Table 4.
Interventions in TPS
| Non-pharmacological | Pharmacological | Pain interventions | ||
|---|---|---|---|---|
| Physical therapy | Tricyclic antidepressants | Head and neck | ||
| Acupuncture, Acupressure | Amitriptyline | Cervical plexus block, TMJ injection | ||
| Myofascial trigger | SNRI | Buccal infiltration, dental intraligamental injection, inferior alveolar nerve | ||
| TENS | Venlafaxine, duloxetine | Infraorbital, mandibular nerve, suprazygomatic maxillary nerve blocks | ||
| Whole body exercise (walking, cycling) | Antiepileptics | Breast | ||
| Yoga | Levetiracetam | Thoracic paravertebral block (radiofrequency ablation, steroids) | ||
| Resistance training | Gabapentinoids | Intercostobrachial nerve, pectoralis-II, serratus anterior plane | ||
| Targeted functional exercises (shoulder exercise) | Gabapentin, pregabalin | Proximal intercostal, erector spinae blocks | ||
| Laser therapy | NMDA antagonist | Thoracic | ||
| Magnetic stimulation | Low-dose ketamine, magnesium, memantine, nitrous oxide | Thoracic epidural, thoracic paravertebral, erector spinae plane | ||
| Opioids | Intercostal, serratus anterior plane blocks | |||
| Psychological therapy | Oxycodone, tramadol, tapentadol, morphine, fentanyl patch | Upper abdomen | ||
| CBT | Opioid substitutes | Thoracic epidural, thoracic paravertebral | ||
| ACT | Buprenorphine, buprenorphine- naloxone, methadone, cannabis | Erector spinae plane, subcostal transversus abdominis plane | ||
| Pain neuroscience education | Steroids | Quadratus lumborum, rectus sheath blocks | ||
| MBI | Dexamethasone, depot methylprednisolone | Abdominopelvic | ||
| Dialectical behavioural therapy | NSAIDs | Lower thoracic/lumbar epidural, paravertebral block | ||
| Desensitisation | Randomised | Transversus abdominis plane, quadratus lumborum | ||
| Sensory discrimination training | Alpha-2-agonist | Ilioinguinal, fascia iliaca, rectus sheath blocks | ||
| Guided imagery | Clonidine, dexmedetomidine | Miscellaneous | ||
| Music therapy | Local anaesthetics | Sympathetic-mediated blocks, epidural steroid, spinal cord stimulation | ||
| Relaxation techniques | Intravenous lignocaine, liposomal bupivacaine | Intra-articular local anaesthetic, continuous wound infiltration devices | ||
| Clinically induced hypnosis | Topical | Subcutaneous infusion pumps, transdermal drug delivery and subperiosteal catheters | ||
| Capsaicin, prilocaine, eutectic mixture |
ACT=acceptance and commitment therapy, CBT=cognitive behavioural therapy, MBI=mindfulness-based intervention, NMDA=N-methyl-d-aspartate, NSAIDs=nonsteroidal anti-inflammatory drugs, SNRI=serotonin–norepinephrine reuptake inhibitor, TENS=transcutaneous electrical nerve stimulation, TMJ=temporomandibular joint, TPS=transitional pain service