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Nonpharmacologic therapies should be considered first-line options for chronic pain.
Nonpharmacologic therapies should be considered first-line options for chronic pain.
These may be used alone or combination with each other, medication treatments, surgeries or other procedures.
These may be used alone or combination with each other, medication treatments, surgeries or other procedures.
Their benefits in addition to pain control include:
Their benefits in addition to pain control include:
Reduced anxiety
Reduced depression
Reduced nausea and vomiting
Improved sleep quality
Increased patient wellbeing
Increased functional gains and reduced debility
The CDC recommends the following nonpharmacologic therapies as doing less risk to patients than opioids while, in some instances, results in better outcomes, include:
The CDC recommends the following nonpharmacologic therapies as doing less risk to patients than opioids while, in some instances, results in better outcomes, include:
Exercise therapy
Weight loss
Acupuncture/Massage Therapy
Psychological therapies such as cognitive behavioral therapy (CBT)
Interventions to improve sleep
Certain procedures
Among key findings from a CDC literature review were that exercise therapy
Among key findings from a CDC literature review were that exercise therapy
Can reduce pain and improve function immediately after exercise
Improves global wellbeing and physical function
Sustained treatment effects for at least 3-6 months
Achieved greater effectiveness when are involved a clinician that in the general population
Interventions for Chronic Pain:
Interventions for Chronic Pain:
Study Outcomes and Recommendations
Study Outcomes and Recommendations
Acupuncture
Acupuncture
Peripheral Neuropathy and Musculoskeletal pain
Peripheral Neuropathy and Musculoskeletal pain
Benefit over control
Benefits persist over time
Treatment frequency individualized to the patient and the pain type and severity. In trials for OA and musculoskeletal pain, avg frequency was 8-15 treatments over 10-12 weeks, 15-60 minutes per session.
Manual or manipulative therapy
Manual or manipulative therapy
Lower extremity Osteoarthritis
Lower extremity Osteoarthritis
Fair evidence for short term
Massage therapy
Massage therapy
All pain populations
All pain populations
Improved pain, function, mood, quality of life
Release of serotonin, which is the body's natural production of anti-pain chemicals.
Pain-coping skills training
Pain-coping skills training
Osteoarthritis, Rheumatoid Arthritis
Osteoarthritis, Rheumatoid Arthritis
Significant benefits for pain and psychological, physical and biological function.
Mind-body therapy that targets psychological factors common in chronic pain. It has been shown to benefit arthritis pain and can be delivered through Internet programs
Yoga
Yoga
Fibromyalgia
Fibromyalgia
Significant effects on pain, fatigue, depression, health related quality of life
Osteoarthritis
Osteoarthritis
Effective
***NIH recommends hatha yoga, iyengar and viniyoga for chronic back pain
Tai Chi
Tai Chi
Osteoarthritis
Osteoarthritis
Positive effects compared to controls on pain, physical function, joint stiffness (all results short term)
Weimer, M. B., MCR, FASAM. (2019). Nonpharmacologic, Nonopioid, and Opioid Treatment Options in Chronic Pain Therapy. 2019 New Jersey Medical Licensure Program,2-21.
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