Noninvasive Nonpharmacological Treatment for Chronic Pain: A Systematic Review
Comparative Effectiveness Review
June 11, 2018
Agency for Healthcare Research and Quality
U.S. Department of Health and Human Services
Pacific Northwest Evidence-based Practice Center
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.
- 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, low-level 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.