Dr Daniel Clauw Highlights the Turn Toward Nondrug Therapies to Treat Chronic Pain

Nondrug therapies that might have been dismissed 30 years ago are now the sorts of treatments physicians are turning to instead of overused treatments like surgical procedures, opioids, and injections, said Daniel Clauw, MD, professor of anesthesiology, medicine (rheumatology), and psychiatry; director of translational research; and director of the Center for Chronic Pain and Fatigue Research.

Transcript

How has pain management for patients with fibromyalgia evolved? Are opioids still beneficial for these patients, since they experience chronic pain, or are we starting to find alternatives so we can taper these patients off opioids?

So, in the last 20 years or so I think physicians have understood that fibromyalgia is a real disease, the approval of 3 different drugs by the FDA helped a lot because those companies had education programs that went along with their drug approvals, but over that period of time I think there has been a gradual acceptance that there is a number of drug therapies that can be helpful in fibromyalgia.

But we also have seen more and more literature suggesting that nondrug therapies—we’ve known forever that cognitive behavioral therapy and exercise were helpful treatments for fibromyalgia, but it’s really been in the last 5 to 10 years that it’s become clear that a much broader set of nondrug therapies are helpful, not just in fibromyalgia but in any chronic pain condition: things like mindfulness, yoga, tai chi, biofeedback chiropractic manipulation, acupuncture, acupressure. These are things that when I was trained 30 or so years ago, we were fairly dismissive of in the US healthcare systems that these things were not effective.

And now 30 years later the pendulum has swung away from the surgical procedures, the opioids, the injections that we overuse in the United States and we’re starting to more and more embrace the use of these nondrug therapies.