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

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 (CignaforHCP.com).

• Coverage Policies (including Monthly Policy Updates)
• Precertification Guidelines
• Case management and health engagement programs (including the chronic condition management program for low back pain).

External resources

AAFP Chronic Pain Management Toolkit 

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