[Document title] [Document subtitle] Abstract [Draw your reader in with an engaging abstract. It is typically a short summary of the document. When you’re ready to add your content, just click here and start typing.] ACPA [Email address] 1 ACPA Resource Guide To Chronic Pain Management An Integrated Guide to Medical, Interventional, Behavioral, Pharmacologic and Rehabilitation Therapies 2019 Edition American Chronic Pain Association P.O. Box 850 Rocklin, CA 95677 Tel 800-533-3231 Fax 916-652-8190 E-mail [email protected] Web Site http://www.theacpa.org Copyright 2019 American Chronic Pain Association, Inc. All rights reserved. No portion of this book may be reproduced without permission of the American Chronic Pain Association, Inc. 2 Table of Contents A STATEMENT FROM THE ACPA BOARD OF DIRECTORS ...........................................................................................................................5 INTRODUCTION ........................................................................................................................................................................................................6 OVERVIEW OF CHRONIC PAIN TREATMENT ..................................................................................................................................................8 WHAT DOES SUCCESSFUL PAIN TREATMENT LOOK LIKE? .......................................................................................................................8 PAIN TYPES, SOURCES & CLASSIFICATION .....................................................................................................................................................9 PAIN IN SPECIAL POPULATIONS .......................................................................................................................................................................10 Pain in Pregnancy.................................................................................................................................................................................................... 10 Pain in Children ...................................................................................................................................................................................................... 10 Pain in Older Persons.............................................................................................................................................................................................. 11 MAJOR TYPES OF INTERVENTIONS FOR PAIN..............................................................................................................................................13 FUNCTIONAL RESTORATION APPROACHES & PROGRAMS .....................................................................................................................13 SELF-DIRECTED INTERVENTIONS ....................................................................................................................................................................15 Self-Care, Self-Management, Self-Development ................................................................................................................................................... 15 ACPA Groups .......................................................................................................................................................................................................... 15 Classes in Chronic Pain & Chronic Disease Self-Management............................................................................................................................ 16 ACTIVE INTERVENTIONS – DELIVERED BY PROFESSIONALS .................................................................................................................17 Information Therapy: Reconditioning the Brain ................................................................................................................................................. 17 Reconditioning the Body: Exercise and Body Awareness .................................................................................................................................... 18 Pilates ....................................................................................................................................................................................................................... 19 Yoga.......................................................................................................................................................................................................................... 19 Feldenkrais .............................................................................................................................................................................................................. 21 Postural Re-Training .............................................................................................................................................................................................. 21 Alexander Technique .............................................................................................................................................................................................. 22 Brain Motor & Sensory Retraining ....................................................................................................................................................................... 22 Graded Motor Imagery ........................................................................................................................................................................................... 22 Desensitization ......................................................................................................................................................................................................... 22 Sensory Re-education .............................................................................................................................................................................................. 23 Virtual Reality ......................................................................................................................................................................................................... 23 Functional Activity Training .................................................................................................................................................................................. 23 Personal Goal Attainment Program ...................................................................................................................................................................... 23 PSYCHOLOGICAL & BEHAVIORAL APPROACHES .......................................................................................................................................25 Cognitive Behavioral Therapy for Pain (Pain-CBT) ............................................................................................................................................ 26 Acceptance and Commitment Therapy (ACT) ..................................................................................................................................................... 27 Motivational Interviewing ...................................................................................................................................................................................... 28 Fear Avoidance Therapy ........................................................................................................................................................................................ 28 Stress-reducing Interventions ................................................................................................................................................................................. 29 Art & Music ............................................................................................................................................................................................................. 30 Biofeedback.............................................................................................................................................................................................................. 30 Hypnosis ................................................................................................................................................................................................................... 30 Reconditioning Brain and Mind ............................................................................................................................................................................. 31 COMPLEMENTARY, ALTERNATIVE & INTEGRATIVE MEDICINE (CAM) ..............................................................................................34 PHYSICAL MODALITIES – NONINVASIVE INTERVENTIONS .....................................................................................................................39 INVASIVE INTERVENTIONS .................................................................................................................................................................................44 MEDICATIONS .........................................................................................................................................................................................................53