Non-Pharmacological Therapy Approaches

With overuse of opioids for the treatment of chronic pain becoming a national public health epidemic, the Centers for Disease Control and Prevention (CDC) released guidelines that recommend nondrug approaches such as physical therapy over long-term or high-dosage use of addictive prescription painkillers. There are a variety of alternatives to explore. 

When people are diagnosed with a serious, life-threatening illness, one of the first things they typically worry about is pain. Other than life expectancy, it's just about the most common question patients and their caregivers ask. There are effective treatments for pain, and you can put those treatment plans in place ahead of time. It's also important to know that medications are not the only option available to treat pain in the context of palliative care. For example, there are many non-pharmacological options that can also be used effectively to help treat pain.

What is Non-Pharmacological Pain Management?

Non-pharmacological pain management is the management of pain without medications. This method utilizes ways to alter thoughts and focus concentration to better manage and reduce pain. Methods of non-pharmacological pain include:

Comfort Therapy

  • Companionship
  • Exercise
  • Hot/Cold Applications
  • Massage Therapy
  • Meditation
  • Music or Art Therapy

Physical and Occupational Therapy

  • Physical Therapy
  • Aquatherapy
  • Tone and Strengthening
  • Desensitization

Psychosocial Therapy/Counseling

  • Individual Counseling
  • Family Counseling
  • Group Counseling

Neurostimulation

  • Transcutaneous Electrical Nerve Stimulation (TENS)
  • Acupuncture
  • Acupressure

Why It's Important

If pain is not treated, it can decrease people’s appetite and make it difficult for them to sleep. They may feel that they lack energy or the ability to do things. Pain can also affect their mood and relationships with others. Non-pharmacological therapies may help decrease pain or give people more control over their pain. This can improve their overall quality of life.

Backed by the CDC

"Nonpharmacologic therapy and nonopioid pharmacologic therapy are preferred for chronic pain," the guidelines state ("CDC Guideline for Prescribing Opioids for Chronic Pain - United States, 2016" - March 15, 2016). "Clinicians should consider opioid therapy only if expected benefits for both pain and function are anticipated to outweigh risks to the patient. If opioids are used, they should be combined with nonpharmacologic therapy and nonopioid pharmacologic therapy, as appropriate."

While there are certain conditions - including cancer treatment, palliative care, and end-of-life care - where opioid prescription for chronic pain may be appropriate, the CDC cited numerous cases where opioid use could be significantly reduced or avoided altogether.