Nonpharmacologic and noninterventional therapies are valuable in treating pain. In fact, physical or functional therapy and cognitive behavioral therapy have been shown to be the most effective for management of chronic pain. In particular, cognitive behavioral therapy has been proven effective in multiple randomized controlled studies as a primary evidence-based treatment for chronic pain. Hot or cold packs, massage, and physical therapy can be helpful for musculoskeletal pain. Similarly, integrative medicine therapies of acupuncture, chiropractic care, biofeedback, meditation, music therapy, guided imagery, cognitive distraction, and framing may be of help in treating pain. Because mood and psychological issues play an important role in the patient’s perception of and response to pain, psychotherapy, support groups, prayer, and pastoral counseling can also help in pain management. Depression and anxiety, which may be instigated by chronic pain or may alter the response to pain, should be treated aggressively with antidepressants and anxiolytics.
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