Nonpharmacological Treatment of Pain in Rheumatic Diseases and Other Musculoskeletal Pain Conditions

Abstract

Pain is a complex phenomenon influenced by a number of biological, psychological, and social factors. The treatment of pain is most effective when using a multidisciplinary approach consisting of a careful selection of pharmacologic and non-pharmacologic interventions based upon disease factors, pain characteristics, psychological coping abilities and lifestyle factors. In this review we focus on research-based evidence for non-pharmacologic interventions including psychological interventions, physical exercise, patient education, and complementary approaches for pain management in patients with rheumatic diseases and common musculoskeletal pain conditions, such as low back pain. The vast proportion of research studies is on adults with chronically painful conditions but pediatric studies are also reviewed wherever possible to give the reader a more inclusive view of non-pharmacological approaches for pain management across the lifespan.

Extent and characteristics of self-reported pain in patients with systemic lupus erythematosus

“…Differentiating between diverse pain conditions in SLE appears necessary in view of their different medical management [35,37]. It should also be said, that at the time of this study, no patient had a known fibromyalgia syndrome diagnosis.…”

“…Studies of nonpharmacological treatments include cognitive behavioural therapy (CBT), acceptance and commitment therapy (ACT), physical activity/exercise, patient education (in group or individual), as well as complementary alternative medicine (CAM; acupuncture, massage, yoga). The majority of nonpharmacological treatments provide beneficial outcomes when used in combination with pharmacological treatment[35,37].…”

The heterogeneity of headache patients who self-medicate: a cluster analysis approach

“…In addition, pharmacists should be vigilant for risk factors for pain chronification and could proactively identify and address concerns about pain medication, which may help to enhance adherence and detect (fear of) addiction. In case of suspicion of MOH, referral to a general practitioner should be made to discuss strategies to reduce the intake of acute pain medication including non-drug treatment options [4], preventative drug treatment (e.g.…”

A Novel Approach in Patient Care and Non-Pharmacological Treatment for Rheumatoid Arthritis.

“…Physical Activity and Exercise are recommended on a daily basis. The American College of Rheumatology and the American Pain Society recommend aerobic exercise and physical therapy .The three main types of exercises: (a) flexibility and range-of-motion (b) muscle conditioning and resistance training and (c) aerobic exercise [18] Patient education and counseling : Education and counseling are important in the management of rheumatoid arthritis as many patients have misconceptions about the nature of arthritis and its cause. Providing the right information may help establish a good long-term relationship between the clinician and patient [19] .…”