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Reliable, easy-to-read patient information on common medical conditions — written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.

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Opioid in benign chronic pain

Introduction

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

Cognitive Behavioral Therapy

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

Rehabilitation

Further information: Physical medicine and rehabilitation

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]

References

  1. ↑ DeBar L, Mayhew M, Benes L, Bonifay A, Deyo RA, Elder CR; et al. (2021). “A Primary Care-Based Cognitive Behavioral Therapy Intervention for Long-Term Opioid Users With Chronic Pain : A Randomized Pragmatic Trial”. Ann Intern Med. doi:10.7326/M21-1436. PMID 34724405 Check |pmid= value (help).
  2. ↑ Geertzen JH, Van Wilgen CP, Schrier E, Dijkstra PU (2006). “Chronic pain in rehabilitation medicine”. Disability and rehabilitation. 28 (6): 363–7. PMID 16492632.
  3. ↑ Smith TJ, Wang EJ, Loprinzi CL (July 2023). “Cutaneous Electroanalgesia for Relief of Chronic and Neuropathic Pain”. N Engl J Med. 389 (2): 158–164. doi:10.1056/NEJMra2110098. PMID 37437145 Check |pmid= value (help).


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