Reduce chronic pain without drugs – review of the most effective methods

pain, review, acupuncture, exercise, CBT, mindfulnessAn updated evidence review into non-invasive non-drug treatment for chronic pain conditions reveals that previous trends are gathering momentum.

Chronic lower back pain

Psychological therapies were associated with small improvements compared with usual care for function and pain at short-term, mid-term, and long-term follow-up.

Function improved over short and/or mid-term for exercise, low-level laser therapy, spinal manipulation, massage, yoga, acupuncture, and multidisciplinary rehabilitation.

Short-term improvements in pain were seen for massage, mindfulness-based stress reduction, acupuncture, multidisciplinary rehabilitation, exercise, low-level laser therapy, and yoga.

Spinal manipulation, yoga, multidisciplinary rehabilitation and exercise and mindfulness-based stress reduction were associated with improved pain in the mid-term.

Compared with exercise, multidisciplinary rehabilitation improved both function and pain in the short- and mid-term.

Chronic neck pain

In the short-term, low-level laser therapy and massage improved function and pain.

Exercise in general improved function long-term, and combination exercise improved function and pain both short- and long-term compared with usual care.

Acupuncture improved function short- and mid-term, but there was no pain improvement compared with sham acupuncture. Compared with acetaminophen, Pilates improved function and pain.

Osteoarthritis pain

Exercise resulted in small short- and long-term improvements in function and pain, and moderate improvement at mid-term follow-up for knee osteoarthritis.

Small short-term improvements in function and pain with exercise were seen for hip osteoarthritis short term.


Short-term functional improvements were seen with exercise, mind-body practices, multidisciplinary rehabilitation and acupuncture compared with usual care or sham treatment.

In the mid-term, there was functional improvement with exercise and acupuncture, cognitive-behavioural therapy, mindfulness-based stress reduction, myofascial release, and multidisciplinary rehabilitation. And the functional improvements persisted long-term for multidisciplinary rehabilitation without improvement in pain.

Compared with exercise, tai chi led to improvement in function in the short- and mid-term.

Pain improved with exercise (short- and mid-term), and for cognitive behavioural therapy (short term), mindfulness practices and multidisciplinary rehabilitation (mid-term).

Chronic tension headache

Evidence was sparse and most trials were of poor quality. Spinal manipulation resulted in moderate improvement in pain short-term.

The research team concludes that “exercise, multidisciplinary rehabilitation, acupuncture, cognitive behavioural therapy, mindfulness practices, massage, and mind-body practices most consistently improve function and/or pain beyond the course of therapy for specific chronic pain conditions.”

Click here to read the original research.

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