What nonpharmacological modalities can be used for pain control?
Given the multifactorial nature of pain, nonpharmacological modalities are often used for the psychological and functional components of the pain experience. Relaxation and biofeedback training are two methods that teach a patient to have a greater sense of awareness of their pain, with the intent to use techniques that allow them to manipulate their psychological, emotional, and physical response. Behavioral training is a similar technique which focuses on extinguishing pain enhancing behaviors such as talking about pain and rather re-focuses attention on behaviors not related to pain. Cognitive behavioral therapy (CBT) coaches patients on how to change negative thoughts and behaviors that prevent coping into behaviors that allow for greater control over one’s pain. Studies have shown mixed results for these pain coping strategies in the elderly; however, when used in a multidisciplinary approach, these methods have been beneficial in helping reduce pain intensity and medication intake.
Physical therapy and occupational therapy are important modalities for preventing frailty, as well as maintaining independence and function. Goals of therapy include stabilizing the primary condition, preventing secondary injuries, changing pain perception, assessing and treating for functional deficits, and fostering modifications around existing disabilities. Physical therapy allows for evaluation of mobility, strength, endurance, and range of motion, whereas occupational therapy evaluates activities of daily living, safety, and independent living skills.
