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Non-drug pain management

Patients experiencing pain should receive safe, effective and informed care.

California’s Pain Patient’s Bill of Rights now encourages the use of evidence-based nonpharmacological therapies for treatment of chronic pain. This guidance is effective Jan. 1, 2023, in accordance with Assembly Bill 2585.

Nonpharmacological pain management treatment

Nonpharmacological pain management treatment is pain management treatment without the use of medication, including behavioral therapy, instrument-based therapy, or immersive therapeutics approved by the federal Food and Drug Administration indicated for the use of managing or treating pain.

Evidence suggests nonpharmacological therapies can provide relief to those experiencing chronic pain and are safer. Effective pain management should:

  • Use nonopioid therapies to the extent possible
  • Identify and address co-existing mental health conditions
  • Focus on functional goals and improvement with patients’ active engagement
  • Use multimodal approaches, including interdisciplinary rehabilitation for patients who have failed standard treatments, have severe functional deficits or psychosocial risk factors

 

Recommended treatments for common chronic pain conditions

The Centers for Disease Control and Prevention recommends the following nonpharmacological treatments for the conditions listed below. Patient education is also recommended.

  • Low back pain: Cognitive behavioral therapy, exercise, interdisciplinary rehabilitation
  • Migraine: Cognitive behavioral therapy, relaxation, Biofeedback, Exercise therapy
  • Osteoarthritis: Exercise, weight loss
  • Fibromyalgia: Low-impact aerobic exercise (e.g., bicycling, brisk walking, swimming, water aerobics), cognitive behavioral therapy, biofeedback, Interdisciplinary rehabilitation

You may also be interested in pain management resources provided by the Sharp HealthCare Safe and Effective Pain Management Initiative.

 

References

Management of pain without medications. Stanford Medicine, Stanford, CA. https://stanfordhealthcare.org/medical-conditions/pain/pain/treatments/non-pharmacological-pain-management.html. Accessed Jan 20, 2023.

Non-drug pain management. MedlinePlus, National Library of Medicine, National Institutes of Health, Bethesda, MD. https://medlineplus.gov/nondrugpainmanagement.html. Accessed Jan 20, 2023.

Nonopioid treatments for chronic pain (PDF). Centers for Disease Control and Prevention, Atlanta, GA. https://www.cdc.gov/drugoverdose/pdf/nonopioid_treatments-a.pdf. Accessed Jan. 20, 2023.

Systematic Review: Noninvasive Nonpharmacological Treatment for Chronic Pain. Content last reviewed September 2022. Effective Health Care Program, Agency for Healthcare Research and Quality, Rockville, MD. https://effectivehealthcare.ahrq.gov/products/noninvasive-nonpharm-pain-update/research. Accessed Jan. 20, 2023.

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