4.8 Review

Multimodal non-invasive non-pharmacological therapies for chronic pain: mechanisms and progress

Journal

BMC MEDICINE
Volume 21, Issue 1, Pages -

Publisher

BMC
DOI: 10.1186/s12916-023-03076-2

Keywords

Pain; Non-invasive non-pharmacological therapies; Physical modalities; Psychological interventions; Complementary and alternative therapies; TENS; CBT; TMS; VR

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This review explores the mechanisms and clinical potential of non-invasive non-pharmacological therapies (NINPT) for chronic pain populations. NINPT utilizes peripheral, spinal, and supraspinal mechanisms to restore normal pain processing and limit central sensitization. However, further research is needed to optimize treatment protocols and individual responses through precision medicine approaches.
BackgroundChronic pain conditions impose significant burdens worldwide. Pharmacological treatments like opioids have limitations. Non-invasive non-pharmacological therapies (NINPT) encompass diverse interventions including physical, psychological, complementary and alternative approaches, and other innovative techniques that provide analgesic options for chronic pain without medications.Main bodyThis review elucidates the mechanisms of major NINPT modalities and synthesizes evidence for their clinical potential across chronic pain populations. NINPT leverages peripheral, spinal, and supraspinal mechanisms to restore normal pain processing and limit central sensitization. However, heterogeneity in treatment protocols and individual responses warrants optimization through precision medicine approaches.ConclusionFuture adoption of NINPT requires addressing limitations in standardization and accessibility as well as synergistic combination with emerging therapies. Overall, this review highlights the promise of NINPT as a valuable complementary option ready for integration into contemporary pain medicine paradigms to improve patient care and outcomes.

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