Pain Management

Non-Medication Alternatives to Manage Pain

Non-medication alternatives can provide relief to those suffering from pain. Here is a list and description of some of these alternatives. This information is an educational aid only…it is not intended as medical advice for individual conditions or treatments. Your healthcare provider can explain the advantages for each treatment and which may work best for the cause of your pain, and help you choose the alternatives that are right for you.


Physiatry, is a medical subspecialty with a focus on maximizing a patient's function, independence and quality of life. A physiatrist is a physician who has completed an accredited residency training program in Physical Medicine and Rehabilitation. The field of rehabilitation medicine supports a comprehensive interdisciplinary approach with special consideration given to non-medication options in the treatment of pain.

The physiatrist can assist in the diagnosis of pain related conditions, order and coordinate treatment with physical therapy, occupational therapy, the patient's primary care physician, other medical specialists and practitioners actively involved with their care.

Keith Rafal, MD is a physical and rehabilitation specialist on Milford Regional's medical staff. For more information visit his practice website at

Nerve Blocks/Interventional Pain Management

Patients needing interventional pain management services suffer distress and discomfort caused by a variety of conditions and disorders, including: chronic low back and neck pain, chronic reflex sympathetic dystrophy (RSD) or complex regional pain syndrome, chronic head and/or facial pain, postsurgical pain, malignancy associated pain, post-traumatic pain, muscle and/or bone pain.

Interventional pain management involves special procedures to treat and manage pain. "Interventional" procedures might include an injection of an anesthetic medicine or steroid around nerves, tendons, joints or muscles; spinal cord stimulation; or a procedure with radio-frequency ablation or cryo-ablation to stop a nerve from working for a long period of time. Combined with other care givers, the objective is to reduce the amount of time pain is experienced and its severity, allow for an increase in activities at home and work, learn new skills for coping with pain, help sleep problems associated with pain and improve the quality of life.

Interventional pain treatment works alongside physical therapists, chiropractors, acupuncturists, psychologists, hypnotherapists and physiatrists to seek the optimal course of treatment for patients in chronic pain.

Physical Therapy

Physical therapy is a safe, effective alternative for treatment of pain recommended by the Center of Disease Control (CDC). Physical Therapists treat pain through movement. Specifically they utilize means such as manual techniques (joint and soft tissue mobilizations, dry needling), electrical stimulation, applying cold/heat or cold laser, as well as exercise (flexibility, strengthening, cardiovascular) and education (relaxation techniques and diaphragm breathing) in order to improve movement patterns and correct imbalances.

Physical Therapy facilities are regulated by the Department of Public Health and hospitals, and also by the Joint Commission on Accreditation of Hospitals. Physical Therapists require state licensure. Learn more about Milford Regional’s physical therapy department.

Occupational Therapy

Occupational therapy is a safe and effective option for clients experiencing pain and related symptoms. Occupational therapists evaluate the physical, cognitive and psychological elements at play in patients who experience chronic pain and place emphasis on the effect that pain can have on daily activities, as well as work and leisure activities. The goal of occupational therapy is to assist clients to live and function productively, and equip them with skills and strategies to manage their pain. Many techniques are used to both treat and manage day-to-day pain, including but not limited to: exercise, use of electrical stimulation, ultrasound, applying hot or cold, relaxation and visualization, home and work environment assessments, instruction and incorporation of adaptive equipment, and orthotics.

Occupational therapy facilities are regulated by the Department of Public Health and hospitals, and also by the Joint Commission on Accreditation of Hospitals. Occupational therapists require state licensure. Learn more about Milford Regional’s occupational therapy department.


Cryotherapy, otherwise known as "cold therapy", is a very effective, easy, and accessible way to treat and manage pain. The use of an ice pack, for example, can be very beneficial in reducing the swelling and pain that can result from injuries, strains, arthritis, and certain medical procedures. The application of a cold pack immediately reduces skin temperature, decreases nerve activity that may be causing the pain, and lowers any associated swelling. When using a cold pack, it is important to make sure that the temperature isn't too extreme, or numbness and loss of sensation could occur. It is advised to layer the cold pack on top of a thin towel to create a protective barrier for the skin. Cryotherapy promotes faster healing while decreasing any inflammation that may be occurring.


Heat therapy is a complement to cold therapy, with similar pain relief effects obtained for different types of injuries. The application of heat, through a moist hot pack for example, raises the temperature of the skin and increases circulation and blood flow to the area, soothing muscle pain and stiffness. Heat can increase flexibility or "loosen" a tight muscle. Heat can also come from a dry hot pack or an ultrasound, depending on the type and location of pain. It is important to maintain safety and attention when applying any type of heat, as the high temperature carries the risk of burning/damaging the skin. Heat should not be used on a swollen or bruised area, as well as on any type of open wound. Minor stiffness or muscle pain can be relieved with 15-20 minute applications.


Aquatic therapy is a very effective and unique approach to pain management. Exercises completed in a properly heated pool reduce the force and pressure that is placed on joints, allowing for more comfortable movement. The resistance that water provides, however, creates a natural way to help strengthen muscles and increase cardiovascular health. Many individuals find calm within heated pools, thereby releasing endorphins (natural painkillers) and promoting relaxation. Aquatic exercise classes can often be found at local gyms and facilities with a pool. Aquatic therapy, on the other hand, is a form of physical therapy and requires a doctor's referral.


Massage therapy is a research-supported pain management technique with many benefits. Professional massage therapy can not only reduce pain, but can improve overall quality of life, help with symptoms of depression and anxiety, and decrease sensitivity. There are many specific causes and triggers of pain that can benefit from massage such as low back pain, fibromyalgia, pain resulting from a procedure or operation, tension headaches, and arthritis. Massage therapy has also been shown to increase mobility in stiff joints. Depending on the location and type of massage therapy, appointments may be singular or recurring.

Massage therapy facilities are regulated by the Department of Public Health and massage therapists require state licensure.


Reflexology is a practice rooted in thousands of years of successful history. Reflexology typically consists of a practitioner applying pressure to certain nerve areas of the feet, which correspond with specific areas in the body. The pressure is meant to stimulate the central nervous system, interrupting or altering the way that pain is felt in the body. Reflexology also has the ability to create a deep state of relaxation. Reflexology, like many methods, is most appropriate for only certain kinds of pain. The most success is found with internal conditions, such as insomnia, migraine headaches, and digestive issues. Reflexology may be a one-time appointment, or may require several sessions.

Professional trained reflexologists have typically completed at least 200 hours of reflexology-only training and have a certificate of completion or diploma from an accredited school or recognized educator. They may be a member of state and/or national reflexology associations such as the Massachusetts Association of Reflexology or the Reflexology Association of America.


Meditation and mindfulness are practices that target the mental and emotional strain that pain can put on the body. Practicing meditation can actually change the way that the mind perceives pain, so that it can possibly become more bearable. Becoming mindful of where aches and pains are felt and how they are felt increases the connection between the mind and the body. Meditation and mindfulness can be taught through classes, one-on-one with an instructor, or by following many different guides found in books and through credible internet sources. Overall, meditation and mindfulness can ease the mental suffering that so often accompanies physical pain.


Reiki is a Japanese form of healing, and has been shown to be an effective alternative to pain medication. Reiki focuses on the energy system within the body, which is divided into seven sections known as chakras. It is believed that disturbances in these energy systems can lead to pain, sickness, and many health conditions. A practitioner uses their own energy, through the placement of their hands, to heal the energy that has been disturbed in a person’s body. Benefits include a reduction in pain, decreased stress, and relaxation of tense muscles.


Hypnosis is a collection of techniques designed to increase focus and relaxation, as well as either increase or decrease the body’s sensitivity and responsiveness. Hypnosis has been shown to play an effective role in pain relief and management by altering different areas of the brain through concentration. This may make the body less sensitive to things such as chronic and acute pain. Hypnosis, whether conducted by an instructor or self-guided, has been proven to reduce pain symptoms in those suffering from headaches, backaches, fibromyalgia, and chronic pain. Hypnosis is also often a component of a greater pain management program, since it targets the mental and sensory aspect.


There is a very strong link between pain and nutritional intake, which is often connected to inflammation. Many food ingredients that are popular in American diets cause inflammation, such as oils and saturated fats. This swelling can contribute to pain, specifically for those with conditions such as arthritis. Obesity also shares a large connection with pain, as excess weight places strain on joints as well as contributes to many conditions and diseases with pain components. A nutritionist can identify the links between diet and specific kinds of pain, and provide a plan for creating a healthier lifestyle. A nutritionist can also play a role for those with diabetes in managing neuropathic pain and quality of life.

Registered Dietitian Nutritionists (RDNs) have met academic and professional requirements established by the Commission on Dietetic Registration, the Academy’s credentialing agency. This includes earning a bachelor's degree from a regionally accredited college or university and completing an accredited, pre-professional experience program. RDNs must also pass a rigorous national level examination and complete continuing education requirements to maintain their credential. Some RDNs hold advanced degrees and additional certifications in specialized areas of practice. Learn more about Milford Regional’s Nutrition Department.

Craniosacral Therapy

Craniosacral therapy is a gentle, hands-on management of the membranes and fluid that surrounds the brain and spinal cord. Using gentle touch to manipulate the suture joints of the cranium, it relieves stress and tension. There are small rhythmic motions of cranial bones that can be manipulated to affect the central nervous system and cerebral spinal fluid from cranium to sacrum to harmonize flow. This system plays a large role in the way that the body functions, so any disruption can increase pain.

A licensed practitioner will use a soft touch to release any restrictions and re-balance the system, which is shown to make significant improvements in chronic pain following injury. Any type of chronic pain can create tensions in the craniosacral system that may linger for years, even after any injury or acute pain is treated. The practitioner will work with the natural rhythm of your body to reset your system to produce optimal functioning and a decrease in pain.


Acupuncture is a safe, effective, natural and drug-free way to eliminate pain. The World Health Organization (WHO) and the National Institute of Health (NIH) acknowledge the benefits of acupuncture in treating and eliminating pain due to a wide range of causes.

Acupuncture practitioners recognize there is a vital energy, called Qi (pronounced “chee”), circulating within the body. Qi flows through a series of acupuncture pathways called meridians. Meridians are like rivers within your body that transport life-giving Qi to every cell, tissue, muscle, organ and gland in the body. A blockage in the flow of Qi anywhere in the body will inhibit the amount of nourishment that reaches our cells, tissues, muscles, organs and glands. Under normal circumstances, your body can easily return to good health and vitality. If the disruption of Qi is prolonged or excessive, or if your body is in a weakened state, the flow of Qi becomes restricted and a variety of symptoms including pain may arise.

An acupuncturist is trained through a Master’s Degree in Acupuncture and is licensed by the Massachusetts Board of Medicine. An acupuncturist is trained to stimulate specific points along acupuncture pathways using a wide variety of tools including thin sterile needles, pressure, magnets, heat, and cupping. An acupuncturist is able to break up blockages and strengthen weaknesses so that Qi can travel freely throughout the body promoting health, well-being, and vitality. Acupuncture is a holistic treatment that treats the root of the problem and the associated symptoms. When the initial cause of the pain is corrected, your body can begin to heal on deeper levels.


Yoga is a practice that combines exercise with the mind-body connection, breath control, meditation, and purposeful movement (stretching and strengthening poses) to create an opportunity to manage pain. Studies have shown that regular yoga practice can help people with arthritis, fibromyalgia, low back pain, migraines, and other chronic pain conditions. Chronic pain conditions can actually alter the brain, and yoga has been shown to reverse those negative effects and promote pathways that reduce and manage pain. Practicing yoga regularly is a gentle way to increase muscle strength and flexibility, as well. There are many local gyms and fitness centers that offer yoga classes for all levels, and many yoga classes can be found on-line.


Chiropractors practice a hands-on, drug-free approach to health care that includes a patient examination, diagnosis of musculoskeletal disorders and treatment of misalignments of the spine through joint manipulation. Your nervous system, through your spinal cord, controls every cell and organ in your body. If your spinal segments aren’t properly aligned and are “locked up or restricted” this can cause compression to your spinal cord and/or nerve roots that exit out of the spinal column. This compression will cause improper function of the nervous system, which over time will cause havoc to one’s overall health by decreasing healing time, causing an inability for the tissues affected to adapt or respond to a changing environment, decreasing range of motion and atrophy and malnutrition of the muscles and other tissues of the region.

Chiropractors are trained in finding joint restrictions and manipulating them to free up the misalignment and restore normal nerve conductance back to the affected tissues that were being deprived of proper nerve function. Without any joint restrictions in the way disrupting proper nerve conductance, your body can function and adapt optimally and avoid dysfunction, sickness and disease.

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