Mind and Body Approaches for Chronic Pain

August 12, 2020 Joe Brady
Posted by Joe Brady on

With over 67,000 deaths a year from drug overdoses there is a high premium on finding alternatives to opioids for treating chronic pain. Fortunately, a variety of mind and body practices have been found in many studies to be helpful for treating chronic pain. In fact, official guidelines recommend them as first-line treatment. Different practices are recommended for chronic low-back pain versus acute pain.

The practices that may be helpful for chronic low-back pain include acupuncture, electromyography biofeedback, low-level laser therapy, mindfulness-based stress reduction, progressive muscle relaxation, spinal manipulation, tai chi, and yoga. A shorter list of practices may be helpful for acute low-back pain include acupuncture, massage therapy, and spinal manipulation.

All these practices have good safety records when used appropriately. This article summarizes current scientific research about mind and body approaches for chronic pain, including fibromyalgia, headache, low-back pain, neck pain, osteoarthritis, and rheumatoid arthritis.

Archives of Internal Medicine: Review of High-Quality Clinical Trials

The best review done to date and published in the Archives of Internal Medicine included 29 high quality, randomized controlled trials (RCTs) of acupuncture for chronic pain. This meta-analysis looked at individual patient data on a total of 17,922 patients. and found that acupuncture was superior to both sham and no-acupuncture control for back pain, neck pain, osteoarthritis, and headache (P < .001). The review found acupuncture to be effective for the treatment of chronic pain and significant differences between true and sham acupuncture indicate that acupuncture is more than just a placebo and is a reasonable referral option for patients with chronic pain.

Acupuncture for Chronic Pain Individual Patient Data Meta-analysis, Andrew J. Vickers, DPhil; Angel M. Cronin, MS; Alexandra C. Maschino, BS; George Lewith, MD; Hugh MacPherson, PhD; Nadine E. Foster, DPhil; Karen J. Sherman, PhD; Claudia M. Witt, MD; Klaus Linde, MD

Arch Intern Med. 2012;172(19):1444-1453. doi:10.1001/archinternmed.2012.3654.

Low Back Pain

For patients with chronic low-back pain, recent evidence-based clinical practice guidelines from the American College of Physicians gave a strong recommendation based on moderate-quality evidence that clinicians and patients should initially select nonpharmacologic treatment with exercise, multidisciplinary rehabilitation, acupuncture, or mindfulness-based stress reduction. The guidelines also strongly recommend, based on low-quality evidence, tai chi, yoga, motor control exercise, progressive relaxation, biofeedback, low-level laser therapy, operant therapy, cognitive behavioral therapy, or spinal manipulation.

Read more about the research of mind and body approaches for chronic low-back pain

Fibromyalgia

Recent systematic reviews and randomized clinical trials provide encouraging evidence that practices such as tai chi, qi gong, yoga, acupuncture, mindfulness, and biofeedback may help relieve some fibromyalgia symptoms. Treatment often involves an individualized approach that may include both pharmacologic therapies (prescription drugs, analgesics, and NSAIDs) and nonpharmacologic interventions such as exercise, muscle strength training, cognitive-behavioral therapy, movement/body awareness practices, massage, acupuncture, and balneotherapy.

Read more about the research of mind and body approaches for fibromyalgia

Read more about the research of mind and body approaches for fibromyalgia

Headache

Results of research on mind and body practices such as relaxation training, biofeedback, acupuncture, and spinal manipulation for headaches suggest that these approaches may help relieve headaches and may be helpful for migraines.

Read more about the research of mind and body approaches for chronic headaches

Read more about the research of mind and body approaches for chronic headaches

Neck Pain

Available evidence indicates that acupuncture for neck pain may provide better pain relief compared to no treatment. There have been studies suggesting that spinal manipulation may help relieve neck pain, but much of the research has been of low quality.

Osteo Arthritis

In 2012, the American College of Rheumatology issued recommendations for using pharmacologic and nonpharmacologic approaches for osteoarthritis (OA) of the hand, hip, and knee. The guidelines conditionally recommend tai chi, along with other nondrug approaches such as self-management programs and walking aids, for managing knee OA. Acupuncture is also conditionally recommended for those who have chronic moderate-to-severe knee pain and are candidates for total knee replacement but can’t or won’t undergo the procedure.

Read more about the research of mind and body approaches for osteoarthritis

Read more about the research of mind and body approaches for chronic neck pain

Rheumatoid Arthritis

Results from clinical trials suggest that some mind and body practices—such as relaxation, mindfulness meditation, tai chi, and yoga—may be beneficial additions to conventional treatment plans, but some studies indicate that these practices may do more to improve other aspects of patients’ health than to relieve pain.

Read more about the research of mind and body approaches for rheumatoid arthritis

Clinical Guidelines

Scientific Literature

Information for Your Patients

NCCIH Clinical Digest is a service of the National Center for Complementary and Integrative Health, NIH, DHHS. NCCIH Clinical Digest, a monthly e-newsletter, offers evidence-based information on complementary health approaches, including scientific literature searches, summaries of NCCIH-funded research, fact sheets for patients, and more.

The National Center for Complementary and Integrative Health is dedicated to exploring complementary health products and practices in the context of rigorous science, training complementary health researchers, and disseminating authoritative information to the public and professionals. For additional information, call NCCIH’s Clearinghouse toll-free at 1-888-644-6226, or visit the NCCIH Web site at nccih.nih.gov. NCCIH is 1 of 27 institutes and centers at the National Institutes of Health, the Federal focal point for medical research in the United States.

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