Nonpharmacological pain management treatment

April 13, 2024

Nonpharmacological pain management treatment is the management of pain without the use of medication. Evidence suggests nonpharmacological analgesic therapies can provide relief to those experiencing chronic pain and are safer1.

Nonpharmacological pain treatment options

Your patients may experience improved pain relief outcomes by utilizing more than one treatment modality, which may include2:

  • Acupuncture.
  • Biofeedback.
  • Chiropractic manipulation.
  • Cognitive behavioral therapies.
  • Instrument-assisted soft tissue mobilization.
  • Massage therapy.
  • Meditation.
  • Mindfulness-based stress reduction.
  • Physical therapy and graded exercise (land/pool).
  • Relaxation techniques.
  • Sleep normalization.
  • Spiritual practices.
  • Transcutaneous electrical nerve stimulation.
  • Virtual reality/immersive therapeutics. 

When appropriate, use methods identified as effective by evidence-based research and approved by the U.S. Food and Drug Administration3.

Chronic pain and behavioral health

Many individuals with chronic pain have coexisting behavioral health conditions that may result from, or contribute to, their physical pain. These patients may benefit from a referral to a behavioral health care provider and other support resources4.

Referrals to virtual and in-person behavioral health providers

Referral reasonDigital/virtual resourceFace-to-face resource
General depression, anxiety, stress

Outpatient evaluation, counseling, medical management

Back pain, chronic pain

Adolescent, young adult

Complex, chronic, comorbidity


Headspace Care (age 18+) – On-demand behavioral health coaching via text-based chats, self-guided activities, and video-based therapy. Interactive clinical content helps build valuable skills needed to manage stress, anxiety, and more. Prescribers and therapists available within five days.  

MDLIVE® (age 10+) – Scheduled visits for behavioral health (therapy, psychiatry). Online video, phone, or MDLIVE app—anytime, anywhere. https://MDLNext.MDLIVE.com888.726.3171  

Talkspace (age 13+) – Online counseling via text, audio, or video messaging, anytime, anywhere. Can message dedicated licensed therapist via text, voice, or video. Scheduled medication management sessions available.  

Brightside Health (age 18+) – Timely virtual access for quality depression and anxiety care. Medication management, evidence-based therapy, self-care, and support from expert providers. Prescribers available within two days; therapists within five days.
If you have questions or want to find a clinic, call the direct help line at 855.873.6189.  

Bright Heart Health (age 13+) 800.892.2695  

LifeStance Health (all ages) www.LifeStance.com770.389.8100

You may also want to consider a referral to an interdisciplinary pain management specialty program, especially for patients who have failed standard treatments, have severe functional deficits, or have psychosocial risk factors.

Cigna Healthcare resources

To support your pain management care delivery, we encourage you to access the resources listed below on the Cigna for Health Care Professionals website (

External resources

AAFP Chronic Pain Management Toolkit 

  1. “Nonopioid Treatments for Chronic Pain.” Centers for Disease Control and Prevention. Retrieved from
  2. “Non-Drug Pain Management.” MedlinePlus. 28 August 2018. Retrieved from
  3. David Taubin, MD, et al. “Approach to the management of chronic non-cancer pain in adults.” UpToDate. 25 March 2024. Retrieved from
  4. Resources and coverage vary based on your patient’s medical or behavioral benefit plan.

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