What Are the Different Types of Non-Pharmacological Pain Management?

Non-pharmacological pain management refers to different methods utilized to either decrease a patient's pain or increase his functional abilities despite subjective complaints of pain. These techniques can employed for pain control, either on their own or as adjunct measures in combination with drugs. Methods of non-pharmacological pain management do not include the "just grin and bear it" method or stoicism. Patients are taught to control, distract or distance themselves from their pain, not simply ignore it. Other methods include exercise, stress reduction, transcutaneous nerve stimulation (TENS) and, in extreme cases, surgery.

Methods of non-pharmacological pain management that do not require medical intervention include relaxation techniques, stress reduction and exercise. Relaxation exercises are frequently taught to the patient experiencing pain using a biofeedback system to provide positive reinforcement as the skills are mastered. Patients then often utilize a recording of a progressive relaxation exercise to reach their maximum attainable level of comfort. Reducing or eliminating areas of optional stress is suggested. Patients are also strongly encouraged to perform whatever kinds of exercise are available to them in order to take advantage of exercise-induced endorphins, the body’s natural antidote to pain.

There are some non-pharmacological pain management techniques that are medically based or require special training to perform. Acupuncture, for instance, requires training on the part of the therapy provider but provides relief or reduction of pain symptoms for some patients. Transcutaneous nerve stimulation (TENS) therapy seeks to “lose” nerve signals for pain under the distraction of competing electrical signals. In some cases, the nerve or nerves that transmit the pain impulse are blocked with anesthesia. A permanent treatment of this type involves surgical interruption of the pain sensation by cutting the nerve.

Most methods of non-pharmacological pain management are not introduced to patients with time-limited acute pain conditions, such as a post-operative recovery periods. They play, however, a much larger role in the lives of cancer patients and patients in chronic pain who often report years of increasing pain and disability in performing activities of daily living (ADLs). Non-pharmacological pain management techniques are more important to the rehabilitation of patients in chronic pain, as opposed to acute pain, because of the negative consequences of long-term pain medication use. Furthermore, these techniques are under the control of the patient and are a part of the overall philosophy of the patient controlling his pain, as opposed to pain controlling the patient’s life. Regaining some degree of control is associated with decreased symptoms of depression and often correlates with increased function and independent ADLs.