Chronic Pain

FAQ
Chronic pain can occur due to issues with the nerves and central nervous system, organs, immune system, or the muscles, joints, and skeleton. Common causes include arthritis, back and neck pain, cancer, fibromyalgia, and headache disorders like migraine.
Treatment may include medications, physical and occupational therapy, and psychological therapies like cognitive behavioral therapy. Procedures, including Botox injections, transcutaneous electrical nerve stimulation, surgery, and steroid injections, may help. Nonpharmaceutical aids like biofeedback therapy, meditation, avoiding overexertion, ergonomic furniture, and heated pads can support pain relief.
Exercising, eating a healthy diet that’s rich in anti-inflammatory foods, avoiding smoking, and getting enough sleep can all support chronic pain treatment. Some people find that gentle exercises like tai chi and qigong help relieve chronic pain.
The risks of using pain relief medications like opioids for a long time include dependency and tolerance, digestive changes, muscle jerks, issues with hormones and the immune system, irregular heartbeat, and side effects like constipation and drowsiness.
Support groups, online forums, and counseling provide support and connect you to others with similar symptoms and treatment journeys. When symptoms become overwhelming, lean on your support network and speak to a doctor or pain management specialist.

Simran Malhotra, MD
Medical Reviewer
Dr. Malhotra completed her internal medicine residency at Medstar Franklin Square Medical Center, where she also served as chief resident in 2015. She completed her fellowship in hospice and palliative medicine at Johns Hopkins Hospital in 2016. She was named Top Doc in Palliative Medicine in 2019 and 2020 by Baltimore Magazine.
On a personal note, she is a BRCA1 previvor with a strong family history of breast and female reproductive cancers, and underwent a risk-reducing bilateral mastectomy and total hysterectomy in 2020 at 32 years old. After learning about her own genetic risk of cancer, and grounded in her professional experiences in palliative care, she founded Wellness By LifestyleMD, a platform where she works with and educates women at high risk for cancer with or without genetic mutations on the powerful impact that positive lifestyle changes can have on their quality of life and even longevity.
In addition to being a diplomate of the American College of Lifestyle Medicine, she completed the T. Colin Campbell plant-based nutrition certification in 2019, the CHEF culinary coaching certification in 2020, and the WellCoaches health and wellness coaching certification in 2022. She is a member of the ACLM women’s health member interest group and serves as the co-chair of the breast cancer subcommittee.
Malhotra has been featured on several blogs and podcasts, where she has shared her unique perspectives and experiences from palliative care as well as from being a genetic mutation carrier who is passionate about using lifestyle as medicine.

Justin Laube, MD
Medical Reviewer
Justin Laube, MD, is a board-certified integrative and internal medicine physician, a teacher, and a consultant with extensive expertise in integrative health, medical education, and trauma healing.
He graduated with a bachelor's in biology from the University of Wisconsin and a medical degree from the University of Minnesota Medical School. During medical school, he completed a graduate certificate in integrative therapies and healing practices through the Earl E. Bakken Center for Spirituality & Healing. He completed his three-year residency training in internal medicine at the University of California in Los Angeles on the primary care track and a two-year fellowship in integrative East-West primary care at the UCLA Health Center for East-West Medicine.
He is currently taking a multiyear personal and professional sabbatical to explore the relationship between childhood trauma, disease, and the processes of healing. He is developing a clinical practice for patients with complex trauma, as well as for others going through significant life transitions. He is working on a book distilling the insights from his sabbatical, teaching, and leading retreats on trauma, integrative health, mindfulness, and well-being for health professionals, students, and the community.
Previously, Dr. Laube was an assistant clinical professor at the UCLA Health Center for East-West Medicine and the David Geffen School of Medicine at UCLA, where he provided primary care and integrative East-West medical consultations. As part of the faculty, he completed a medical education fellowship and received a certificate in innovation in curriculum design and evaluation. He was the fellowship director at the Center for East-West Medicine and led courses for physician fellows, residents, and medical students.

Beth Biggee, MD
Medical Reviewer
Beth Biggee, MD, is medical director and an integrative rheumatologist at Rheumission, a virtual integrative rheumatology practice for people residing in California and Pennsylvania. This first-of-its-kind company offers whole person autoimmune care by a team of integrative rheumatologists, lifestyle medicine practitioners, autoimmune dietitians, psychologists, and care coordinators.
Dr. Biggee also works as a healthcare wellness consultant for Synergy Wellness Center in Hudson, Massachusetts. Teamed with Synergy, she provides in-person lifestyle medicine and holistic consults, and contributes to employee workplace wellness programs. She has over 20 years of experience in rheumatology and holds board certifications in rheumatology and integrative and lifestyle medicine. Dr. Biggee brings a human-centered approach to wellness rather than focusing solely on diseases.
Dr. Biggee graduated cum laude with a bachelor's degree from Canisius College, and graduated magna cum laude and as valedictorian from SUNY Health Science Center at Syracuse Medical School. She completed her internship and residency in internal medicine at Yale New Haven Hospital, completed her fellowship in rheumatology at Tufts–New England Medical Center, and completed training in integrative rheumatology at the University of Arizona Andrew Weil Center for Integrative Medicine. Following her training, she attained board certification in rheumatology and internal medicine through the American Board of Internal Medicine, attained board certification in integrative medicine through the American Board of Physician Specialties, and attained accreditation as a certified lifestyle medicine physician through the American College of Lifestyle Medicine. She is certified in Helms auricular acupuncture and is currently completing coursework for the Aloha Ayurveda integrative medicine course for physicians.
In prior roles, Dr. Biggee taught as an assistant clinical professor of medicine at Mary Imogene Bassett Hospital (an affiliate of Columbia University). She was also clinical associate of medicine at Tufts University School of Medicine and instructed "introduction to clinical medicine" for medical students at Tufts. She was preceptor for the Lawrence General Hospital Family Medicine Residency.
Dr. Biggee has published in Annals of Rheumatic Diseases, Arthritis in Rheumatism, Current Opinions in Rheumatology, Journal for Musculoskeletal Medicine, Medicine and Health Rhode Island, and Field Guide to Internal Medicine.

Andra Picincu, CN, CPT
Medical Reviewer

Jason Paul Chua, MD, PhD
Medical Reviewer
Jason Chua, MD, PhD, is an assistant professor in the Department of Neurology and Division of Movement Disorders at Johns Hopkins School of Medicine. He received his training at the University of Michigan, where he obtained medical and graduate degrees, then completed a residency in neurology and a combined clinical/research fellowship in movement disorders and neurodegeneration.
Dr. Chua’s primary research interests are in neurodegenerative disease, with a special focus on the cellular housekeeping pathway of autophagy and its impact on disease development in diseases such as Parkinson disease. His work has been supported by multiple research training and career development grants from the National Institute of Neurological Disorders and Stroke and the American Academy of Neurology. He is the primary or coauthor of 14 peer-reviewed scientific publications and two peer-reviewed online learning modules from the American Academy of Neurology. He is also a contributing author to The Little Black Book of Neurology by Osama Zaldat, MD and Alan Lerner, MD, and has peer reviewed for the scientific journals Autophagy, eLife, and Neurobiology of Disease.

Grant Chu, MD
Medical Reviewer
Grant Chu, MD, is an assistant clinical professor at the David Geffen School of Medicine at UCLA. Dr. Chu is also the associate director of education at the UCLA Center for East-West Medicine, using technology to further medical education.
He is board-certified in internal medicine by the American Board of Internal Medicine and is a diplomate of the National Certification Commission for Acupuncture and Oriental Medicine.
He received a bachelor's degree in neuroscience from Brown University, where he also earned his medical degree. He has a master's in acupuncture and oriental medicine from South Baylo University and a master's in business administration from the University of Illinois. He completed his residency in internal medicine at the University of California in Los Angeles and a fellowship at the Center for East-West Medicine at UCLA.
He has held academic appointments at the University of California in Irvine and the University of Queensland in Australia.

Allison Young, MD
Medical Reviewer
Allison Young, MD, is a board-certified psychiatrist providing services via telehealth throughout New York and Florida.
In addition to her private practice, Dr. Young serves as an affiliate professor of psychiatry at Florida Atlantic University Charles E. Schmidt College of Medicine. She previously taught and mentored medical trainees at the NYU Grossman School of Medicine. She speaks at national conferences and has published scientific articles on a variety of mental health topics, most notably on the use of evidence-based lifestyle interventions in mental health care.
Young graduated magna cum laude from Georgetown University with a bachelor of science degree in neurobiology and theology. She obtained her doctor of medicine degree with honors in neuroscience and physiology from the NYU Grossman School of Medicine. She continued her training at NYU during her psychiatry residency, when she was among a small group selected to be part of the residency researcher program and studied novel ways to assess and treat mental distress, with a focus on anxiety, trauma, and grief.
During her psychiatry training, Young sought additional training in women’s mental health and cognitive behavioral therapy. She has also studied and completed further training in evidence-based lifestyle interventions in mental health care, including stress management, exercise, and nutrition. She is an active member of the American College of Lifestyle Medicine, through which she helps create resources as well as educate physicians and patients on the intersection of lifestyle medicine and mental health.

Samir Dalvi, MD
Medical Reviewer
Samir Dalvi, MD, is a board-certified rheumatologist. He has over 14 years of experience in caring for patients with rheumatologic diseases, including osteoarthritis, rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, lupus, and gout.

Seth Gillihan, PhD
Medical Reviewer
- Chronic Pain. Cleveland Clinic. September 3, 2024.
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