Chronic Pain Relief: Six Expert-Recommended Treatments

Living with chronic pain is a deeply personal experience that can impact your physical, mental, and emotional well-being. Treating chronic pain is not a one-size-fits-all approach and often involves combining multiple therapies tailored to your unique needs and goals.

Pari Azari, MD, a double board-certified pain management physician, shares six complementary approaches that support long-term pain relief, improve daily function, and enhance your overall quality of life.

Movement and gentle exercise

Many people living with chronic pain fear movement or exercise may aggravate or worsen their symptoms. But avoiding movement for long periods can lead to muscle weakness, joint stiffness, and weight gain, which may increase pain over time.

Dr. Azari explains, “Regular, gentle movement is one of the most effective tools for managing chronic pain. When you move, your body increases blood flow to muscles and joints, delivering oxygen and nutrients that support healing while helping to flush out substances that can contribute to inflammation and discomfort.

Movement also triggers the release of endorphins — your body's natural painkillers — which can help elevate mood and reduce the perception of pain.

Over time, staying active helps maintain joint lubrication, supports healthy cartilage, and strengthens the muscles that stabilize and protect your joints.

Low-impact activities that may be especially helpful for people living with chronic pain include:

• Walking: A simple, accessible way to improve circulation, maintain mobility, and boost mood.
• Swimming or water-based exercise: The buoyancy of water supports your body weight, reducing stress on joints while allowing you to move more freely.
• Stretching routines: Even a few minutes of daily stretching can help relieve muscle tension, improve range of motion, and ease stiffness.

Dr. Azari says, “The key is to start slowly and gradually increase activity at a pace that feels manageable. Even small amounts of daily movement can make a meaningful difference over time.”

Physical therapy

While general movement and exercise are important, physical therapy takes it a step further by providing a structured, personalized treatment plan guided by a trained professional. Targeted exercises may help you improve strength, flexibility, mobility, and daily function while supporting long-term pain relief.

"I often recommend physical therapy for patients experiencing chronic pain in the back, neck, knees, and shoulders," says Dr. Azari.

Techniques such as graded exposure therapy — a step-by-step approach to reintroducing movements you may have been avoiding — can be especially effective for patients with pain-related fear.

The American College of Physicians recommends non-pharmacologic therapies, including exercise and rehabilitation, as a first-line treatment for chronic pain.

Massage therapy

Therapeutic massage focuses on alleviating pain by reducing tension in soft tissues (muscles, tendons, ligaments), increasing blood flow circulation, and helping reduce inflammation.

Massage therapy may also support the release of endorphins, the body's natural painkillers, which can help lower stress levels and promote relaxation.

Therapeutic massage therapy may be especially helpful for people living with chronic pain conditions such as:

• Arthritis

• Fibromyalgia

• Sciatica

• Myofascial pain syndrome

Breathing exercises and mind-body therapies

Chronic pain can keep your body in a constant state of "fight or flight." This stress response may increase muscle tension, raise your heart rate, and intensify pain.

"Breathing exercises are a simple but powerful way to help calm the nervous system and shift your body into a calmer, more relaxed state," says Dr. Azari.

"Even a few minutes of controlled breathing may help reduce muscle tension, lower stress levels, and support pain relief."

A few breathing techniques you can practice at home include:

• 4-7-8 breathing: Inhale through your nose for four seconds, hold your breath for seven seconds, then slowly exhale for eight seconds.
• Box breathing: Slowly breathe in for a count of four, hold your breath for four, breathe out for four, then hold again for four. Repeat this pattern at a comfortable pace, like moving around the four sides of a box.

Breathing exercises are part of a broader category of mind-body therapies. Dr. Azari shares another approach worth exploring is mindfulness-based stress reduction (MBSR).

MBSR is a structured program that combines mindfulness meditation, body awareness, and gentle movement to reduce stress, improve daily coping, and enhance overall well-being.

Cognitive behavioral therapy

When pain persists, it can lead to a cycle of negative thoughts, emotions, and behaviors that can make pain feel more overwhelming and difficult to manage.

Cognitive behavioral therapy for chronic pain (CBT-CP) helps break this harmful cycle by teaching you how to recognize unhelpful thought patterns that could be contributing to your pain. CBT-CP specialists work with patients to develop effective coping strategies to manage and decrease the physical and emotional challenges associated with chronic pain.

“One of the key benefits of CBT-CP is that its effects can be long-lasting. Research shows that the skills and strategies learned during therapy may continue to provide relief even after treatment ends, giving patients lasting tools to manage their pain,” explains Dr. Azari.

Over time, CBT-CP may also help improve sleep, which can be especially beneficial since pain and poor sleep often reinforce one another.

Social Support

"One of the most important things I remind patients of is that you do not have to go through chronic pain alone," says Dr. Azari. "Support from family, friends, peer support groups, or healthcare providers can make a meaningful difference in reducing feelings of isolation, lowering stress levels, and supporting your emotional well-being – all of which may positively affect how you cope with chronic pain."

Social support can come in many forms:

• Emotional support includes empathy, encouragement, and reassurance from trusted friends, family members, or peer support groups.
• Practical support involves help with daily tasks such as transportation, errands, or household activities.
• Informational support provides guidance, education, and resources from healthcare professionals and trusted organizations.

Structured pain self-management programs and peer-led support groups, such as those offered through organizations like the American Chronic Pain Association, can provide emotional support as well as opportunities to learn practical strategies for managing pain day to day.

Talk to your provider

If you or a loved one is living with chronic pain, talk to your primary care provider about creating a personalized pain management plan.

Together, you can explore treatment options that address your pain from multiple angles and find what works best for you.