Chronic pain management: nonpharmacological therapies for chronic pain.

Author: Chang KL1, Fillingim R2, Hurley RW3, Schmidt S4.
1University of Florida Health Family Medicine - Hampton Oaks, 200 SW 62nd Blvd Suite D, Gainesville, FL 32608, 2Clinical and Translational Research Building Room 3216, 2004 Mowry Road, Gainesville, FL 32610-0404, 3MCW Pain Management Center, 959 N. North Mayfair Road, Milwaukee, WI 53226, 4University of Florida Health Family Medicine - Hampton Oaks, 200 SW 62nd Blvd Suite D, Gainesville, FL 32608,
Conference/Journal: FP Essent.
Date published: 2015 May
Other: Volume ID: 432 , Pages: 21-6 , Word Count: 214

Nonpharmacologic therapies have become a vital part of managing chronic pain (CP). Although these can be used as stand-alone therapies, nonpharmacologic treatments often are used to augment and complement pharmacologic treatments (ie, multimodal therapy). Nonpharmacologic approaches can be classified as behavioral, cognitive, integrative, and physical therapies. Core principles in developing a treatment plan are explaining the nature of the CP condition, setting appropriate goals, and developing a comprehensive treatment approach and plan for adherence. Clinicians should become familiar with these interventions so that they can offer patients flexibility in the pain management approach. Effective noninvasive treatment modalities for CP include behavioral therapy for short-term pain relief; cognitive behavioral therapy for reducing long-term pain and disability; hypnosis as adjunctive therapy; guided imagery, diaphragmatic breathing, and muscle relaxation, especially for cancer-related pain; mindfulness-based stress reduction for patients with chronic low back pain; acupuncture for multiple pain conditions; combination manipulation, manual therapy, endurance exercise, stretching, and strengthening for chronic neck pain; animal-assisted therapy; and S-adenosyl-L-methionine for joint pain. Guidelines for use of these treatment modalities are based on expert panel recommendations in combination with data from randomized controlled trials.
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PMID: 25970869