Pain non-pharmacological interventions

Non-pharmacological interventions are multi-component interventions:

  • First find out what the client’s goals are (quality of life, preventing physical decline, improving ADL, etc.).
  • Provide self-management support in the form of relaxation activities that suit the individual, such as yoga, relaxation techniques and daytime activities.
  • Provide psychotherapeutic education: information about options for preventing pain, self-management of pain medication, symptom monitoring, motivational interviewing, preventing stress.

With non-pharmacological interventions, it may be useful to look for distraction, for example listening to music or watching television.

If possible, increasing activity in older people, for example through an exercise programme, is an important first choice for treatment. This includes strength training, endurance, flexibility and balance exercises

Various non-pharmacological interventions exist for the treatment of pain and its consequences for daily functioning, and the interventions take many different forms. The problem, however, is that little research has been conducted on these interventions. Certain forms may help, but the effects have not yet been scientifically established. The forms of intervention listed below are among those for which research has shown their effect:

  1. a) exercise therapy for chronic pain in the back, neck and shoulder and for osteoarthritis or rheumatoid arthritis
  2. b) conversations with a psychologist, cognitive behavioural therapy or mindfulness/meditation for chronic pain
  3. c) TENS or low-dose laser therapy for knee pain
  4. d) ensuring that the patient feels comfortable, such as through massage or relaxation exercises
  5. e) alternative medicine such as acupuncture for chronic lower back pain

It is important to note, however, that the research often did not include older people.

The interventions are aimed at improving the participation of older people in society. With this group it is important to gain insight into which activities can no longer be carried out as desired and what influence this has on their participation. This may involve interventions by a (geriatric) physiotherapist (such as exercises, walking training, posture advice), occupational therapist (such as training adapted actions/posture advice) or psychologist (such as progressive relaxation, biofeedback).v

 

References:

Verenso (2016) Multidisciplinaire richtlijn pijn bij kwetsbare ouderen. https://www.verenso.nl/_asset/_public/Richtlijnen_kwaliteit/richtlijnen/database/VER-003-32-Richtlijn-Pijn-deel2-v5LR.pdf  Hoofdstuk 4 

Bleijenberg N. (2019) in: Bakker T., Habes V., Quist, G., Van der Sande, J., Van de Vrie, W. (2019) Klinisch redeneren bij ouderen. Functiebehoud in levensloopperspectief. Bohn Stafleu van Loghum