Table of ContentsView AllTable of ContentsWhat Is Pain ManagementTypes of TreatmentsBenefitsEmotional EffectsFinding the Right CareFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
What Is Pain Management
Types of Treatments
Benefits
Emotional Effects
Finding the Right Care
Frequently Asked Questions
Chronic pain—defined as pain that persists for several months—is very common: An estimated 1 in 5 Americans have chronic pain, and 1 in 12 have pain that limits their daily activities.
For many types of chronic pain, such as low back pain, neuropathic pain (pain related to the nervous system), or arthritis, there is no easy fix.
Doctors once primarily treated chronic pain primarily with passive treatments like medications. It is now known that pain medications are rarely effective on their own and can lead to addiction and other serious side effects.
Today, many pain management specialists emphasize the importance of active treatments in addition to passive treatments like medications and surgery.
During active treatments, such as physical therapy, meditation, and exercise regimens, the patient actively engages in their own therapy, either alone or with a trained healthcare provider. Active treatments can often reduce pain and improve overall quality of life.
This article will explain the benefits and downsides of both active and passive treatments, as well as which type of therapy may be best for certain conditions.
Jose Luis Pelaez / Getty Images
What Is Pain Management?
Pain managementis a branch of medicine focused on relieving severe or chronic pain. Pain management specialists treat a wide range of pain-causing conditions, such as diabetic neuropathy, fibromyalgia, arthritis, lower back pain, neck pain, and sciatica.
Because chronic pain is difficult to eliminate completely, pain management specialists instead aim to reduce pain while improving social, emotional, and physical functioning and overall quality of life.
Active Treatment
Passive Treatment
Passive treatments are provided to the person in pain, such as medications, acupuncture, or massage therapy. During these treatments, you are a passive recipient and do not actively work towards your own recovery.
Types of Passive and Active Treatments
Many different active and passive treatments are used to treat chronic pain. The right combination will depend on the reasons for your pain, its intensity and duration, and your personal preferences and goals.
Passive treatments for pain include:
During active treatments, you engage in activities and exercises that help relieve your pain and improve your physical and emotional functioning and quality of life, either on your own or with the help of someone else, such as a physical therapist or occupational therapist or psychologist.
Active treatments include:
Benefits of Active vs. Passive Therapies
Passive treatments such as opioids and NSAIDs can be highly effective for treating acute, injury-related pain for conditions like broken bones or a recent surgery.
But for many types of chronic pain, such as low back pain, neck pain, and arthritic (joint) pain, a purely passive treatment approach rarely has a significant impact on pain or improving daily functioning.Active treatments often give better long-term outcomes and more improved day-to-day functioning and quality of life.
Because active treatments involve effort and real work on your part, they can boost your sense of personal efficacy and competence while increasing your independence.
Pain management specialists therefore emphasize active treatments, while using passive therapies as an adjunct, as a bridge to more active therapies, or as a last resort.
Active treatments have shown benefits in treating:
The right mix of active and passive therapies depends on the person’s specific type of pain, its location, intensity, and duration, and the person’s goals.
The downsides of a purely passive treatment approach include:
The benefits of an active approach include:
Emotional and Mental Aspects of Chronic Pain
Chronic pain is not just a physical condition but one that affects a person’s overall emotional and mental well-being. As many as 80% of people with chronic pain experience depression or anxiety.They may avoid activities out of fear of exacerbating their pain and feel isolated and hopeless. Such feelings can increase stress and muscle tension, worsen pain, and further impair day-to-day functioning.
Active therapies involving pain-focused psychotherapy or joining a support group in addition to passive therapies like antidepressants can often help alleviate emotional and mental suffering and improve your quality of life.
Finding a Pain Management Care Team
The first step to starting on a treatment plan is finding a care team you can trust. Pain specialists should be medical doctors with special training in pain management. Pain treatment centers are ideal because they employ a team of specialists who can help with different aspects of chronic pain. You may wish to ask your primary care doctor and friends for recommendations.
10 Types of Back Pain Specialists
If you do not have health insurance, you should still discuss your symptoms with a healthcare provider and ask them for suggestions on finding affordable active or passive therapies.
Once you find the right team, you will need to communicate your needs and follow up with them about any side effects or other concerns you might encounter. It’s critical to be upfront and honest and to advocate for yourself and your needs.
Summary
Both active and passive therapies serve their own purpose and can offer benefits to those recovering from an injury or specific condition. For most people, a combination of these therapies can lead to better pain management, although it’s best to discuss these treatment options with a healthcare provider to come up with a pain management plan that’s tailored to your body and its needs.
A Word From Verywell
Having chronic or recurrent pain is a miserable experience, and one that can make you feel helpless, hopeless, and alone. In the midst of such feelings, finding the motivation for an active treatment program can be challenging. Remember that despite these considerable hurdles, active treatments are often very effective and become easier to perform with time and practice.
To avoid exacerbating your pain and to stay safe, always talk to your pain management team before embarking on a particular treatment or therapy.
Frequently Asked QuestionsThe most powerful pain relievers are prescription opioid-based medications (also called narcotics). Because opioids can cause dizziness and falls in the elderly and can be habit forming (lead to addiction), these powerful drugs are generally reserved for cancer pain, short-term treatment of acute pain, and when other treatments for chronic pain prove insufficient.NSAIDs, certain antidepressants, and other pain-reducing medications are less powerful than opioids but have fewer serious side effects.To determine the best treatment plan, your doctor and care team will conduct a thorough physical exam to determine the cause of your pain and your social, emotional, and physical functioning. For most types of chronic pain, your doctor will start with a conservative management plan, one that does not involve opioids but may include a mix of treatments such as physical therapy and non-opioid medications.Active treatments have been shown to benefit a wide variety of pain types, including arthritis, back pain, headaches, and nerve pain.Active treatments require sticking to a treatment plan and being consistent in your efforts. Which active management approaches are the right for you will depend on your specific type of pain, its underlying cause, and whether you have other chronic conditions. Your pain management team will work with you to determine the best mix of passive and active therapies.
The most powerful pain relievers are prescription opioid-based medications (also called narcotics). Because opioids can cause dizziness and falls in the elderly and can be habit forming (lead to addiction), these powerful drugs are generally reserved for cancer pain, short-term treatment of acute pain, and when other treatments for chronic pain prove insufficient.NSAIDs, certain antidepressants, and other pain-reducing medications are less powerful than opioids but have fewer serious side effects.
To determine the best treatment plan, your doctor and care team will conduct a thorough physical exam to determine the cause of your pain and your social, emotional, and physical functioning. For most types of chronic pain, your doctor will start with a conservative management plan, one that does not involve opioids but may include a mix of treatments such as physical therapy and non-opioid medications.
Active treatments have been shown to benefit a wide variety of pain types, including arthritis, back pain, headaches, and nerve pain.Active treatments require sticking to a treatment plan and being consistent in your efforts. Which active management approaches are the right for you will depend on your specific type of pain, its underlying cause, and whether you have other chronic conditions. Your pain management team will work with you to determine the best mix of passive and active therapies.
16 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Centers for Disease Control and Prevention.Prevalence of Chronic Pain and High-Impact Chronic Pain Among Adults — United States.Cosio D, Lin E.Role of Active Versus Passive Complementary and Integrative Health Approaches in Pain Management.Glob Adv Health Med. 2018;7:2164956118768492. doi:10.1177/2164956118768492Anheyer D, Haller H, Lauche R, Dobos G, Cramer H.Yoga for treating low back pain: a systematic review and meta-analysisPain. 2021;10.1097/j.pain.0000000000002416. doi:10.1097/j.pain.0000000000002416Pain Management Network.Chronic Pain Management Strategies.Owen GT, Bruel BM, Schade CM, Eckmann MS, Hustak EC, Engle MP.Evidence-based pain medicine for primary care physicians.Proc (Bayl Univ Med Cent). 2018;31(1):37-47. doi:10.1080/08998280.2017.1400290American Family Physician.Choosing Wisely: Avoid protracted use of passive or palliative physical therapeutic modalities for low-back pain disorders unless they support the goal(s) of an active treatment plan.Qaseem A, Wilt TJ, McLean RM, Forciea MA.Noninvasive treatments for acute, subacute, and chronic low back pain: a clinical practice guideline from the American college of physicians.Ann Intern Med. 2017;166(7):514-530.Kolasinski SL, Neogi T, Hochberg MC, et al.American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee[published correction appears in Arthritis Care Res (Hoboken). 2021 May;73(5):764].Arthritis Care Res (Hoboken). 2020;72(2):149-162. doi:10.1002/acr.24131Geneen LJ, Moore RA, Clarke C, Martin D, Colvin LA, Smith BH.Physical activity and exercise for chronic pain in adults: an overview of Cochrane Reviews.Cochrane Database Syst Rev. 2017;4(4):CD011279. doi:10.1002/14651858.CD011279.pub3an Laake-Geelen CCM, Smeets RJEM, Quadflieg SPAB, Kleijnen J, Verbunt JA.The effect of exercise therapy combined with psychological therapy on physical activity and quality of life in patients with painful diabetic neuropathy: a systematic review.Scand J Pain. 2019;19(3):433-439. doi:10.1515/sjpain-2019-0001Nees TA, Riewe E, Waschke D, Schiltenwolf M, Neubauer E, Wang H.Multidisciplinary Pain Management of Chronic Back Pain: Helpful Treatments from the Patients' Perspective.J Clin Med. 2020;9(1):145. doi:10.3390/jcm9010145American Family Physician. Choosing Wisely:Avoid protracted use of passive or palliative physical therapeutic modalities for low-back pain disorders unless they support the goal(s) of an active treatment plan.Lee M, Silverman SM, Hansen H, Patel VB, Manchikanti L.A comprehensive review of opioid-induced hyperalgesia.Pain Physician. 2011;14(2):145-161.Moskowitz M, Golden M.Neuroplastix: change the brain; relieve the pain; transform the person.Integrated Pain Management.Knowing the Best Pain Management Doctors Near You: How to.National Institute on Aging.Pain: You Can Get Help.
16 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Centers for Disease Control and Prevention.Prevalence of Chronic Pain and High-Impact Chronic Pain Among Adults — United States.Cosio D, Lin E.Role of Active Versus Passive Complementary and Integrative Health Approaches in Pain Management.Glob Adv Health Med. 2018;7:2164956118768492. doi:10.1177/2164956118768492Anheyer D, Haller H, Lauche R, Dobos G, Cramer H.Yoga for treating low back pain: a systematic review and meta-analysisPain. 2021;10.1097/j.pain.0000000000002416. doi:10.1097/j.pain.0000000000002416Pain Management Network.Chronic Pain Management Strategies.Owen GT, Bruel BM, Schade CM, Eckmann MS, Hustak EC, Engle MP.Evidence-based pain medicine for primary care physicians.Proc (Bayl Univ Med Cent). 2018;31(1):37-47. doi:10.1080/08998280.2017.1400290American Family Physician.Choosing Wisely: Avoid protracted use of passive or palliative physical therapeutic modalities for low-back pain disorders unless they support the goal(s) of an active treatment plan.Qaseem A, Wilt TJ, McLean RM, Forciea MA.Noninvasive treatments for acute, subacute, and chronic low back pain: a clinical practice guideline from the American college of physicians.Ann Intern Med. 2017;166(7):514-530.Kolasinski SL, Neogi T, Hochberg MC, et al.American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee[published correction appears in Arthritis Care Res (Hoboken). 2021 May;73(5):764].Arthritis Care Res (Hoboken). 2020;72(2):149-162. doi:10.1002/acr.24131Geneen LJ, Moore RA, Clarke C, Martin D, Colvin LA, Smith BH.Physical activity and exercise for chronic pain in adults: an overview of Cochrane Reviews.Cochrane Database Syst Rev. 2017;4(4):CD011279. doi:10.1002/14651858.CD011279.pub3an Laake-Geelen CCM, Smeets RJEM, Quadflieg SPAB, Kleijnen J, Verbunt JA.The effect of exercise therapy combined with psychological therapy on physical activity and quality of life in patients with painful diabetic neuropathy: a systematic review.Scand J Pain. 2019;19(3):433-439. doi:10.1515/sjpain-2019-0001Nees TA, Riewe E, Waschke D, Schiltenwolf M, Neubauer E, Wang H.Multidisciplinary Pain Management of Chronic Back Pain: Helpful Treatments from the Patients' Perspective.J Clin Med. 2020;9(1):145. doi:10.3390/jcm9010145American Family Physician. Choosing Wisely:Avoid protracted use of passive or palliative physical therapeutic modalities for low-back pain disorders unless they support the goal(s) of an active treatment plan.Lee M, Silverman SM, Hansen H, Patel VB, Manchikanti L.A comprehensive review of opioid-induced hyperalgesia.Pain Physician. 2011;14(2):145-161.Moskowitz M, Golden M.Neuroplastix: change the brain; relieve the pain; transform the person.Integrated Pain Management.Knowing the Best Pain Management Doctors Near You: How to.National Institute on Aging.Pain: You Can Get Help.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Centers for Disease Control and Prevention.Prevalence of Chronic Pain and High-Impact Chronic Pain Among Adults — United States.Cosio D, Lin E.Role of Active Versus Passive Complementary and Integrative Health Approaches in Pain Management.Glob Adv Health Med. 2018;7:2164956118768492. doi:10.1177/2164956118768492Anheyer D, Haller H, Lauche R, Dobos G, Cramer H.Yoga for treating low back pain: a systematic review and meta-analysisPain. 2021;10.1097/j.pain.0000000000002416. doi:10.1097/j.pain.0000000000002416Pain Management Network.Chronic Pain Management Strategies.Owen GT, Bruel BM, Schade CM, Eckmann MS, Hustak EC, Engle MP.Evidence-based pain medicine for primary care physicians.Proc (Bayl Univ Med Cent). 2018;31(1):37-47. doi:10.1080/08998280.2017.1400290American Family Physician.Choosing Wisely: Avoid protracted use of passive or palliative physical therapeutic modalities for low-back pain disorders unless they support the goal(s) of an active treatment plan.Qaseem A, Wilt TJ, McLean RM, Forciea MA.Noninvasive treatments for acute, subacute, and chronic low back pain: a clinical practice guideline from the American college of physicians.Ann Intern Med. 2017;166(7):514-530.Kolasinski SL, Neogi T, Hochberg MC, et al.American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee[published correction appears in Arthritis Care Res (Hoboken). 2021 May;73(5):764].Arthritis Care Res (Hoboken). 2020;72(2):149-162. doi:10.1002/acr.24131Geneen LJ, Moore RA, Clarke C, Martin D, Colvin LA, Smith BH.Physical activity and exercise for chronic pain in adults: an overview of Cochrane Reviews.Cochrane Database Syst Rev. 2017;4(4):CD011279. doi:10.1002/14651858.CD011279.pub3an Laake-Geelen CCM, Smeets RJEM, Quadflieg SPAB, Kleijnen J, Verbunt JA.The effect of exercise therapy combined with psychological therapy on physical activity and quality of life in patients with painful diabetic neuropathy: a systematic review.Scand J Pain. 2019;19(3):433-439. doi:10.1515/sjpain-2019-0001Nees TA, Riewe E, Waschke D, Schiltenwolf M, Neubauer E, Wang H.Multidisciplinary Pain Management of Chronic Back Pain: Helpful Treatments from the Patients' Perspective.J Clin Med. 2020;9(1):145. doi:10.3390/jcm9010145American Family Physician. Choosing Wisely:Avoid protracted use of passive or palliative physical therapeutic modalities for low-back pain disorders unless they support the goal(s) of an active treatment plan.Lee M, Silverman SM, Hansen H, Patel VB, Manchikanti L.A comprehensive review of opioid-induced hyperalgesia.Pain Physician. 2011;14(2):145-161.Moskowitz M, Golden M.Neuroplastix: change the brain; relieve the pain; transform the person.Integrated Pain Management.Knowing the Best Pain Management Doctors Near You: How to.National Institute on Aging.Pain: You Can Get Help.
Centers for Disease Control and Prevention.Prevalence of Chronic Pain and High-Impact Chronic Pain Among Adults — United States.
Cosio D, Lin E.Role of Active Versus Passive Complementary and Integrative Health Approaches in Pain Management.Glob Adv Health Med. 2018;7:2164956118768492. doi:10.1177/2164956118768492
Anheyer D, Haller H, Lauche R, Dobos G, Cramer H.Yoga for treating low back pain: a systematic review and meta-analysisPain. 2021;10.1097/j.pain.0000000000002416. doi:10.1097/j.pain.0000000000002416
Pain Management Network.Chronic Pain Management Strategies.
Owen GT, Bruel BM, Schade CM, Eckmann MS, Hustak EC, Engle MP.Evidence-based pain medicine for primary care physicians.Proc (Bayl Univ Med Cent). 2018;31(1):37-47. doi:10.1080/08998280.2017.1400290
American Family Physician.Choosing Wisely: Avoid protracted use of passive or palliative physical therapeutic modalities for low-back pain disorders unless they support the goal(s) of an active treatment plan.
Qaseem A, Wilt TJ, McLean RM, Forciea MA.Noninvasive treatments for acute, subacute, and chronic low back pain: a clinical practice guideline from the American college of physicians.Ann Intern Med. 2017;166(7):514-530.
Kolasinski SL, Neogi T, Hochberg MC, et al.American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee[published correction appears in Arthritis Care Res (Hoboken). 2021 May;73(5):764].Arthritis Care Res (Hoboken). 2020;72(2):149-162. doi:10.1002/acr.24131
Geneen LJ, Moore RA, Clarke C, Martin D, Colvin LA, Smith BH.Physical activity and exercise for chronic pain in adults: an overview of Cochrane Reviews.Cochrane Database Syst Rev. 2017;4(4):CD011279. doi:10.1002/14651858.CD011279.pub3
an Laake-Geelen CCM, Smeets RJEM, Quadflieg SPAB, Kleijnen J, Verbunt JA.The effect of exercise therapy combined with psychological therapy on physical activity and quality of life in patients with painful diabetic neuropathy: a systematic review.Scand J Pain. 2019;19(3):433-439. doi:10.1515/sjpain-2019-0001
Nees TA, Riewe E, Waschke D, Schiltenwolf M, Neubauer E, Wang H.Multidisciplinary Pain Management of Chronic Back Pain: Helpful Treatments from the Patients' Perspective.J Clin Med. 2020;9(1):145. doi:10.3390/jcm9010145
American Family Physician. Choosing Wisely:Avoid protracted use of passive or palliative physical therapeutic modalities for low-back pain disorders unless they support the goal(s) of an active treatment plan.
Lee M, Silverman SM, Hansen H, Patel VB, Manchikanti L.A comprehensive review of opioid-induced hyperalgesia.Pain Physician. 2011;14(2):145-161.
Moskowitz M, Golden M.Neuroplastix: change the brain; relieve the pain; transform the person.
Integrated Pain Management.Knowing the Best Pain Management Doctors Near You: How to.
National Institute on Aging.Pain: You Can Get Help.
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