Noninvasive Nonpharmacological Treatment for Chronic Pain: Evidence Summary

Purpose of Review

To assess which noninvasive nonpharmacological treatments for common chronic pain conditions improve function and pain for at least 1 month after treatment.

Key Messages

• Interventions that improved function and/ or pain for at least 1 month when used for—

– Chronic low back pain: Exercise, psychological therapies (primarily cognitive behavioral therapy [CBT]), spinal manipulation, low-level laser therapy, massage, mindfulness-based stress reduction, yoga, acupuncture, multidisciplinary rehabilitation (MDR).

– Chronic neck pain: Exercise, lowlevel laser, Alexander Technique, acupuncture.

– Knee osteoarthritis: Exercise, ultrasound.

– Hip osteoarthritis: Exercise, manual therapies.

– Fibromyalgia: Exercise, CBT, myofascial release massage, tai chi, qigong, acupuncture, MDR.

– Chronic tension headache: Spinal manipulation.

• Most effects were small. Long-term evidence was sparse.

• There was no evidence suggesting serious harms from any of the interventions studied; data on harms were limited.