Evaluation of Chronic, Noncancer Pain Management Initiative in a Multidisciplinary Pain Clinic.

Managing chronic pain without relying heavily on opioid medications is a major challenge for many patients, especially veterans. Researchers evaluated a new approach to pain management led by an advanced practice nurse using a team-based method that included non-drug therapies like acupuncture, physical therapy, and yoga, along with non-opioid medications.

The study followed 34 veterans (mostly men, average age 63) who had been using opioids for chronic pain, with 93% experiencing low back pain. The multidisciplinary pain clinic provided education and treatment options beyond opioids, including injections, behavioral therapy, sleep classes, and complementary therapies.

The results were significant. Patients' opioid use decreased by nearly half (from an average of 41 morphine equivalent daily dose to 23), while their pain scores also dropped substantially (from 6.1 to 3.1 on a 10-point scale). Importantly, 94% of participants preferred non-opioid medications and 86% preferred non-drug therapies like acupuncture and yoga.

What this means for patients: Chronic pain can be effectively managed without heavy reliance on opioids. A comprehensive approach that includes acupuncture as part of a multidisciplinary treatment plan can reduce both pain levels and opioid dependence. The study demonstrates that acupuncture, combined with other therapies, offers a viable alternative for those seeking to reduce opioid use while still managing their pain effectively. When considering acupuncture for chronic pain management, seek a licensed acupuncturist who is credentialed and experienced in treating pain conditions.

This retrospective quality improvement project evaluated an APRN-led multidisciplinary pain clinic utilizing a biopsychosocial approach guided by the PDSA framework. Thirty-four veterans (91.8% male, mean age 63.18±15.39 years) with chronic non-cancer pain on opioid therapy were included via convenience sampling. Interventions included non-opioid medications, non-pharmacologic modalities (acupuncture, physical therapy, yoga), injections (51%), and behavioral health referrals (46%).

Results demonstrated statistically significant reductions in both morphine equivalent daily dose (MEDD: 41.04 to 23.05, p<0.0001) and patient-reported pain scores (6.11 to 3.1 on 0-10 scale, t=4.99, df=28, p<0.0001). Low back pain was most prevalent (93%). Patient preference favored non-opioid medications (94%) and non-pharmacologic therapies (86%).

Clinical takeaway: Multidisciplinary approaches incorporating acupuncture and other non-pharmacologic modalities enable safe opioid tapering while significantly reducing pain scores in chronic pain management, supporting integration of complementary therapies in clinical practice.