Chronic Pain: Non-Pharmacological Treatments and Rehabilitation Strategies

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Clinical Rehabilitation".

Deadline for manuscript submissions: 30 June 2025 | Viewed by 2531

Special Issue Editor


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Guest Editor
School of Health and Exercise Sciences, Faculty of Health and Social Development, The University of British Columbia, Kelowna, BC V1V 1V9, Canada
Interests: exercise; health behavior change; pain; disability; public health

Special Issue Information

Dear Colleagues,

This Special Issue aims to collect the latest developments and cutting-edge research on the management of chronic pain. Musculoskeletal and neuropathic pain affect many people across different populations regardless of its etiology. Pharmacological therapies commonly represent the first line of treatment, but they are not always effective. This Special Issue will focus on the latest research on different non-pharmacological strategies to manage chronic pain and reduce its negative impact on both physical and mental health. Interventions of interest include but are not limited to exercise, physical therapy, health behavior change and cognitive behavioral therapies, administered alone or combined with pharmacotherapy. We accept submissions of interventions studies, reviews, and qualitative studies that explore patients and clinicians’ perspectives on the non-pharmacological strategies to manage chronic pain. The goal of this Special Issue is to increase awareness of the options for the non-pharmacological management of chronic pain and highlight the existing gaps and future research directions.

Dr. Matteo Ponzano
Guest Editor

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Keywords

  • pain
  • neuropathies
  • musculoskeletal health
  • biopsychosocial management
  • physical therapy
  • cognitive behavioral therapies

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Published Papers (2 papers)

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Research

17 pages, 454 KiB  
Article
Keeping It Simple—Pain Science Education for Patients with Chronic Pain Referred to Community-Based Rehabilitation: Translation, Adaptation, and Clinical Feasibility Testing of PNE4Adults
by Bettina Eiger, Michael Skovdal Rathleff, Kelly Ickmans, Emma Rheel and Christian Lund Straszek
J. Clin. Med. 2025, 14(3), 771; https://doi.org/10.3390/jcm14030771 - 24 Jan 2025
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Abstract
Background/Objectives: Pain science education accommodating low health literacy is needed for people with chronic pain. The purpose of this study was to translate PNE4Kids, contextually adapt it into PNE4Adults, and test the feasibility of the newly developed pain science education program (PNE4Adults) [...] Read more.
Background/Objectives: Pain science education accommodating low health literacy is needed for people with chronic pain. The purpose of this study was to translate PNE4Kids, contextually adapt it into PNE4Adults, and test the feasibility of the newly developed pain science education program (PNE4Adults) for adult patients with chronic musculoskeletal pain in the municipality. Methods: A three-step approach was used to (1) translate PNE4Kids into Danish, (2) adapt to age and context (PNE4Adults), and (3) test the feasibility. (1) Translation was performed by a native Dane fluent in Dutch. (2) Two think-aloud group sessions were held, with therapists and end users. (3) Feasibility was tested amongst twenty adult patients with chronic musculoskeletal pain consecutively referred for rehabilitation in the municipality. The a priori success criteria were determined to be 70% acceptability and 70% understandability. Prior to inclusion of the first patient, the study was pre-registered on clinicaltrial.gov [NCT05140031]. Results: Translation was successfully performed. Both the therapist and end users found the program easy to grasp, the simplicity and interactive nature of the program ingenious, and the program to be well suited to an adult population. All patients (100%), across health literacy levels, found PNE4Adults comprehensible and acceptable. Conclusions: The aims were successfully met. Progression to a full trial is warranted and is underway. Full article
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24 pages, 3412 KiB  
Article
Effects of Different Transcranial Direct Current Stimulation Intensities over Dorsolateral Prefrontal Cortex on Brain Electrical Activity and Heart Rate Variability in Healthy and Fibromyalgia Women: A Randomized Crossover Trial
by Mari Carmen Gomez-Alvaro, Narcis Gusi, Ricardo Cano-Plasencia, Juan Luis Leon-Llamas, Alvaro Murillo-Garcia, Maria Melo-Alonso and Santos Villafaina
J. Clin. Med. 2024, 13(24), 7526; https://doi.org/10.3390/jcm13247526 - 11 Dec 2024
Viewed by 1031
Abstract
People with fibromyalgia (FM) exhibit alterations in brain electrical activity and autonomic modulation compared to healthy individuals. Objectives: This study aimed to investigate transcranial direct current stimulation (tDCS) effects on brain electrocortical activity and heart rate variability (HRV), specifically targeting the dorsolateral [...] Read more.
People with fibromyalgia (FM) exhibit alterations in brain electrical activity and autonomic modulation compared to healthy individuals. Objectives: This study aimed to investigate transcranial direct current stimulation (tDCS) effects on brain electrocortical activity and heart rate variability (HRV), specifically targeting the dorsolateral prefrontal cortex in both healthy controls (HC) and FM groups, to identify potential differences in the responses between these groups, and to compare the effectiveness of two distinct tDCS intensities (1 mA and 2 mA) against a sham condition. Methods: Electroencephalography and electrocardiogram signals were recorded pre- and post-tDCS intervention. All participants underwent the three conditions (sham, 1 mA, and 2 mA) over three separate weeks, randomized in order. Results: No statistically significant baseline differences were found in the investigated HRV variables. In the FM group, 1 mA tDCS induced significant increases in LF, LF/HF, mean HR, SDNN, RMSSD, total power, SD1, SD2, and SampEn, and a decrease in HF, suggesting a shift toward sympathetic dominance. Additionally, 2 mA significantly increased SampEn compared to sham and 1 mA. In the HC group, sham increased DFA1 compared to 1 mA, and 2 mA induced smaller changes in SampEn relative to sham and 1 mA. No significant differences were found between FM and HC groups for any tDCS intensity. Conclusions: The effects of dlPFC-tDCS on HRV are intensity- and group-dependent, with the FM group exhibiting more pronounced changes at 1 mA and 2 mA. These findings emphasize the need for individualized stimulation protocols, given the variability in responses across groups and intensities. Full article
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