with you to adopt and adapt your life – taking into account your lifestyle, household, and other factors – to a customized lifestyle plan, set goals, and achieve lower disease activity. It typically takes people with autoimmune condition(s) three to six months to improve function, lessen pain and fatigue, and lower disease activity. Some people can experience improvement in as short as six weeks.

Not only does lifestyle medicine improve autoimmune symptoms, but it also can improve cardiovascular disease, metabolic issues, mental health and weight concerns at the same time. This approach may also reduce risks for dementia, cancer, and developing other autoimmune diseases throughout your lifetime. Lifestyle medicine is for a lifetime. This approach not only helps to achieve low disease activity for you now, but throughout your life.

To learn more about our Rheumission approach to care, please visit the Approach section of our site, or book a 15-minute intro call with one of our providers. The Rheumission Way helps you get back to being you, with more joy and less pain. We will listen to you and co-create a plan that works for where you are now, and where you want to be. We are always here for you.

About the Author

Dr. Beth Biggee is an Integrative Lifestyle Rheumatologist at Rheumission, bridging the gap between traditional and complementary medicine. With over two decades of expertise in Rheumatology, her distinguished career is marked by triple board certifications in Rheumatology, Integrative Medicine, and Lifestyle Medicine. She earned her medical degree from SUNY Upstate Medical Center in Syracuse, NY, and completed her Internal Medicine residency at the Yale New Haven Hospital. Dr. Biggee specialized in Rheumatology through a fellowship at Tufts Medical School in Boston. Her holistic vision of health was further enriched by completing Andrew Weil's renowned Integrative Medicine fellowship at the University of Arizona and by becoming a Certified Lifestyle Physician through the American Board of Lifestyle Medicine.

Beyond her medical training, Dr. Biggee has deepened her expertise in healing modalities such as learning HeartMath, a cutting-edge neurofeedback technique for stress management, and practicing Usui Holy Fire Reiki. She also holds a certification in Auricular Acupuncture from the Helms Medical Institute. Her passion for plant-based therapies led her to enroll in the Herbal Medicine Foundations Program at Medicine Lodge Academy, and she has pursued extensive hands-on training in Ayurvedic medicine for physicians.

References

Note: This information is for informational purposes only. No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment and before undertaking a new healthcare regimen, and never disregard professional medical advice or delay in seeking it because of something you have read on this website.

How does a virtual rheumatology care team work for you?

As you go through your patient journey, there’s one key element that becomes clear: finding the right, supportive rheumatologist and overall healthcare team is the most important part of life as a person with a chronic condition.

The right doctor and team help keep you on a successful path to sustained remission – feeling good, positive and hopeful each day about the symptoms that touch most aspects of your life and the treatment to heal them.

When you're looking for or considering a new rheumatology practice, it may feel like a given that an in-person appointment is mandatory. And I understand that, as an autoimmune rheumatology patient myself, first diagnosed 14 years ago.

However, through the years of my practice and as a patient, I see great benefits to a telehealth practice — if I felt I wasn't able to diagnose you, or treat your symptoms as well or better than an in-person appointment, I would not practice medicine this way.

Rheumission has adopted a virtual-first approach to treating rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis. We believe that our telehealth model improves accessibility, convenience, and better serves our patients overall. Below I’ll take you through the three reasons why.

Why is a virtual visit as good as an in-person visit?

A virtual rheumatology visit can be just as good as an in-person visit because, in both scenarios, the patient’s clinical history, labs, and imaging often inform the diagnosis.

Sometimes, swelling can be subtle and hard to visualize through a virtual exam. In these cases, the patient would be referred out for imaging. This is not dissimilar to in-person visits - rheumatologists often order imaging to fully visualize joint swelling before confirming a diagnosis.

An in-person visit does allow me to press on joints and do needle injections and aspirations. If injections are needed for virtual patients, you may be referred to local clinics who can perform the test and then send me the results that we can review together.

How can I ensure that my diagnosis will be the same as if I saw you in-person?

A rheumatology diagnosis relies most heavily on the patient’s clinical history, labs, and imaging. However, there are some cases where parts of the physical exam are unclear, and the patient’s history, labs, and imaging do not provide enough information. In these few cases, a referral to an in-person rheumatologist may be needed.

In all rheumatology visits, it’s important that I can focus on you, and listen closely to your history. Some in-person doctors barely examine patients or look at them during a visit.

Communication does not need to be rushed during a telehealth visit, and communication styles are often very individual to the provider. At Rheumission, our initial visits are one hour long, and follow-up visits run for 30 minutes. This is an uncommonly high amount of time for medical appointments, but we understand and value deeply listening to our patients and their history, before jumping into treatment decisions.

What are some benefits of virtual care?

Virtual care increases accessibility and decreases wait times before appointments. If there’s a case where you need an in-person exam, you can start and continue on with virtual appointments rather than waiting months for any sort of care.

As an autoimmune patient myself, I know that a lot of autoimmune patients struggle with brain fog and keeping track of their appointments. One benefit of virtual care is that it’s easier to jump into a visit or make up a visit after the fact. For example, say you forgot about your appointment and went to the beach. You remembered that you had an appointment once you got there, but you could still complete the exam outside of your home. Virtual visits can be completed anywhere at the convenience of the patient. If this were an in-person visit, it would be much more difficult to make up the visit if forgotten.

A common issue with our world’s shift towards more remote/virtual models is a general decrease in physical activity. In the case of virtual appointments, you lose the walk to and from the clinic.

This would be a loss for a conventional telehealth practice that does not include movement as a part of its treatment approach. However, here at Rheumission, we’ve adopted an integrative, lifestyle approach where we encourage patients to incorporate more movement into their routine as part of every treatment plan.

So what's the most important thing to know about telehealth rheumatology visits?

Remote rheumatology visits are comparable to in-person appointments, with increased availability, convenience, and unrushed time for deeper conversations about your health.

While remote models are still relatively new, we believe that the increased accessibility and coordination of care within a telehealth practice is the best way forward for rheumatology patients, which is why we set up Rheumission – so that we can give you the best care possible.

To learn more about our Rheumission approach to care, please visit the Approach section of our site, or book a 15-minute intro call with one of our providers. Our approach is to help you get back to being you, with more joy and less pain. We will listen to you and co-create a plan that works for where you are now, and where you want to be. We are always here for you.

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About the Author

Dr. Micah Yu is an integrative rheumatologist who incorporates complementary medicine with traditional rheumatology. He is quadruple board-certified in Rheumatology, Internal Medicine, Integrative Medicine and Lifestyle Medicine. He obtained his MD from Chicago Medical School and holds a Masters in Healthcare Administration and Biomedical sciences. He completed his internal medicine residency and rheumatology fellowship at Loma Linda University in Southern California. He is a graduate of the Andrew Weil Integrative Medicine Fellowship at the University of Arizona. In addition, he is certified in functional medicine through the Institute of Functional Medicine. He has a very unique perspective on autoimmune disease and arthritis, as he is both a patient with arthritis and physician. Dr. Yu was diagnosed with gout at the age of 17 and later diagnosed with spondyloarthritis as well. He is able to understand his patient’s medical problems from a patient perspective. The foundation of his practice is to combine allopathic medicine with complementary medicine. He works with his patients to come up with a treatment plan that not only fights the disease, but also is aligned with his patient’s goals. In addition to Rheumission, Dr. Yu is on social media under @MYAutoimmuneMD educating about autoimmune diseases and integrative medicine.

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What is conventional or traditional rheumatology?

Conventional rheumatology describes the medical care that is most common and that we are most familiar with in the US. In conventional rheumatology, the focus is on taking history and performing an exam, obtaining appropriate labs and imaging, making a disease diagnosis, and treating a diagnosis with prescription medications. Diagnosis and management are focused on the disease.

What treatments and medications are common in conventional rheumatology?

After taking a history and exam; labs, x-rays, ultrasound, and/or MRI may be ordered to assist in making the diagnosis. Treatments including medications in different forms including oral, injections and infusions are typically prescribed.

This includes medications that treat the cause of the inflammation, such as DMARDs and biologics. Corticosteroids, such as prednisone, and NSAIDs, such as aspirin and ibuprofen, treat flares of inflammation. Joint injections and physical therapy are additional treatments used frequently to manage rheumatologic disease.

What does the typical patient experience look like in traditional rheumatology, including diagnosis time, wait times, and referrals to other specialists?

There is often a long wait, several months in some cases, for a visit with a rheumatology specialist. Access to rheumatologists can be limited due to high demand and lack of enough specialists. This adds to the all-too-common delay in a diagnosis, which can be several months to years. Sometimes, a referral will be required from a person’s PCP to see a rheumatologist, depending on the insurance plan or practice.

What is integrative rheumatology?

Integrative Rheumatology is a combination of conventional rheumatology care, with the addition of holistic or complimentary treatments or care plans, making this an integrative approach to treating patients. The patient’s symptoms will be evaluated, diagnosed and managed from a whole body approach.

Rheumatologic diseases are most often systemic diseases that are affected by diet and lifestyle. Addressing diet, exercise, sleep, stress and mental health are some of the paths to assisting in achieving remission from disease, which cannot always be attained with medication alone. Integrative Rheumatology focuses on these lifestyle pillars, making changes in nutrition, sleep patterns, stress management, physical activity and mental health to improve a patient’s overall wellness. A team approach with experts in several of these areas is used in many cases. Improving these underlying areas of health will contribute to improving the disease.

Integrative health aims for well-coordinated care among different providers and institutions by bringing conventional and complementary approaches together to care for the whole person².

How is integrative different from conventional? Key differences / similarities?

Starting with similarities, both conventional and integrative rheumatology will include taking a patient’s history and performing a physical exam (which in a virtual setting, means showing areas of swelling to the camera, or taking a photo and sending it in a secure way to your provider). Blood tests and imaging may be ordered to assist further in making a diagnosis. Medications would be the first line of treatment in conventional rheumatology, while addressing lifestyle changes would be a main focus in integrative rheumatology, with medication also being prescribed when needed.

The first difference between conventional and integrative rheumatology is in asking about your medical and family history. The history taken by an integrative rheumatologist will include diet, sleep, exercise, stress and other lifestyle aspects. The ongoing management in integrative rheumatology involves management of all these areas to bring disease under control, from a whole body approach.

What tools/treatments are common in integrative rheum?

Nutrition is a major focus and usually includes introducing an anti-inflammatory diet, often with a visit to a registered dietician recommended to guide the transition to a new diet. At Rheumission, our registered dietitian has specialized training to work with autoimmune patients. We also ensure that your food journey is taken at the pace that works for your lifestyle, which may mean you go through the anti-inflammatory diet more slowly or more quickly than others.

We have learned there is a significant connection between the gut, microbiome and inflammation in our bodies. Supplements are utilized for most patients, along with recommendations for physical activity, stress management, improving sleep and mind body medicine tools to manage symptoms of the disease. Acupuncture is another therapy often recommended.

What does the typical patient experience look like in integrative rheumatology?

The history taken will be a little different as noted above. Initially, treatment will focus on nutrition, moving towards an anti-inflammatory diet, as described above. Supplements are recommended, as well as regular physical activity that is gentle and does not stress your joints and muscles.

Stress management and mind body tools such as meditation, breath work and relaxation techniques are used to decrease the underlying inflammatory state in the body.

At Rheumission, we are fortunate to have a team of providers with expertise in all of these treatments and lifestyle changes to work with and help our patients. Your team will include lifestyle medicine providers, a registered dietician, and an autoimmune psychologist to support our patients.

‍What does training for integrative rheumatology include?

Training is usually additional training after completing the traditional education and residency as a physician, PA or NP. There are Integrative Medicine fellowships available at several medical schools in the country. The integrative providers at Rheumission were all trained at the Andrew Weil Center for Integrative Medicine at the University of Arizona.

As a provider, what made you decide to work in integrative rather than conventional?

An integrative approach is how I have tried best to live my own life and manage illness with positive results. I strongly believe there is so much we can do to prevent and manage disease with improvement in lifestyle modalities. It is very rewarding to work with patients who are actively involved in their disease management and wellness.

What benefits do you think integrative rheumatology brings patients?

Because rheumatologic diseases are systemic diseases significantly impacted by one’s lifestyle, including stress, nutrition, and sleep, improving these channels can have a significant impact on improving disease and achieving remission. Often, medication alone is not enough to achieve improvements when there is continued underlying inflammation triggered by poor diet, inadequate sleep or significant stress. Addressing the patient’s disease from a whole body perspective is very effective.

About the Author

Jill Ryan is a seasoned Rheumatology Physician Assistant with over 30 years of experience and a strong commitment to patient care. She worked at Dartmouth Health System as a Rheumatology Physician Assistant for 24 years, and prior to that role, as an Internal Medicine Physician Assistant for 8 years. Jill is deeply passionate about caring for patients and guiding them on their wellness journeys. With training in integrative medicine, she focuses on holistic approaches that empower individuals to manage autoimmune diseases effectively, believing in the importance of patient education and developing personalized care plans that promote overall health and well-being.

References

1. Integrative Rheumatology by Randy Horowitz, MD, PhD, Daniel Muller, MD, PhD. 2011.

2. NIH: National Center for Complementary and Integrative Health. Complementary, alternative, or integrative health: What’s in a name? 2022 Oct.

As someone who's faced the challenges of chronic illness and autoimmune disease, I understand how crucial it is to have a healthcare approach that sees you as a whole person, not just a set of symptoms. But what is integrative medicine? How is it different from other types of medicine, and how can it help you on your health journey? I'll try to explain this with 8 factors that set it apart, which are all so important for holistic treatment to help you find a new normal on your autoimmune journey.

What is Integrative Medicine?

Integrative medicine is a holistic approach that combines conventional treatments with complementary therapies. It focuses on treating the whole person – mind, body, and spirit. Unlike conventional medicine, which often zeroes in on specific symptoms and diseases, integrative medicine looks at all aspects of your health and well-being. This approach has helped me immensely, both as a patient and a provider to people with rheumatology conditions.

Integrative Medicine vs. Conventional and Functional Medicine

You might be wondering how integrative medicine differs from conventional and functional medicine. Conventional medicine is what most of us are familiar with – doctors diagnosing and treating diseases primarily with pharmaceuticals and surgery. Functional medicine, on the other hand, aims to identify and address the root causes of diseases, often through personalized nutrition and extensive food and other testing. Integrative medicine encompasses the best of both worlds, combining conventional treatments with holistic practices like nutrition, exercise, and mindfulness^1,2.

Studies have shown that patients often report higher satisfaction with integrative medicine because it provides a more personalized and compassionate approach to care^1,2. Patients feel more connected to their healthcare team, and this relationship can lead to better health outcomes.

So with that background, here are the top 8 reasons Integrative Medicine is different and better for your treatment, slowing condition progression, and overall improvement of your quality of life.

#1: The Power of Food and Nourishment

One of the pillars of integrative medicine is nutrition. You’ve probably heard the saying, “food is fuel,” and it’s true! Research has shown that phytonutrients found in fruits, vegetables, and other plant-based foods can have anti-inflammatory effects on the body. Changing my diet has been a game-changer for me and my patients. Unfortunately, conventional medicine often overlooks nutrition, but integrative practitioners are working to change that².

#2: Movement and Exercise

Another key component is exercise and gentle movement. Whether it’s strengthening exercises, stretches, yoga, or simply walking, physical activity is essential for improving health. Exercise not only benefits the body but also the mind, helping to reduce stress and improve mood¹.

#3: Focusing on the Mind

Our mental health is just as important as our physical health. Integrative medicine uses techniques like guided imagery, hypnotherapy, and mindfulness to help manage both physical and mental health challenges. These therapies can be incredibly effective for reducing stress and improving overall well-being^1,2.

#4: Alternative Treatments

Integrative medicine also includes alternative treatments such as acupuncture, vagus nerve treatment, and therapeutic massages. While these treatments might not work for everyone, they can be beneficial when used alongside conventional therapies.

#5: Environmental Medicine

Integrative medicine considers the impact of environmental factors on health. Pollution, toxins in products, and other environmental influences can contribute to chronic inflammation and other health issues. By addressing these factors, integrative medicine offers a more comprehensive approach to treatment².

#6: The Importance of Sleep

Sleep is a critical component of overall health, yet it's often neglected. Integrative medicine emphasizes the importance of good sleep hygiene and aims to identify and treat sleep disorders that may be contributing to chronic health issues. Techniques such as improving sleep environments, establishing regular sleep routines, and using relaxation therapies can make a significant difference in a patient's sleep quality².

#7: Social Connections and Support Networks

Strong social connections and support networks play a vital role in maintaining health and wellness. Integrative medicine encourages patients to foster relationships and build communities that provide emotional support. This can include group therapy sessions, community activities, or simply maintaining close contact with family and friends. The sense of belonging and support can greatly enhance mental and emotional health^1,2.

#8: Personalized Medicine

Integrative medicine is all about personalized care. Each patient is unique, and their treatment plans should reflect that. Integrative medicine providers take the time to understand the individual's health history, lifestyle, and personal goals. This personalized approach ensures that treatments are tailored to the specific needs of each patient, leading to more effective and meaningful health results that you can see and feel in your daily life².

A New Approach to Healthcare

Integrative medicine is an open-minded and beneficial way to approach healthcare. Despite some misconceptions, it doesn’t reject conventional medicine, but enhances it with additional tools and strategies. This dynamic approach is the future of healthcare, especially for those of us living with chronic illness¹.

If this resonates with you, consider seeking out a doctor who practices integrative medicine. Our doors are always open at Rheumission, and many other practices share our whole person approach to health.

Take control of your health journey and explore the benefits of integrative medicine today. You deserve a healthcare approach that sees and treats you as a whole person. Stay healthy and strong!

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To learn more about our Rheumission approach to care, please visit the Approach section of our site, or book a 15-minute intro call with one of our providers. The Rheumission Way helps you get back to being you, with more joy and less pain. We will listen to you and co-create a plan that works for where you are now, and where you want to be. We are always here for you.

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About the Author

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References

1. Mastorci, F. (2023). Toward Patient Care: Integrative and Complementary Approaches. https://link.springer.com/chapter/10.1007/978-3-031-23852-9_11

2. "The possibilities and challenges of integrative medicine implementation in clinical psychology: a qualitative study in Indonesia." (2020). BMC Complementary Medicine and Therapies, 20(1), 1-12. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7362562/

Chronic pain affects over 50 million adults in the United States², and for approximately 17 million of these individuals, it limits their ability to engage in daily activities. This statistic alone is staggering but doesn’t tell the full story.

In addition to the profound effects on physical health, pain also has a negative impact on emotional well-being and behavior. Often, people living with chronic pain report feelings of sadness or depression³, heightened anxiety¹, a decline in energy levels⁵, and sleep disturbances⁴.

Chronic pain, physical health, and mental health are interconnected in a complex cycle that can be difficult to break.

‍The Connection Between Pain, Emotions, and Behaviors

Let’s look at a common scenario many people with chronic pain experience. Imagine you wake up in the morning with intense pain. Immediately, you feel a wave of anxiety and sadness, worrying about how bad the pain will get throughout the day.

Thoughts like, “What if this doesn’t get better?” or “I’m not sure I can handle this,” begin to dominate your mind.

These emotions may impact your behavior during the rest of your day. You may avoid physical activity, fearing that movement will worsen the pain. You might cancel plans with friends or family, anticipating that your pain-induced irritability or low mood could negatively affect others.

As the day progresses, the pain worsens and the sadness continues, leading you to find comfort in unhealthy choices. You might reach for comfort food to soothe your emotions, coffee to boost energy, or even alcohol to numb the pain.

Unfortunately, these coping mechanisms often backfire. Unhealthy eating, increased caffeine, and alcohol intake can further intensify your symptoms.

And so, the cycle continues: you wake up the next day more exhausted, irritable, and anxious, with the pain feeling worse than before.

Now, let’s imagine a different scenario. Picture waking up in the morning with little or no pain after a restful night’s sleep. Your emotions are more positive, you feel more relaxed and optimistic about the day ahead. Since you slept well, you have the energy to engage in behaviors and activities you enjoy, such as a light exercise routine or spending time with loved ones.

Throughout the day, you make healthier food choices, opting for fruits and vegetables that nourish your body and contribute to your overall well-being. You don’t need caffeine to stay alert or alcohol to cope with discomfort because your pain is manageable. By the end of the day, you feel accomplished and content, and when it’s time to sleep, you fall asleep easily, ready to face another day.

These two scenarios highlight the deep connection between pain, emotions, and behaviors. Chronic pain is not just a physical experience; it affects every aspect of your life, from your mood to your energy levels, to your decision-making. Understanding this connection is so important for managing chronic pain.

While pain medication and other pharmacological treatments can provide relief, they often address only one part of the problem. Chronic pain requires a more holistic approach—one that considers how pain impacts your thoughts, behaviors, and emotions.

Rheumission’s Approach

At Rheumission, we understand that managing chronic pain goes beyond prescribing medication. Our multidisciplinary team of autoimmune experts, including rheumatologists, registered dietitians, lifestyle medicine providers, and chronic pain psychologists, collaborates to provide whole-person care tailored to you and your needs.

Our goal is to improve not only your physical pain, but your overall quality of life, by addressing how pain impacts your emotions and behaviors.

One of the key components of our approach is the inclusion of autoimmune psychological support. During your sessions, your provider will ask you questions about your pain, such as when and where the pain occurs, how it affects your mood, and how you respond to it. Together, you and your autoimmune psychologist will explore the emotional and behavioral patterns that may be contributing to the persistence or worsening of your pain.

You’ll talk about coping strategies that can help you break the cycle of pain, negative emotions, and unhelpful behaviors. These strategies may include mindfulness practices, cognitive-behavioral therapy (CBT), or techniques for improving sleep quality and managing stress.

Ultimately, the goal of our holistic treatment approach is to empower you to take control of your pain and improve your quality of life. We believe that addressing pain’s impact on both your physical and mental health can help you achieve lasting relief and well-being.

If you are living with chronic pain, know that you are not alone, and there are solutions that can help. Together, we can break the cycle of pain and empower you to reclaim your life.

To learn more about our Rheumission approach to care, please visit the Approach section of our site, or book a 15-minute intro call with one of our providers. The Rheumission Way helps you get back to being you, with more joy and less pain. We will listen to you and co-create a plan that works for where you are now, and where you want to be. We are always here for you.

About the Author

Lize Tibiriçá, PsyD, is a Clinical Psychologist who also holds a master’s degree in Ergonomics and Occupational Safety. Dr. Tibiriçá utilizes an integrative approach to psychology specifically designed to meet each person's needs and facilitate long-lasting change. She is dedicated to working with her clients to improve their quality of life and well-being. She listens to and invites her clients to actively participate in decisions related to their treatment.

References:

1. McWilliams LA, Cox BJ, Enns MW. Mood and anxiety disorders associated with chronic pain: an examination in a nationally representative sample. Pain. 2003;106:127–33. doi: 10.1016/s0304-3959(03)00301-4.

2. Rikard SM, Strahan AE, Schmit KM, Guy GP Jr.. Chronic Pain Among Adults — United States, 2019–2021. MMWR Morb Mortal Wkly Rep 2023;72:379–385. DOI: http://dx.doi.org/10.15585/mmwr.mm7215a1

3. Vadivelu N, Kai AM, Kodumudi G, Babayan K, Fontes M, Burg MM. Pain and Psychology-A Reciprocal Relationship. Ochsner J. 2017;17(2):173-180.

4. Whale K, Gooberman-Hill R. The Importance of Sleep for People With Chronic Pain: Current Insights and Evidence. JBMR Plus. 2022;6(7):e10658. Published 2022 Jun 17. doi:10.1002/jbm4.10658

5. Yamada K, Adams H, Ellis T, et al. The temporal relation between pain and fatigue in individuals receiving treatment for chronic musculoskeletal pain. BMC Musculoskelet Disord. 2022;23(1):219. Published 2022 Mar 8. doi:10.1186/s12891-022-05162-7