Robert G. Badgett, M.D.[1], Parth Vikram Singh, MBBS[2]

A randomized controlled trial found a reduction in pain and disability although no reduction in opioid use^[1]. The intervention includes 12 modules of learning coping skills. The modules include:

1. Understanding pain/pain education and role of pain coping skills
2. Applying progressive muscle relaxation (PMR) and adaptation model.
3. Activity-rest cycle
4. Pleasant activity scheduling
5. Relaxation mini-practices
6. Pleasant imagery
7. Emotional regulation: leaning in
8. Emotional regulation: leaning out
9. Cognitive restructuring
10. Use of calming self-statements
11. Problem-solving/reinforcing the application of learned skills
12. Relapse prevention and maintenance enhancement training

As alluded to earlier there are other modalities used in the treatment of chronic pain. These include: physical modalities such as thermal agents and electrotherapy. Complementary and alternative medicine, therapeutic exercise and behavioral therapy are also utilized autonomously or in tandem with interventional techniques and conventional pharmacotherapy. This is most often structured in a multidisciplinary or interdisciplinary program.^[2]

Electroanalgesia is a nonpharmacologic pain-management approach that delivers electrical stimulation through cutaneous electrodes to modulate pain signaling. Contemporary forms of electroanalgesia are used primarily in patients with chronic pain and neuropathic pain, particularly when pharmacologic therapies are ineffective or poorly tolerated.^[3]

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