Treatments for chronic pain reviewed: exercise, acupuncture and CBT come out top

Exercise, acupuncture and cognitive behavioural therapy (CBT) are among the more successful non-invasive and non-drug-based treatments for chronic pain, says a new review of the evidence.

A team looked at which treatments for selected chronic pain conditions are associated with persistent improvement in function and pain outcomes at least one month after the completion of treatment.

They reviewed data from 202 trials, some of which were small, but the results are still interesting.

When focusing on fibromyalgia in particular, in the short-term, acupuncture, cognitive behavioural therapy, tai chi, qigong, and exercise were associated with slight improvements in function compared with an attention control, sham, no treatment, or usual care.

Slight improvements persisted in the mid-term for exercise, acupuncture, and cognitive behavioural therapy, and were also seen for myofascial release massage and multidisciplinary rehabilitation. Pain improved slightly with multidisciplinary rehabilitation in the mid-term.

In the long-term, small improvements in function continued for multidisciplinary rehabilitation but not for exercise or massage. Massage improved long-term pain slightly, but no clear impact on pain for exercise or multidisciplinary rehabilitation was seen. Short-term cognitive behavioural therapy was associated with a slight improvement in function but not pain compared with pregabalin.

Looking at chronic pain as a whole, the team concludes that “exercise, multidisciplinary rehabilitation, acupuncture, cognitive behavioural therapy, and mind-body practices were most consistently associated with durable slight to moderate improvements in function and pain for specific chronic pain conditions.”

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