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Nondrug Treatments for Chronic Pain

In addition to drug therapy, several nondrug treatments can be helpful for chronic pain, including:

• Alternative remedies. Although doctors don’t know exactly how it works, there is good scientific evidence that acupuncture can offer significant relief from chronic pain. Other alternative remedies proven to work against pain include massage, mindfulness meditation, spinal manipulation by a chiropractor or osteopath, and biofeedback, in which a patient wearing sensors that record various bodily processes learns to control the muscle tension and other processes that can contribute to chronic pain.

• Exercise. Low-impact forms of exercise like walking, bicycling, swimming, and simply stretching can help relieve chronic pain. Some people find it particularly helpful to participate in a structured exercise program given by a local hospital.

• Physical therapy. Pain patients who work with a physical therapist or occupational therapist can learn to avoid the particular ways of moving that contribute to chronic pain.

• Nerve stimulation. Tiny jolts of electricity can help block the nerve impulses that cause chronic pain. These jolts can be delivered through the skin via transcutaneous electrical nerve stimulation (TENS) or via implantable devices.

• Psychological therapies. A form of psychotherapy known as cognitive behavioral therapy is particularly helpful for many people with chronic pain. It helps them find ways to cope with their discomfort and limit the extent to which pain interferes with daily life.

Unlike some traditional forms of psychotherapy, which focus on personal relationships and early life experiences, cognitive behavioral therapy aims to help people think realistically about their pain and find ways to work around physical limitations.

"Cognitive behavioral therapy helps people overcome the mistaken belief that they need to lie in bed until their pain is gone, or that if they go back to work they will cause permanent damage to their body," Says Chou.

Picking the Right Treatment for Chronic Pain

Given all the ways chronic pain can be treated, how is one to know which treatment, or combination of treatments, makes the most sense for your chronic pain?

"We don’t have enough evidence from studies to know just which approach is right for which patient," says Portenoy. "Picking the right treatment is a matter of clinical judgment, and it involves talking with the patient" about the specific nature of the pain and the effectiveness of any treatments that have already been tried.

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