From the Guidelines
I strongly recommend a multimodal approach to pain relief, prioritizing non-pharmacological methods such as physical therapy, cognitive behavioral therapy (CBT), and mind-body techniques like yoga and meditation, as these have been shown to improve pain and function without serious harm 1. When considering alternative approaches for pain relief, it's essential to prioritize methods that promote overall well-being and minimize risks.
- Non-pharmacological methods like physical therapy, CBT, and mind-body techniques have been recommended for chronic pain management, as they promote patient acceptance of responsibility for change and the development of adaptive behaviors 1.
- Yoga, in particular, has been recommended for the treatment of chronic neck/back pain, headache, rheumatoid arthritis, and general musculoskeletal pain, with strong, moderate evidence 1.
- Physical and occupational therapy are also recommended for chronic pain, with strong, low evidence 1.
- Hypnosis is recommended for neuropathic pain, with strong, low evidence 1.
- While acupuncture may be considered for chronic pain, the evidence is weaker, and it should be used with caution 1. The most recent and highest-quality study, published in 2022, emphasizes the importance of noninvasive nonpharmacologic approaches, including physical therapy, weight loss, and behavioral therapies, in improving pain and function without serious harm 1.
- This study highlights the benefits of exercise therapy, cognitive behavioral therapy, and mindfulness-based stress reduction in reducing pain and improving function.
- It also emphasizes the importance of increasing access to noninvasive nonpharmacologic therapies, which can be limited by insurance coverage and cost. By prioritizing these non-pharmacological methods and considering the individual's specific needs and circumstances, healthcare providers can help patients manage their pain effectively while minimizing the risks associated with pharmacological treatments.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Alternative Approaches for Pain Relief
Among the alternative approaches for pain relief, several nonpharmacological interventions have shown potential in reducing pain, opioid consumption, stress, and anxiety. These interventions include:
- Acupuncture 2, 3, 4
- Massage therapy 3, 5, 6
- Mind-body therapies such as mindfulness, meditation, and biofeedback 2, 3, 5
- Movement therapies like yoga and tai chi 3, 5, 6
- Psychological modalities including cognitive behavioral therapy and acceptance and commitment therapy 2, 3, 5
- Physical interventions like physical therapy, therapeutic exercise, and chiropractic interventions 2, 5, 6
Evidence-Based Nonpharmacologic Strategies
Studies have demonstrated the effectiveness of these nonpharmacologic strategies in managing acute and chronic pain. For example:
- Acupuncture therapy has been found to be an efficacious strategy for acute pain, with potential to avoid or reduce opioid reliance 4
- Mind-body therapies like meditation and yoga have been shown to reduce pain and improve quality of life in patients with chronic pain 3, 5
- Cognitive behavioral therapy has been found to be effective in managing chronic pain by teaching patients coping skills and strategies to manage pain 2, 3, 5
Non-Opioid and Non-Pharmacological Pain Management Modalities
A project in Minnesota aimed to identify and map evidence-based non-opioid and non-pharmacological pain management modalities across the state. The project found that:
- There are various non-pharmacological pain management modalities available, including acupuncture, massage therapy, mind-body therapies, and movement therapies 6
- These modalities can be used to manage chronic pain and reduce reliance on opioids 6
- A website was created to provide a searchable database of providers and facilities offering these modalities, making it easier for patients and healthcare providers to access evidence-based non-pharmacological pain management options 6