Table 2 Intervention classes and individual treatments (generic drug names given for pharmacological agents)
Class | Examples of individual treatments |
|---|---|
Pharmacological | |
Antidepressants: SNRI | Duloxetine, desvenlafaxine, levomilnacipran, venlafaxine, milnacipran |
Antidepressants: SSRI | Fluoxetine, fluvoxamine, paroxetine, escitalopram, citalopram, sertraline, vilazodone |
Antidepressants: tricyclic | Amitriptyline, amoxapine, desipramine, imipramine, doxepin, clomipramine, trimipramine, protriptyline, imipramine, nortriptyline, doxepin, nortriptyline |
NSAIDs | Ibuprofen, naproxen, sulindac, ketoprofen, tolmetin, etodolac, fenoprofen, diclofenac, flurbiprofen, piroxicam, ketorolac, Indomethacin, meloxicam, nabumetone, oxaprozin mefenamic acid, diflunisal, fenoprofen |
Opioids (strong) | Morphine, hydromorphone, oxycodone, fentanyl, methadone, buprenorphine, diamorphine, tapentadol |
Opioids (weak) | Codeine, hydrocodone, tramadol, pentazocine, tilidine |
Muscle relaxants: benzodiazepines | Diazepam, estazolam, quazepam, alprazolam, chlordiazepoxide, clorazepate, lorazepam, flurazepam, clonazepam, temazepam, midazolam |
Muscle relaxants: skeletal | Flupirtin, orphenadrine, dantrolene, carisoprodol, tizanidine, incobotulinumtoxinA, cyclobenzaprine, metaxalone, baclofen, methocarbamol, chlorzoxazone |
Paracetamol | Â |
Topical agents (non-opioid) | Diclofenac, capsaicin, lidocaine |
Non-pharmacological treatments | |
Acupuncture | Acupuncture, dry needling |
Exercise: non-specific | Walking, swimming, running, stretching, aerobics |
Exercise: mind-body and bodily awareness | Yoga, tai chi, Pilates, motor control exercise, alexander technique |
Manual therapy: spinal manipulation | High-velocity thrust techniques at or near the end of the passive or physiologic range of motion |
Manual therapy: spinal mobilisation | Low-grade velocity movement techniques within the patient’s range of motion and control |
Massage | Soft tissue massage, acupressure |
Mindfulness | Mindfulness, mindfulness-based stress reduction |
Multidisciplinary approaches | Packages that include coordinated delivery of interventions from across different disciplinary practices/clinics (which typically consist of physical and psychological therapy, e.g. education + physiotherapy + exercise + counselling) |
Patient education: basic | Back school (e.g. instruction on anatomy and function of the back), brief educational intervention, advice on importance of staying active, reassurance, McKenzie therapy |
Patient education: pain neuroscience | Educational sessions that describe the neurobiology and neurophysiology of pain by the nervous system |
Psychological therapy | CBT, operant therapy, behavioural therapy, self-regulatory therapy |