Non-medicine treatments for pain

There are many different types of non-medication treatments available. These are the more common approaches:

• Self-care
• Physiotherapy
• Manual therapy
• Rongoā Māori
• Cognitive behavioural therapy (CBT)
• Transcutaneous electrical nerve stimulation (TENS)
• Acupuncture

There are a number of things you can do for yourself, or with support from your whānau and friends or usual health care provider, to help with your pain. They can improve your symptoms or help you to cope with them better. These are seen as types of self-care and include working on:

• your activity levels
• what and how you eat
• how you manage important things like stress, mood and sleep
• maintaining an active social life.

Making a pain plan for how you can improve these aspects of your life, and what to do when you have a bad day, can be helpful.

Be active

Be more active and do exercise. Exercise is for everyone and is very important for people living with pain. However, exercise can be difficult when you are in pain, especially if you have other long-term conditions or are overweight. You may have got into a 'no exercise' habit to try and avoid pain but the right type of exercise can actually help you to manage it better. 

• Some people living with pain are afraid of doing exercise in case they make things worse.
• It can be difficult to know how to get started and what types of exercise are right for you. Your doctor, nurse or a physiotherapist can help you with this.
• Gentle stretching and walking are good things to try.
• Start slowly and pace yourself, then if all is going well you can gradually increase what you are doing and the length of time you do it for.

Eat well

Eat a wide range of foods, so that you can get all the energy, vitamins and minerals you need to be healthy.

Healthy eating is not about sticking to strict diets or depriving yourself of the foods you love. It’s about eating a balanced range of foods that help you feel great, have more energy, improve your outlook and help you achieve and maintain a healthy weight. If you are overweight, losing some weight can improve your pain symptoms. Read more about healthy eating.

Connect with others

When you’re in pain you may avoid going out and doing things you enjoy. Studies show staying connected with whānau and friends is important for your mental wellbeing.

Try joining a new group or start doing something that you used to enjoy. Catch up with people as much as possible. Talking, laughing and doing things with people you enjoy is the best medicine.

Distract yourself

Being engaged in activities, by yourself or with others, can provide distraction from thinking about your pain. It may be as simple as going for a walk and looking at your surroundings or listening to music.

Mindfulness

Mindfulness is the practice of being aware of each moment of your day as it happens. It can help to reduce stress, tension and anxiety. It can also help you to avoid focusing too much on your pain as well as directing your thoughts in a way that is helpful to managing your pain. Read more about mindfulness.

Get enough sleep

Many people skip on sleep but regular, good quality sleep is important for brain functioning, emotional wellbeing, physical health, daytime performance and personal safety. Not getting enough sleep is common and can have serious impacts on your health and wellbeing. It can also mean that you don’t cope as well with your pain. 

Research suggests that adults need at least 7–8 hours of sleep each night to be well rested.  To restore your sleep balance, you need at least 2 nights in a row of unrestricted good quality sleep.

If you have problems sleeping:

• try to get into a routine
• create a peaceful sleep environment
• avoid coffee, alcohol and exercise in the hours before you want to go to sleep
• avoid looking at a screen (eg, tv, phone or computer) in the hour or so before you want to sleep – reading or meditating is more relaxing for your brain.

Read more about sleep.

Learn about pain

There are some excellent books, apps, videos and online courses that people with pain have found helpful. Find more information on and resources for pain, including videos and apps.

As well as learning how to look after yourself better in order to manage your pain, there are also specific treatments you can be referred to specialist health professionals for. You may like to take the following points into consideration when you are talking to your doctor or another health professional about what is right for you.

Once you have decided on a treatment, you may like to discuss with the therapist more about the benefits you may experience, possible timeframes and when a review will take place to discuss any progress. Remember that you don't have to continue treatment if you don't think it is helping you or if you don't feel comfortable with the therapist. You can stop at any time.

Pain often results in inactivity. This can cause stiff joints, weak muscles, increased weight, poor fitness and getting breathless more easily, as well as low mood. This, in turn, can result in more inactivity and increased pain. 

Physiotherapy or exercise under the supervision and guidance of a physiotherapist can be used to manage ongoing, persistent or chronic pain.

Before starting any treatment, the physiotherapist will do an assessment,  taking into account any other health conditions you have and your current state of health, to help you decide on the best approach for you.

• Your physiotherapist may advise you to do general exercises (eg,  walking, swimming, dancing or cycling) or specific exercises designed to increase the strength and movement of particular muscles or joints.   
• The exercises recommended are specific to you and your condition/s.
• They are designed to keep you active and build on what you can already do.
• Your physiotherapist may also use other methods of treatment which can include massage, transcutaneous electrical nerve stimulation (TENS) and acupressure/acupuncture.
• Each therapist works in a slightly different way depending on their training and experience.  

There are 3 main types of manual therapy – massage, manipulation and mobilisation. These are usually performed by physiotherapists, chiropractors, osteopaths and some acupuncturists. 

Massage may involve gentle as well as deep-tissue hands-on treatment to ease tension in your muscles and distract you from your pain. The effects of massage may only be short-term but this may help you to get over a difficult period. You can give yourself a massage or you can see a qualified therapist. You can even ask a family member or good friend to give you a gentle massage – but make sure they know what they are doing!

Self-massage tips

• You can use your hands, or a foam roller, massage balls or other massage aids, such as a tennis ball or a golf ball to massage the soles of your feet.
• If you are using a ball for your feet, put it on the floor, place your bare foot on top of it and gently roll the ball along the length of your foot. If you’re unsteady on your feet, sit down while you do this.
• If you’re massaging elsewhere on your body, before starting, ease some of your muscle tension with a warm shower or by applying a heat pack (warm not hot) to the painful area.
• Use smooth, firm strokes. You’ll feel the difference between strokes that are relieving your muscle tension, and those that are adding to it.
• Adjust the pressure, from hard to gentle, based on the degree of your pain.
• Using an oil or lotion can help your hands move smoothly over your skin; however, it’s not essential – it’s a personal choice.
• Try to massage yourself regularly to prevent muscle pain and tension building up.

Manipulation is a more forceful movement of a joint, possibly beyond what it would normally do. It can help to increase your range of movement and reduce pain. 

Mobilisation is a gentle movement where your joint is moved as much as possible within your existing range of motion. Tai chi is an example of an exercise that promotes joint mobility by stretching in a slow, focused manner.

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Rongoā Māori is traditional Māori medicine or healing. Rongoā Māori is seen in 2 main forms – rongoā rākau and Te Oo Mai Reia. Rongoā rākau (plant remedies) are plant or tree-based medicinal remedies.

Te Oo Mai Reia (spiritual healing) uses different physical techniques alongside spiritual ones. Te Oo Mei Reia can be seen as Māori healing through prayer, cleansing work and bodywork, which is known as known as mirimiri (massage) and kōmiri (deep massage). Please note: The name of this type of healing and the variations may change from iwi to iwi but the principles remain the same. Read more about Rongoā Māori.

CBT is a type of counselling that can help you manage your pain by changing the way you think about it. It can reduce anxiety and distress associated with long-term pain. It focuses on teaching you techniques and skills to help you cope better with chronic pain, such as relaxation, distraction, planning and routine, and problem-solving. All of these techniques are used in order to replace the negative thoughts common to chronic pain with more positive and calming thought processes. Read more about CBT.

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In this technique, a hand-held device called a TENS machine is used to pass a small electric current through your skin to your nerves. It can reduce your pain by interfering with pain signals and blocking them from reaching your brain, or by stimulating production of your body's natural pain-relieving chemicals (called endorphins). It can also reduce the sensation of muscle tension and spasm. 

The effects of TENS may be short-term; evidence for long-term benefit is weak. TENS is not suitable for everyone, eg, people with a pacemaker should not use it. 

Acupuncture is the practice of stimulating specific points under your skin using very thin needles. There are 2 broad types of acupuncture in New Zealand: traditional Chinese acupuncture and Western medical acupuncture.

Acupuncture is generally safe as long as you see a registered and trained provider who uses sterile needles. Acupuncture may be mildly effective for a limited number of conditions, including some types of pain. However, the overall evidence is weak and conflicting.

It's not recommended that you have acupuncture as a sole treatment for your pain, but it can normally be safely used alongside standard treatments, such as with a doctor, nurse or physiotherapist. Read more about acupuncture.