Integrative Medicine for Refractory Chronic Conditions: Why It Makes Sense in Pediatrics Too

New center one of the few exclusively devoted to pediatrics

About 12 percent of U.S. children use some form of complementary medicine, according to the NIH’s National Center for Complementary and Integrative Health. As the evidence in support of complementary and integrative medical techniques mounts, that percentage is likely to climb.

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To meet this demand, Cleveland Clinic Children’s has launched a Center for Pediatric Integrative Medicine to complement traditional medical care for young patients with a range of difficult-to-manage chronic conditions.

Conceived as complementary care

“Going beyond a child’s physical needs to address lifestyle and emotional needs can reduce the frequency of disease episodes, decrease stress related to chronic illness and improve quality of life,” says Center Director Benjamin Katholi, MD, a pediatric physiatrist. He notes that integrative medicine techniques can reduce children’s pain, improve sleep, lower blood pressure and improve bowel function.

Dr. Katholi emphasizes that the center’s treatments are intended as a complement to — not a replacement for — traditional medical therapies. “Our aim is to enhance patients’ existing medical care, to work in tandem with their traditional providers and to ensure patients are maintaining their relationships with those traditional providers.”

A multiplicity of conditions treated…

The center — located at Cleveland Clinic Children’s Hospital for Rehabilitation on Cleveland’s east side, treats a range of difficult-to-manage chronic conditions in children and adolescents, including:

  • Anxiety and depression due to chronic illness
  • Arthritis and musculoskeletal pain
  • Asthma, allergies and other pulmonary problems
  • Concussions and other brain injuries
  • Chronic pain, including abdominal and myofascial pain
  • Delayed wound healing
  • Headache
  • Impaired mobility
  • Sports and traumatic injuries
  • Vocal cord dysfunction

 …By a multiplicity of specialists and techniques

The center is staffed by a multidisciplinary team of dedicated pediatric specialists in behavioral medicine, physical medicine and rehabilitation, pain management, pulmonary medicine, general pediatrics and nutrition along with dedicated pediatric occupational and physical therapists.

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Team members are certified in a host of therapeutic techniques, including:

  • Acupuncture, acupressure and laser acupuncture
  • Biofeedback
  • Guided imagery and hypnosis
  • Integrative dry needling
  • Frequency-specific microcurrent therapy
  • Craniosacral therapy
  • Myofascial release and osteopathic manipulation
  • Reiki and therapeutic touch (the latter for infants)
  • Relaxation/breathing strategies and yoga

Dr. Katholi finds frequency-specific microcurrent (FSM) therapy particularly exciting. “It is subsensory (painless) and noninvasive, and has lasting effects,” he says. “Research suggests that delivering micro-amperage current while using specific frequencies to resonate with damaged tissues can reduce inflammation, improve ATP production and enhance healing. We’ve found FSM therapy highly effective for nerve and muscle pain, acute and chronic musculoskeletal injuries, and arthritis in children.”


Integrative medicine in action. Dr. Katholi uses frequency-specific microcurrent (FSM) therapy on a 14-year-old who contends with long-standing (and formerly debilitating) chronic pain related to a spine tumor during his infancy. Each week the boy and his family travel 125 miles from Bowling Green, Ohio, for interventions at Cleveland Clinic Children’s Center for Pediatric Integrative Medicine that include FSM therapy and acupuncture. “They’ve really helped him function much better,” says his mother.

One of few pediatric-specific integrative medicine centers

The new center is one of relatively few focused on using integrative medicine specifically in children, notes center team member David Burke, DO, a general pediatrician with long-standing interests in osteopathic manipulation and complementary medicine.

“While Cleveland Clinic Children’s has offered many integrative medicine services to children for years, this formal center has brought them all under one roof in a handsomely renovated space at the Children’s Hospital for Rehabilitation, where many complex cases are managed,” Dr. Burke says.

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The center was the vision of Cleveland Clinic Children’s Physician-in-Chief, Giovanni Piedimonte, MD, and was realized through efforts directed by Jennifer Manning-Detering, administrator of the Children’s Hospital for Rehabilitation. “We concluded it was best to have a central location where we could all work together using a team approach to make visits convenient and efficient for patients, develop research protocols and monitor efficacy,” Dr. Burke explains.

The payoffs include the ability for various pediatric subspecialists to see patients together. “Various staff from the center can be present to better serve patients,” Dr. Burke says. “This allows us to learn from one another, streamline appointments for patients and complement each other’s therapies.”

A research mission too

Another payoff is coordinated research efforts. Center staff are beginning research on several integrative treatments — including acupuncture, reiki and FSM therapy — to better define their potential benefits for children with various conditions.

“We are committed to providing evidence-based care at this center and helping to define the most effective complementary therapies for enhancing traditional care,” says Dr. Katholi.