In numerous earlier articles we have considered the efficacy or otherwise of non-pharmacological treatments and therapies for chronic pain.
What are non-pharmacological therapies for chronic pain?
Living with chronic pain can be debilitating. But of course, it’s not just the pain and other direct symptoms of your condition which affect you. Inevitably, the side-effects of your daily regime of medication contribute a significant amount to your limitations. Whether it’s fatigue, brain fog, nausea, gastric problems, dizziness, weight gain/loss – the list goes on – pharmaceuticals are well and truly a double-edged sword.
Despite that, few people are able to contemplate a life without prescribed medication. Whatever the side-effects, in most cases pharmaceuticals such as opioids, anti-convulsants and antidepressants are a tried and tested way of taking the edge off your pain.
However, at some time every pain sufferer will have at least considered what else is out there, not necessarily to replace their prescribed, but as a supplement to it. Common non-pharmacological treatments and therapies include:
- Chiropractic manipulation;
- Cranial osteopathy;
- Cognitive behavioural therapy;
- Mindfulness and other mind-body techniques such as yoga, tai chi and qi gong;
- Music Therapy;
- Using a TENS machine;
- Vitamins and other food supplements.
In the past, a limited amount of research has suggested that using non-pharmacological therapies to manage chronic pain can be effective not only in decreasing the level of pain itself, but also in improving function and reducing longer-term serious adverse outcomes such as substance misuse or even suicide.
Now, the results of an extensive study of the medical records of over 275,000 people have been published in the Journal of General Internal Medicine. The study suggests that among this particular cohort – active-duty members of the US military suffering chronic pain – individuals who received non-pharmacological therapies were considerably less likely to experience adverse outcomes after retiring from active service.
More specifically, those who received non-pharmacological therapies were found to be:
- 8% less likely to experience new-onset alcohol and/or drug use disorders;
- 12% less likely to experience suicidal ideation;
- 17% less likely to experience a self-inflicted injury, including attempted suicide;
- 18% less likely to intentionally overdose on opioids, barbiturates, sedatives or other pharmaceuticals; and
- 35% less likely to accidentally overdose on those same types of drugs.
However, the authors acknowledged a number of limitations in the research itself.
The effects of individual therapies were not studied and significantly, although most of the non-pharmacological therapies were commenced after the diagnosis of chronic pain, the nature of the research meant that there was no way to determine whether those therapies were used specifically to treat pain.
In terms of the relevance of this study to the more general chronic pain community, it must also be remembered that on discharge from active service, US military personnel move under the umbrella of the Veterans Health Administration which, in their own words, is “the largest integrated health care system in the United States”. Arguably then, the ongoing care and support available to them is far greater than for most people suffering chronic pain. In itself, this must surely be beneficial.
For those not fortunate enough to have access to the same level of continuing support, please remember that your pain clinician will be more than happy to discuss with you non-pharmacological and even alternative therapies, either on an ad hoc basis or as part of a combination, multimodal approach to pain management.