Four Ways to Treat Chronic Pain WITHOUT Medications

Written By Natan Schleider M.D. on January 13th, 2020


Dr. Gustav Zander, a Swedish physician known for inventing mechanotherapy, which was defined in 1890 as “the employment of mechanical means for the cure of disease.” Zander exhibited his exercise machines at the 1876 Centennial Exhibition in Philadelphia where they won a gold medal. By 1906 Zander had established his first gyms with these machines in 146 countries.

In my arsenal of pain management treatments are plenty of evidence based treatments that do not require you to swallow a pill.

If you suffer from chronic pain, your doctor may walk into the cold exam room you’ve been waiting in with your paper gown and say something like: “Here at A1 Pain Management Center, an integrative, multi-modal, team delivers interdisciplinary care. Before initiating analgesics, my staff will give you some resources. Follow up one week.” Was that English?

Below are definitions and explanations of 5 ways to manage chronic pain you are likely to hear about so let’s sort through the jargon.

  1. Mind Body Therapy incorporates a blend of light exercises and meditation along a continuum. Examples include meditation, mindfulness, mindful based stress reduction (MBSR), yoga, and Tai Chi. Evidence supports that Mind Body Therapy causes SMALL improvement in chronic pain with moderate improvement range of motion, depression and anxiety.
  2. Exercise Therapy is most effective for patients with orthopedic or musculo-skeletal pain like chronic back, shoulder, hip, or knee pain. Examples included graded, resistance, aerobic, and pilates exercise. Medical evidence, while not strong, does suggest that exercise therapy causes SMALL to MODERATE reduction in chronic pain with improved quality of life.
  3. Manual Therapy involves another trained professional helping your movements and include Rehabilitation, Manipulation (IE chiropractic movement, osteopathic manipulative movement, passive movements done with physical therapist), Acupuncture, and Massage. While massage therapy has data to support short term improvement, manipulation and acupuncture can provide chronic pain relief for short to intermediate amounts of time (days to weeks).
  4. Psychological Therapy, namely cognitive behavioral therapy (CBT) and Acceptance and Commitment Therapy (ACT) can improve chronic pain. These will be helpful for those patients who are interested in cause, effect, and prevention of pain triggers; however, if you are thinking ‘I don’t see how sitting around and talking about crap is going to help my back pain’ then exercise or manual therapy may be more for you.

So what did the doctor mean with all that jargon before?

Essentially the doctor is saying that there are resources other than pills, surgery, and injections that can help chronic pain. It is up to the patient and doctor to chose which work and which do not. That said, unlike a pill, all above therapies will involve the patient be willing to put in time and effort.

Source: Using Non-Pharmacologic Treatment Modalities: Practical Guidance for Pain Management by American Medical Association December 12th, 2018

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