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Physical modalities in chronic pain management.

Barbara Rakel1, John O Barr

  • 1Department of Nursing Services and Patient Care, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, T-150 GH, Iowa City, IA 52242, USA. barbara-rakel@uiowa.edu

The Nursing Clinics of North America
|October 22, 2003
PubMed
Summary

Physical modalities show limited but positive effectiveness for chronic pain in adults and older individuals, with therapeutic exercise being most supported. Patient factors and proper training are crucial for optimal outcomes.

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Area of Science:

  • Rehabilitation Medicine
  • Pain Management
  • Geriatrics

Background:

  • Chronic pain affects adults and older individuals, necessitating effective management strategies.
  • Physical modalities represent a range of interventions used in pain management.
  • Evidence for the effectiveness of various physical modalities is evolving.

Purpose of the Study:

  • To review the evidence for the effectiveness of physical modalities in managing chronic pain.
  • To identify factors influencing the efficacy of physical modalities.
  • To provide recommendations for the appropriate use of physical modalities in chronic pain management.

Main Methods:

  • Systematic review of existing research on physical modalities for chronic pain.
  • Analysis of studies focusing on therapeutic exercise, TENS, massage, and other modalities.

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  • Evaluation of patient characteristics and contextual factors impacting treatment outcomes.

    • Main Results:

    • Limited but positive evidence supports select physical modalities, especially therapeutic exercise, for chronic pain.
    • Effectiveness is generally short-term but can last up to a year; patient characteristics (e.g., depression, anxiety) can reduce efficacy.
    • Research is most robust for chronic low back pain and knee osteoarthritis; further evaluation is needed for other conditions.

    Conclusions:

    • Physical modalities are appropriate for chronic pain in older adults with precautions; formal training is essential for practitioners.
    • Individualized selection based on functional goals, impairments, and patient preference is recommended.
    • A multidisciplinary approach enhances chronic pain management, and improved research methodologies are needed.