Treatment typeOptions
LifestyleCessation of tobacco products, weight loss
PhysicalExercise*, manipulation, physical therapy, stretching and yoga, surgical therapies (nerve blocks, trigger point injections, spinal infusion or stimulation), transcutaneous electric nerve stimulation
PsychologicBiofeedback, cognitive behavior therapy†, counseling, hypnosis, music‡, relaxation†
Complementary or alternativeAcupuncture, herbal remedies, massage, mindfulness meditation, reflexology
OccupationalOccupational therapy, work conditioning programs
Nonopioid analgesicsAcetaminophen, NSAIDs, salicylates (aspirin)
Opioid medications (nonsynthetic, synthetic)§‖Combination opioid and nonopioid medications (codeine, hydrocodone [Hycodan], or oxycodone [Roxicodone] plus acetaminophen, aspirin, or an NSAID)
Noncombination or “strong” opioid medications, such as morphine (MS Contin) and its derivatives (butorphanol [Stadol], codeine, fentanyl [Duragesic], hydrocodone, hydromorphone [Dilaudid]¶, levorphanol [Levo-Dromoran], methadone, oxycodone)
Tramadol (Ultram)
Adjuvant medicationsAnticonvulsant medications (carbamazepine [Tegretol]**, gabapentin [Neurontin]**, lamotrigine [Lamictal], phenytoin [Dilantin], pregabalin [Lyrica], valproic acid [Depakene])
Antidepressants (selective serotonin reuptake inhibitors, tricyclic††)
Atypical antidepressants (duloxetine [Cymbalta], venlafaxine [Effexor]††)
Topical lidocaine (Xylocaine)‡‡
Others (topical capsaicin, cyclobenzaprine [Flexeril], lidocaine patches)