Chronic pain is a combination of both physical and psychological derangements. Thus, successful management requires addressing all of its aspects. There are two groups of nonpharmacologic treatments for chronic pain:

  • Physical interventions, e.g. PT, acupuncture, chiropractic manipulation, massage, etc, and
  • Psychoeducational interventions, e.g. CBT, family therapy, psychotherapy, and patient education.

A combination of Exercise and psychoeducational approaches can lead to a significant reduction in pain and improvement in functional status for a number of musculoskeletal conditions.

Multimodal interventions may include:

  1. Behavioral medicine approaches: CBT, Biofeedback, Relaxation therapy, Psychotherapy and individual or group counseling
  2. Aerobic exercise
  3. Thermal applications (heat/cold)
  4. Acupuncture
  5. PT / OT
  6. Chiropractic and osteopathic manipulation
  7. Ultrasonic stimulation
  8. Electrical neuromodulation: Transcutaneous electrical nerve stimulation (TENS), Spinal cord stimulation
  9. Interventional approaches: Ablative techniques, Botulinum toxin injections, Nerve blocks, Trigger point injections, Epidural steroid injections
  10. Surgical approaches: Minimally invasive techniques

 

Reference

https://www.uptodate.com/contents/overview-of-the-treatment-of-chronic-non-cancer-pain

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