Chronic pain is a combination of both physical and psychological derangements. Thus, successful management requires addressing all of its aspects. There are two groups of nonpharmacologic treatments for chronic pain:
- Physical interventions, e.g. PT, acupuncture, chiropractic manipulation, massage, etc, and
- Psychoeducational interventions, e.g. CBT, family therapy, psychotherapy, and patient education.
A combination of Exercise and psychoeducational approaches can lead to a significant reduction in pain and improvement in functional status for a number of musculoskeletal conditions.
Multimodal interventions may include:
- Behavioral medicine approaches: CBT, Biofeedback, Relaxation therapy, Psychotherapy and individual or group counseling
- Aerobic exercise
- Thermal applications (heat/cold)
- Acupuncture
- PT / OT
- Chiropractic and osteopathic manipulation
- Ultrasonic stimulation
- Electrical neuromodulation: Transcutaneous electrical nerve stimulation (TENS), Spinal cord stimulation
- Interventional approaches: Ablative techniques, Botulinum toxin injections, Nerve blocks, Trigger point injections, Epidural steroid injections
- Surgical approaches: Minimally invasive techniques
Reference
https://www.uptodate.com/contents/overview-of-the-treatment-of-chronic-non-cancer-pain