Moving Beyond Medications PDF
Advanced Back and Neck Care • May 23, 2024
Non-Pharmacological Approaches to Pain Management and Well-Being
In response to the current public health crisis of opioid abuse, overdose, and death, many organizations have issued guidelines and recommendations for treating pain, including the former Surgeon General’s “Turn the Tide” campaign. Similar to other guidelines, this campaign recommends non-pharmacological approaches as first line pain treatment, with opioids to be considered only if these and non-opioid pharmacological treatments are ineffective. This document expands upon those recommendations to help primary care clinicians and their patients with this approach.
1) Assess Patient’s Pain and Well-Being
- Perform a thorough assessment of the patient’s pain condition, treatments, lifestyle and overall health status
- Ask the patient to describe the pain, including word descriptors, location, duration, aggravating and alleviating factors, intensity, and functional impact
- Ask about the patient’s psychological status (e.g., depression, anxiety, ineffective coping styles), nutritional health, sleep pattern, and social and environmental contributors to the pain experience
2) Set Goals Jointly with the Patient
- Ask the patient what he or she would like to do, if pain treatment is successful
- Jointly decide on 2-3 SMART (Specific, Measurable, Attainable, Relevant, Time Bound) goals as measures of progress. Set goals for outcomes important to patient, not for pain intensity alone
3) Educate the Patient about Integrative Pain Management Options
Describe evidence-informed non-pharmacological and self-care approaches to managing pain and promoting wellness, including but not limited to:
- Acupuncture
- Chiropractic, Osteopathic and Myofascial Manipulation, Massage Therapy, and Physical Therapy
- Cognitive Behavioral Therapy, Stress Management, and other psychological therapies
- Mind-Body Approaches, Meditation, Biofeedback, Guided Imagery
- Yoga, Tai Chi, and other movement therapies
4) Develop a Treatment Plan with the Patient; Assess Potential Challenges
- Based on your clinical assessment and discussion with the patient, develop a treatment plan
- Discuss potential challenges, and ways to overcome them, with the patient
- Reinforce that 1) chronic pain is a complex problem with no simple solutions; 2) each patient’s path is a little different and you will be there to support your patient along their path; 3) just as the tide causes all boats to rise, getting healthier overall helps all medical conditions improve–even chronic pain
- Obtain patient’s commitment to carry out the treatment plan
5) Follow Up, Troubleshoot and Modify Treatment Plan as Needed
- See the patient regularly; assess progress toward identified goals at each
- appointment
- Encourage changes they have made and urge them to continue the good work
- Problem-solve to help overcome barriers to treatment plan adherence
- Modify treatment plan to maximize progress toward goals
Resources for Information on Nonpharmacological Approaches to Pain Management and Wellbeing
Originally posted on January 30,2023, this article has been updated on August 24, 2024 to reflect the latest research and statistics. Our editorial team has ensured you’re viewing the most current data on this topic. Need help or have a question? Email us.
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At the very least, you'll want to keep this to a minimum. Inflammation is often visible—think red skin or a swollen knee. However, inflammation can also occur on the inside, and it's not always so easy to detect. "Inflammation is a physiological process involved in the defense of our body and the repair of tissues," says Jenna Stangland, RD , a Momentous advisor. Stangland explains that inflammation can be triggered by infections, trauma, toxins or allergic reactions. Sometimes, it becomes chronic in the muscles and tissues. Unfortunately, Stangland says chronic inflammation carries risks. "Chronic inflammation can end up stimulating the development of cardiovascular diseases, autoimmune disease, neurological disease or cancer," Stangland says. "This type of inflammation can last several months as a result of inability to combat and reduce it." Diet isn't a cure-all for chronic inflammation or the diseases it can trigger. However, it's an important tool. "Diet plays a significant role in inflammation, as certain foods can either promote or reduce inflammation in the body," says Michelle Routhenstein, MS, RD, CDCES, CDN , a preventive cardiology dietitian at EntirelyNourished.com . One food in particular is worth avoiding. RDs shared the food to limit if you have chronic inflammation. Related: The One Diet That Will Actually Lower Your Heart Attack Risk, According to Cardiologists
What does the medical peer reviewed literature say may be at the root of the following diseases: Metabolic Syndrome/Insulin Resistance/Diabetes Cardiovascular Disease Cancer Obesity Depression Autoimmune Disease Neurodegenerative disease (Alzheimer's and Parkinson's disease) Osteoporosis Immunosenescence (the progressive decline in immune function with increasing age) The Answer is: INFLAMMATION
18 or 80 most anyone can do these. Remember create a habit first. Perform these exercises just twice a week.
