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New Priorities for Nonpharmacologic Management of Pain

June 07, 2016
Partap S. Khalsa, D.C., Ph.D.
Partap Khalsa, D.C., Ph.D.

Deputy Director
Division of Extramural Research
National Center for Complementary and Integrative Health

View Dr. Khalsa's biographical sketch

Chronic pain is a common and difficult problem. The 2012 National Health Interview Survey showed that nearly 40 million U.S. adults (17.6 percent) have severe pain and about 25.3 million (11.2 percent) have pain every day. The annual economic cost of chronic pain in the United States, including both treatment and lost productivity, has been estimated at nearly $635 billion. To manage pain, many patients are prescribed drugs such as opioids, but the drugs aren’t consistently effective, can have disabling side effects, may worsen pain conditions in some people, and can be misused.

There’s evidence that some complementary health approaches may help people manage pain, and they might also enable people to reduce their use of pain medications. Finding the best ways to incorporate effective complementary approaches into pain management strategies is one of our Center’s top research priorities. We also seek to understand how complementary approaches work to relieve pain and to predict which people will most likely respond to the approaches. This could help health care providers plan more effective pain treatment programs.

In our Center’s new 2016 Strategic Plan: Exploring the Science of Complementary and Integrative Health, we focus on nonpharmacologic management of pain as one of our top scientific priorities. Some of the key research questions that we hope to answer in the next few years include:

  • Can nonpharmacologic methods be combined with drug treatment in ways that might safely reduce the use of opioid painkillers?
  • Could pain management be improved by using multiple complementary approaches together (say, probiotics along with meditation)?
  • What objective measures can be developed and validated so that we can better measure the effect of complementary approaches on pain?
  • What role does the microbiome play? How does signaling between the brain, gut, and microbiome affect chronic pain?

Want to learn more? Please visit our new strategic plan to find out about more about our priorities for pain research. If you have any comments, you can share them with us below. We welcome your input.



Comments are now closed for this post.

The only pain I’ve really experienced is recovering from c-section surgeries, nor am I a medical provider, so I will try to be as objective as possible and sensitive to issues that cause chronic pain. I think exercise and healthy living are very important to pain management, and not enough patients are willing to become mobile to naturally manage pain, nor are doctors telling patients that being overweight and/or obese is a high contributor to the need for narcotic pain management. For example, my step mother has some back disc issues that have caused her to have surgery, and some type of medication dispenser placed inside her back to manage pain, which ended up having to be removed after it began to protrude through her skin. But, she is otherwise sedentary and has never been active. Before her condition got worse - which I assume is how many conditions get to the point that natural pain management techniques will not work or not works as effectively - she could have excersized and changed her diet to see if that would help manage any pain. So other than prevention and safety, patient accountability comes in as the next highest pain management technique. We as humans are allowed to be lazy and are not held accountable for our health spiraling out of control and costing our nation billions of dollars to provide pain management. The government plays a part as well, with campaings to help people stop smoking; commercials with those who have suffered life long injuries as a result of smoking, yet, tobacco companies are still legally making and selling cigarettes and other tobacco products -it’s a contradiction, and the government is costing our nation just as much as individuals are because of these kinds of behaviors.

I think this is a brilliant approach to chronic pain & is so very long overdo.  I think that the biggest problem is that the insurance companies have been in bed with big pharma for so long that they don’t want to offer other options.   My coverage will pay $25,000 per year for drugs that do very little but make me nauseous, but only $750 per year combined for all alternatives (massage, acupuncture, chiropractic, physic,naturopath,etc)The actual issue is not that chronic pain patients are fat & lazy, as the obviously uneducated woman above commented!  FYI, as someone living with chronic pain I find your comments very offensive.  So, you has c-section with an epidural or did you get put under?  Life is rough, however did you survive it?  Sorry, for the rant…the rest of you.Chronic pain…you don’t get it, until you get it!

Thank you for finally helping this be a priority. My practice deals with nonpharmacologic management of chronic pain a lot. There are many success stories we have using guided imagery, healing touch, ozone therapy, chiropractic care, acupuncture, herbal therapies, nutrition (not dietary planning) and lifestyle changes. Kudos to this movement! Let me know if you want some of the stories. We’re part of the national ozone therapy research study as well. Sue

This page last modified June 09, 2016