Pain. We rate it, we manage it, we try to avoid it, and sometimes we ignore it. But pain can be the first sign that tells us something is wrong. In her role as a researcher, Helene Langevin, MD, focuses on understanding and addressing patients’ pain, and as director of the Osher Center for Integrative Medicine at BWH and HMS, Langevin works to overcome the “pain points” or challenges that investigators in the field of integrative medicine face.
For more than 20 years, Langevin has been investigating how acupuncture and other forms of mechanical tissue stimulation may help mitigate pain. Her research focuses on fascia—the connective tissue found beneath the skin, around muscles and internal organs. In addition to conducting her own research, Langevin’s mission at the Osher Center is two-fold: bringing researchers in the field together and incorporating integrative medicine into the foundations of conventional medicine.
A Path Toward Understanding Pain
Langevin joined BWH in 2012, and is also a part-time professor at University of Vermont College of Medicine. Before Langevin became a professor and began her research on connective tissue in chronic pain, she was practicing internal medicine in New York, where she first experienced the challenges of treating pain.
“I was seeing a lot of patients with chronic pain, and it was very frustrating for me,” Langevin said. “I felt like I didn’t have a lot to offer them.”
Langevin ventured out, attended night classes at an acupuncture school and became deeply fascinated with the mechanisms of needle therapy on a physiological level. She could feel a slight tug on a needle after manipulating it within a patient’s tissue. It wasn’t caused by muscle since the tug could be felt even in the wrist of a patient where there isn’t muscle. Connective tissue was grasping the needle, and Langevin wanted to know how and why.
Langevin partnered with the orthopedic department at the University of Vermont to build a robotic device that could consistently insert a needle into tissue, manipulate it, rotate the needle back and forth and then measure the force needed to pull it out. The more a needle was manipulated, the greater the force needed to pull it out.
“That really got me interested in the idea of using observations from different healing traditions as an inspiration for asking new questions in science,” she said. “For example, acupuncture needles can be used as tools to investigate basic connective tissue physiology.”
Acupuncture is just one of the integrative therapies the staff at the Osher Center offer to patients and study. Integrative medicine, a model of care that uses therapies differing from conventional medical methods, also includes meditation, herbal medicine, massage, yoga and tai chi, among other therapies.
The Osher Center is focused on enhancing human health, resilience and quality of life by connecting integrative medicine researchers, educators and clinicians across HMS, the Harvard-affiliated hospitals and the other Osher centers at the University of California San Francisco (UCSF), Northwestern, the Karolinska Institute in Sweden and Vanderbilt.
Ultimately, they strive to bring together the integrative medicine community and, on a second level, incorporate integrative therapies into the traditional medical field.
To do this, the BWH- and HMS-based center displays an online network map on its website linking about 700 integrative researchers in the Boston area. Each has at least one integrative medicine related publication. Navigating it, the viewer can see each researcher’s collaborations and publications.
“It’s a really useful tool that shows the extent of what is already happening here,” Langevin said. “This network of integrative medicine was so huge and so rich, but we suspected that it wasn’t fully aware of itself.”
To extend the web connection, the Osher Center is now building a clinical network map capturing the connections among integrative medicine researchers outside of Boston.
“Research thrives on collaboration,” Langevin said. “Ultimately, to strengthen integrative medicine, we need to join up and work as a collective.”
The Center is also bringing clinicians and researchers together, physically, for events in and around the BWH campus. Since February, the center has been hosting conventional grand rounds with a non-conventional twist.
“We bring a patient in and discuss the management of his or her case from the point of view of a multidisciplinary team including conventional and integrative medicine practitioners,” said Langevin
Integrative Medicine Grand Rounds occur on the first Tuesday of each month from 8 to 9 a.m. in the Bornstein Amphitheater.
Furthermore, the Osher Center at HMS is hosting a unique conference bringing the Society of Acupuncture Research, the Society for Integrative Oncology and the Fascia Research Society together. On Nov. 14, 12 speakers will discuss the use of integrative medicine to treat oncological diseases. The event will take place at Harvard Medical School with registration available online.
Through these events, Langevin wants the center to foster inclusiveness and break down the silos that isolate different disciplines.
“I think that there’s a communication gap between medicine as it’s taught in medical school and the whole world of integrative medicine,” she said. “There are barriers on both sides that prevent respectful dialogue between these two cultures.”
The integrative world also faces broader challenges. There is a lack of insurance reimbursement for many integrative medicine treatments. Langevin believes advancing the research front is the key in order to demonstrate the cost-effectiveness and mechanisms of integrative therapies and allow insurance companies to comfortably fund integrative patient care.
Through connection and collaboration, holding discussions and surfacing integrative medicine awareness, the Osher Center aims to overcome the challenges.