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UPMC doctor: Pain relief possible without opioids

It is estimated that more than 30% of Americans are living with chronic and acute pain, and that percentage increases with age. In the past, opioids have commonly been the choice for chronic pain management. However, this approach to treating pain has been largely proven ineffective while also contributed to our nation’s opioid epidemic, causing many people with chronic pain to look for opioid alternatives.

Opioids Play A Role

While prescription opioid medication can play an important role in helping manage acute or short-term pain or pain associated with diseases such as cancer, these drugs were never intended to routinely treat chronic or long-term pain. Even today, there is a lack of evidence for such extended use.

Opioids work by binding to opioid receptors in the brain to block pain signals. These receptors also control important functions in your body, so using opioids can cause a range of side effects, including:

• respiratory instability

• sleep apnea

• mood disorders

• constipation

• vomiting and nausea

• allergic reactions

• physical dependence

• dangerous interactions with other drugs

When you take opioids, your body builds up a tolerance, meaning that you may need to take a higher dose to feel the same relief over time. A pain management specialist can manage many of these side effects with other prescription medications. But as you balance pain relief with side-effect management, you may find yourself ordering your day around your medication schedule.

Additionally, higher doses can lead to more side effects and you can become dependent on the medication to function. But it doesn’t have to be this way.

Non-Opioid Treatment Options

There are many non-opioid pain medications that are available over the counter or by prescription, such as ibuprofen, acetaminophen, aspirin, and steroids, and some patients find that these are all they need. Other people find relief with non-drug therapies that can be used alone or in combination with medications. These include:

• Physical and Occupational Therapy – A physical or occupational therapist or physician who specializes in physical medicine and rehabilitation may be able to create an exercise program that helps you improve your ability to function and decreases your pain. Whirlpools, ultrasound, and deep-muscle massages may also help.

• Relaxation and Posture – Many patients also find relief from massages and other relaxation techniques, as well as biofeedback, where you learn to control involuntary functions such as your heart rate. Additionally, many patients may underestimate how much of a role posture can play in their pain. Sometimes minor modifications in our lifestyle related to how we sit, lift, walk, and move can make a big impact.

• Injections or Nerve Blocks – If you are having a muscle spasm or nerve pain, injections with local anesthetics or other medications can help short-circuit your pain. Some of these treatments can have lasting effects, while others can provide temporary relief until a long-term treatment plan can be established.

• Neurostimulation or Spinal Cord Stimulation – Neurostimulation therapy treatment of spinal cord stimulation is a very safe way to treat pain from multiple parts of the body (neck, arms, abdomen, back, knee, feet, and others). This advanced therapy is different from electrostimulation as mentioned below. Spinal cord stimulator therapy involves placement of a fully implantable reversible system that allows patient to self-regulate their pain with a handheld device. Spinal cord stimulator implant is like a cardiac pacemaker, where wires and batteries are used. However, for spinal cord stimulators, the wires are placed in the spine rather than the heart.

• Electrostimulation – Electrical nerve stimulation can provide short-term pain relief, especially for various types of muscle pain, by sending low-voltage electrical signals from a small device to the painful area through pads attached to the skin.

• Surgery – When other treatments aren’t effective, surgery can be performed to correct abnormalities in your body that may be responsible for your pain. Surgery is traumatic and can require extensive follow-up care but can prove to be the best option for some patients.

Talk to Your Provider

While body pains associated with aging are a natural part of life, pain shouldn’t control your life. If you’re living with chronic pain, talk to your primary care provider. They can provide initial evaluation and refer you to a specialist if needed. Pain management specialists can work with you to create an individualized comprehensive self-management program that will allow for greater control over your chronic pain.

Vwaire Orhurhu, MD, MPH, is a pain management physician with UPMC Pain Management. People of all ages can benefit from pain management to treat discomfort from surgery, chronic or acute muscular conditions, or skeletal, neuropathic, and cancer pain. Orhurhu sees patients at UPMC Pain Management, 1100 Grampian Blvd., Williamsport; UPMC Lock Haven, 24 Cree Dr., 3rd Floor, Lock Haven; and UPMC Specialty Care, 2330 Saint Mary St. West, 1st Floor, Lewisburg. To schedule an appointment, call 570-326-8457.

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