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Dr Wayne Jonas Discusses Nonpharmacological Therapies to Treat Chronic and Acute Pain


Wayne Jonas, MD, executive director of Samueli Integrative Health Programs at H&S Ventures, discusses current nondrug therapies available to patients to manage chronic and acute pain.


What are some nonpharmacological therapies that patients with chronic or acute pain should consider as an alternative or an addition to pharmacological therapy?

So, there is a growing list of nonpharmacological and integrative approaches for chronic pain that have good evidence. I would recommend to everyone who treats people with chronic pain to, number 1, consider mind/body approaches and relaxation components, such as mindfulness-based stress reduction, biofeedback, for example, or other types of approaches like imagery. These are very useful. Cognitive behavioral therapy has been shown to be effective for chronic pain and, also, should be made available.

A very common chronic pain condition is low back pain. Many people have it sometime during their life and very often it becomes chronic. Therapeutic yoga and not just going to a yoga studio. Engaging in properly trained therapeutic yoga is very effective for low back pain and is one of the main recommendations on the American College of Physicians' guidelines on chronic low back pain.

Acupuncture is another modality that's been shown to be effective and it's more effective than placebo or sham acupuncture and almost as effective as nonsteroidal, anti-inflammatory medications.

Diet can influence pain, and it does this through inflammation, and we can talk about that in more detail.

Increasingly, there are more FDA-cleared devices. Things that help pain directly but also can help with the comorbidities or the concomitant components that aggravate chronic pain, such as insomnia, anxiety, and depression. And so, these things should be looked at. Increasingly, it's been shown that laser and light can be used to help modulate pain and pain signals. These nonpharmacological approaches are also useful and should be considered in everybody's medical bag.

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